[Renal carcinoma and multiple malignant neoplasms].
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Biomedical subjects
Publications and source records attributed to A Cardesa.
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To assess the biological significance of human chorionic gonadotropin (HCG) detection in large bowel carcinomas, we have studied immunohistochemically 50 colorectal carcinomas, 20 adenomas, 8 ulcerative colitis, and 10 normal colonic mucosae. The HCG-immunoreactive cells were found in 26 carcinomas (52%). Positivity was not detected in any normal mucosa or benign lesions. Cells containing HCG predominated in mucinous (80%) and poorly differentiated carcinomas (92%). No trophoblastic differentiation could be demonstrated in any tumor. Human chorionic gonadotropin was detected more frequently in carcinomas invading the entire bowel wall (67%) than in those confined to the submucosa or muscularis propria (30%). Fifteen of 19 cases (79%) with lymph node and/or hepatic metastases had HCG in the primary tumor, whereas only 9 of 23 cases (32%) without metastases showed HCG immunoreactivity. The eight patients with hepatic metastases had HCG in the primary tumor. Thus, the immunohistochemical detection of HCG in colorectal carcinomas may be a biological marker of prognostic significance.
The autopsy findings in 24 cases (representing 17 males and seven females) that underwent bone marrow transplantation during the course of disease are reported. The mean age of the patients was 20.0 years, with individual ages ranging from 7 to 40 years. In 23 cases, serious infectious disease occurred. A patient frequently exhibited more than one type of infection. In total, there were seven mycotic, eight cytomegalovirus, and 15 bacterial infections. Twenty-three cases showed striking lung pathology, the most prevalent lesions being infectious diseases and those of diffuse alveolar damage, which was found in ten cases. Gastrointestinal tract pathology of differing types was observed in 13 cases. Necrotizing enterocolitis was observed in three of these cases. Three cases also displayed cholangiolar cholestasis, probably related to their terminal infectious disease. In only two cases could graft-vs-host disease be proved histologically.
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Lung blastoma is a rare primary tumor of the lung. There are only 18 cases reported in medical bibliography under 15 years old. A girl 4 years old is reported. A pulmonary congenital cyst in right middle lobe was excised in other hospital at 15 months old. A pneumoblastoma developed at 4 years old in the same location. It was excised by bilobectomy and treated after words with radium and polychemotherapy. Evolution after 29 months of intervention is quite good. She is in good health without recidives or metastases. Lung blastoma is a mixed tumor composed by embryonic mesenchyma and endothelial cores of embryology origin. A review has been done about published cases and it's commented the relation between blastoma and peripheral pulmonary cysts. Three of the 4 cases in pediatric bibliography presented that association and in another the disorders merge with 3 years of influence. In our case the lapse was 31 months after cyst exeresis.
Two cases of telangiectatic hamartoma of the iris and ciliary body are reported, one of them with its histopathological study. No previous cases have been found, as such, in the current literature. The most important descriptions of primary vascular lesions of the iris and ciliary body are briefly reviewed.
Two cases of papillary-cystic neoplasm of the pancreas are reported in women aged 22 and 23 years. The patient in the first case presented with acute abdominal pain and hemoperitoneum. This form of presentation has not been previously reported. This type of pancreatic tumor is very rare, exclusively affecting young women, and has a good prognosis despite its various histologic features, which suggest a malignant appearance. The authors consider this neoplasm as having an acinar origin because in the cells of one of the patients we observed ultrastructurally the presence of abundant rough endoplasmatic reticulum with formation of annulate lamellae and a few prezymogen granules.
A case of malignant polyposis coli, occurring in a 71-year-old man in association with a primary invasive adenocarcinoma of the gallbladder is presented. The eventuality that the carcinoma of the gallbladder could be a metastasis from the colonic neoplasia was excluded due to the observation in the mucosa of the gallbladder of changes corresponding to carcinoma in situ. This is the fourth case reported of polyposis coli coexisting with a carcinoma of the biliary tract.
Weekly SC administration of 2,2-dioxopropylnitrosamine to 88 Sprague-Dawley rats resulted in the induction of 76 separate neoplasms in the respiratory region of the nasal cavities. No tumors of the olfactory region were found. Histologically there were 37 squamous papillomas, 17 transitional papillomas, and 22 squamous cell carcinomas. These tumors were compared with a selected group of 53 related human tumors of the nasal and paranasal cavities, consisting of 11 squamous cell papillomas, 13 transitional papillomas, and 29 squamous cell carcinomas. While the experimental squamous cell papillomas showed a striking histological resemblance with the squamous papillomas observed in man, none of the experimental transitional papillomas had evidence of the characteristics inverted pattern seen in humans; nevertheless, the experimental tumors showed signs of incomplete squamous metaplasia and preservation of intraepithelial secretory glands, features commonly seen in transitional papillomas of man. The squamous cell carcinomas of this experiment were very similar to the corresponding human tumors in morphology and sex incidence. In both species a significant number of squamous cell carcinomas were keratinizing and of a high grade of histological malignancy. In addition, 69% of the human squamous cell carcinomas occurred in the male sex, and 72% of the experimental carcinomas developed in males. This comparative study suggests that further studies investigating the significance of nitrosamines as suspected etiologic factors of nasal carcinogenesis in man may be useful.
Glomerulonephritis is a very unusual feature of relapsing polychondritis. A 16-year-old woman presented with microscopic hematuria and severe renal insufficiency during the course of relapsing polychondritis. A renal biopsy specimen disclosed focal segmental proliferative glomerulonephritis with necrotizing lesions and crescent formation. Immunofluorescent studies suggested immune complex mediated glomerular injury. The renal involvement appeared during high-dose steroid therapy. Subsequently, she was treated by adding plasmapheresis and cyclophosphamide during 6 weeks, with sustained improvement. A regimen of plasmapheresis and immunosuppression warrants consideration for use in cases of relapsing polychondritis with glomerulonephritis.
In a series of 500 autopsies cancer was found to be the first cause of death (24.6 por 100), followed by infectious diseases (23.8 per 100), and vascular diseases (22.2 per 100). The most frequent kind of malignant tumors found were lung neoplasms (17.8 per 100), followed by leukemias (17.0 per 100) and digestive tract tumors (11.3 per 100). Metastases were produced most frequently by tumors of the lungs (82.6 per 100), liver (81.8 per 100) and digestive tract (64.2 per 100). Metastases were found mainly in the lymph glands and liver.
75 Schwann cell tumors were induced in the offspring of Wistar rats which had been treated intraperitoneally with 15 mg/kg b.w. ethylnitrosourea on the 15th day of pregnancy. Plexiform structures characterized by poorly-developed, distorted and bizarre bundles of nerves were seen in 2 of 33 benign tumors, and in 17 of 42 malignant schwannomas. Since when seen in man similar findings are distinctive of neurofibromatosis, it is suggested that this experiment may offer a model for studying non-inherited forms of neurofibromatosis and, more particularly, the malignant changes often associated with this disease.
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