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At least 487 records · Page 27Linked to original sources
PubMed1997

Multicentric Castleman's disease with an increased serum level of macrophage colony-stimulating factor.

We describe a 74-year-old patient with multicentric Castleman's disease (MCD) whose serum macrophage colony-stimulating factor level was elevated. Serum levels of tumor necrosis factor-alpha and interleukin 6 were also elevated at presentation, and they returned to normal levels after chemotherapy. Although the total serum cholesterol level was below normal on admission, it increased after chemotherapy. These results suggest that the activation of monocytes or macrophages may be involved in certain pathological phenomena in MCD.

Aged↗
PubMed2000

Genetic epidemiology of HbS in Oman: multicentric origin for the betaS gene.

On the basis of a sample of 117 chromosomes, we have demonstrated the multicentric origin of the sickle mutation in Northern Oman. Three major haplotypes coexist: 52.1% Benin (typical and atypicals), 26.7% Arab-India, and 21.4% Bantu. These haplotypes are not autochthonous to Oman but originated elsewhere and arrived in Oman by gene flow. The distribution of haplotypes is in excellent agreement with the historical record, which establishes clear ancient contacts between Oman and sub-Sahara west Africa and explains the presence of the Benin haplotype; contacts with Iraq, Iran, present-day Pakistan, and India explain the presence of the Arab-India haplotype. More recent contacts with East Africa (Zanzibar/Mombasa) explain the presence of the Bantu haplotype. The pattern of the Arab-India haplotype in the populations of the Arabian peninsula reinforces the hypothesis that this particular mutation originated in the Harappa culture or in a nearby population and in addition reveals that the Sassanian Empire might have been the vehicle by which this Indo-European sickle mutation migrated (gene flow) to the present-day Arabian peninsula, including Oman.

Hemoglobin, Sickle↗
PubMed1998

Diet and squamous-cell cancer of the oesophagus: a French multicentre case-control study.

An increasing number of reports suggest that diet has an impact on oesophageal cancer risk in Western countries, where alcohol and tobacco are held to be the major determinants of the risk. The aim of our study was to identify dietary factors influencing the risk of oesophageal cancer in France and to determine whether certain of these could explain some of the geographical variations. We conducted a multicentre case-control study in 3 regions expected to have different diet and drinking habits (Normandy, Burgundy and Midi Pyrénées). Two hundred eight cases and 399 controls, all males, were interviewed about their eating, drinking and smoking habits. After proper adjustment for drinking and smoking, high consumption of butter and low consumption of fresh fish, vegetables and fruits were associated strongly and independently with an increase in oesophageal-cancer risk. Consistently, cholesterol appeared as a risk factor and vitamin E, vitamin D and phosphorus as independent protective factors. The protective effect of citrus and other fresh fruits (vitamin C) was confined strictly to heavy drinkers. Our findings suggest that more than one-third of the high incidence of oesophageal cancer in northwest France could be explained by the local excess in butter consumption, whereas geographical variations in consumption of dietary protective factors could explain no more than 10% of it. Overall, a large proportion (57%) of the excess incidence of oesophageal cancer in northwest France could be explained by local dietary habits, e.g., drinking hot Calvados liquor and excessive consumption of butter.

Alcohol Drinking↗
PubMed1998

Efficacy of breast-cancer screening for female relatives of breast-cancer-index cases: Taiwan multicentre cancer screening (TAMCAS).

Although the efficacy of mass screening for breast cancer has been established in Western countries, this strategy may be too costly for other countries with low incidence rates of breast cancer. We propose an alternative approach to screen female relatives of breast-cancer-index cases from hospitals, as part of the Taiwan multicentre cancer screening (TAMCAS) project. In order to assess the efficacy of this programme, and to estimate how often this high-risk group should be screened, we firstly elucidated the disease natural history from the pre-clinical screen-detectable phase (PCDP) by estimating the relevant parameters based on Markov chain models. We further predicted the proportion of interval cancers, advanced breast tumours and deaths from breast cancers by different screening frequencies. Results showed that the estimate of mean sojourn time (MST) for this high-risk group (1.9 years; 95% CI.1.18-4.86) is shorter than that for females from the general population. Analysis of a surrogate endpoint based on regional lymph-node spread and tumour size shows that annual screening for this high-risk group is likely to confer a significant 33% reduction in breast-cancer mortality compared with a non-significant 25 and 20% reduction for 2 yearly and 3-yearly screening regimes respectively. The above results suggest that a 1-year interval might be appropriate for this high-risk group. A simple cost-effectiveness analysis indicates a cost per year of life saved for mass screening ($72,480) 15 times that for the high-risk group ($4,851 ).

Breast Neoplasms↗
PubMed1997

Discrimination between multicentric and multifocal breast carcinoma by cytogenetic investigation of macroscopically distinct ipsilateral lesions.

Whether macroscopically distinct carcinomas in the same breast are clonally related (multifocal breast carcinoma) or unrelated (multicentric breast carcinoma) is no longer only a scientific-pathological issue but, because different therapeutic strategies may be preferable for cases with intramammary metastatic disease compared with cases of multiple primary breast carcinomas, one that may have profound clinical implications. We studied the evolutionary relationship among macroscopically distinct, ipsilateral breast carcinomas by cytogenetic analysis of 26 tumorous lesions from 12 patients. Sixteen of the 26 foci (62%) were found to contain clonal chromosome abnormalities. Two carcinoma foci were karyotypically abnormal in each of seven patients. Four of these cases had an evolutionarily related, cytogenetically abnormal clone in the two lesions from the same breast, whereas the remaining three cases had completely different clonal karyotypic aberrations in the separate foci. These results, together with our previous findings in five other informative cases, show that multiple, synchronous breast tumors sometimes arise through intramammary spreading of a single primary carcinoma, whereas on other occasions they are the result of the simultaneous emergence of pathogenetically independent carcinomas within the breast. In the total material, an association was seen between the proximity of the foci and the likelihood of them being karyotypically related.

Breast Neoplasms↗
PubMed2000

Manifestations of three HHV-8-related diseases in an HIV-negative patient: immunoblastic variant multicentric Castleman's disease, primary effusion lymphoma, and Kaposi's sarcoma.

We describe a 73-year-old HIV negative patient who presented with symptomatic hypoglycemia. Over the course of several months she was diagnosed with three human herpesvirus-8 related diseases: multicentric Castleman's disease, primary effusion lymphoma and Kaposi's sarcoma. No improvement was observed following cytotoxic therapy and she died 16 months after her initial presentation. The etiology of the hypoglycemia remained obscure over the course of this patient's disease. This case is the first report of a patient with three human herpesvirus-8 related diseases, and the first report of severe hypoglycemia as the presenting symptom of any of these diseases.

Aged↗
PubMed2001

Treatment of HIV-associated multicentric Castleman's disease with oral etoposide.

Multicentric Castleman's disease (MCD) is a lymphoproliferative disorder that can be defined based upon both clinical and pathological characteristics. The clinical features of this frequently fatal disease include fever, generalized lymphadenopathy, fatigue, splenomegaly, hepatomegaly, and pancytopenia. Recently, severe forms of this disease have been diagnosed in HIV positive patients. Human herpesvirus type 8 (HHV-8) DNA sequences have been detected in peripheral blood mononuclear cells (PBMCs) of patients with Kaposi's sarcoma and MCD, regardless of HIV infection status. Treatment and outcomes in HIV associated MCD are generally unfavorable. We recently treated two HIV-positive patients diagnosed with aggressive MCD with daily oral etoposide (50 mg). The first patient had relapsed on several occasions despite previous therapy with doxil, paclitaxel, and oral ganciclovir. The second patient was treatment naive. Both patients had HHV-8 detectable by polymerase chain reaction in PBMCs, widespread tumor, and B-type symptoms when therapy was initiated. In both cases remissions (documented by computerized tomography) have been durable, 1.5 and 6 months, respectively, with minimal side effects. Oral etoposide may be a safe, tolerable, and active agent in MCD.

Administration, Oral↗
PubMed2001

Primary effusion lymphoma in HIV-infected patients with multicentric Castleman's disease.

Multicentric Castleman's disease (MCD) and primary effusion lymphoma (PEL) are two B-cell lymphoproliferative diseases associated with Kaposi's sarcoma-associated herpes virus/human herpesvirus-8 (KSHV/HHV-8). Although MCD is considered a prelymphoma state, it is not known whether a pathogenetic link exists between MCD and PEL. This paper reports the clinico-pathological features of four cases of PEL (two pericardial, one pleural, and one peritoneal) developing in the context of HIV-associated MCD. Effusions, lymph nodes, spleen, and additional tissues from three autopsies were examined for morphology/immunophenotype, search for HHV-8 DNA, and assessment of immunoglobulin heavy chain gene (IgH) configuration using polymerase chain reaction (PCR)-based techniques. MCD and PEL samples contained HHV-8 DNA. Clonal IgH rearrangements were detected only in PEL, whereas MCD tissues were polyclonal. Light-chain immunostaining confirmed B-cell clonality in PEL (two lambda, one kappa, one not tested) and polyclonality in MCD. The autopsies revealed different morphological variants of visceral KS and multi-organ atypical infiltrates exhibiting immunoblastic/plasmablastic features reminiscent of PEL morphology, with a restriction of lambda-positive cells. In two cases, using microdissection and IgH PCR analysis, multiple/discrete bands were found in the infiltrates, compatible with polyclonality/oligoclonality. The case showing an oligoclonal IgH ladder contained a rearrangement of identical junctional size to the PEL clone; however, further analysis with PEL-derived clonotypic primers and sequencing of PCR products showed no amplification and nucleotide diversity, respectively, indicating that the two B-cell populations examined were clonally unrelated. These data show that MCD and PEL may co-exist in HIV-infected patients, suggesting a relevant association between these two HHV-8-related disorders. Although a definite clonal relationship between MCD and PEL was not demonstrated, it is hypothesized that in some MCD cases, within expanded polyclonal B-cell populations secondary to HHV-8 infection, clonal expansions may occur that localize into a body cavity, i.e. PEL.

Adult↗
PubMed1975

Multicentric breast cancer. The incidence of new cancers in the homolateral breast after partial mastectomy.

Multicentric microfoci of cancer are often present in patients with cancer of the breast and affect the contralateral breast as well as the originally affected one. despite the high incidence of these microfoci of cancer, the appearance of new clinical cancers is rare. In a period of 610 patient-years of exposure after partial mastectomy for cancer, six new cancers appeared in the contralateral breast and four in the affected one. These findings suggest that after partial mastectomy the danger of the appearance of a new cancer in the affected breast is less than might have been anticipated.

Breast Neoplasms↗
PubMed1976

Successful therapy with methotrexate of a multicentric mixed lymphoma of the central nervous system.

Primary lymphoma of the central nervous system (CNS) is extremely rare. A case of mixed histiocytic lymphocytic lymphoma of the CNS that initially occurred in the spinal cord is reported. Multicentric recurrence following radiotherapy was successfully treated with intrathecal methotrexate and the patient remains free of disease after 4 years. The role of intrathecal methotrexate as alternative therapy following irradiation failure is discussed.

Humans↗
PubMed1982

Multicentric breast carcinomas: clinical-radiographic-pathologic whole organ studies and 10-year survival.

Selection of breast cancer patients with microscopically limited disease but with excess mortality or women with regional disease and lessened mortality has remained an unsolved and critical challenge. The many usual histologic features such as tumor size, stage of disease or tumor differentiations were found reduced to lessened significant prognostic factors by the presence of multicentricity of tumors and multiplicity of histologic types of carcinoma. This observation was noted upon review of 161 clinical, radiographic and histopathologic whole breast studies on 156 patients with follow-up from 11-15 years. Epidemiologic, clinical, and radiographic data had been compiled prospectively prior to diagnosis. Women with single site and single type of carcinoma had a better prognosis (2.5% mortality per year) than those with multiple sites and multipe types (15% mortality per year) even though the stage of the disease may be similar. When the latter groups contained a scirrhous type duct carcinoma, the annual mortality rate approached 25%.

Adenocarcinoma↗
PubMed1985

Multicentric giant lymph node hyperplasia. A report of seven cases.

Multicentric giant lymph node hyperplasia (MGLH) is a distinct lymphoproliferative disorder, which may terminate in malignant lymphoma. The clinical features and laboratory findings of seven cases are reported here. The histologic changes in lymph nodes were those of giant lymph node hyperplasia, plasma cell type. Immunoperoxidase staining showed intracytoplasmatic polyclonal immunoglobulins. Malignant lymphoma supervened in two cases, one of which was proved by autopsy; in the other there was transformation of a polyclonal gammopathy into a monoclonal one. Two of the patients also developed Kaposi's sarcoma.

Aged↗
PubMed1988

Postradiation multicentric osteosarcoma.

The oncogenic effects of radiation are well-established. Osteosarcomas and fibrosarcomas are the two most common histologic types of secondary sarcoma. In this article a case of postradiation osteosarcoma is presented in which four discrete foci of sarcomatous transformation have occurred in the tibia and fibula after irradiation for a rhabdomyosarcoma of the calf 8 years earlier. A review of the literature reveals no similar case. Although synchronous, multifocal osteosarcoma without prior radiation has been described, this case differs in clinical, radiographic, and pathologic features; it best fits the description of postradiation multicentric osteosarcoma.

Bone Neoplasms↗
PubMed1993

Bilateral multicentric papillary renal tumors with heteroclonal origin based on tissue-specific karyotype instability.

BACKGROUND: Papillary chromophilic renal tumors were cytogenetically characterized by combined trisomies 7 and 17 along with other numeric chromosome aberrations. They occurred as bilateral multifocal lesions. METHODS: A patient was presented who simultaneously developed bilateral multicentric papillary renal tumors. Tissue specimens from six tumors and tumor-free kidneys were cytogenetically characterized. RESULTS: The tumors showed trisomy of chromosomes 7, 16, and 17 along with various other numeric abnormalities. In normal tissue from both kidneys, a wide variety of clonal and nonclonal numeric and structural chromosome aberrations were found. CONCLUSIONS: The cytogenetic heteroclonality of the tumors strongly favors the assumption that they arose as independent primaries. A tissue-specific karyotype instability may be the basic event of multiple tumorigenesis.

Adenoma↗
PubMed1993

Combination of chemotherapy and recombinant alpha-interferon in advanced non-small cell lung cancer. Multicentric Randomized FONICAP Trial Report. The Italian Lung Cancer Task Force.

BACKGROUND: Preclinical data suggested that alpha-interferon (IFN) may potentiate chemotherapy cytotoxicity. METHODS: A prospective multicentric randomized trial was initiated to assess the clinical benefit of adding recombinant alpha-2-IFN to combination chemotherapy in patients with metastatic non-small cell lung cancer. A total of 182 patients were randomized to receive either cisplatin-epidoxorubicin-cyclophosphamide (CEP) combination chemotherapy (cisplatin, 60 mg/m2; epidoxorubicin, 50 mg/m2; and cyclophosphamide, 400 mg/m2 intravenously) alone on day 1 or the same chemotherapy plus recombinant alpha-2-IFN at the dose of 5 MU intramuscularly from day -2 to +4, then 3 times weekly. RESULTS: The median survival was 6 months in the CEP plus IFN arm versus 5.5 months in the control arm. The log-rank test showed a marginal statistically significant difference (P = 0.045) in favor of CEP chemotherapy, which disappeared when survival curves were adjusted for prognostic factors. Progression-free survival was similar in the two treatment arms. Considering all eligible patients, the response rate was 7.6% in the CEP arm versus 18.9% in the CEP plus IFN arm (P = 0.042). Nearly 40% of the patients receiving IFN had grade 3-4 nadir leukopenia versus 15% in the control arm (P = 0.01) and 12.5% versus 4.2% had grade 3-4 thrombocytopenia. Apart from the usual constitutional symptoms, IFN was also responsible for increased emesis and mucositis. CONCLUSIONS: This study indicates that the addition of recombinant alpha-IFN to CEP chemotherapy can increase response rate and toxicity to treatment without a positive effect on progression-free survival and survival.

Aged↗
PubMed1994

The multicentric occurrence of squamous epithelial dysplasia and squamous cell carcinoma in the esophagus.

BACKGROUND: The biologic significance of esophageal dysplasia has not yet been completely elucidated, especially regarding the process of multiple occurrences of squamous cell carcinoma. METHODS: The multiplicity of dysplasia in 73 patients with solitary carcinoma of the esophagus (Group I) and 21 with multiple carcinomas (Group II) was compared in surgically resected specimens. RESULTS: Thirty-nine second carcinomas were identified in 13 patients of Group II, and all were superficial. The incidences of five or more isolated dysplasias in cases without continuity to a carcinomatous lesion, was 6.8% and 66.7% in Groups I and II, respectively (P < 0.01). In a case with three or more carcinomas, the incidence increased to 84.6%. The coexistence of all grades of isolated dysplasias was observed in 10 patients (47.6%) in Group II but in only 6 patients (8.2%) in Group I (P < 0.01). CONCLUSIONS: These findings suggest that various degrees of evolving biologically related lesions, such as dysplasia and carcinoma, can occur multicentrically in the same esophagus.

Carcinoma in Situ↗
PubMed2005

Efficacy of rituximab in an aggressive form of multicentric Castleman disease associated with immune phenomena.

Multicentric Castleman disease (MCD) is an uncommon lymphoproliferative disorder for which the best therapeutic option is not yet well established. Immune-related disorders are rare complications of MCD. We report on an MCD case in a 23-year-old patient with extensive abdominal involvement and associated immune hemolytic anemia and Raynaud phenomenon. He was negative for human immunodeficiency virus (HIV) and human herpesvirus-8 (HHV-8). After 8 courses of the anti-CD20 monoclonal antibody (rituximab), the patient achieved complete remission. Interestingly, Raynaud phenomenon disappeared under treatment and no new hemolytic events occurred. Anti-CD20 antibody treatment could be an attractive therapeutic approach for MCD, mainly when immune-related disorders are associated.

Adult↗
PubMed2005

Multicentric glial brain tumors of a varying degree of differentiation in patient with chronic lymphocytic leukemia.

Chronic lymphocytic leukemia is associated with an increased incidence of secondary neoplasms. Primary brain tumors are rarely seen; however, an increased risk relative to the general population has been observed in male patients with chronic lymphocytic leukemia. A case report of a 62-year-old man with progressive chronic lymphocytic leukemia and pronounced neurologic symptoms is presented. Richter's syndrome or brain infiltration with leukemia cells was clinically suspected and suggested by computed tomography findings. Progression of the neurologic symptoms rapidly continued and the patient died. Neuropathologic examination revealed multicentric glial tumors of a varying degree of differentiation located throughout the brain and cerebellum.

Brain Neoplasms↗