Cell morphology in field effects and in sites distant from malignant tumors
Department of Pathology, University of Massachusetts Medical School, Worcester, MA, United States
AIMS: Identification and predictive evaluation of abnormal nuclear structures in cells of normal appearing tissues adjacent to and distant from malignant tumors. METHOD: Using the highest magnification of the light microscope, cells were examined in routine exploratory and surgical specimens and in experimental designs for in-depth studies of malignancy-associated nuclear changes (MAC). RESULTS: In well-differentiated cells, a distinct nuclear hyperchromatic cribriform structure comparable to pulmonary small cell carcinoma was consistently observed in normal-appearing tissues adjacent to and distant from malignant neoplasms. These changes were first seen in cells of the buccal mucosa, in aspirated ciliated bronchial cells and in those of sputum. MAC in squamous cells of the esophagus were associated with gastric carcinoma. In liver biopsies from patients with malignant neoplasms but without liver metastasis, MAC were noted in 74% of the cases. In blood smears, MAC were evident in polymorphonuclear leukocytes and in peripheral blood lymphocytes. Cultured lymphocytes had abnormal changes in 37% of individuals with a strong family history of cancer. MAC were also present in bone marrow-derived megakaryocytes. Nuclear MAC in buccal cells could be observed 2.5 to 9 years prior to the diagnosis of cancer. CONCLUSION: Presence of MAC in false-negative specimens may advance the diagnosis of a suspected tumor. Identification of MAC may also serve as a predictive indicator of oncogenesis.
Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Nice, France; February 7 - 10, 2004; in poster session 797 (Manifestations of cancer).