No abstract

No abstract

Three cases of adenocarcinoma of the lung manifesting as acute pericardial effusion with tamponade are presented and the medical literature concerning this unusual manifestation of extracardiac malignancy is reviewed. We have found 22 cases of carcinoma and 4 cases of sarcoma. Of the carcinomas, 14 of 19 (74%) with known primary are pulmonary and 13 of 18 (72%) with tissue diagnosis are adenocarcinomas. Daignosis was made by cytologic examination of pericardial fluid in 14 of 16 cases (87%) in which it was performed. The lymphatic drainage of the heart renders some anatomical explanations for the prevalence of carcinoma of the lung as the cause of cardiac tamponade and the discrepancy of finding tumor cells in the pericardial fluid but not in the pericardium. Patients treated with pericardiectomy with or without ancillary radio- or chemotherapy survived longer than those treated with periocardiocentesis or radio- or chemotherapy alone.

Inflammatory cells are believed to play an important role in the pathogenesis of emphysema; however, a relationship between presence of cells in the lung parenchyma and its destruction has never been shown. The aim of this study was to quantitate alveolar septal cellularity in smokers' lungs and to investigate its relationship with parenchymal destruction and lung function. The lungs of 23 smokers (SS) undergoing thoracotomy for localized pulmonary lesions were compared with those of eight nonsmokers (NS) and five smokers (AS) who died suddenly of nonrespiratory causes. Pulmonary function tests were performed within 1 wk of surgery in SS. For each subject, we quantitated alveolar wall cells (CELLS), an index of alveolar wall destruction (DI), and the mean linear intercept (Lm). As no significant differences were found between S and AS with regard to these indices, we combined them (Group S) for comparison with NS. Although Lm was not significantly different between S and NS, (0.331 +/- 0.072 versus 0.288 +/- 0.038), CELLS and DI were higher in S than in NS (48 +/- 8 versus 25 +/- 2 cells/mm, p less than 0.001; 47 +/- 20 versus 17 +/- 5, p less than 0.001, respectively). Further, CELLS and DI were significantly correlated (r = 0.799, p less than 0.001). The number of polymorphonuclear cells (PMN) in S can exceed that in NS by as much as 5-fold; however, PMN were inversely correlated with parenchymal destruction (DI) (r = 0.598, p less than 0.01). Thus, smokers' lungs have alveolar septal hypercellularity, possibly inflammatory, and closely related to destruction involving cells other than the PMN.

No abstract

No abstract

No abstract

This study is to examine the potential usefulness of immunohistochemical staining for carcinoembryonic antigen (CEA)-like material in the differential diagnosis of mesotheliomas (12 cases) from other lung cancers (14 cases) that had been previously diagnosed by transmission and scanning electron microscopy and conventional light microscopy. Indirect immunofluorescent staining for CEA was carried out on formalin-fixed parafthembedded sections, and the slides were examined under code. All 9 cases of diffuse mesothelioma were negative, and all 12 cases of adenocarcinoma and bronchioloalveolar carcinoma were positive for CEA-like material. Three localized mesotheliomas and a carcinoid tumor were also negative. A squamous cell carcinoma was positive. A positive immunohistochemical result for CEA-like material in lung cancers will raise the possibility of its being of bronchial epithelial origin.Cancer 44:937-943, 1979.ARCINOEMBRYONIC ANTIGEN (CEA) was C originally isolated from colon cancer in 1965 by Gold and Freedman7,' and was subsequently identified in a variety of malignant and nonmalignant conditions, including those of the lung,14 by immunologic methods. Since complete identity of oncofetal antigen of the lung cancers with that of the digestive tract cancers has not been established, we will refer to the antigen found in the respiratory tract cancers by immunohistochemical method as the CEA-like material. Ontogenetically, mesothelium and endoderm are different, the latter being the precursor of gut and respiratory epithelium. The mesothelium lines the outer and the endoderm lines the inner surface of the wall of the primitive yolk sac as early as 15-18 days after ovulation in human, and the two types of cell already show different ultrastructural morphology at this stage of development." The elongated and bushy microvilli in the primitive mesothelium persist in adult as well as in neoplastic mesothelial cells, and their presence is considered to be a useful ultrastructural marker in differentiating the mesothelioma from a d e n o c a r~i n o m a .~J~J~*~~ Because of the difference in ontogeny, it is thought that the mesothelial tumor may also differ from the tumors of endodermal origin with respect to the ontofetal antigenic expression. Since CEA can be demonstrated by immunohistochemical method in tissues that have been previously fixed in f~r m a l i n ,~, '~ a study was carried out to determine if the staining for CEA-like material may provide useful distinguishing features that may be applied prospectively in the differential diagnosis of mesothelial tumors from other pulmonary tumors. The present study compares the results of immunohistochemical staining and electron microscopic study of mesotheliomas and lung cancers. MATERIALS A N D METHODSTwelve cases of mesotheliomas and 14 cases of various lung cancers were collected from the file of the Department of Pathology at McGill University. Of the 26 cases, 17 were studied by light and electron microscopy (EM) ( Table 1). For light microscopy, 7 p thick se...