Biomedical subjects
Publications and source records attributed to S Kenan.
A cold abscess secondary to tuberculous spondylitis or osteomyelitis is a well-recognized entity. However, a soft tissue tuberculous abscess without bone involvement is rare. We present such a case.
Multifocal osteosarcoma is uncommon. Long-term survival of an incompletely treated case is exceptional. We report an unusual case of bifocal sclerosing osteosarcoma in a 38-year-old women that involved the left ilium and right proximal femur. The femoral lesion was resected. The tumor in the left ilium was not treated. She did not receive chemotherapy and has been free of metastases for 7 years. Recently, growth of the pelvic osteosarcoma has resulted in vascular compression and edema of the lower extremity. The patient's alkaline phosphatase has been elevated throughout. The tumor was HMB-45 positive, which has not been previously reported in osteosarcoma. The pathogenesis of multifocal osteosarcoma is discussed.
Hereditary bone dysplasia (HBD) is an extremely rare clinicopathological entity manifested by diaphyseal medullary stenosis and cortical bone thickening associated with a propensity for fractures affecting the long tubular bone. Malignant transformation has been reported to occur at an alarming frequency. The hereditary pattern appears to be autosomal dominant. In this paper we present the case of a 19-year-old man with hereditary bone dysplasia who was unaware of his underlying condition until he presented with malignant transformation arising in an area of bone infarct of the left tibia.
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A 35-year-old woman presented with a painful swelling in the left distal radius that had been present for 1 year. Radiography and computerized tomography revealed a sclerotic surface lesion that had grown over the year and eroded the cortex. Histological examination demonstrated two distinct components: a cartilaginous low- to moderate-grade osteosarcoma on the surface and a high-grade osteosarcoma in the intramedullary component. This case is uncommon in two aspects: the radius is a rare site for such a tumor and the dedifferentiation was revealed at the time of the first surgery and was not secondary to recurrence.
The case of a 55-year-old man with chondrosarcoma to the cervical spine is described. Two years previously the patient had undergone a right hip replacement for synovial chondromatosis. Re-evaluation of the biopsy specimen from the right hip taken at the time of the initial operation showed areas of chondrosarcoma arising in the background of synovial chondromatosis. The unusual presentation of this rare entity is discussed.
OBJECTIVE: To evaluate the signal characteristics of primary non-Hodgkin's lymphoma of bone on MRI. DESIGNS AND PATIENTS: Ten patients with primary non-Hodgkin's lymphoma of bone were included in the study. T1- and T2-weighted imaging was performed. The signal intensity of the lesions was compared with that of the surrounding muscle. RESULTS: The results of the MRI were compared with the histological findings. In the majority of cases (5/10) the lesion involved the femur. In one case each the tibia, humerus, ileum, sacrum, and skull, respectively, were affected. A soft tissue mass was present in four cases. In nine of ten cases on T1-weighted imaging the lesion was hypointense. On T2-weighted imaging seven of ten lesions were hypointense compared with muscle, one isointense and, in two cases, part of the lesion showed slightly hyperintense signal. In all ten cases the signal pattern appeared inhomogeneous. Pathological examination showed extensive fibrosis in the majority of cases. CONCLUSION: According to our results there is decreased signal intensity of bone marrow on both T1- and T2-weighted imaging, unlike other primary round cell tumors of bone. Because the diagnoses were established with small tissue biopsies, the reason for these findings is speculative.
The clinical behavior of giant cell tumor is related to the radiological appearance. To test the hypothesis that in vitro proliferation of the neoplastic stromal cell population of giant cell tumors is related to the radiological appearance, this study was undertaken. A prospective analysis of the cells migrating from 13 consecutive tumors was conducted. Growth curves and population doubling-times (PDT) for first and fifth passages were calculated and alkaline phosphatase levels were measured and compared to preoperative radiographic staging. A strong negative correlation was found between PDT and the radiographic stage. Tumors in stages I and II (low aggressiveness) were found to have an average cell population doubling-time of 11 (SD 2.2) days, while those in stage III (high aggressiveness) showed a doubling-time of 6 (SD 2.2) days. Low alkaline phosphatase activity was noted in all cultures, a finding consistent with the putative preosteoblastic potential of these stromal cells. This putative origin is also indicated by the differentiation response to retinoic acid. The findings suggest that the in vitro proliferation of the mononuclear stromal cell population of giant cell tumors is related to the radiographic stage and may predict the clinical behavior of these tumors.
We present the case of a 53-year-old patient with fibrocartilagenous dysplasia. The area involved was in the proximal femur and presented a lytic lesion with extensive calcifications which radiologically mimicked chondrosarcoma. The radiopathological pattern of this rare entity is discussed in detail and the literature reviewed.
We report a unique case of juxtacortical osteoblastoma of the humeral shaft, which stimulated the appearance of an extraosseous extension of Gaucher-cell deposits. The tumour was treated successfully by curettage and bone grafting. We can find no previous report of this association between osteoblastoma and Gaucher's disease.
Autolymphocyte therapy (ALT) is tumor-specific, adoptive cellular therapy of neoplastic disease using nonspecific ex vivo activation of autologous peripheral blood lymphocytes (PBL), which are composed primarily of memory T-cells (ALT-cells) and are active in patients with metastatic renal cell carcinoma and melanoma. Ex vivo pretreatment of tumor target cells with certain chemotherapeutic agents can enhance susceptibility to lysis by antitumor lymphocytes. To determine if cis-diamminedichloroplatinum(II) (CDDP) enhances ex vivo antitumor cytotoxicity of ALT-cells and if this lysis is mediated by T- and/or NK-cells and is human leukocyte antigen (HLA)-restricted, human soft tissue sarcoma (STS) target cells were derived from primary and metastatic surgical specimens and were incubated with and without CDDP. ALT-cells were prepared from autologous PBL obtained prior to surgery. Primary (PSTS) and metastatic (MSTS) target cells from each group were labelled with chromium 51 (51Cr) and used as targets for ALT-cells, CD45-depleted ALT-cells, CD56 (NK)-depleted ALT-cells, and PBL in a standard (4-hour) and delayed (18-hour) 51Cr release assay. Interferon-gamma (IFN-gamma) release was measured as an indication of antitumor effect and recognition by the noncytolytic lymphocytes in ALT-cells. Primary tumor target cells incubated in CDDP showed enhanced lysis as measured by the 51Cr release assay compared to non-CDDP-treated controls. Metastatic tumor target cells showed less lysis than the primary targets, although this was enhanced by pretreating metastatic tumor targets with CDDP. Lysis of all tumor targets was significantly greater when ALT-cells were used as the effector cells rather than PBL. Depletion of memory T-cells abrogated ex vivo lysis. Depletion of NK cells (CD56+) affected ex vivo lysis of autologous targets during the 4-hour but not the 18-hour assay. Ex vivo ALT-cell lysis and IFN-gamma release against only the autologous tumor targets confirmed tumor-specificity in one patient. Restriction of ALT-cell lysis and IFN-gamma release against HLA-A2+ autologous and one allogeneic HLA-A2+ STS tumor target, but not other non-STS targets, was demonstrated in another patient. These data suggest that CDDP may help render STS susceptible to tumor-specific, immune-mediated attack and that the combination of ALT and CDDP may lead to effective tumor-specific chemoimmunotherapy in patients with metastatic STS.
OBJECTIVE: To evaluate the role of magnetic resonance imaging (MRI) and computed tomography (CT) in the diagnosis of intramuscular ganglia (IMG) that arise from the superior tibiofibular joint (STFJ). MATERIAL AND METHODS: Our series consisted of three men and three women. Four patients were studied by MRI, one by CT only, and two by both modalities. Contrast was used in one of the two patients studied by CT. MRI was obtained in at least two orthogonal planes to demonstrate the relation of the ganglia to STFJ. RESULTS: The MR and CT appearance of these ganglia was basically that of a well-defined soft tissue mass with low attenuation on CT images consistent with the presence of fluid. On MR studies, they had an isointense signal on T1-weighted images and a homogenous high-intensity signal on T2-weighted images. MRI demonstrated the attachment of these ganglia to the STFJ. CONCLUSION: CT and MRI were effective, noninvasive modalities in the evaluation of IMG. The imaging features on both modalities were consistent with the presence of fluid- containing lesions that had close proximity and were attached to the STFJ. The combination of location and the fluid consistency of these lesions facilitated the diagnosis.
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An exceptionally rare case of periosteal Ewing's sarcoma involving the mid shaft of the right tibia was reported. In this case, MRI was the technique that confirmed the integrity of the bone marrow. The clinical, radiographic, and histopathologic features of Ewing's sarcoma have been discussed, as has the differential diagnosis of the periosteal type of this tumor.
A case of an elastofibroma in the right scapular region in a 56-year-old woman was reported. The clinical and pathological findings were discussed. The location of this lesion was uncommon. The common sites were mentioned. The differential diagnosis and magnetic resonance findings were also described.