Undifferentiated carcinoma

Chen F, Yan J, Lai W, et al. Epstein-Barr virus-associated nonsmall cell lung carcinoma Undifferentiated lymphoepithelio-ma-like carcinomas as a distinct entity with better prognosis. Cancer. 1998 82 2334-2342. 

As is the case with undifferentiated carcinomas, undifferentiated sarcomas are an extraordinarily heterogeneous collection of different tumors. The undifferentiated endometrial sarcoma (of which many examples were considered high-grade endometrial stromal sarcoma) is the best known member of this group. Despite this, the criteria for diagnosing this tumor and its immunophenotype are not well understood. Some examples might represent de-differentiation from a low-grade endometrial stromal sarcoma.Immunohlstochemistry has been studied in a small series of such cases. CDIO and PR expression were noted to be lost when compared to the differentiated components in most cases. 

L., Bavetsias, V., et al. (2005). Aurora B overexpression associates with the thyroid carcinoma undifferentiated phenotype and is required for thyroid carcinoma cell proliferation. The Journal of Clinical Endocrinology and Metabolism, 90, 928-935. 

Thyroid oaroinoma Papillary oaroinoma Follioular oaroinoma Poorly differentiated carcinoma Undifferentiated (anaplastic) carcinoma Squamous cell carcinoma Mucoepidermoid carcinoma... 

Other adenocarcinomas Mucinous carcinoma Serous carcinoma Clear-cell carcinoma Mixed carcinoma Squamous-cell carcinoma Transitional-cell carcinoma Small-cell carcinoma Undifferentiated carcinoma... 

Figure 3.3 Comparison of array CGH among DNA extracted from fresh tissue, FFPE tissue by heating protocol or nonheating protocol for two human tissue samples of metastatic carcinoma in lymph node (a-c), and undifferentiated non-small cell carcinoma (d-f). Array CGH hybridization genomic profiles show ratio values representing relative copy number of single BACs. A good result is scored as 1.0 that indicates a low standard deviation for gains (>0.2), normal (0.0), or losses (<-0.2). In these two cases, fresh samples show best score as 2, both FFPE tissue samples show identical score of 3. Each spot represents the average of three replicates. Clones are ordered by chromosomal position as numbers at the bottom (x axis) of each picture. The y axis is the log2 ratio of test reference intensity. Provided by Sandy DeVries from Dr. Frederic Waldman s Lab at UCSF.

The other well-known member of this superfamily is CEA or carcinoem-bryonic antigen. CEA is a widely used tumor marker, especially for monitoring patients with diagnosed colorectal cancer (M5). It is a high-molecular-weight (Afr 200,000, approximately) glycoprotein containing about 60% carbohydrate. In normal colonic cells and in well-differentiated colon carcinomas, the distribution of CEA is apical. However, in undifferentiated colonic tumors, CEA is present on all of the cell membrane (J3). Whether this altered subcellular localization of CEA mediates cancer spread is presently unclear. 

Advances in cell culture techniques have allowed the use of trophoblast cell cultures to evaluate the various transporter and metabolic systems of the placenta. Many studies have used primary cultures of undifferentiated cytotro-phoblasts isolated from placentas, whereas others have used trophoblast cell lines as a model. Trophoblast cell lines can be generated from normal tissues or malignant tissues and also from embryonal carcinomas exhibiting trophoblast differentiation [48],... 

A retrospective study of 136 BCME workers employed at least 5 years revealed 5 cases of lung cancer, which represented a ninefold increase in lung cancer risks 0.54 cases would have been expected to occur in the plant population. The predominant histologic type of carcinoma was small cell undifferentiated. Exposure ranged from 7.5 to 14 years, and the mean induction period was 15 years. In addition, abnormal sputum cytology was observed in 34% of 115 current workers with exposure to BCME for 5 or more years, as contrasted with 11 % in a control group. 

Patients with other types of unresectable cancer also may benefit from chemotherapy, as evidenced by prolongation of life, shrinkage of tumor, and improvement in symptoms. Notable among these are ovarian epithelial and breast carcinomas, oat cell (small cell undifferentiated) carcinoma of the lung, and acute myelocytic leukemia. Cancers that are for the most part resistant to today s agents include melanoma, colorectal and renal carcinomas, and non-oat cell cancers of the lung. 

NTl79 Hirota, N. Intranuclear rodlets in undifferentiated carcinomas of salivary glands in strain A mice in a study involving a tobacco specific nitrosamine, N-nitrosonornicotine. Cancer Lett 1979 6(6) 365-369. 

Cadherins. Cadherins are a group of glycoproteins that facilitate Ca2+-dependent cell-cell adhesive interactions.20 When cadherin function is disrupted, the release of a tumor cell can result. It was shown that the aggressive metastasis of undifferentiated epithelial carcinoma cells that had lost cell-cell adhesion could be stopped by transfection with E-cad-herin cDNA.21 Therefore, it was suggested that E-cadherin suppresses metastasis,22 which was further supported by more recent studies that showed the loss of adhesion of human gastric, prostatic, and lung cancer cells was due to the gene mutation of a protein associated with the proper function of cadherin.23... 

Shimoyama, Y., and Hirohashi, S. Cadherin intercellular adhesion molecule in hepatocellular carcinoma Loss of E-cadherin expression in an undifferentiated carcinoma. Cancer Lett. 57 131—135, 1991. 

The most common type of primary liver tumor is hepatocellular carcinoma other types include cholangiocarcinoma, angiosarcoma, glandular carcinoma, and undifferentiated liver cell carcinoma. Although a wide variety of chemicals are known to induce liver cancer in laboratory animals (Table 14.1), the incidence of primary liver cancer in humans in the United States is very low. 

There is a potentially dangerous interaction with cancer treatment in patients with schizophrenia taking clozapine, because of the unpredictable risk of myelotoxicity. However, a 37-year-old patient taking clozapine for schizophrenia was given full-dose cisplatin and concomitant radiotherapy for an undifferentiated nasopharyngeal carcinoma, without significant neutropenia (250). 

The monoclonal antibody BER-EP4 recognizes a cell-membrane glycoprotein consisting of two polypeptide chains (mol wt 34 kDa and 39 kDa). Its antigen is expressed on a wide variety of epithelial tumors, including small-cell undifferentiated carcinomas and neuroendocrine tumors. It is not found on nonepithelial or mesothelial tumors. 

Hepatocellular carcinoma (HCC) originates in the hepatocytes consequently, HCC resembles liver parenchyma in morphology. It may present as highly differentiated, moderately differentiated or undifferentiated (anaplastic). The most common (and basic) structure is the trabecular localization of tumour cells around sinusoidal vessels. Clinically, HCC is considered to be an extremely malignant, rapidly progressing form. Therapeutic measures still remain limited. 

Fig. 37.7 Small to medium-nodular, alcoholic cirrhosis with undifferentiated, multilobular hepatocellular carcinoma and subcapsu-lar vascularization...

Chan ATC, Lo YMD, Zee B, Chan LYS, Ma BB, Leung SF, et al. Plasma Epstein-Barr virus DNA and residual disease after radiotherapy for undifferentiated nasopharyngeal carcinoma. J Natl Cancer Inst 2002 94 1614-19. 

Hara, E., T. Kato, S. Nakada, S. SekiyaandK. Oda. Subtractive cDNA cloning using oligo(dT)30-latex and PCR isolation of cDNA clones specific to undifferentiated human embryonal carcinoma cells. Nucleic... 

For patients who present with primary lymph node metastases, there may be clues to the primary site of the tumor on the basis of tumor morphology (adenocarcinoma, squamous cell carcinoma, or undifferentiated carcinoma) and the anatomic site of lymph node involvement. 

Almost all squamous cell carcinomas, half of transitional cell carcinomas, and many undifferentiated large cell carcinomas immunostain with CK5/6 (Table CK5/6 has excellent sensitivity and specificity for the detection of squamous differentiation in poorly differentiated carcinomas.p63 is also seen with high frequency in squamous and transitional carcinomas, and when used with the CK5/6 antibody affords high sensitivity and specificity for squamous differentiation. 758... 

Used as a supplement to detect epithelial neoplasms because CKs may rarely be locally positive or negative in undifferentiated carcinomas... 

Large cell undifferentiated neuroendocrine carcinoma (LCNEC) can present as CUPS, and it is easy to miss the diagnosis without applying the appropriate neuroendocrine markers. The correct diagnosis of LCNEC is an important distinction because it carries the same dismal prognosis as does small cell carcinoma, whether in the lung or gastrointestinal tract. 776 Synaptophysin may be the most frequent positive marker in LCNEC. ... 

Kirsten F, Ghi CH, Leary JA, et al. Metastatic adeno or undifferentiated carcinoma from an unknown primary site—natural history and guidelines for identification of treatable subsets. Q JMed. 1987 62 143-161. 

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