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Cutaneous Signs of Internal Malignancies
196
ONCOLOGY AND CHEMOTHERAPY
Interestingly, few instances of bladder or sexual dysfunction were seen in the series, possibly because the dissection kept close to the rectal wall with either technique. Only 1 man required prostatic resection and he had had obstructive symptoms before abdominoperineal excision of the rectum. While sexual dysfunction was difficult to evaluate because of the age of many of the patients, nonetheless, the majority clearly showed no evidence of impairment. T. D. A. 2 figures, 2 tables, 16 references Papillary Serous Carcinoma of the Retroperitoneum T. M. ULBRIGHT, D. J. MORLEY, L. M. ROTH AND R. L. BERK OW, Departments of Pathology, Medical Genetics and Pediatrics (Division of Pediatric Hematology-Oncology), Indiana University School of Medicine, Indianapolis, Indiana
used recreational drugs, with marijuana and amyl nitrite the most common type. Of the 10 patients 9 had deficient cellular immunity and inverted T cell helper/suppressor ratios. The only patient with normal cellular immunity had nodal granulomas. Humoral immunity was normal in all patients. While the abnormalities observed in these lymph nodes are not specific for any distinctive disease they may have characteristic features peculiar to this syndrome. It is of the utmost importance to establish the correct diagnosis and differentiate these changes from those of lymphoma. W. J. C. 8 figures, 3 tables, 29 references The APUD Puzzle G. E. MOORE, Department of Surgical Oncology, Denver General Hospital, Denver, Colorado
Amer. J. Clin. Path., 79: 633-637 (May) 1983
N. Y. State J. Med., 84: 2-3 (Jan.) 1984
Neoplasms with histologic features of ovarian or uterine tumors have been documented at extragenital sites. It is believed that these tumors can arise from metaplasia of coelomic mesothelium and submesothelium mesenchyme~2 types of tissue that form important components of the developing ovary and miillerian structures. The authors describe a retroperitoneal neoplasm in an 11year-old girl with a microscopic appearance identical to that of papillary serous adenocarcinoma of the ovary. There was no evidence of a pathological condition of the ovary. lmmunohistochemical staining for amylase was positive within the cytoplasm of the tumor cells. Since amylase is a marker for serous ovarian tumors this finding supports the belief that ovariantype neoplasms that occur at ectopic locations essentially are identical to their ovarian counterparts. The authors believe that these tumors originate as metaplasia of the mesothelium and support the concept that these tumors should exhibit a biological behavior and therapeutic response similar to those of an ovarian neoplasm of the same grade and comparable stage. They also suggest that demonstration of intracytoplasmic amylase also may prove useful in differentiating peritoneal serous tumors from nonmetaplastic mesothelial tumors. W.J. C. 2 figures, 29 references
APUD (Amin Precursor Uptake and Decarboxylation) tumors were believed to derive from neuroectodermal cells of the embryonic neural crest. Although found in diverse anatomic locations these tumors are recognized by the production of similar catecholamine products. An exciting phenomenon is the oncocytoma-like replication of mitochondria found frequently in these tumors. The author speculates that a virus or oncogene may be responsible for the fixation of cellular metabolic production at an "APUD level". G. F. S.
Lymphadenopathy in Homosexual Men. Morbid Anatomy With Clinical and Immunologic Correlations L.A. GUARDA, J. J. BUTLER, P. MANSELL, E. M. HERSH, J. REUBEN AND G. R. NEWELL, Departments of Pathology, Cancer Prevention, and Clinical Immunology and Biology Therapy, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, Houston, Texas Amer. J. Clin. Path., 79: 559-568 (May) 1983 The authors evaluated the histopathologic features of lymph nodes removed from 11 young, homosexual men who presented with lymph node enlargement >3 months in duration accompanied by fever and weight loss. Reactive follicular and sinusoidal hyperplasia was the main finding in 10 patients. The medullary sinuses were packed with monomorphic round sinusoidal cells associated with neutrophils. Granulomas packed the subcapsular sinuses in 1 of the 10 patients, while 1 presented with lymphoid-depleted nodes with absent germinal centers and a prominent vascular pattern. This latter feature caused difficulty in distinguishing the nodal form of Kaposi's sarcoma. All patients had a history of sexual promiscuity and
Cutaneous Signs of Internal Malignancies
F. HELM, Department of Dermatology, Roswell Park Memorial Institute, Buffalo, New York J. Surg. Oneal., 23: 1-4 (May) 1983 The association of certain skin lesions with internal malignancies has been noted for a long time. In this discussion of cutaneous signs of internal malignancies the author notes that the more common paraneoplastic skin changes associated with malignancies include acanthosis nigricans, dermatomyositis and secondary ichthyosis. Each of these entities is discussed in detail. In addition, the glucagonoma syndrome, consisting of cell tumor of the pancreas, migratory necrolytic erythema and diabetes mellitus, is described. The author emphasizes that recognition of these skin lesions may lead to early detection of the underlying cancer and improvement in a chance for cure.
W.J.C. 4 figures, 12 references
Suppressor Substance Produced by the K562 Cell Line In Vitro J.M. KORZELIUS, P. M. BEALMEAR AND 0. A. HOLTERMANN, Departments of Dermatology and Viral Leukemia, Roswell Park Memorial Institute, Buffalo, New York
J. Surg. Oneal., 23: 16-20 (May) 1983 Malignant neoplasms often are associated with functional disturbances of the immune system. The mechanism of such disturbances appears to be complex. In most instances the source of immunosuppressive factors has not been determined. However, normal host tissue and tumor cells have been implicated as sites of production. The authors discuss in vitro production of a substance with suppressive effects on lymphocytes by a cell line, K562, that was established from the patient with chronic myelogenous leukemia. The K562 line elab-
ONCOLOGY AND CHEMOTHERAPY
Interestingly, few instances of bladder or sexual dysfunction were seen in the series, possibly because the dissection kept close to the rectal wall with either technique. Only 1 man required prostatic resection and he had had obstructive symptoms before abdominoperineal excision of the rectum. While sexual dysfunction was difficult to evaluate because of the age of many of the patients, nonetheless, the majority clearly showed no evidence of impairment. T. D. A. 2 figures, 2 tables, 16 references Papillary Serous Carcinoma of the Retroperitoneum T. M. ULBRIGHT, D. J. MORLEY, L. M. ROTH AND R. L. BERK OW, Departments of Pathology, Medical Genetics and Pediatrics (Division of Pediatric Hematology-Oncology), Indiana University School of Medicine, Indianapolis, Indiana
used recreational drugs, with marijuana and amyl nitrite the most common type. Of the 10 patients 9 had deficient cellular immunity and inverted T cell helper/suppressor ratios. The only patient with normal cellular immunity had nodal granulomas. Humoral immunity was normal in all patients. While the abnormalities observed in these lymph nodes are not specific for any distinctive disease they may have characteristic features peculiar to this syndrome. It is of the utmost importance to establish the correct diagnosis and differentiate these changes from those of lymphoma. W. J. C. 8 figures, 3 tables, 29 references The APUD Puzzle G. E. MOORE, Department of Surgical Oncology, Denver General Hospital, Denver, Colorado
Amer. J. Clin. Path., 79: 633-637 (May) 1983
N. Y. State J. Med., 84: 2-3 (Jan.) 1984
Neoplasms with histologic features of ovarian or uterine tumors have been documented at extragenital sites. It is believed that these tumors can arise from metaplasia of coelomic mesothelium and submesothelium mesenchyme~2 types of tissue that form important components of the developing ovary and miillerian structures. The authors describe a retroperitoneal neoplasm in an 11year-old girl with a microscopic appearance identical to that of papillary serous adenocarcinoma of the ovary. There was no evidence of a pathological condition of the ovary. lmmunohistochemical staining for amylase was positive within the cytoplasm of the tumor cells. Since amylase is a marker for serous ovarian tumors this finding supports the belief that ovariantype neoplasms that occur at ectopic locations essentially are identical to their ovarian counterparts. The authors believe that these tumors originate as metaplasia of the mesothelium and support the concept that these tumors should exhibit a biological behavior and therapeutic response similar to those of an ovarian neoplasm of the same grade and comparable stage. They also suggest that demonstration of intracytoplasmic amylase also may prove useful in differentiating peritoneal serous tumors from nonmetaplastic mesothelial tumors. W.J. C. 2 figures, 29 references
APUD (Amin Precursor Uptake and Decarboxylation) tumors were believed to derive from neuroectodermal cells of the embryonic neural crest. Although found in diverse anatomic locations these tumors are recognized by the production of similar catecholamine products. An exciting phenomenon is the oncocytoma-like replication of mitochondria found frequently in these tumors. The author speculates that a virus or oncogene may be responsible for the fixation of cellular metabolic production at an "APUD level". G. F. S.
Lymphadenopathy in Homosexual Men. Morbid Anatomy With Clinical and Immunologic Correlations L.A. GUARDA, J. J. BUTLER, P. MANSELL, E. M. HERSH, J. REUBEN AND G. R. NEWELL, Departments of Pathology, Cancer Prevention, and Clinical Immunology and Biology Therapy, The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, Houston, Texas Amer. J. Clin. Path., 79: 559-568 (May) 1983 The authors evaluated the histopathologic features of lymph nodes removed from 11 young, homosexual men who presented with lymph node enlargement >3 months in duration accompanied by fever and weight loss. Reactive follicular and sinusoidal hyperplasia was the main finding in 10 patients. The medullary sinuses were packed with monomorphic round sinusoidal cells associated with neutrophils. Granulomas packed the subcapsular sinuses in 1 of the 10 patients, while 1 presented with lymphoid-depleted nodes with absent germinal centers and a prominent vascular pattern. This latter feature caused difficulty in distinguishing the nodal form of Kaposi's sarcoma. All patients had a history of sexual promiscuity and
Cutaneous Signs of Internal Malignancies
F. HELM, Department of Dermatology, Roswell Park Memorial Institute, Buffalo, New York J. Surg. Oneal., 23: 1-4 (May) 1983 The association of certain skin lesions with internal malignancies has been noted for a long time. In this discussion of cutaneous signs of internal malignancies the author notes that the more common paraneoplastic skin changes associated with malignancies include acanthosis nigricans, dermatomyositis and secondary ichthyosis. Each of these entities is discussed in detail. In addition, the glucagonoma syndrome, consisting of cell tumor of the pancreas, migratory necrolytic erythema and diabetes mellitus, is described. The author emphasizes that recognition of these skin lesions may lead to early detection of the underlying cancer and improvement in a chance for cure.
W.J.C. 4 figures, 12 references
Suppressor Substance Produced by the K562 Cell Line In Vitro J.M. KORZELIUS, P. M. BEALMEAR AND 0. A. HOLTERMANN, Departments of Dermatology and Viral Leukemia, Roswell Park Memorial Institute, Buffalo, New York
J. Surg. Oneal., 23: 16-20 (May) 1983 Malignant neoplasms often are associated with functional disturbances of the immune system. The mechanism of such disturbances appears to be complex. In most instances the source of immunosuppressive factors has not been determined. However, normal host tissue and tumor cells have been implicated as sites of production. The authors discuss in vitro production of a substance with suppressive effects on lymphocytes by a cell line, K562, that was established from the patient with chronic myelogenous leukemia. The K562 line elab-