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Esophageal adenocarcinoma is a virulent malignancy that is rapidly increasing in incidence. Overexpression of p53, a tumor-suppressor gene with prognostic significance in many malignancies, has not been adequately evaluated in this disease. The purpose of this study was to evaluate the pattern and importance of p53 protein accumulation in patients with esophageal adenocarcinoma. Immunohistochemical analysis was performed on formalin-fixed, paraffin-embedded tissue from 24 patients, all of whom had early stage disease. Nineteen of 24 patients underwent surgery, and 16 had complete tumor resection. p53 oncoprotein immunoreactivity was demonstrated in 50% (12/24) of patients overall and 50% (8/16) of patients undergoing esophagectomy. p53 overexpression was more common in patients with well-differentiated tumors (P = 0.07). The tissue surrounding tumor stained positive for p53 in six patients, four of whom had no evidence of Barrett's epithelium. Among the 16 patients who underwent esophagectomy, those whose tumors demonstrated p53 overexpression had a longer overall (28 vs. 13.5 months) and disease-free (24.3 vs. 13 months) median survival. The difference in disease-free survival was significant (P = 0.05). Our findings suggest that p53 overexpression may serve as a marker of improved survival in patients with esophageal adenocarcinoma.

Background. Thymic hyperplasia after successful treatment of malignant disease is a well‐documented phenomenon, particularly in younger patients with testicular carcinoma. However, it has been reported only sporadically in association with Hodgkin disease. The authors report the first instance of an adult with nodular sclerosing Hodgkin disease who had thymic hyperplasia develop after clinical and radiographic complete remission (CR) with chemotherapy alone. Methods. In addition to the current case, 20 other instances of thymic hyperplasia have been culled from the literature and analyzed. Results. The median age of these 21 patients was 23 years of age (range, 8‐40 years of age). Thymic hyperplasia was noted after treatment was initiated or completed in all but two patients; and all did well, with one exception: a 17 year‐old boy who was inadvertently treated for relapsed Hodgkin disease and who died of fibrinous pneumonitis and nocardia, with pathologic CR noted at autopsy. Conclusions. Thymic hyperplasia in association with Hodgkin disease appears to be a favorable prognostic phenomenon, restricted to younger patients in the first modal peak of Hodgkin incidence. Prospective studies have yet to be performed.

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