Abstracts/Lung Cancer I2 (1995) 265-329

small-cell lung carcinoma (SCLC). Previous studies have investigated immunohistochemical staining of SCLC with small numbers of antibodies, but few have examined large series with s brusd pel of antibodies. For this reason, the authors examined the distribution and intensity of staining of 20 open-lung biopsy (OLB) and 21 hansbronchial biopsy (TBB) specimens of SCLC with II panel of epithclial, ncurocndocrinc, and hormonal markers. Small-cell lung carcinoma stained most frequently with epithclial markers, followed by neumendocrinc and hormonal markers. Similar percentages of OLB and TBB specimens stained for kerrdin (100% each) and epithelial membrane antigen (100% and 95%. respectively). Unexpectedly, BER-EP4 stained 100% of OLB specimens. Chmmogranin A wss the most frequent ncuroendocrinc marker in OLB and TBB spccimcns (60% and 47%, respectively) followed by neumn- specific enolsse (60% and 33%). Leu-7 (40% and 24%), and synaptophysin (5% and 19%). No ncumendcwine immunohistachemicsl reactivity wss found in 24% of TBB spccimcns and 20% of OLB specimens. Bombesin wss the most sensitive hormonal marker (45% of OLB specimens). These results show that keratin, cpithclisl membrane antigen, and BER-EP4 sre reliable cpithclial markers for SCLC in both TBB and OLB specimens. In addition, negative staining for ncuroendocrinc markers, because it can occur in ss many as 25% of c8scs, should not deter the diagnosis of SCLC.

Cytochemical studies to determine the histogeaesis in auaplastic or poorly differentiated pulmonary tumours Pisiricilar R, Yerci 0, Topslidis T, Atsy 2. Zyfologisches Inrtiluf, Hannowr Pneumologic 1994,48:7 18-20.

Proper hi&genetic classification of pulmonsry turnours is most important in choosing the best possible trcntmcnt. Since this is very difficult especially in case of anaplastic or poorly differentiated turnours, additional pointers on histogcnesis, supplied by complementray histochemicsl examinations, are vary helpful. IO5 bronchial carcinomas wara cxsmined cytcchcmically by means of air-dried smear pmpsrstions (imprint, brush sn puncture smears). Cytochemical examinations wcrc performed in respect of alkaline phosphatasc, acid phosphatsse, PAS reaction and unspecific esterase. It wss found that the dedifferentistcd squamous cell carcinomas were alkaline phosphstasc-negative and weakly positive to acid phosphatase and unspecific csterasc, whereas dcdifferentiated sdenocsrcinomas were strongly positive to acid phosphatasc and unspecific csterasc. The PAS resction wss always slightly to moderately positive. Small-cell bronchial carcinomas were negative in all cytochemical examinations.

Clinical assessment

Bmachogeaic curiaoma presenting as a pseudopqaacy Manzi D, Greenberg B, Maier D, Forouhar F, Malchoff CD. Deparfmenf a/ Obs:errics/cvneccdo~, Surgical Research Cente: Univ of Connecticn~ Heal/h Cento: Farmington. C7Y Chest 1995:107:567-9.

A young woman with an occult bronchogenic carcinoma presented with secondary amenorrhea and sn elevated beta subunit of human chorionic gonsdotmpin that wss mistakenly attributed to pregnancy. Physicians should be swore that this carcinoma may present solely with sn elevated bets human chorionio gonadotropin value, and the potential exists for confusion with pregnancy &te in women of childbearing age.

lbc~polypeptideanti~sctumtestin theprwperati~evaiuatioa

of non-small cell lung cancer: Diagnostic yield aad comparison with coomaioaal stagingmetbods Buccheri G, Fenigno D. En Repubblica IO/C, I-12018 Roccavione 0’). Chest 1995:107:471-6.

Tissue pdypeptidc antigen (TPA) is s protein produced and released by prolifersting cells that hss been shown to possess several characteristics for an ideal tumor marker. Our purpose wss to determine the yield of TPA in the pretrurtment assessment of non-small ccl1 lung cancer (NSCLC), in comparison with s bsselinc clinical evaluation and multiorgan computed tomography (CT)

assumed to be the gold standard for pnsurgicsl staging. One hundred four patients with NSCLC undewent thorswtorny, medisstinoscopy, or biopsy of suspected metsstatic deposits, in addition to an extensive noninvasive evaluation of their stage of disease. We restsgal retrospectively (UICC 1987 clsssiticstion) these patients, on the basis of the following: (I) clinical history and physical examination, routine laboratory tests, bmnchoscopy. chest radiographs, and any other exsm~nnation ss indicated by the prior baseline evaluation (BE stage); (2) the wrwn level of TPA (TPA stsgek (3) the reading of a CT scan of brain, thorax, and abdomen obtained with no limitation to clinic-al information (CT stage); snd (4) pathologic findings (RE stage). The TPA stage wss calculated using 20 threshold values ranging from 45 UR. to 450 U/L. On the basis of the RE stage, sensitivity, speciticity, accuracy, and predictive capabilities of BE, CT, and TPA were dctcrmined for stage I and II (full operability, FO), stsge IlIs (possible operability, W), and stage W and IV (full inoperability, FI). The TPA thresholds were I IO U/L for detecting FO with the highest rate of success, and 160 U/L for detecting R. Using these thresholds BE, CT, and TPA showd s diagnostic accuracy of, respectively, 75%. 79%, and 68% for FO; 87%. 69%, and 77% for PO, 87%, 77%, and 76% for R. The sccurscy of BE, CT, and TPA for bath FO and R wss, respectively, 85%, 69%. and 69%. Of 74 patients classified operable by BE, 6 had s serum concentrstion of TPA less than 50 Un and all 6 were confirmed in stage I or II at the subsequent thorscotomy, 15 others, out of 26 patients judged to have inoperable conditions by BE, had s TPA test nxdt above I35 U/L and all I5 were pathologically clsssitied in stsge W or IV Using appropriate threshold values of TPA, it should be possible to predict NSCLC resectability with s diagnostic accuracy similar to that routinely achieved by CT.

The rokof iatraoperativeukrasmmd ia lung cancer patients Herman K, Kolcdziejski L. K/i&a Chirwgii Onkalogrcsne$ Centin Onkologii, Krakow. Acts Endosc Pal 1994;4:1914.

Intraoperativc ultrasound (I.O.U.) examination results in 83 lung csncer patients were analyzed. I.I.U. wss performed to evaluate direct invasion of tumor, lymph node metastasis and to exsmine liver through the diaphragm. Local invasion or lymph node enlargement were found in 8 cases (10%) and liver lesions in 24 (29%) from which I5 cases were punctured and cytologically examined. Tmnsdiaphrsgmstic liver scenes shown in 15 patients (18%) were compared to the preoperative ultrssuunds. In 13 patients such new information gathered from I.O.U. changed the surgical approach. Average time ofexamination was 1 I minutes. lntraoperative ultrasound in the lung cancer patients is an important method to determine local invasion of the tumor and liver lesions. I.O.U. is wry helpful in selecting the type of surgical sppmach.

in autopsy cast of hmg cancer metastasizingto renal cell cancer lad

reaaldhttsadcnuma Takiguchi Y, Kasamalsu N. Hsshiiume I, Hsnzaws S, Sssski K, Babs M et al. Deparbnenr of Chest Medicine, Hamamatsw Medical Center 328, Tomiwka- cho. Hamamati. Jpn J Thorsc Dis 1994;32: 1204-S.

A 67-year-old woman with bloody stool wss admitted to our hospital. Chest radiograph on admission showed s hrmor shadow in the right lower lung field. Lung sdenocarcinoma of right S’ and villousadenoma ofthc rcchtm were detected. Although she wss treated with chemotherapy and radiotherapy, she died of respiratory failure. At autopsy, madnatcly differentiated sdenocsminoms of the right lung,rensl cell carcinome,and villous &noms ofthe rectum were confirmed Lung sdenocarcinomss ware detected in the focus of the renal cell carcinoma and in the villous sdenome. Metsstssis of s cancer into another coexisting tumor in the ssme individual is extremely rsrc, and II satisfactory explanation for this phenomenon has not yet bxn offered.

nPrtmentofbrainmetastaswfromprimarybngcaocer Ryan GF, Ball DL. Smith JG. Peler MacCallum Cancer Institute. 481 Little Lonsdale St.. Melbourne, @c. 3000. Int J Rsdiat Oncol Biol Phys 1995;3 l:273- 8.

Purpose: A retrospective study of psticnts treated st the Peter MacCallum Cancer Institute for brain metsstases from primary carcinoma of the lung is presented. Met/tads andhfatetialr: The medical records of 416 pstients with the disgnosis of primary carcinoma of the lung who presented with, or subsequently developed, brain mct.sstsses during the period January 19&1 to December 1987 were reviewed. Information on II number of factors of potential prognostic