Tomas Aparisi

Giant cell tumor of bone

The fine structural localization of nonspecific alkaline phosphatase was elucidated in two giant cell tumors of bone using lead as capturing ion and Β-glycerophosphate as substrate in the incubation solution. Lead phosphate precipitate — indicating presence of alkaline phosphatase — was demonstrated on the plasma membranes, and the membranes bordering vesicles and vacuoles of presumed endocytotic nature, in giant cells and type 1 stromal cells (fibroblast-like cells). The findings support the view that stromal cells type I and giant cells are histogenetically related.

Lysis of autologous tumor cells by blood lymphocytes tested at the time of surgery

SummaryLymphocyte-mediated lysis of autologous tumor cells (autologous lymphocyte cytotoxocity ALC) was tested at the time of surgery in 108 patients (46 squamous cell carcinomas of the lung, 25 adenocarcinomas of the lung, 19 soft tissue sarcomas and 18 osteosarcomas). The clinical course of these patients in relation to the test results has been published previously. The group was evaluated again after an extended observation time, now with a mean of 80.2 months (range 36–108). The test was rarely positive in patients with metastasis (2 out of 28 experiments).There was a correlation between the ALC results and the postsurgical clinical course for patients without detectable metastasis in that (1) a negative test was invariably a bad prognostic sign, i.e., all 32 patients with negative ALC died within 3 years (mean survival time 16.1 months). (2) The remission and survival times were longer for the ALC positive patients (p<0.001). (3) All 37 individuals who are alive at present without recurrence belong to the reactive group.The ALC results correlated with the clinical course in 88% of patients. The correlation was highest for the groups of soft tissue sarcoma and adenocarcinoma of the lung. There was no correlation between killing of K562 cells and ALC, or between lymphoproliferative response to PHA and ALC reactivity.

Giant cell tumor of bone. Variations in patterns of appearance of different cell types.

Eleven benign giant cell tumors of bone were studied in the electron microscope, and the fine structural localization of acid phosphatase was elucidated. Three distinct cell types are always present in these tumors: stromal cells type 1; stromal cells type 2; and multinucleated giant cells. Small mononuclear cells may also occur, but are not likely to be actively participating in the neoplastic process. The range of variability in the fine structure of the different cell types constituting this tumor has been established. Variations in appearances include: a) presence of nuclear pseudoinclusions in stromal cells type 1 and multinucleated giant cells; b) aberrations in the structure of the rough surfaced endoplasmic reticulum in the same cell types; c) occurrence of ruffled borders, ectoplasmic layers and cytoplasmic labyrinths containing acid phosphatase in the giant cells. Some giant cells show evidence of marked phagocytic activity and contain large and numerous residual bodies carrying acid phosphatase. The significance of the interrelations between the different cell types are discussed and the possible role of stromal cells type 2 in immunological mechanisms directed against the tumor cells are mentioned.

Human osteogenic sarcoma: fine structure of the fibroblastic type.

The fine structure of representative regions of nine fibroblastic osteogenic sarcomas was studied. As judged by light microscopic criteria, the tumors represented both highly malignant (grades 3-4) and less malignant (grade 2) varieties. By electron microscopy, six basic cell types were found in the selected regions (fibroblastlike, histiocytelike, and myofibroblastlike cells, along with xanthoma cells, multinucleated giant cells, and undifferentiated cells). In addition, occasional osteoblastlike cells were encountered. Fibroblastlike cells in general, and especially in grade 2 tumors, showed a fine structure, enabling differentiation from osteoblastlike cells. Multinucleated giant cells were of two morphologic types, and the fine structure appeared to be related to the malignancy potential and differentiation of the tumors. Many multinucleated giant cells in grade 2 tumors had a ruffled border and appeared to be highly active in digestive events (especially phagocytosis of whole cells and portions of cells). Accumulation of variable amounts of lipid in droplet form was common in the various types of cells present in the tissues. The observations were discussed with particular emphasis on the interrelationships and functional roles of the cells.

Studies on the fine structure of osteoblastoma with notes on the localization of nonspecific acid and alkaline phosphatase.

Electron microscopy of two osteoblastomas revealed the existence of three distinct types of cells in this tumor: osteoblast like, macrophage like, and multinucleated giant cells. In addition to the lysosomes, most Golgi cisternae and vesicles in the osteoblast like cells showed evidence of acid phosphatase activity. Deposits of lead phosphate indicating the site of this enzyme in the macrophage like cells were confined to the large and abundant lysosomes. Wide spread deposition of final product was noted in the cytoplasm of the multi‐nucleated giant cells, both in conventional lysosomes, Golgi regions and special organelles probably corresponding to GERL. With regard to nonspecific alkaline phosphatase, final product indicating the location of enzyme activity was confined to the plasma membranes and associated vesicular and vacuolar structures in the osteoblast like cells. The findings suggest that the giant cells in osteoblastomas participate in lytic bone destructive and resorptive processes while osteoblast like cells appear to be osteoid and bone forming carriers of the neoplastic properties of the tumor.

Correlation between lymphocyte-mediated auto-tumor reactivities and the clinical course

SummaryT-cell-enriched blood lymphocyte populations from 24 osteosarcoma and 22 soft-tissue sarcoma patients were assayed at the time of surgery for proliferative response to, and/or cytotoxic potential against autologous tumor cells. Tumor-free period and survival of the patients were correlated with the results obtained in the in vitro tests. The observation time was between 18 and 118 months (mean 62) for the osteosarcoma patients and between 18 and 72 (mean 42) for the patients with soft-tissue sarcoma. In both groups tumor-free period and survival were longer for those individuals who had auto-tumor reactivity. In the non-reactive group, all patients died within 3 years. Almost all patients had cytotoxicity against K562.

Can historical controls be used in current clinical trials in osteosarcoma?. Metastases and survival in a historical and a concurrent group.

Abstract A historical group consisting of 35 patients with osteosarcoma (preceding paper) was compared to a concurrent group of 23 patients. The treatment for the primary tumors differed only slightly in the two groups. Neither of the groups received adjuvant therapy. A more active approach was adopted for treatment of pulmonary metastases in the concurrent group. All the patients were followed for at least 2.5 years. The percentage of patients not developing metastases and the survival rate in the historical group were approximately one half those for the concurrent group. An analysis of prognostic factors disclosed differences between the two groups as regards the size and histological type of the tumor. The results of the study cast doubt on the suitability of historical controls in current clinical trials conducted to ascertain the effectiveness of adjuvant therapy for osteosarcoma. The importance of analysing prognostic factors is emphasized, especially where the patient groups are small and the follow-up is short.

Human Osteogenic Sarcoma: Fine Structure of Hard Tissue Areas

The structure of hard tissue areas (with osteoid and calcified matrix) in 10 osteoblastic, chondroblastic, and fibroblastic osteogenic sarcomas was studied in the electron microscope. Neoplastic cells commonly associated with these areas and presumably actively involved in the production of hard tissue were osteoblast-like cells types 1 and 3, chondroblast-like cells type 1, and fibroblast-like cells, as defined and characterized in previous studies. The cells differed from those in soft tissue areas of osteogenic sarcomas in but one respect: they usually showed presence of irregular extrusions at their surfaces. Other types of osteoblast-like and chondroblast-like cells occurred rarely or not at all. Two types of multinucleated giant cells were recognized in these areas, one showing a fine structure reminiscent of that in osteoclasts, the other probably being of a neoplastic nature and engaged in the production of the calcifying matrix. The evidence suggested that neoplastic osteoblast-like, chondroblast-like, and fibroblast-like cells as well as certain multinucleated giant cells might all be involved in the mineralization process and/or the formation of osteoid in osteogenic sarcomas. Although phenotypically of highly variable appearance, all these different cells may thus functionally (and probably histogenetically) be closed related. The mineralization process in the tumor tissue appeared to be a modification of what occurs in normal ossification, possibly with an alternative or complementary pathway involving the production of spherical bodies with layered contents.

Human Osteogenic Sarcoma: Fine Structural Localization of Adenosine Triphosphatase

The localization of ATPases in 7 osteogenic sarcomas of osteoblastic, chondroblastic and fibroblastic type was investigated at the fine structural level using two types of substrates: one with lead as capturing ion and one with strontium (the latter presumed to reveal sites of Na+-K+-dependent transport ATPase). Reaction product with the lead-ATP medium was located on the plasma membrane and the membranes bordering subjacent vesicles and vacuoles in all the various types of osteoblastlike and fibroblastlike cells and also in types 1 and 3 chondroblastlike cells, and multinucleated giant cells believed to be neoplastic. Furthermore, deposits of reaction product were demonstrated in lysosomelike organelles in all the aforementioned cells. Except in the case of chondroblastlike cells, precipitates marking the localization of enzyme were confined to areas of the plasma membrane where adjacent cells were closely applied (the free surface lacked precipitates). In chondroblastlike cells the reaction product was usually deposited along the whole plasma membrane. Presence of L-Homoarginine or L-Tetramisole in the incubation medium in concentrations that have been shown to completely abolish alkaline phosphatase activity did not affect the occurrence of the reaction product with ATP as substrate indicating that the enzyme hydrolysing ATP was substrate-specific. Reaction product marking sites of Na+-K+-dependent ATPase was confined to plasma membranes and lysosomes of cells in vessel walls. The observations strengthen the notion obtained in studies on the localization of alkaline phosphatase, namely that osteoblastlike, chondroblastlike, and fibroblastlike cells in osteogenic sarcomas are histogenetically related to one another and to those multinucleated giant cells that presumably are of a neoplastic nature.

Malignant giant cell tumor of bone

The fine structure of the different cell types constituting a primary malignant giant cell tumor of bone has been studied and the localization of acid phosphatase in relation to the subcellular organelles been demonstrated. Three distinct cell types with characteristic ultrastructural features were observed: giant cells, fibroblast-like cells, and cells with abundant lipid inclusions and mitochondria. Certain differences were noted between these three cell types and their counterparts in benign giant cell tumors of bone (described in a separate report). The enzyme histochemical and morphological data suggested that the giant cells in the malignant tumor might possess a more active and expansive lysosomal apparatus than corresponding cells in the benign variant.