Malignant mixed epithelial/mesenchymal neoplasmas of the lung

1
198 Abstracts/Lung Cancer 13 (1995) 185-232 and in male patients @ = 0.023). Counter to previous studies in other solid tumors, immunocytochemical detection of ~53 expression does not predict a poor clinical outcome in non- smallcell lung cancer. In early-stage lung cancer it might be associated with an impruved disease- free survival, which suggests that the majority of the detected protein inherits the wild-type tumor suppressor function. High prevalence of bcl-2 oncoprotein expression in small cell lung cancer Higaahiyama M, Doi 0, Kodama K, Yokouchi H, Tateishi R. Department of Thoracic Surgery, The Centerfor Adult Diseases, Nakamichi 1-3-3. Higashinai-ku. Osaka, 537. Anticancer Res 1995;15:503-5. Bcl-2 oncoprotein, a member of a new category of oncogenes associated with the regulation of programmed cell death (apoptosis), has been considered to be involved in biological processes such as tumorigenesis and tumor development. To determine the role of bcl-2 oncoprotein in lung cancer, we preliminarily examined the expression of this protein in various histological types. Inuuunohistochemical staining using monoclonal bcl-2 onmprotein antibody was performed in surgically resected frozen specimens. Bcl-2 staining was seen in nine of 13 small cell lung cancers (69%) while only 18 out of 69 non-small cell lung cancers (26%) expressed bcl-2 oncoprotein, showing a significantly increased incidence of bcl-2 onmprotein expression in the former histological type. Considering the greater aggressiveness of small cell lung cancer compared to non-small cell lung cancer, the possibility exists that the high prevalence ofbcl-2 oncoprotein expression in small cell lung cancer is closely associated with tumorigenesis and tumor development. Distribution of the carbohydrate antigens, DU-PAN-2 and CA19-9, in tumors of the lung Ohshio G, Yamaki K, Imamura T, Suwa H, Chang CY, Wada H et al. Department ofSwge~, Faculty OfMedicine, Kyoto lJniversi& Shogoin Kawara-cho 34, Sakyo-ku, Kyoto 606. Tumori 1995;81:67-73. Aims and backgrtxmd: The carbohydrate chains of malignant OZIIS appear to be related to oncofetal differentiation. The serum levels Of CAl9-9 have been reported to be evaluated in some patients with lung carcinomas, however, the distribution of carbohydrate antigens were not precisely described. We have investigated in this study the distribution of DU-PAN-2 and CAl9-9 antigens in lung tumors. Methods: Ninety-five specimens of lung tumors were selected from surgical specimens. The expression of DU-PAN-2 and CAl9-9 were studied by immunohystochemical techniques. The relationship between the expression of these antigens and the classification or the differen- tiation degree of the tumors were examined. Results: DU-PAN-2 or CAl9-9 antigens were detected in 41 (54%) and 45 (59%) cases of the 76 malignant epithelial tumors investigated. These antigens were detected in all types of malignant epithelial tumors, including squamous cell carcinomas, where they were mainly localized to the entire cell surface of malignant cells. In adenocarcinomas, huge cell carcinomas and small cell carcinomas, however, these antigens were commonly detected both on the cell membrane and in the cytoplasm. There was positive correlation between the degree of differentiation and DU-PAN- 2, but not CAl9-9 expression. Among the non-epithelial tumors investigated, those antigens were detected in pulmonary blastomas but not in mesotheliomas. Conclusions: Immunohistochemical studies for DU-PAN-2 and CAl9-9 are useful for defining characteristics of the lung tumors. DU-PAN-2 could be a marker for differentiating between malignant epitbelial tumors and mesotheliomas. Lung tumors of uncertain histogeneais Shimosato Y. Clinical Laboratories Division, National Cancer Center Hospital, 5-1-l. Tsukiji Chuo-ku, Tokyo 104. Semin Diagn Pathol 1995;12:185-92. Unusual lung tumors of uncertain origin have been described briefly concerning benign clear cell (sugar) tumor and, in more detail, concerning pneumocytoma (so-called sclerosing hemangioma). Melanocytic differentiation of clear cell tumor, which is peculiar to the lung, has been suggested recently. Sclerosing hemangioma, also unique to the lung is now mnsidered to be a tumor (neoplasm) related to alveolar epithelial cells. It shows invasive growth and multiplicity (or aerogenous metastasis), but is very rarely capable of lymph node metastasis. It should be designated as pneumocytoma. Lung tumors derived from ectopic tissues Man&v&y AM. Patholo@Laborato?yMedicine Dept., Cedars-Sinai Medical Center 8700 Beverly Blvd. Los Angeles, CA 90048. Semin Diagn Pathol 1995;12:172-84. Ectopic tissues rarely occur in the lung. They include endometriosis, neuroglial tissue, thyroid, pancreas, and adrenal, Choristomas are very rare developmental anomalies derived from these ectopic tissues, They develop as a mass composed of histologically normal tissues that are heterotopic in the lung. wous intrapulmonary neoplasms also rarely develop from ectopic tissues. They include malignant melanoma, thymoma, meningioma, glomus tumor, germ cell neoplasms (chorio- carcinoma and teratoma), and ependymoma. The clinimpathological features of these unusual pulmonary neoplasms are discussed. Malignant mixed epitheiial/mesenchymal neoplasms of the lung Bcrho hJ, Moran CA, Suster S. Department ofPathoiogy, Mount Sinai Medical Center: 4300AIton Rd. Miami Beach, FL 33140. Semin Diagn Path01 1995;12:123-39. The existence of biphasic neoplasms occurring primarily in the lung is a well-known albeit rare event. The spectmm of malignant tumors displaying a mixed epitheliabmesenchymal growth pattern is rather narrow when these tumors occur primarily in the lung. The two most often encountered neoplasms showing features of epithelial and mesenchymal differentiation are carcinosarcomas and pulmonary blastomas. Tumors with analogous features are of ubiquitous distribution in the human body and have been described in numerous other organs, including the gastrointestinal tract, the genitourinary tract, and the endocrine system. Although the histopathologic features of these tumors may seem simple in most cases, there appear to be numerous pitfalls in their diagnosis; gray areas still remain in the characterization of these tumors, because a certain degree of overlap may be encountered with these two conditions. Such problems are understandable because the incidence of these tumors in the general population is very rare. Therefore, one is expected to find divergent points of view regarding these neoplasms. It is of importance, however, to unity criteria not only for diagnostic purposes, but also to determine the prevalence and behavior of these neoplasms, because such information may provide a rationale for adjustment and improvement in the treatment and diagnosis of these unusual neoplasms. We will review past and current concepts regarding these unusual tumors, as well as their more salient histopathologic features. Primary salivary gland-type tumors of the lung Moran CA. Pulmonary/MedrastinaI Pathol. Dept., Armed Forces Institute of Pathology, Washington, DC 20306-6000. Semin Diagn Path01 1995;12:106-22. Primary pulmonary neoplasms that bear similar histopathologic features to those seen in salivary glands are rare. Although their presence

Transcript of Malignant mixed epithelial/mesenchymal neoplasmas of the lung

198 Abstracts/Lung Cancer 13 (1995) 185-232

and in male patients @ = 0.023). Counter to previous studies in other solid tumors, immunocytochemical detection of ~53 expression does not predict a poor clinical outcome in non- smallcell lung cancer. In early-stage lung cancer it might be associated with an impruved disease- free survival, which suggests that the majority of the detected protein inherits the wild-type tumor suppressor function.

High prevalence of bcl-2 oncoprotein expression in small cell lung cancer Higaahiyama M, Doi 0, Kodama K, Yokouchi H, Tateishi R. Department

of Thoracic Surgery, The Centerfor Adult Diseases, Nakamichi 1-3-3. Higashinai-ku. Osaka, 537. Anticancer Res 1995;15:503-5.

Bcl-2 oncoprotein, a member of a new category of oncogenes associated with the regulation of programmed cell death (apoptosis), has been considered to be involved in biological processes such as tumorigenesis and tumor development. To determine the role of bcl-2 oncoprotein in lung cancer, we preliminarily examined the expression of this protein in various histological types. Inuuunohistochemical staining using monoclonal bcl-2 onmprotein antibody was performed in surgically resected frozen specimens. Bcl-2 staining was seen in nine of 13 small cell lung cancers (69%) while only 18 out of 69 non-small cell lung cancers (26%) expressed bcl-2 oncoprotein, showing a significantly increased incidence of bcl-2 onmprotein expression in the former histological type. Considering the greater aggressiveness of small cell lung cancer compared to non-small cell lung cancer, the possibility exists that the high prevalence ofbcl-2 oncoprotein expression in small cell lung cancer is closely associated with tumorigenesis and tumor development.

Distribution of the carbohydrate antigens, DU-PAN-2 and CA19-9, in tumors of the lung Ohshio G, Yamaki K, Imamura T, Suwa H, Chang CY, Wada H et al. Department ofSwge~, Faculty OfMedicine, Kyoto lJniversi& Shogoin Kawara-cho 34, Sakyo-ku, Kyoto 606. Tumori 1995;81:67-73.

Aims and backgrtxmd: The carbohydrate chains of malignant OZIIS

appear to be related to oncofetal differentiation. The serum levels Of

CAl9-9 have been reported to be evaluated in some patients with lung carcinomas, however, the distribution of carbohydrate antigens were not precisely described. We have investigated in this study the distribution of DU-PAN-2 and CAl9-9 antigens in lung tumors. Methods: Ninety-five specimens of lung tumors were selected from surgical specimens. The expression of DU-PAN-2 and CAl9-9 were studied by immunohystochemical techniques. The relationship between the expression of these antigens and the classification or the differen- tiation degree of the tumors were examined. Results: DU-PAN-2 or CAl9-9 antigens were detected in 41 (54%) and 45 (59%) cases of the 76 malignant epithelial tumors investigated. These antigens were detected in all types of malignant epithelial tumors, including squamous cell carcinomas, where they were mainly localized to the entire cell surface of malignant cells. In adenocarcinomas, huge cell carcinomas and small cell carcinomas, however, these antigens were commonly detected both on the cell membrane and in the cytoplasm. There was positive correlation between the degree of differentiation and DU-PAN- 2, but not CAl9-9 expression. Among the non-epithelial tumors investigated, those antigens were detected in pulmonary blastomas but not in mesotheliomas. Conclusions: Immunohistochemical studies for DU-PAN-2 and CAl9-9 are useful for defining characteristics of the lung tumors. DU-PAN-2 could be a marker for differentiating between malignant epitbelial tumors and mesotheliomas.

Lung tumors of uncertain histogeneais Shimosato Y. Clinical Laboratories Division, National Cancer Center Hospital, 5-1-l. Tsukiji Chuo-ku, Tokyo 104. Semin Diagn Pathol 1995;12:185-92.

Unusual lung tumors of uncertain origin have been described briefly concerning benign clear cell (sugar) tumor and, in more detail, concerning pneumocytoma (so-called sclerosing hemangioma). Melanocytic differentiation of clear cell tumor, which is peculiar to the lung, has been suggested recently. Sclerosing hemangioma, also unique to the lung is now mnsidered to be a tumor (neoplasm) related to alveolar epithelial cells. It shows invasive growth and multiplicity (or aerogenous metastasis), but is very rarely capable of lymph node metastasis. It should be designated as pneumocytoma.

Lung tumors derived from ectopic tissues Man&v&y AM. Patholo@Laborato?yMedicine Dept., Cedars-Sinai Medical Center 8700 Beverly Blvd. Los Angeles, CA 90048. Semin Diagn Pathol 1995;12:172-84.

Ectopic tissues rarely occur in the lung. They include endometriosis, neuroglial tissue, thyroid, pancreas, and adrenal, Choristomas are very rare developmental anomalies derived from these ectopic tissues, They develop as a mass composed of histologically normal tissues that are heterotopic in the lung. wous intrapulmonary neoplasms also rarely develop from ectopic tissues. They include malignant melanoma, thymoma, meningioma, glomus tumor, germ cell neoplasms (chorio- carcinoma and teratoma), and ependymoma. The clinimpathological features of these unusual pulmonary neoplasms are discussed.

Malignant mixed epitheiial/mesenchymal neoplasms of the lung Bcrho hJ, Moran CA, Suster S. Department ofPathoiogy, Mount Sinai Medical Center: 4300AIton Rd. Miami Beach, FL 33140. Semin Diagn Path01 1995;12:123-39.

The existence of biphasic neoplasms occurring primarily in the lung is a well-known albeit rare event. The spectmm of malignant tumors displaying a mixed epitheliabmesenchymal growth pattern is rather narrow when these tumors occur primarily in the lung. The two most often encountered neoplasms showing features of epithelial and mesenchymal differentiation are carcinosarcomas and pulmonary blastomas. Tumors with analogous features are of ubiquitous distribution in the human body and have been described in numerous other organs, including the gastrointestinal tract, the genitourinary tract, and the endocrine system. Although the histopathologic features of these tumors may seem simple in most cases, there appear to be numerous pitfalls in their diagnosis; gray areas still remain in the characterization of these tumors, because a certain degree of overlap may be encountered with these two conditions. Such problems are understandable because the incidence of these tumors in the general population is very rare. Therefore, one is expected to find divergent points of view regarding these neoplasms. It is of importance, however, to unity criteria not only for diagnostic purposes, but also to determine the prevalence and behavior of these neoplasms, because such information may provide a rationale for adjustment and improvement in the treatment and diagnosis of these unusual neoplasms. We will review past and current concepts regarding these unusual tumors, as well as their more salient histopathologic features.

Primary salivary gland-type tumors of the lung Moran CA. Pulmonary/MedrastinaI Pathol. Dept., Armed Forces Institute of Pathology, Washington, DC 20306-6000. Semin Diagn Path01 1995;12:106-22.

Primary pulmonary neoplasms that bear similar histopathologic features to those seen in salivary glands are rare. Although their presence