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Bilateral breast tumors with a histologically scirrhous pattern were conclusively diagnosed as gastric carcinoma metastatic to the breast using mucosubstance histochemistry and electron microscopy. The majority of the carcinoma cells gave histochemically positive reactions for galactose oxidase-Schiff, stable class III con A, and high-iron diamine-alcian blue (HID-AB). Also electron microscopically, numerous HID-positive mucus droplets (sulfomucin) were seen in the carcinoma cells. These findings invalidated the possibility that the carcinomas were primary breast cancer. The practical applications of distinctive patterns of mucus secretion are discussed.

Supplementary diagnosing methods for thyroid cancer were discussed, with particular reference to medical images. Although palpation is, of course, essential in the examination of nodules, we have also used soft X-rays and I-123 scintigraphy, as well as Tl-201 scintigraphy, ultrasonography and aspiration biopsy. In addition, various diagnosing methods have been employed to determine the degree of invasion in advanced cancer patients, such as CT scan for observing invasion of the surrounding tissues, naso-tracheoscopy for invasion of the trachea and a flow meter for vascular tracts. When the tumor size is under 2 cm, we use soft X-rays, ultrasonography and sometimes try additional aspiration biopsy. When the tumor is smaller, aspiration biopsy is employed with ultrasonography. For tumors larger than 2 cm, we use soft-X-rays, I-123 scintigraphy and ultrasonography. Tl-201 scintigraphy is employed to determine operative indication, following which aspiration biopsy and CT scan are performed. CT scan, tracheofiberscopy and doppler flow studies are carried out for advanced cancer cases to determine the degree of invasion of carcinomas.

The patient was a 48-year-old woman who had undergone radical surgery for gastric carcinoma in 1981. Seventeen months after the operation, recurrence of gastric carcinoma at the anastomotic stoma was found, and total gastrectomy was performed. Fourteen months after the second operation, she was revealed to have bilateral breast tumors and underwent exploratory excision. Histological examination suggested primary malignant tumor of the breast. Bilateral standard radical mastectomy was done seven days after the excision. Final histological examination revealed metastatic breast cancer originating from the stomach. She died from general metastasis seven months after the radical mastectomy in spite of adjuvant immunochemotherapy.

Unlabelled: The patient was a 76-year-old man. When he was 31, he had undergone right lobectomy for thyroid cancer. Following this, had repeated recurrences, and finally reached total-thyroidectomized status. Consequently, he was given thyroxin and PS-K thereafter. When he was 75, 131I therapy was undertaken for lung metastases. The changes of serum anti-microsomal antibody (AMA), immunosuppressive substance (ISS) and thyroglobulin (TG) were as follows: three months after the therapy, AMA was 40(2), although it had always been negative before. Nine months later, ISS and TG markedly decreased., Conclusion: Under the administration of immunomodulating agents, 131I therapy might induce antitumor immunological responses by the effect of enhancement of cancer cell antigenicity.

From 1982 to 1985, twenty-nine patients with suspected hyperparathyroidism were examined using 201Tl-99mTc subtraction scintigraphy (Tl-Tc), computed tomography (CT) and ultrasonography (US). For diagnosing neoplasm (adenoma or cancer), the sensitivities of the three procedures were 80 per cent or more, with no statistically significant differences. For diagnosing hyperplasia of the parathyroid glands, CT scan had the highest sensitivity (47 per cent). The most frequent source of error was minimally enlarged glands, weighing less than 500 mg. The second highest source of error was thyroid nodules, such as adenomatous goiter or cancer. Serum calcium and c-PTH levels were significantly higher in those with a parathyroid neoplasm than in those with hyperplasia (p less than 0.01, p less than 0.05, respectively). We concluded that hyperplasia is less easy to detect than neoplasm, and CT scan is superior to Tl-Tc or US scan for localizing hyperplasia.