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• W4230698912 abstract "Introduction: Noninfiltrating papillary cystomas of the ovary are regarded as borderline cases of malignancy. Histologic criteria are frequently unsatisfactory in diagnosing benign and malignant changes of these tumors. Cytophotometric DNA-measurements were performed in this study to determine in a more objective way the possible malignant transformation of epithelial cells of these cystomas.Material and Method: One serous and one mucinous cystadenocarcinoma and eight cystomas (5 serous, 3 mucinous) were analysed clinically, histologically and cytophotometrically. Six cases were diagnosed in the histological laboratory of the Department of Obstetrics and Gynecology of the University Hospital Hamburg. Two cases were detected in the gynecologic department of the Elim Hospital Hamburg, two cases came from the department of pathology of the General Hospital Hagen/Westfalen.Parts of the formalin-fixed specimens were stained with H & E and by the procedure of Feulgen for DNA-determination. Hydrolysis time was 12 minutes. Tissue sections for cytophotometry were 10 μ in thickness. The DNA-measurements at 570 μm were done with a Leitz microspectrophotometer MPV I after careful focussing of cell nuclei. The plugtechnique was used (Swift and Rasch, 1956). The DNA-content of single nuclei is expressed in arbitrary units (AU/DNA). In every case the average DNA-content of the epithelial cells was measured in addition. This method was described recently (Würthner, Sachs, Bahnsen, 1972). Consequently, there are two DNA-histograms representing DNA-content of single nuclei (figures A) and the average DNA-content (figures B).Results: The serous and the mucinous cystadenocarcinoma showed less than 20% of diploid cells (case 4 and 8, fig. 5, 6, 10, 11). The histologically benign, nonproliferatingcystomas contained more than 70% of diploid cells (case 1, 3, 7; fig. 1, 3, 4, 9, 11). (Serous papillary cystomas). The papillary proliferating cystomas had 20–70% of diploid cells (case 2, 5, 6, 9) (Fig. 2, 4, 7, 8, 11), (2 and 5 serous proliferating cystoma, 6 mucinous low grade proliferating cystoma, 9 mucinous proliferating cystoma). Case 10 (low grade proliferating mucinous cystoma which spread in to the omentum majus) was hypodiploid and triploid. (Fig. 14, 15, 16).The histologically and cytophotometrically benign cases were controlled clinically during more than five years (case 1, 3) and 1¼ years (case 7). The follow-up showed no sign of malignancy in these cases. By the DNA-histogram case 2 was regarded as malignant. However, the women delivered two healthy children two and four years after partial resection of the left ovary and total removal of the right ovary. The DNA-histograms of case 5 (serous proliferating cystoma) were classified as malignant. Two years later no indication for malignant growth can be observed clinically. A nonproliferating mucinous cystoma (case 6) had an atypical DNA-content. Another mucinous cystoma with marked proliferation had a DNA-histogram similar to those of carcinomas in situ (Case 9). Case 10, a mucinous cystoma which spread into the omentum majus had an irregular hypodiploid and triploid DNA-content. Possibly some mucinous cystomas are in fact carcinomas of minimal aggressiveness and limited metastasizing capability. The last three cases were detected only recently and clinical follow-up was not yet possible.Discussion: More than 90% of carcinomas showed characteristic DNA-stemlines or a broad scattering of DNA values. Precancerous dysplasia and carcinoma in situ of cervix uteri were ascertained in a similar manner (see Sachs, Stegner, Bahnsen, 1972). Based on the histological diagnosis the prognosis of papillary ovarian cystomas is uncertain in the individual case. In an analogous way this study attempts to use the DNA-measurements of epithelial cells as a parameter for a malignant change of papillary cystomas (see also Weiss, Richard, Okagaki, 1969). Cystadenocarcinomas of this series were aneuploid. Proliferating papillary cystomas had, in four cases, DNA-histograms which indicate malignancy. (Case 2, serous proliferating cystoma; case 5, serous proliferating cystoma; case 9, high grade proliferating mucinous cystoma; case 10, moderately proliferating mucinous cystoma, which spread in to the omentum majus). On the other hand, a nonproliferating respectively low-grade proliferating mucinous cystoma with an irregular DNA-content should be regarded as potentially malignant (case 6). The other nonproliferating cystomas had a DNA-pattern of regular diploid-tetraploid range (case 1, 3, 7). Presence or absence of proliferation of papillary cystomas should not be the only parameter for judging the reversibility or probability of progression to carcinoma.The radical therapy in all cases with papillary ovarian cystomas is still the therapy of choice. However, case 2 (Fig. 2 and 4) of this study shows that this may not be justified in every case in spite of a cytophotometrically atypical DNA-content." @default.
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• W4230698912 date "1985-05-01" @default.
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• W4230698912 title "Letters to the Case" @default.
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• W4230698912 doi "https://doi.org/10.1016/s0344-0338(85)80218-1" @default.
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