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PubMed1976

Computed body tomography.

Only the surface of the diagnostic possibilities inherent in CT imaging has been scratched. Solic organ pathology is readily visible in most instances by computed tomography. With further extension of present knowledge and development of newer contrast agents, the ability of computed body tomography to image a wide range of diseases appears almost limitless.

Adenoma↗
PubMed1991

[Cancer in husband and wife--a report of 105 couples].

The occurrence of cancer in both members of 105 couples related only by marriage, is reported from a regional hospital, 68 couples had tumors of the same histopathologic type. 6 had tumors of the same organ, with similar histology. The tumors were of the brain (astrocytoma), urinary bladder (transitional cell carcinoma) lung (adenocarcinoma), retroperitoneum (sarcoma), stomach (adenocarcinoma) and colon (adenocarcinoma). The significance of our observations is unclear, and they are most probably coincidences. Analysis of more data could help to explain these observations, because factors such as environment, nutrition and contamination affect both members of a married couple for extended periods of time.

Adenocarcinoma↗
PubMed1991

[The posterior interparieto-peritoneal or retroperitoneal spaces. 2: Pathological x-ray computed tomographic image].

The old reports about the interparieto-peritoneal spaces described particularly the renal space and its environment. The CT scan has modified the in vivo study of the extraperitoneal spaces (E.P.S.) and brought the question of the acquired knowledge up again. An anatomical research was performed in the first part of this study which describes the structures limited between the parietalis fascia and visceral peritoneal fascias. These are the true EPS which the main element is the propria fascia of Sappey (lateroconal fascia) and its anterior and posterior renal double layers. All these lamellar structures limits spaces variably infiltrated with fat tissue: the anterior pararenal space almost virtual, the posterior pararenal space which continues till the Bogros space and the anterior and posterior renal spaces of the renal compartment which the fat continues till the bladder and accompanies the ureter. The second part of this study precises some notions of general topography which are necessary for reading abnormal CT scan images. This part reminds the aortic and arterial general organization of the vertebrates as described by Mackay. It underlines the architectural importance of the three areas so defined: parietal or peripheral, intermediate or mesoblastic genitourinary and deep lateral or digestive endoblastic. These three areas corresponds to the three vascular aortic circles. It emphasized the importance to accept in practice the notion of visceral joining fascia which has been proved in adult people. The longitudinal architecture of the compartments is precise with respect to their appartenance to one among the three arterial arches of Mackay. What the anatomy suggest, the pathology can prove. Several pathological processes are studied on CT scan: large hemorrhagic or necrotic collections in acute pancreatitis, abnormalities or diseases of renal or adrenal compartments, extraperitoneal mesenchymomas, diseases of the psoas compartment. All these observations are analysed in order to explain anatomical and CT scan findings. This study refers not only to the oldest researches which are still valuable but also to the most recent controversies. All the questions are not solved using the clearest schemes.

Abdomen↗
PubMed1990

Recurrent ovarian granulosa cell tumor: role of combination chemotherapy with report of a long-term response to a cyclophosphamide, doxorubicin and cisplatin regimen.

We report a patient who, at age 43, underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for an unrupted 10 cm granulosa cell tumor. A recurrence was subtotally totally resected 2.5 years later, followed by six cycles of cyclophosphamide, doxorubicin, and cis-platin (CAP) chemotherapy. She had no evidence of disease at second-look laparotomy. Serum estradiol (E2) levels paralleled her clinical course, becoming elevated at the time of her recurrence, and returning to postmenopausal levels during her chemotherapy. Four years later, further elevation in E2 heralded a second recurrence of tumor. The patient underwent a cytoreductive procedure and has resumed chemotherapy. Reports of the few other patients treated with multiagent chemotherapy are reviewed. Several combinations appear active, with the CAP regimen having possibly less toxicity. Compared with radiotherapy, chemotherapy may yield longer survival in patients with recurrent granulosa cell tumor, but actual cure remains elusive.

Adult↗
PubMed1990

[An autopsy case of multiple myeloma accompanied by extensive nodular infiltration into the extraskeletal tissue].

Discussed is the case of a 41-year-old Japanese man dead at 4 months after start of his clinical course of multiple myeloma of the Bence-Jones protein lambda type of the skull. Autopsy findings revealed that atypical plasmacytes had infiltrated extensively into the testes, the retroperitoneum, including the pancreas and the renal pelvis, the bilateral pleura, the right subclavian soft tissue, and the meningism, but not to the liver, spleen, and lymph nodes. In both testes, which weighted 120 g and 100 g, respectively, myeloma cells were found disseminated throughout the testicular tissue. Such a testicular involvement in cases of a multiple myeloma is extremely rare. The pertinent literature also is reviewed.

Adult↗
PubMed1990

[Clinical reevaluation of continuous intravenous infusion of 5-fluorouracil--plasma concentrations and clinical dose by continuous intravenous and 60-min infusions].

Daily and intermittent continuous intravenous infusions [by gravity drip, (IVG) or infusion pump, (IVP)] and intermittent short-time intravenous drip infusion of 5-FU were carried out on advanced cancer patients. The MTD and dose-limiting toxicity were investigated in relation to the plasma concentrations of 5-FU determined by HPLC. Responses in eleven patients receiving IVG administration daily at 8-21 mg/kg/day were NC, but those given 5-FU alone showed no adverse reactions. Plasma concentrations were too low to be determined. In 9 patients receiving IVG or IVP administration weekly at 60 mg/kg for 24 hr, 1 of the 5 evaluable patients showed reduced hepatic metastatic lesions. One of 4 patients receiving IVP administration weekly at 120 mg/kg for 48 hr showed a disappearance of metastatic lesions in the skeletal muscle, but bone marrow suppression was observed as dose-limiting toxicity. Pharmacokinetics were more stable in IVP than in IVG with less individual difference in the plasma concentrations. Among the outpatients receiving short-time iv, IVG administration once or twice a week, 2 patients given weekly administrations at 20 mg/kg for 60 min showed slight adverse reactions. In 6 patients given high-dose administrations, bone marrow suppression was observed. When pharmacokinetics in the patients given 5-FU for 60 min were compared between the IVG and IVP groups, there were individual differences in plasma concentrations, but the differences were not significant. It was concluded from above results that the following practical dose schedules would be recommendable: 60 mg/kg for 24hr/week by IVP for inpatients and 20 mg/kg for 60 min/week by IVG for outpatients.

Adult↗
PubMed1990

Fine-needle aspiration cytology of malignant hemangiopericytomas with ultrastructural and flow cytometric analyses.

A hemangiopericytoma (HPC) is an uncommon soft-tissue neoplasm that may arise in many body sites. The cytologic features of fine-needle aspirates (FNAs) of HPCs have only rarely been described in the literature. We examined FNAs of malignant HPCs from the head and neck region (three) and the retroperitoneum (one) in four adults (aged 38 to 83 years). All four FNAs yielded cellular specimens that consisted of uninuclear tumor cells with high nuclear-cytoplasmic ratios. The cytomorphological spectrum included nuclei that were oval to elongate and had very finely granular, evenly distributed chromatin with one or two small but distinct nucleoli. Hemangiopericytomas yield aspirates that may be considered malignant and may suggest sarcoma. Histologically, all four neoplasms manifested high mitotic activity. The ultrastructural features of all four tumors were supportive of the diagnosis of HPC. Although a specific primary diagnosis of HPC on FNA of a soft-tissue mass is unlikely, cytologic analysis may allow diagnosis of recurrent or metastatic HPC. We were able to perform flow cytometric determinations of tumor DNA content on three of the resected neoplasms. In two, an aneuploid pattern was found, including the neoplasm with the most marked pleomorphism in the FNA. The third was diploid.

Adult↗
PubMedDate not supplied

Sister Mary Joseph's nodule. Diagnosis of umbilical metastases by fine needle aspiration.

Three cases of Sister Mary Joseph's nodule (umbilical metastases) are presented. The probable primary tumor in all three cases was an ovarian adenocarcinoma. Fine needle aspiration (FNA) was used to confirm the secondary nature of the umbilical lesion in one case. The entity is named after Sister Mary Joseph, who was Superintendent at the Mayo Clinic in the early part of this century. The primary lesion is most commonly found in the genital or gastrointestinal tracts. Since the prognosis for this lesion is extremely poor, with a mean survival of a few months, surgery is usually not indicated; FNA is recommended as a convenient means of confirming the suspected diagnosis.

Abdominal Neoplasms↗
PubMedDate not supplied

[Retrovesical pelvic masses: diagnosis].

We present two cases of pelvic masses with retrovesical localization: one consisting of a mature cystic teratoma and the other in a ganglionic metastasis of a subclinical prostate adenocarcinoma. We carry out an analysis of the clinical aspects as well as a review of the diagnostic guidelines to be followed in the light of the existence of a neoformation in this location. We analyse the possible differential diagnoses to be established with these tumours, which we should take into consideration despite their rare incidence and form of presentation.

Adenocarcinoma↗
PubMed1985

[Value of double "J" ureteral stents in cancerology].

Self-retaining silicone ureteral stents are used for prolonged urinary drainage in situ. Thanks to the exceptional patient tolerance, they appear to be the best indwelling catheters for the treatment of ureteral obstruction due to cancer. Eighteen catheters were placed in sixteen patients. Endoscopic insertion was carried out in 8 patients (9 catheters were inserted; one patient requiring bilateral catheterisation). An operative procedure was necessary in the remaining 8 cases: in 4 cases a simple ureteral dissection was necessary, whereas ureterostomy had to be carried out in the 5 remaining cases. During the treatment, the patient tolerance was excellent. Mean survival time, after catheterisation was 5,5 months and one patient had a functional catheter for 15 months. Obstruction of the catheter was observed in 3 cases but ureterostomy was avoided in 7 cases and 8 kidneys were protected in 6 cases. The palliative use of the double J catheter when no other treatment is possible for malignant ureteral obstruction precludes the need for ureterostomy. These catheters can be used for strategic curative treatment if nephrotoxic drugs are required to treat obstructive tumors of the ureters. Bladder disease is a contra-indication to the use of these catheters although their insertion is rarely impossible. In cases of acute obstruction, it is better to prepare the pathway with a traditional catheter, which is easier to manage, it is always possible to insert a double J catheter after some time has elapsed.

Adolescent↗
PubMed1989

[Relation of the serosal invasion mode to a recurrence in advanced gastric carcinomas].

Discussed are the attributable factors affecting the type of carcinomatous recurrence seen in 126 patients who had been operated on for their gastric carcinomas from 1979 to 1982 and who later showed a macroscopically positive serosal invasion (S0) and a histologically ss alpha approximately se invasion and required a curative resection. Forty-six percent of the patients with an ss beta approximately se invasion had a peritoneal recurrence, 21% a liver recurrence, and 33% a recurrence of some other type, whereas those with ss alpha had no such recurrence. Peritoneal recurrence tended to increase with the increase in the length of the serosal invasion and its rates were: one third in serosal invasions of less than 3 cm, one third in invasions of 3 approximately 6 cm and another third in invasions of over 6 cm. The smaller ratio of submucosal length to subserosal length, especially when less than 1.0, meant a greater frequency of peritoneal recurrence. The histologic characteristics of carcinomas that developed a peritoneal recurrence were poorly differentiated, contained INF alpha and had weaker cellular cohesion, whereas those that developed a liver metastasis were well differentiated carcinomas, contained INF beta and had a tighter cellular cohesion.

Adenocarcinoma, Mucinous↗