Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.2.1.36 (hyaluronidase)
 4,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adenocarcinomas of or in lung that clinically and pathologically mimic diffuse pleural mesotheliomas are rare. We reviewed selected clinical and pathologic features of 15 autopsy/surgical cases previously reported in the medical literature and of 15 additional cases from the files of the Armed Forces Institute of Pathology (AFIP). Ninety percent of the patients were men. The median age was 61 years. Sixty-three percent of the patients smoked, 17% of them had possible or definite occupational exposure to asbestos, and one patient had microscopically proven asbestosis. Most patients had chest pain, shortness of breath, or cough, and had unilateral pleural effusion in the chest x-ray. At thoracotomy or at autopsy, numerous nodules, plaques, or a continuous rind of tumor was present over the pleural surface. Microscopically, the tumors showed simplified glands, nests, cords, papillary, tubulopapillary or biphasic patterns of growth. The neoplasms contained mucin that stained with diastase-predigested periodic acid-Schiff (PAS), mucicarmine, and alcian blue (with or without hyaluronidase predigestion). All patients died with/of tumor, with a mean survival of 4.7 months for those reported in the medical literature and of 7 months for those in the AFIP files. These adenocarcinomas therefore mimic pleural mesothelioma not only in their clinical and gross and microscopic appearance, but also in their prognosis.
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PMID:Pseudomesotheliomatous adenocarcinoma: a reappraisal. 160 54

A 71-year-old asbestos-exposed male with symptoms suggestive of asbestosis for the previous 8 years presented with abdominal distension and ascites. Clinically, a diagnosis of mesothelioma carcinoma was made. Light microscopy of an omental biopsy failed to advance the diagnosis: The tumor was a solid, papillary, and glandular neoplasm lacking mucin and hyaluronidase-sensitive Alcian blue staining material. Immunohistochemistry gave positive results for Ber-EP4, LeuM1, and CEA, markers, favoring carcinoma. Electron microscopy revealed processes in channels and lumina, which were long, slender, and uncoated with a length: diameter ratio of 19.7. A few possessed small rootlets. A glycocalyx and glycocalyceal bodies were not seen. Other features included tonofibrils, a basal lamina, and desmosomes. The patient died 3 months following the onset of abdominal symptoms. Autopsy findings included solid and papillary tumor throughout the peritoneum, but no intrinsic tumor of the gastrointestinal tract or elsewhere. Arriving at a final diagnosis was complicated by immunohistochemistry, which favored carcinoma, and ultrastructure, which suggested mesothelioma. Taking into account all lines of evidence, it was concluded that the tumor was probably a mesothelioma but one with some features developed to an extent more typical of carcinoma.
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PMID:Malignant epithelial mesothelioma of the peritoneum: observations on a problem case. 883 40

In the 1960s, a close relationship between heavy exposures to crocidolite asbestos and mesothelioma was established. The debate on the diagnosis of mesothelioma became complicated because of the possibility of litigation. Well differentiated mesothelioma cells are mucicarmine negative but alcian blue and periodic acid-Schiff (PAS) positive, which are removed by hyaluronidase and diastase digestion. By electron microscopy (EM), they show bush-like elongated, slender, and branching microvilli. By immunohistochemistry they express both keratin and vimentin but not carcinoembryonic antigenicity (CEA), B72.3, Ber-EP4, and Leu-M1. In poorly differentiated mesotheliomas, chromosomal and molecular biological alterations are common and complex but these alterations also overlap with that of poorly differentiated tumours of the lung and other organs. A poorly differentiated pleural tumour is most likely metastatic and needs good team work to locate the primary site. The diagnosis of a mesothelioma and asbestosis should be established separately. Future studies will be focused less on the phenotypic differences but more on the broad molecular and multi-phasic mechanisms of carcinogenesis, irrespective of the aetiological agents, in poorly differentiated tumours.
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PMID:Pleural mesothelioma: an approach to diagnostic problems. 944 Nov 14