Breast Neoplasms: Lambropoulou M

Limberis V, Romanidis C, Galazios G, Koutsougeras G, Papadopoulos N, Lambropoulou M, Simopoulos C. · Department of Obstetrics & Gynecology, Democritus University of Thrace, Greece. · Eur J Gynaecol Oncol. · Pubmed #19317265 No free full text.

Abstract: BACKGROUND: Frozen section biopsy has been widely used for intraoperative diagnosis and evaluation of sentinel lymph nodes, so a decision can be made regarding whether to perform axillary clearance during primary surgery. This study aims to discuss the reliability of a simpler and faster method - touch imprint cytology - in the interpretation of metastasis from breast cancer. METHODS: A retrospective review of 41 sentinel lymph node biopsies from patients with breast cancer were examined by intraoperative imprint cytology using rapid Diff-Quick staining. Paraffin-embedded permanent sections were examined using hematoxylin and eosin stained sections from the sentinel lymph nodes in collaboration with the employment of an anti-cytokeratin antibody. RESULTS: Sixteen of all sentinel nodes harbored metastases in the paraffin sections, of which all 16 were identified by imprint cytology (sensitivity 93%). CONCLUSION: Touch imprint cytology is a fast and reliable alternative for intraoperative evaluation of sentinel lymph nodes in breast cancer patients.

Tamiolakis D, Tsamis I, Thomaidis V, Lambropoulou M, Alexiadis G, Venizelos I, Jivanakis T, Papadopoulos N. · Department of Cytology, General Hospital of Chania, Crete, Greece. · Chirurgia (Bucur). · Pubmed #17966942 No free full text.

Abstract: Jaw bone disorders causing oral complaints are common in primary care settings. Most of these conditions are of a chronic and benign nature. However they also may be the symptoms of a primary or secondary malignant process in the bone. The most common malignant bone tumor is metastatic carcinoma, and tumors arising in the breast, prostate, thyroid, lung and kidney have a special propensity to spread to bone. Yet metastases to the bones are rare; less than one per cent of all neoplasms metastases to the maxillofacial area. We describe four cases of metastatic tumours to the jaws. Two cases originated from the thyroid gland while the rest were from the oesophagus and the liver respectively. Three lesions occurred in the mandible and one in the maxilla. Patients presented with oral discomforts disregarding the primary tumor. Physicians who frequently advise patients with oral complaints should keep in mind that whereas these symptoms are mostly of a chronic and benign nature, metastases from a malignant tumor must be included in the differential diagnosis.

Tamiolakisl D, Venizelos I, Lambropoulou M, Jivannakis T, Seliniotakis E, Tsikouras P, Limberis V, Tsalkidis A, Papadopoulos N. · Department of Cytology, General Hospital of Chania. · Acta Medica (Hradec Kralove). · Pubmed #15844251 No free full text.

Abstract: AIM: Breast cancer is a frequent cause of death among women with gynaecologic malignancies despite the introduction of combination chemotherapy. There is therefore a need for new therapeutic strategies for patients with breast cancer, such as cellular immunotherapy. In this immunohistochemical study we analyzed the epithelial expression of major histocompatibility complex (MHC) class II (HLA-DR) on atypical and malignant primary mammary epithelial cells, as well as the magnitude of the stromal T lymphocytes (T4 subset) at the tumor site. EXPERIMENTAL DESIGN: The study was carried out retrospectively in tumor tissue from 82 patients with mammary lesions (31 cases of atypical ductal hyperplasia -ADH-, 12 cases of ductal carcinoma in situ -DCIS- and 39 cases of infiltrating ductal carcinoma not otherwise specified -IDC-NOS). Medullary carcinomas were not included in our investigation. Material used had been formalin fixed and paraffin embedded. RESULTS: HLA class II (DR) was expressed in 20 of 31 ADHs (64.5%), in 4 of 12 DCISs (33.3%), and in 10 of 39 IDC-NOSs (25.6%). CD4 was expressed in 9 of 31 ADHs (29%), in 5 of 12 DCISs (42%), and in 26 of 39 IDC-NOSs (67%). CONCLUSIONS: The results showed decreased epithelial expression of HLA class II (DR) and increased stromal expression of CD4, as the lesion progressed to malignancy. Gradual loss of epithelial HLA class II expression might be a manifestation of cellular differentiation from the atypical form versus the malignant one, signaling simultaneously a selective effect on the response capacity of the immune system.

Tamiolakis D, Papadopoulos N, Cheva A, Lambropoulou M, Kotini A, Jivannakis T, Simopoulos C. · Department of Cytology, Regional Hospital of Alexandroupolis, Greece. · Eur J Gynaecol Oncol. · Pubmed #12440829 No free full text.

Abstract: Myoepithelial cells are normally located between the epithelial cells and the basal lamina of secretory elements of exocrine glands. Their role in the histogenesis of breast tumours has been studied extensively, and a definite differentiation towards myoepithelial cells has been demonstrated in adenoid cystic carcinoma, adenomyoepithelioma, low-grade adenosquamous (syringomatous) carcinoma, pure malignant myoepithelioma and poorly differentiated myoepithelial-rich breast carcinoma. All these tumours are of low malignancy, with the exception of malignant myoepithelioma and poorly differentiated myoepithelial-rich carcinoma. We examined the possibility that invasive ductal carcinoma of the breast might show differentiation towards both epithelial and myoepithelial cells because there is no reason to assume that one type of differentiation necessarily excludes the other. We performed the avidin-biotin immunohistochemical analysis of 20 cases of infiltrating ductal carcinomas (IDCs) with diffuse fibrosis, 20 cases of IDCs without fibrosis and five cases of metaplastic carcinomas, to detect myoepithelial differentiation of the tumour cells. Myoepithelial differentiation was determined by the expression of alpha-smooth muscle actin (alpha-SMA). We concluded that IDCs with diffuse fibrosis are associated with a myoepithelial immunophenotype of carcinoma cells.

Tamiolakis D, Simopoulos C, Cheva A, Lambropoulou M, Kotini A, Jivannakis T, Papadopoulos N. · Department of Cytology, Regional Hospital of Alexandroupolis, Democritus University of Thrace, Greece. · Eur J Gynaecol Oncol. · Pubmed #12440819 No free full text.

Abstract: Medullary carcinoma (MC) of the breast is considered to carry a more favorable prognosis than other subtypes of infiltrating ductal carcinoma. This is a biological paradox because its clinical behavior contrasts with its anaplastic morphology. MC is characterized by a dense lymphocytic infiltrate. In this study, we determined the immunological profile of tumor infiltrating lymphocytes (TILs) in MC by CD20 (L26), CD8, and CD45RO (UCHL 1) immunostaining on paraffin-embedded sections. We examined 14 cases of typical MC (TMC), 15 cases of atypical MC (AMC) classified according to Ridolfi criteria (1977) and 19 cases of poorly differentiated infiltrating ductal carcinoma (PDC-NOS). TILs were quantified separately into cells infiltrating tumor nests (intraepithelial) and cells infiltrating tumor stroma (stromal). The number of CD8 positive and CD20 positive cells infiltrating tumor nests and tumor stroma were significantly increased in TMC and AMC as opposed to the PDC-NOS group. There was a loss in the number of CD45RO positive cells, both intraepithelial and stromal, in TMC and AMC as opposed to the PDC-NOS group. We conclude that MC tumor lymphocytic infiltrate demonstrates a mixed-T cytotoxic (CD8+) and B cell (CD20+)-immunophenotypic profile. This might in part explain the improved clinical outcome of the disease.

Papadopoulos N, Kotini A, Cheva A, Jivannakis T, Lambropoulou M, Bobos M, Vavetsis S, Tamiolakis D. · Department of Histology-Embryology, Democritus University of Thrace, Alexandroupolis, Greece. · Eur J Gynaecol Oncol. · Pubmed #12440813 No free full text.

Abstract: Vimentin is an intermediate filament protein normally expressed in mesenchymal cells, but evidence is accumulating in the literature which suggests that the aberrant expression of vimentin in epithelial cancer cells might be related to local invasiveness and metastatic potential. Previous studies strongly support the implication of vimentin in the metastatic progression of breast and cervical lesions. The secretory component is isolated from human colostrum and is of help in more precise grading of endometrial carcinoma. In this study we examined vimentin and secretory component (SC) expression in adenomatous hyperplasia, atypical adenomatous hyperplasia and well-differentiated adenocarcinoma (cribriform pattern). The results showed decreased expression of vimentin and increased expression of the secretory component as the lesion progressed to malignancy.

Papadopoulos N, Tamiolakis D, Lambropoulou M, Alexiadis G, Manavis J, Anastasiadis P, Sivridis E. · Department of Pathology, Democritus University of Thrace, Dragana-Alexandroupolis, Greece. · Eur J Gynaecol Oncol. · Pubmed #11446482 No free full text.

Abstract: Mammary non-Hodgkin's lymphomas are uncommon and account for 2% of all extranodal lymphomas. Stringent diagnostic criteria are applied in the diagnosis of primary lymphoma considering that the breast is a recognized site for disseminated extranodal lymphoma. Our case report was established by histology alone.

Papadopoulos N, Tamiolakis D, Lambropoulou M, Alexiadis G, Deftereos S, Manavis J, Polychronidis A, Sivridis E. · Department of Pathology, Democritus University of Thrace, Alexandroupolis, Greece. · Eur J Gynaecol Oncol. · Pubmed #11446477 No free full text.

Abstract: A case of mucinous carcinoma of the breast is reported in a female aged 71 years. On gross examination of the left mastectomy specimen two relatively well-circumscribed masses with a gelatinous cut surface were found. Touch imprint cytology was consistent with a low-grade malignancy and histologic and histochemical examination revealed a mucinous carcinoma. Careful prospective correlation between the cytological appearances of cells in imprints and the subsequent histopathology may lead to a more precise cytodiagnosis of a tumor associated with a comparative good prognosis.

Tamiolakis D, Papadopoulos N, Venizelos J, Lambropoulou M, Romanidis C, Petrakis G, Limberis V, Galazios G, Koutsougeras G, Simopoulos C. · Department of Cytology, Regional Hospital of Chania, Greece. · Onkologie. · Pubmed #16974114 No free full text.

Abstract: BACKGROUND: Imprint cytology may provide a fast and accurate method for intraoperative screening of sentinel lymph nodes, so a decision can be made regarding whether to perform axillary clearance during primary surgery. If the findings are negative, in many cases axillary dissection can be omitted. Patients and METHODS: 128 sentinel nodes from a cohort of 87 patients that had been identified using technetium-99m nanocolloid as a radioactive tracer and Patent blue dye were dissected for rapid Diff-Quick stained touch preparations. Intraoperative evaluation of sentinel node status by imprint cytology was correlated with histopathological results of permanent sections. Tumor-negative nodes in routine paraffin sections were further investigated with the employment of an anti-cytokeratin antibody. RESULTS: 36 of all sentinel nodes harbored metastases in the paraffin sections, of which 32 were identified by imprint cytology (sensitivity 88.8%). 3 sentinel nodes were positive by imprint cytology and negative by histopathology of the paraffin sections. Comparison of the results of the touch preparations with the final histopathology (hematoxylin-eosin and anticytokeratin antibody stains) demonstrated a sensitivity of 83.3% and a negative predictive value of 92.5%. The specificity and positive predictive value were 100% each. CONCLUSIONS: Touch imprint cytology is potentially useful for intraoperative evaluation of sentinel lymph nodes in breast cancer patients.