Showing papers in "Cancer in 1966"
TL;DR: The authors suggest that the Hodgkin's disease process represents the attempted induction of malignant neoplasia and that the evolution of the histologic process is a manifestation of the natural history of the disease.
Abstract: This paper evaluates the significance of the clinical stages and histologic features of Hodgkin's disease in 377 U. S. Army cases from World War II with a 15- to 18-year follow-up. From this study 6 histologic types have emerged: (1) lymphocytic and/or histiocytic (L & H), nodular; (2) lymphocytic and/or histiocytic (L & H), diffuse; (3) nodular sclerosis; (4) mixed; (5) diffuse fibrosis and (6) reticular. There is a definite relationship between histologic types, clinical stages and survival. The L & H types are expressions of lymphocytic proliferation and diffuse fibrosis and reticular types represent lymphocytic depletion while the mixed is intermediate between these extremes. Nodular sclerosis appears to be a regional expression of Hodgkin's disease in the mediastinum and is of major prognostic significance in stage I. The histologic types are regarded as expressions of an attempted host response and possibly evidence of the dramatic interplay between the host and the factors responsible for the development of Reed-Sternberg cells. The authors suggest that the Hodgkin's disease process represents the attempted induction of malignant neoplasia and that the evolution of the histologic process is a manifestation of the natural history of the disease.
482 citations
TL;DR: A relationship between the use of chewing tobacco and oral cavity lesions was evident in this indigent, predominantly rural patient group.
Abstract: Verrucous carcinoma, a distinctive variant of epidermoid carcinoma, was found in the oral cavity (77 cases), larynx (12 cases), nasal fossa (4 cases), glans penis (8 cases), vulva (1 case), vagina (1 case), scrotum (1 case). A relationship between the use of chewing tobacco and oral cavity lesions was evident in this indigent, predominantly rural patient group. Locally aggressive behavior with bone invasion occurred in 15 instances. Lymph node metastases were not found except in 4 patients treated by radiation, apparently as a result of alteration of the biologic character of the lesion. Radiation therapy (17 patients) failed to control the lesion in all instances. The response to surgical excision (88 patients) was excellent.
438 citations
TL;DR: The size of the primary tumor and presence of vein invasion showed a slight correlation with the patient's prognosis but no correlation was found with increasing degrees of cellular atypism and x‐ray irradiation appeared to be of benefit.
Abstract: The clinical and pathologic features of 53 endometrical stromal tumors were studied to determine which pathologic characteristics were related to the clinical behavior. Morphologically, stromal tumors were divided into 2 groups: 18 tumors with pushing margins (stromal nodules) and 35 tumors with infiltrating margins (endolymphatic stromal myosis or stromal sarcoma). Stromal nodules, which were expansile, noninfiltrating lesions composed of cells similar to those found in normal endometrial stroma, were considered benign. The tumors with infiltrating margins were separated on the basis of mitotic activity. Patients with endolymphatic stromal myosis had 100% survival at 5 years and those with stromal sarcoma had 55% survival. The size of the primary tumor and presence of vein invasion showed a slight correlation with the patient's prognosis but no correlation was found with increasing degrees of cellular atypism. For patients whose disease was not controlled by hysterectomy and who had symptomatic extra-uterine tumor, x-ray irradiation appeared to be of benefit. The patients' symptoms and physical examination findings were not different from those of patients having other uterine tumors.
393 citations
TL;DR: The skin tumors were indicative of progression of the primary tumor and early fatal termination, the duration of life averaging about 3 months after the appearance of the skin tumors, and the necropsies revealed widespread metastases.
Abstract: A series of 36 patients having cutaneous metastases, including 32 necropsied cases in necropsy series of approximately 2,300 cases of internal carcinoma derived from the Long Beach Veterans Administration Hospital. The lung was the primary site in 17 of the 36 cases, the gastro-intestinal tract in 8 and the genito-urinary tract in 10; the primary site of one was uncertain. The tumors of the lung most commonly metastasized to the skin of the chest and those of the gastro-intestinal tract and genitourinary tract to the abdominal wall. The skin metastases were multiple except for 4 cases, usually widespread in location and occasionally appeared in small crops. The tumors were most commonly solid painless elevated nodules, ranging from one to 3 cm in diameter, having an intact overlying epidermis. The microscopic appearance had features of adenocarcinoma in 26 of the 36 cases. The skin tumors were indicative of progression of the primary tumor and early fatal termination, the duration of life averaging about 3 months after the appearance of the skin tumors. The necropsies revealed widespread metastases.
302 citations
TL;DR: Differences between the cancer patients and the comparison subjects suggest that the etiological basis for endometrial cancer may be increased retention of certain endogenous hormones, and the most practical preventive measure appears to be an effective reduction in weight.
Abstract: A study was conducted to investigate by epidemiological means the factors that contribute to endometrial cancer and their interrelationships if any. In addition to a search of the literature on endometrial cancer studies hospital records of 900 endometrial cancer patients were studied and a case-comparison test of 112 endometrial cancer patients and 200 controls was carried out. Population characteristics gynecologic history and exposure to various conditions were tabulated. Obesity was found to be the most important factor associated with endometrial cancer. Tallness enhanced the risk in obese women. These facts suggest the possibility of a pituitary hormone dysfunction most likely the growth function. The etiology of the disease seems to include retention of endogenous hormones resulting in an endocrine imbalance. The prevalence of late menopause heavy bleeding and premenstrual breast swelling in endometrial cancer patients corroborates this hypothesis. Hypertension and high blood sugar may be associated with endometrial cancer independent of the height and weight factors.
253 citations
TL;DR: The authors hypothesize that the tumor is not, in fact, odontogenic in origin as has been suggested but may arise from neural crest cells which migrate in many cases with the odontoblasts that form the dentin of the maxillary anterior teeth.
Abstract: A case of melanotic neuroectodermal tumor of infancy (melanotic progonoma, retinal anlage tumor, melanoameloblastoma) associated with high urinary excretion of vanilmandelic acid is presented for the first time and discussed in the light of probable origin from the neural crest. The VMA levels returned to normal after removal of the tumor. With regard to pathogenesis and its very frequent occurrence in the upper anterior jaw, the authors hypothesize that the tumor is not, in fact, odontogenic in origin as has been suggested but may arise from neural crest cells which migrate in many cases with the odontoblasts that form the dentin of the maxillary anterior teeth.
242 citations
TL;DR: The ultrastructure of the neurilemmoma has been compared with that of the neurofibroma as discussed by the authors, and morphological evidence supports the concept that both of the lesions arise from Schwann cells.
Abstract: The ultrastructure of the neurilemmoma has been compared with that of the neurofibroma. Large aggregates of extremely thin cytoplasmic processes characterize Antoni type A neurilemmoma tissue. In Antoni type B tissue, the tumor cells present as globular structures containing many organelles and osmophilic material. The neurofibroma consists of widely scattered cells which closely resemble non-neoplastic Schwann cells. Although the patterns of the 2 tumors are widely different, morphological evidence is presented which supports the concept that both of the lesions arise from Schwann cells. Some features of a human traumatic neuroma are presented.
223 citations
TL;DR: A group of 49 Mayo Clinic patients in whom the original diagnosis of lymphoma was made at splenectomy is reported and the group with lymphocytic lymphoma had a 5‐year survival rate of 60%, considerably higher than that for patients with lesions of other histologic types.
Abstract: A group of 49 Mayo Clinic patients in whom the original diagnosis of lymphoma was made at splenectomy is reported. Systemic symptoms and pain were the commonest complaints and peripheral blood cytopenias were the major abnormal laboratory findings. The correct diagnosis was suspected in almost half of the patients prior to surgery. The 5-year survival rate for the entire group was 31%. The survival rate of 17 patients with localized lesions that were resected was considerably better than in those with residual tumor left after surgery. Patients of various histologic types of lymphoma with a follicular pattern of distribution tended to have a better prognosis than those with diffuse infiltration. The group with lymphocytic lymphoma had a 5-year survival rate of 60%, considerably higher than that for patients with lesions of other histologic types.
175 citations
TL;DR: The authors believe that carcinosarcomas arise both from multipotent neoplastic cells that have the capacity to form both epithelium and stroma and from multiple neoplastics cell types having fixed potencies.
Abstract: The clinical and pathologic findings of 31 patients with uterine carcinosarcoma are presented. Carcinosarcomas arose within the endometrium and all but 2 invaded the myometrium and lymphatic spaces. Tumor had spread beyond the uterus in 12 (39%) of patients at the time of initial therapy. None of 8 patients (26%) who were free of cancer at last contact had extra-uterine extension or metastasis. Because the patients with carcinosarcoma had a significantly better survival rate than did a similar group with mixed mesodermal tumors, the 2 types of neoplasms should be separated. The authors believe that carcinosarcomas arise both from multipotent neoplastic cells that have the capacity to form both epithelium and stroma and from multiple neoplastic cell types having fixed potencies. Origin from embryonal rests, primitive analagen, or collision tumors is rejected. Because the distribution of metastatic lesions of uterine carcinosarcomas is similar to that of endometrial carcinomas, surgical management should be similar. It is not clear whether irradiation has any value as treatment.
163 citations
TL;DR: The findings indicate that spindle and giant cell carcinomas arise from the papillary and follicular type, and the treatment for all thyroid carcinomas is total thyroidectomy.
Abstract: Thirty‐three autopsy cases of clinical thyroid carcinoma were studied as to types, precursor changes and biologic behavior of the tumors. Eleven carcinomas were of the solid type; 13 were spindle and giant cell and the remainder were papillary, follicular or both. The findings indicate that spindle and giant cell carcinomas arise from the papillary and follicular type. No precursor changes were found in the other tumors or in 9 occult carcinomas found at autopsy. The biologic behavior of all types, other than the spindle and giant cell, is unpredictable; survivals vary from a few months to 20 years or longer. The mortality rate is much higher than commonly is believed: Among the 554 patients treated, it was 19%. The treatment for all thyroid carcinomas is total thyroidectomy.
159 citations
TL;DR: Since acinic cell carcinoma has proved to be a malignant, metastatic type of tumor, the authors recommend that parotidectomy be combined with neck dissection.
Abstract: In a histological re-examination and re-classification of a series of 1,678 tumors of the parotid gland 37 (2.2%) exhibited the structures characteristic of acinic cell carcinoma. A long-term follow-up study showed that the prognosis quoad vitam in this type of tumor is poorer than previously has been inferred from short-term follow-ups. Thus the determinate survival rate fell from 89% at 5-year follow-up to 56% after 20-year follow-up. The prognosis is nevertheless much better than in adenoid cystic carcinoma of the parotid gland, as disclosed by a comparative study. This difference is evident after 5-year follow-up and becomes still more marked with time. Acinic cell carcinoma cannot be divided into a benign and a malignant variant on the basis of various histological criteria, such as infiltrative growth and high incidence of mitesis. This is because even the histologically apparently benign variant may have a clinically malignant course. Metastasis was observed in 7 cases, in 4 of them to regional lymph nodes. Since acinic cell carcinoma has proved to be a malignant, metastatic type of tumor, the authors recommend that parotidectomy be combined with neck dissection.
TL;DR: Sixty‐two of approximately 40,000 patients screened for cancer by vaginal smears showed cellular changes compatible with a herpes simplex infection, and the possibility of a relation between cervical atypia and a herpetic genital infection should be considered.
Abstract: Sixty-two of approximately 40,000 patients screened for cancer by vaginal smears showed cellular changes compatible with a herpes simplex infection. Thirty-two had a cervical biopsy; 4 presented with an in situ carcinoma involving mainly the endocervical canal; 6 had squamous atypia; another 11 showed granulation tissues with acute cervicitis; 5 had a lesion histologically compatible with a herpes simplex infection and in 6 no peculiar microscopic lesion was revealed. A brief description of the cytological and histological findings are given. The possibility of a relation between cervical atypia and a herpetic genital infection should be considered.
TL;DR: Two vascular tumors of the nervous system, hemangiopericytoma and hemangio‐endothelioma, were readily distinguishable from each other on the basis of their fine structural characteristics.
Abstract: Two vascular tumors of the nervous system, hemangiopericytoma and hemangio‐endothelioma, were readily distinguishable from each other on the basis of their fine structural characteristics. In hemangiopericytoma the exaggerated vasculature was lined with a single layer of cells showing only minor departures from normal endothelium. The tumor cells were closely crowded and cytologically unspecialized, bearing no processes. They sometimes contained osmiophilic particles. Extracellular material occurred around blood vessels and in narrow trabeculae separating the cells into groups. In hemangio‐endothelioma abnormal endothelial cells often were voluminous and showed irregular borders with many fine processes and cytoplasmic vesicles. They tended to lose their proper relation to vascular channels. The cells making up the masses between vessels were variable, scattered and irregular. A few had fibrillar cytoplasm. They were set in an extensive matrix of extracellular material. The few foam cells present contained amorphous lipid inclusions.
TL;DR: The lesions of adenoid squamous cell carcinoma develop in exposed areas, particularly about the head and neck regions in persons with fair skin who spend considerable time outside, and there was metastasis in 3 patients and direct extension in 2 patients, which led to the death of 5 patients.
Abstract: The lesions of adenoid squamous cell carcinoma develop in exposed areas, particularly about the head and neck regions in persons with fair skin who spend considerable time outside. The microsocopic features consist of invasion of the corium by proliferating atypical epithelial cells forming an adenoid pattern. The adenoid structure is usually composed of a single peripheral layer of cohesive cuboidal epithelial cells, and toward the center of the lobule there is acantholysis with formation of lumina containing dyskeratotic cells. The precursor stages of adenoid squamous cell carcinoma are classified histopathologically as senile keratosis with acantholysis. The most frequent histologic site of origin in this material was from the upper part of the pilary outer root sheath but some arose from the epidermis. Mucin associated with the adenoid structure showed identical histochemical reactions to those of mucin occurring in the pilary sheath and epidermis (hyaluronic acid) and differed from those of mucin seen in sweat glands (sialomucin). Among 155 patients having 213 lesions of adenoid squamous cell carcinoma there was metastasis in 3 patients (to regional lymph nodes in 2 and to regional lymph nodes and to lung in 1) and direct extension in 2 patients, which led to the death of the 5 patients. Surgical excision is the treatment of choice.
TL;DR: Cytological studies revealed that all of the cell lines have a normal diploid karyotype with few aberrant cells, and none of the cultured cells derived from chronic myelocytic leukemia retained the Ph chromosome.
Abstract: New human leukemia cell lines from 4 patients have been established. All are characterized by preferential growth in small clumps and large flat plaques of cells. The cell lines were adapted to suspension cultures and grown in one- to 200-liter containers. The design of practical automated units for continuous culture of leukemia cells has been accomplished. Some of the nutritional requirements of these cell lines are summarized. Cytological studies revealed that all of the cell lines have a normal diploid karyotype with few aberrant cells. None of the cultured cells derived from chronic myelocytic leukemia retained the Ph chromosome. Electron microscopy has shown virus-like particles in several of these cell lines. Preliminary studies of the value of these cultured leukemia cells in biochemical, viral and clinical immunological studies are discussed.
TL;DR: The lungs of 50 consecutive autopsied cases of acute leukemia were studied and cultures were obtained from 36 patients, finding 30 patients had major pulmonary lesions and the most frequently identified pathogens were Pseudomonas sp.
Abstract: The lungs of 50 consecutive autopsied cases of acute leukemia were studied and cultures were obtained from 36. Thirty-one patients had major pulmonary lesions. Most of these were not recognized antemortem. Infection was the most common pulmonary complication. Pulmonary disease was present in 95% of those cases with abnormal chest x-rays but 59% of the patients with normal chest x-rays also had pulmonary pathology. Leukemic involvement was identified microscopically in 64% of the lungs. Peribronchial infiltrates were found most frequently. Patients with high levels of circulating abnormal cells had more severe leukemic involvement of the lung. Pulmonary hemorrhage was found in 54% of the lungs and was severe in 12%. The incidence of pulmonary hemorrhage was higher in patients with severe thrombocytopenia. Thirty-one major and 29 minor pulmonary infections were found in 40 of the patients. Many of these were unrecognized clinically and the offending organism was seldom isolated antemortem. The most frequently identified pathogens were Pseudomonas sp., Candidia sp., and Aspergillus sp.
TL;DR: Responsiveness was not affected by the clinical state of the patient except in Hodgkin's disease where improvement in transformation capacity is seen with amelioration of symptoms and remission.
Abstract: Lymphocyte transformation in tissue culture by PHA stimulation is a useful technique for the evaluation of the lymphocyte in disorders of the lymphatic apparatus. Impaired responsiveness to PHA in Hodgkin's disease was confirmed. Inhibition of lymphocyte transformation by Hodgkin's plasma is suggested. Normal responsiveness was found in small cell lymphocytic lymphosarcoma and other lymphosarcoma whereas marked impairment was noted in chronic lymphatic leukemia. Responsiveness was not affected by the clinical state of the patient except in Hodgkin's disease where improvement in transformation capacity is seen with amelioration of symptoms and remission.
TL;DR: Six cases are presented of an entity which previously had been described as lymphangiopericytoma, but which now are considered to be more correctly termed “lymphangiomyoma” and the authors conclude that the lesion is best considered as a hamartoma, often of multifocal origin.
Abstract: Six cases are presented of an entity which previously had been described as lymphangiopericytoma, but which now are considered to be more correctly termed “lymphangiomyoma” An additional 14 cases from the literature are reviewed. The lesion, which shows a striking female sex predominance, often involves the thoracic duct, has an almost constant association with chylothorax and a frequent one with pulmonary disease consisting of lymphangiectasis, honeycombing with proliferation of smooth muscle and atypical lipid pneumonia, possibly of chylous origin. No lesion has metastasized to distant organs or invaded organs locally and the authors conclude that the lesion is best considered as a hamartoma, often of multifocal origin. A close relationship is noted between lymphangiomyoma and certain secondary lesions associated with tuberous sclerosis. The clinical course and response to therapy are described.
TL;DR: It is concluded that actinomycin D used alone is the most effective chemotherapeutic means of destroying metastases from embryonal carcinoma, teratocarcinoma and choriocarc inoma while chlorambucil is the best drug for metastatic seminoma.
Abstract: Of 154 patients given chemotherapy for metastatic testis cancer 24 were rendered free of disease. In 21 of those patients actinomycin D had been used alone or in combination with chlorambucil or chlorambucil plus methotrexate. Of the others, 2 had seminoma which disappeared with chlorambucil and in the third chorionic gonadotrophin disappeared with 6-mercaptopurine and 6-diazo-5-oxo-levonorleucine. Regressions of lesser degree were seen with the above agents and with actinomycin D in combination with other agents; and also with vincristine sulfate, mithramycin, vinblastine sulfate and nitrofurazone though such regressions were generally of no clinical significance. The author concludes that actinomycin D used alone is the most effective chemotherapeutic means of destroying metastases from embryonal carcinoma, teratocarcinoma and choriocarcinoma while chlorambucil is the best drug for metastatic seminoma.
TL;DR: Hepatotoxicity of methotrexate (MTX) therapy was studied in 22 patients and Liver biopsies revealed a chronic portal inflammatory reaction in 7/10.
Abstract: Hepatotoxicity of methotrexate (MTX) therapy was studied in 22 patients. During intensive MTX therapy, values for SGOT, SGPT, LDH and BSP were 140 μ, 315 μ, 753 μ and 13% with control values of 13.5 μ, 20.5 μ, 379 μ and 4%, respectively. During intermittent therapy these values were 50 μ, 110 μ, 544 μ and 10% with controls of 13 μ, 15 μ, 355 μ and 3%. Other liver function tests remained normal. After cessation of intermittent therapy, recovery occurred in one month. Liver biopsies revealed a chronic portal inflammatory reaction in 7/10. Methotrexate can be used in nonmalignant disorders provided that careful control of its toxic side effects is maintained.
TL;DR: The transfusion of large numbers of platelets significantly reduced the incidence and severity of hemorrhagic complications in these patients with acute leukemia and may have slightly prolonged their survival.
Abstract: The effect of platelet transfusion therapy in acute leukemia was studied in 27 cases, whose autopsy findings were compared to 30 similar cases treated prior to availability of such therapy. Major hemorrhage which was considered to be the proximate cause of death was present in 63% of the controls, but occurred in only 15% of the platelet-treated group. This difference was highly significant (p <.001). Of the 30 patients who did not receive intensive platelet therapy, 15 (50%) had gross intracranial hemorrhage and 27 (90%) had gross pulmonary hemorrhage. In contrast, of the 27 patients in the study group who had received platelet therapy, 5 (19%) had gross intracranial hemorrhage and 14 (52%) had gross pulmonary hemorrhage. The platelet-treated patients had a significantly decreased incidence of intracranial hemorrhage (p < .05) and of pulmonary hemorrhage (p <.005) compared to the control group of patients. The incidence of gastrointestinal hemorrhage was slightly lower in the study group; there were no differences in the amount of hemorrhage in the heart and kidney. The transfusion of large numbers of platelets significantly reduced the incidence and severity of hemorrhagic complications in these patients with acute leukemia and may have slightly prolonged their survival.
TL;DR: This clinical and pathologic study of 24 vaginal polyps, 22 from adults and 2 from infants, was prompted by the need for recognition of a benign polypoid vaginal lesion which must be distinguished from sarcoma botryoides, rhabdomyosarcoma and mixed mesodermal tumor.
Abstract: This clinical and pathologic study of 24 vaginal polyps, 22 from adults and 2 from infants, was prompted by the need for recognition of a benign polypoid vaginal lesion which must be distinguished from sarcoma botryoides, rhabdomyosarcoma and mixed mesodermal tumor. Twelve of the 22 polyps from adults contained atypical cells within the stroma. Five of these patients were pregnant when the polyp was discovered. Follow-up showed that the polyps are benign and adequately treated by local excision. The polyps from the 2 newborn infants were present at birth and were characterized by diffuse edema but contained no atypical stromal cells. One of the polyps regressed after biopsy. The other was locally excised and did not recur. Maternal hormones are thought to induce the intra-uterine development of the polyps in infants. The criteria for distinguishing vaginal polyps from sarcoma botryoides, rhabdomyosarcoma and mixed mesodermal tumor are discussed.
TL;DR: No toxic effects were seen after administration of a partially purified L‐asparaginase (PPLAFI) in C3H mice with small tumors from 0 to 2 days or in monkeys during 9 days of observation, but profuse diarrhea was observed in mice with massive tumors after PPLAFi treatment, during tumor regression.
Abstract: The toxic and antineoplastic effects of guinea pig serum L-asparaginase have been investigated. The enzyme is active against early (0 day) through late (24 day) 6C3HED subcutaneous tumors in C3H mice but whole guinea pig serum in the same doses was not at all effective against intracerebral tumors comprising the same cells. Whole guinea pig serum caused no acute toxic effects in mice with small tumors. No toxic effects were seen after administration of a partially purified L-asparaginase (PPLAFI) in C3H mice with small tumors from 0 to 2 days or in monkeys during 9 days of observation. Profuse diarrhea was observed in mice with massive tumors after PPLAFI treatment, during tumor regression. The effects of PPLAFI are described in a human with leukemia.
TL;DR: Special attention is drawn to the relatively high likelihood of malignant melanomas arising in pre‐existing nevus pigmentosus giganticus and the poor prognosis in these cases, probably due to difficult and hence late diagnosis.
Abstract: Two cases of malignant melanoma with metastases in children are reported, (boy—2 years; girl—11 years). From these 2 cases and from 43 previously reported cases in the literature it appears that the disease is at least as aggressive in children as in adults. The 3-year survival rate in children compares with the 5-year survival rate in adults at a similar stage in the disease. Special attention is drawn to the relatively high likelihood of malignant melanomas arising in pre-existing nevus pigmentosus giganticus and the poor prognosis in these cases, probably due to difficult and hence late diagnosis.
TL;DR: The immunological defect of early active Hodgkin's disease is characterized by depression of delayed hypersensitivity and can be assessed by negative reactions to a battery of skin allergies or by the inability to acquire contact sensitivity.
Abstract: The immunological defect of early active Hodgkin's disease is characterized by depression of delayed hypersensitivity and can be assessed by negative reactions to a battery of skin allergens or by the inability to acquire contact sensitivity. Unlike a similar defect in patients with other neoplastic conditions, the deficiency in Hodgkin's disease is seen in patients in good clinical condition with an apparently localized process. While the homograft reaction is depressed in these Hodgkin's patients, antibody formation is largely intact and the lymphocyte count is normal or but slightly decreased. There is preliminary evidence that the anergy of early Hodgkin's disease is a peripheral defect—a manifestation of abnormal lymphocyte function. Later in the course of the disorder profound lymphopenia develops and most probably contributes to the more severe and complex immunological deficiencies and infectious complications of advanced Hodgkin's disease.
TL;DR: A basis is established for the occurrence of multiple types of testicular tumor in one testis and for the histogenesis of the various germinal tumors of the testicle.
Abstract: Thirteen seminomas, 5 embryonal carcinomas and 3 teratocarcinomas were studied ultrastructurally to obtain information upon the histogenesis, pathogenesis and interrelationships of the tumors. The ultrastructure of seminoma closely mimicked abortive stages in spermatogenesis; no evidence of somatic differentiation was present. Tumor cells that closely resembled spermatocytes appeared to be the stem cells which originated the more differentiated elements of seminoma. Embryonal carcinoma, whether occurring alone or as a component of teratocarcinoma, was similar in its ultrastructure and bore no resemblance to that of seminoma. Moreover, these embryonal carcinomas were indisguishable from those of the mouse. Since embryonal carcinoma of the mouse has been shown to be the multipotential stem cell of murine teratocarcinomas, it seems reasonable to suppose that human embryonal carcinoma would also serve as the multipotential stem cells of human teratocarcinomas. A basis is established for the occurrence of multiple types of testicular tumor in one testis and for the histogenesis of the various germinal tumors of the testicle.
TL;DR: Arguments supporting the view that Hodgkin's disease is always incurable are examined critically and rejected in the light of modern advances in diagnostic methodology and the development of techniques for intensive wide‐field mega‐voltage radiotherapy.
Abstract: Arguments supporting the view that Hodgkin's disease is always incurable are examined critically and rejected in the light of modern advances in diagnostic methodology and the development of techniques for intensive wide-field mega-voltage radiotherapy. Previously untreated patients with Hodgkin's disease deserve an aggressive hopeful approach; a meticulous clinical evaluation, including routine lymphangiography, permits accurate staging, on the basis of which informed decisions regarding treatment may be made. Wide-field mega-voltage radiotherapy to doses of 3,500 to 4,000 rads in 4 weeks is the treatment of choice for regionally localized disease and offers a substantial chance of permanent cure. Intensive radiotherapy also has been tolerated impressively well by patients with generalized (stage III) disease in a clinical investigation currently in progress.
TL;DR: Fifty‐eight cases of synovial sarcoma were studied from the morbid anatomical point of view and no correlation was found between the histological picture and prognosis.
Abstract: Fifty-eight cases of synovial sarcoma were studied from the morbid anatomical point of view. The literature was reviewed and some clinical aspects were described. The essential biphasic histological pattern of these tumors is emphasized and they are divided into 3 histological groups. Group A includes tumors in which the spindle cell elements and the pseudoepithelial ones are clearly seen throughout the tumor. In Group B the spindle cell (fibrosarcomatous) elements predominate. Group C tumors show mainly a pseudoepithelial structure. The overall 5-year survival rate was 51% and no correlation was found between the histological picture and prognosis.
TL;DR: Twenty‐two cases of radiation induced neoplasms following curative therapy for retinoblastoma are reviewed, and three new cases are reported.
Abstract: Twenty‐two cases of radiation induced neoplasms following curative therapy for retinoblastoma are reviewed, and three new cases are reported. Twenty‐four of the 25 growths were malignant, and most were of the osteogenic series and its variants. The young age of the patients at the time of radiotherapy had no apparent effect upon the length of the latent interval, as persons receiving radiotherapy in adulthood had similar latent periods preceding the development of similar tumors. The prognosis of these tumors was exceptionally poor, in part due to the large proportion of sarcomas and also due to the proximity of the tumors to the deep structures of the face and base of the skull.
TL;DR: Most interesting testimony to the antiquity of this tumor is exhibited in several mummies of pre‐Colombian Incas of Peru, some estimated to be 2,400 years old, which show diffuse metastases to bones, particularly of the skull and extremities.
Abstract: The first accredited mention of melanoma was by Hippocrates in the fifth century, B.C. The legendary rumor that this tumor was described in the Ebers Papyrus is apocryphal. A number of references to “fatal black tumors with metastases and black fluid in the body” are encountered in European literature between 1650 and 1760. Laennec discussed “la melanose” in 1806 and Robert Carswell, in 1838, first employed the word melanoma. During the eighteenth century moles—either natural or as appliques (“mouches pour Bal”)—were popular as beauty marks. Later, in addition to being considered beautiful, they had religious implications. In the early 1930's moles on the upper part of the trunk—consonant with an ancient ritualistic qualification—played a significant role in the incarnation of the fourteenth Dalai Lama. Most interesting testimony to the antiquity of this tumor is exhibited in several mummies of pre-Colombian Incas of Peru, some estimated to be 2,400 years old, which show diffuse metastases to bones, particularly of the skull and extremities.