Indurative mastopathy is a benign, elastotic lesion of the breast characterized by a stellate appearance, with surrounding compressed and distorted ducts causing a pseudo-infiltrative pattern. In previously reported cases of benign sclerosing lesions of the breast there has been no evidence of local recurrence of metastasis following excisional biopsy. The significance of identifying indurative mastopathy lies in recognizing its benign nature despite clinical, radiographic, and gross histologic features that are indistinguishable from malignancy, thereby saving the patient additional surgery or radiotherapy once an excisional biopsy has been performed.
An analysis of failure to control locally recurrent or metastatic melanoma was used to substantiate the value of thickness as a guide to surgical management. There were no local recurrences in patients with melanomas less than 0.76 mm in thickness, regardless of the skin margins excised. The three year actuarial incidence of subsequent regional metastases in patients initially treated by wide local excision (WLE) of their melanoma was directly correlated with tumor thickness (p = <0.001); it was 0% for lesions <0.76 mm, 25% for 0.76 to 1.50 mm lesions, 51% for 1.50 to 3.99 mm lesions and 62% for lesions >4.0 mm in thickness. At five years, patients with melanomas of 1.50 to 3.99 mm thickness who had WLE plus elective regional node dissection (RND) had a calculated 15% incidence of distant metastases and an actuarial survival rate of 83%, while patients with melanomas of the same thickness who had WLE alone as their initial surgical treatment had a 78% incidence of distant metastases and a 37% survival rate (p = 0.001 and 0.01, respectively). In patients with melanomas exceeding 4.0 mm in thickness, the potential benefits of RND were less apparent because of a high risk (>70%) of distant metastases at the time of initial diagnosis. Based upon this analysis, our initial surgical management of melanomas <0.76 is a WLE using a 2.0 cm margin of skin, while thicker lesions are excised using a 3 to 5 cm skin margin. Elective RND is not indicated for lesion <0.76 mm in thickness, but it is considered for 0.76 to 1.50 mm lesions in selected patients and is employed for virtually all patients with lesions exceeding 1.5 mm in thickness. The rationale of elective RND is improved survival in patients with intermediate thickness lesions (0.76 to 3.99 mm) while it is justifiable as a staging procedure for lesions exceeding 4.0 mm thickness. Cancer 43:883–888, 1979.
Clinical and pathologic characteristics of melanoma were compared among 1647 clinical Stage I patients treated at the University of Alabama in Birmingham (USA) and The University of Sydney (Australia) between 1955 and 1980 to determine what changes occurred over a quarter century. Over this period, the number of patients treated annually has increased substantially. There was a steady increase in the proportion of patients presenting with localized disease (clinical Stage I). Melanomas became thinner, less invasive, less ulcerative and thus more curable. They also exhibited more of a radial growth phase. The median thickness of melanomas decreased in Australia from 2.5 mm prior to 1960 to 1.1 mm during the period 1976 to 1980, while in Alabama it has decreased from 3.3 to 1.4 mm. There was a significant increase in melanomas located on the trunk in males and a corresponding decrease in male head and neck melanomas. No significant change in the site distribution was observed for any major anatomical area on female patients. There were minimal differences in the incidence of both clinical and pathologic parameters among melanoma patients in Alabama, USA and in New South Wales, Australia even when accounting for their year of diagnosis. Long-term survival rates in patients with localized disease were found to increase slightly during the 25 year time frame of this analysis. The changes that have occurred are likely due to earlier diagnosis and changes in the biological nature of the disease.
We evaluated the histopathology, DNA content, and proliferative activity of colonic polyps independently. Paraffin-embedded specimens were used as source material. In each case, additional sections were cut at 3 microns and stained with hematoxylin-eosin and trichrome for histopathologic analysis. For DNA analysis and measurement of proliferative activity, the polyp parts were dissected and the nonpolypoid tissue was discarded. The study was limited to those specimens that were received in our department in the years 1972 and 1977. Of the 104 polyps that were submitted for flow cytometric analysis, 36 could not be analyzed owing to excessive debris or insufficient nuclei. DNA aneuploidy was identified in 32% of the cases, with a higher value noted in larger polyps and in severely dysplastic polyps, but these values were not statistically significant. Multiple adenomas from the same patient often showed different DNA histograms. When analyzed according to the percentage of cells in S phase, no significant difference was found in proliferative activity of polyps according to DNA content or size of the polyps. These results suggest that the diagnostic significance of aneuploidy and proliferative activity in polyps must be interpreted with caution.
A case of chordoma was studied with light and electron microscopes. The study revealed the presence of 2 cell types—the stellate and the physaliferous cells—and many transitional cells were observed sharing some features of both cell types. Mitoses were found only in the stellate cell type. Virus-like particles were frequently seen in the cytoplasm of the intermediate and physaliferous cells. Various nuclear morphology was observed and thought to be related to cell differentiation or to the formation of virus-like particles. The study confirmed previous reports on the presence of 2 cell types and indicated that the physaliferous cells evolved from the stellate cells through a process of cisternal dilatation and secretion.
The mammary gland proliferates and differentiates into its functional state under the influence of various hormones secreted during pregnancy and lactation. Lipid, protein, and carbohydrates, which are important constituents of milk, are known to be secreted by this gland. These substances are synthesized and secreted by the mammary gland in varying concentrations during the gestation and lactation periods. The Golgi apparatus is known to play an important role in the secretory activity of the cells. It is the site of the formation of glycoprotein on the rough surface of the endoplasmic reticulum. In a previous study we were able to show the formation of two types of proteins formed in the epithelial cells of the mammary ductules of pregnant rats that were secreted into the lumina before parturition. The Golgi apparatus played no part in the formation of these particles.
Abstract Virgin female Sprague‐Dawley rats were mated, and after the appearance of vaginal plugs were placed in individual cages. The animals were sacrificed at different intervals from the second day of gestation until delivery. Breast tissue was studied with the light and electron microscope. The study suggests that breast tissue undergoes changes as early as four days after fertilization and continues throughout pregnancy. The changes start with accumulation of many ribosomes and polysomes within the epithelial cell cytoplasm. Lipid droplets appear early and increase in number as pregnancy advances. Two types of proteinaceous particles appear within the cytoplasm on the seventh day of gestation, and are totally secreted into the lumina before parturition. The particles are believed to play a role in colustrum composition. The Golgi apparatus plays no role in the formation of the proteinaceous particles. The particles are formed in relation to rough surfaced endoplasmic reticulum. The changes seen are limited to the ductular epithelium and are not seen in the large ducts. In animals treated with colchicine, mitoses are seen in the ductular epithelium very early in pregnancy and continue throughout the gestation period.
