Renal oncocytomas: clinical, radiological and histological features

Proximal renal tubular adenomas with oncocytic features, also known as renal oncocytomas, are rare, probably benign, tumors of the kidney. They are easily misdiagnosed as carcinomas. However, radiological, histological and ultrastructural characteristics allow their differentiation from adenomas and adenocarcinomas. We report 4 cases of renal oncocytomas and review the literature.

Immunization by irradiated whole cells or cell extracts against an experimental bladder tumor

A tissue culture cell line has been developed from the MBT-2, a carcinogen induced bladder tumor of C3H/HeN mice. The culture-adapted cells retained the capacity to induce progressive tumors in syngeneic mice. Amputation-challenge experiments with live cells showed that MBT-2 induces transplantation immunity. Immunization with irradiated MBT-2 cells or hypotonic membrane preparations from this tumor protected the animals against challenge with viable MBT-2 cells. Intraperitoneal administration of bacille Calmette Guérin failed to protect against tumor development and may have adversely affected the immunoprotection yielded by tumor extracts.

The occurrence of nail pitting in Reiter's syndrome

Some authors have stated that nail pitting never occurs in Reiter's syndrome. The case of a patient with incomplete Reiter's syndrome with nail pitting and HLA-A2, 28; B18, 27 is presented. Patients who have both psoriasis and Reiter's syndrome have demonstrated increased frequency of HLA-A2 and B27 and markedly decreased frequency of HLA loci associated with psoriasis. The particular finding of nail pitting is presented to illustrate that this change may occur in Reiter's syndrome and may reflect a predisposition to the development of psoriasis or psoriasiform lesions conferred by HLA-A2 with B27, as suggested by previously reported HLA typing studies.

Pilomatricoma: treatment by incision and curettement

The usual method of treatment of pilomatricoma (calcifying epitheliona of Malherbe) is excision. We present a review of eight patients with ten tumors treated by incision and curettement. Follow-up ranged from 1 to 10 years, and there have been no recurrences. An alternative method of therapy with excellent results is presented.

In vitro augmentation of cytotoxicity against tumor cell lines by mumps virus

Cultures of leukocytes from normal subjects and bladder and kidney cancer patients contain cells cytotoxic against various tissue culture human cell lines. Postculture cytotoxicity was increased, in some experiments, after cocultivation with an inactivated strain of mumps virus. Effector cells seem to have an Fc receptor inasmuch as the activity was removed by absorption on immoblized antigen-antibody complexes.

Ectopic human chorionic gonadotropin in breast carcinoma

Immunoreactive human chorionic gonadotropin (hCG) was found in 9 of 65 surgically removed malignant breast tumors. Concentrations ranged from 5 to greater than 500 mIU hCG/g tumor. hCG was measured by a beta-chain specific readiommunoassay. In further study of these specimens, an immunoperoxidase staining technique was used to stain for hCG in formalin-fixed sections. The hCG was shown to be localized within the cytoplasm and on the surface of the malignant cells.

Inhalant, marijuana, and alcohol abuse among barrio children and adolescents

Prevalence of inhalant, marijuana, and alcohol abuse was studied in a sample of 457 male and female Mexican-American children and adolescents between the ages of 9 and 17 years. Subjects interviewed resided in four housing projects located in East Los Angeles. All interviews were conducted by adolescents who resided in the same housing projects. Results indicated that compared to a national sample, Mexican-American adolescents were at least 14 times more likely to be currently abusing inhalants. The prevalence rate of marijuana was double the national rate, but the prevalence of alcohol was equal to that found nationally. Reasons for elevated substance abuse rates are explored.

An objective look at acid phosphatase determinations: a comparison of biochemical and immunological methods

Measurements of serum and bone marrow acid phosphatase were made by 3 enzymatic methods, alpha-naphthyl phosphate, beta-glycerol phosphate, and thymolphthalein monophosphate, and ocmpared to a double antibody radioimmunoassay. Serum and bone marrow acid phosphatase levels were studied in 46 controls with histologically proven benign prostatic hyperplasia and in 135 patients with various stages of prostatic carcinoma. In the control group the upper limit for bone marrow acid phosphatase was found to be significantly higher than the corresponding serum limit with respect to the enzymatic assays studied. The radioimmunoassay was the only method suitable for the analysis of the prostatic acid phosphatase content of bone marrow. A larger number of elevations were noted in patients with extracapsular and metastatic disease when prostatic acid phosphatase measurement was carried out by radioimmunoassay as compared to enzymatic methods. However, only 8% of the patients with intracapsular disease had elevations of prostatic acid phosphatase as measured by radioimmunoassay. Additional standardisation of immunological methods and clinical trials is required before comparison can be made of results from various centres using immunological methods for the measurement of prostatic acid phosphatase and a true assessment made of the usefulness of this procedure.

Assessment of cavernous hemangioma of bladder by technetium-99-tagged albumin scan

A case of cavernous hemangioma of the bladder is presented and its endoscopic appearance is illustrated. A scan utilizing technetium-99-labeled albumin has been found valuable in determining the extent of the lesion.

Adjuvant immunotherapy in superficial bladder cancer

The use of BCG as an intracavitary form of immunotherapy in human bladder cancers is discussed. The result of a clinical trial in which BCG is administered in the treatment of human bladder cancers is reported. Possible uses of this tumor model in the study of immunotherapy employing BCG are suggested.

Carcinoma of the prostate: a critical look at staging

To stage accurately the extent of the disease comprehensive investigations were done on 75 patients with histologically documented carcinoma of the prostate. Estimation of bone marrow acid phosphatase appears to be the most sensitive test to detect blood-borne metastases. Serum acid phosphatase appears to be of little value in the detection of early blood spread and may have a role only in monitoring the effect of treatment on advanced disease. Bone scanning with technetium compounds has the disadvantage of non-specificity but has far greater sensitivity than a skeletal survey. Bone marrow cytology was not rewarding in the detection of early metastatic disease. Pedal lymphangiography is a highly inaccurate method to detect lymphatic spread of carcinoma of the prostate and pelvic lymphadenectomy, when indicated, remains the only truly adequate method to assess lymph node involvement. There was a 37 per cent incidence of metastatic lymph node pathology in 30 patients undergoing this procedure before either radical prostatectomy or deep x-ray therapy. A close correlation was found between stage and grade of disease and incidence of nodal pathology. There was some correlation between degree of nodal involvement and evidence of blood spread as detected by elevated bone marrow acid phosphatase levels. The significance of this finding remains unclear.

Blunt trauma to renal artery

A case of intimal laceration of the renal artery by blunt trauma is presented. Although complete and prolonged functional loss was documented, total recovery was eventually observed. Postulates regarding pathogenesis are provided. The usefulness of arteriography for therapeutic and prognostic reasons is emphasized.

Intracavitary Bacillus Calmette-Guerin in the treatment of superficial bladder tumors

Patients with recurrent superficial bladder tumors have been treated by vesical and intradermal administration of Bacillus Calmette-Guerin. The pattern of recurrence in 9 patients has been altered favorably. Although the findings are still preliminary they appear to hold promise of a new therapeutic approach to the treatment of a group of neoplasms for which effective therapy is still lacking.

Immune reactivity in renal cancer: a sequential study

We evaluated 18 patients with adenocarcinoma of the kidney immunologically in a linear fashion. Delayed cutaneous hypersensitivity was significantly altered in patients with metastatic disease. In vitro studies have shown a progressive decline in the absolute number of circulating lymphocytes and the T cell subpopulations that parallels the advance of the maligant process. Evaluation of lymphocyte function by the response to mitogens appears to be of little significance in a sequential study.

Bacillus Calmette-Guerin in the treatment of adenocarcinoma of the kidney

Of 18 patients with renal adenocarcinoma 10 with metastatic disease received Bacillus Calmette-Guerin immunotherapy. Objective responses were recorded in 4 patients. When the intradermal route and relatively small amounts of vaccine were used the complications were minimal and self-limiting. Bacillus Calmette-Guerin immunotherapy appears to be more effective than other modalities in the treatment of renal adenocarcinoma. However, definitive conclusions cannot be drawn since there is no control group. A prospective clinical trial is now in progress at this institution.

The choice of estrogen preparations in the treatment of prostatic cancer

A total of 154 patients with carcinoma of the prostate received estrogen therapy with diethylstillbestrol (DES), chlorotrianisene or ethinyl estradiol. During a mean follow-up period of 26 months the incidence of complications -- thromboembolic episodes, fluid retention and gynecomastia -- was recorded. Although the incidence of cardiovascular complications was significantly higher in the DES group, the differences in mortality between the groups were not significant. The differences in incidence of fluid retention and gynecomastia also lacked significance. All three compounds produced adrenal cortical hyperplasia as indicated by the increased serum cortisol values.

Response of renal adenocarcinoma to cyclophosphamide

A group of patients with metastatic renal adenocarcinoma was treated with cyclophosphamide. No antitumor effect was noted and, probably, enhancement of neoplastic growth was produced in some cases. Compared with other available therapies, a shorter survival rate was noted.

Hormones in the treatment of metastatic renal cancer

Metastatic renal adenocarcinoma has been highly resistant to most therapeutic approaches. However, hormonal treatment has been reported to induce significant subjective or objective improvement. Two groups of patients receiving either androgens or progestogens were evaluated. The number of responses was disappointing. Furthermore, neither of the 2 regimens appeared to increase the mean surival between detection of metastases and fatal outcome.

The value of mechanical cell harvesting in diagnosis and prognosis of bladder tumor recurrence

Specimens obtained after scraping the bladder mucosa were found to be of excellent quality because of the large cell harvest and the minimal inflammatory exudate. In addition, tumor recurrence could be predicted in a significant number of cases with this technique.

Allergy and cancer

An unusual long-term survival of a patient with metastatic renal cancer is reported. Asthma developed after lung lesions were detected. After development of his allergy, new lesions have failed to appear and growth of old ones has slowed. The possibility that allergy can be a factor in the control of neoplasia is discussed.

Oestrogen therapy and serum cortisol in carcinoma of the prostate

Patients with prostatic cancer, receiving oestrogen therapy were found to have elevated serum cortisol levels and lymphopenia. Oestrogens are known to have a profound effect on the immune system; the possibility that this effect is mediated through the adrenal cortex is discussed. The significance of these findings, however, remains to be determined.

Haemangioma of the bladder

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