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At least 631 records · Page 35Linked to original sources
PubMed1996

Mucosal lymphangiectasia in gastric adenocarcinoma.

OBJECTIVE: To describe the occurrence and significance of mucosal lymphangiectasia in gastric adenocarcinoma. DESIGN: One hundred consecutive gastrectomies for adenocarcinoma were reviewed, using 25 consecutive gastroscopically biopsied gastrectomy specimens with peptic ulcers as negative controls. SETTING: The specimens were collected over a period of 25 months in two general hospitals and processed according to a standard protocol. PATIENTS: Chinese living in Hong Kong. RESULTS: Twenty cases of adenocarcinoma were found to show mucosal lymphangiectasia, which was arbitrarily defined as the presence of ectatic lymphatic channels in the lamina propria having maximum dimensions greater than that of a foveolar gland. The ectatic lymphatics were lined by simple endothelium, devoid of fibromuscular wall, and they either were optically empty or contained scant mononuclear leukocytes. None of the patients had preoperative evidence of malabsorption syndrome or protein-losing enteropathy. Lymphangiectasia was most readily seen in the superficial lamina propria near the main tumor. In 10 cases (50%), lymphangiectasia extended to the nonneoplastic part of the gastric mucosa, at a distance of at least 2 cm away from the main tumor. Tumor emboli were seen in the ectatic lymphatics in 11 cases (55%). In two cases (10%), the distal line of resection was involved by intramucosal lymphatic spread. The tumor permeating the lymphatics did not evoke any inflammatory or desmoplastic reaction in the perilymphatic lamina propria, similar to the phenomenon of so-called lymphangitis carcinomatosa. In eight cases (40%), there were foci beyond the main tumor where mucosal lymphangiectasia was present, but without tumor in its immediate vicinity. All (100%) of the 20 stomachs with mucosal lymphangiectasia had metastases in regional lymph nodes, whereas only 59 of the 80 cases (73.75%) without lymphangiectasia were node-positive (P < .025). All node-negative cases did not show lymphangiectasia. Twenty-five consecutive gastrectomies for peptic ulcer disease that had undergone preoperative mucosal biopsies showed no lymphangiectasia, suggesting that mucosal biopsy was not the cause of mucosal lymphangiectasia. CONCLUSIONS: (1) Gastric mucosal lymphangiectasia is associated with carcinoma but not peptic ulcer, (2) Mucosal lymphangiectasia in gastric carcinoma signifies lymph node metastases, and (3) Gastric carcinoma can spread along the mucosa via intramucosal lymphatics.

Adenocarcinoma↗
PubMed1995

[Pulmonary metastases of glioblastoma].

Extracranial metastases arising from primary brain tumors are very unusual. We report a case of glioblastoma with intra-thoracic spread characterized by mediastinal lymph nodes metastasis and bronchial, lung parenchyma and pleura carcinomatous lymphangitis. Pathologic findings are consistent with non-differentiated cell proliferation but Glial Fibrillary Acidic Protein immunodetection can be helpful to relate such a non-differentiated cell proliferation to its glial origin. The mechanisms of extra-cerebral spread are discussed according to autopsic findings and to the data reported in the literature.

Autopsy↗
PubMed1996

A lymphatic filarial survey revealing a focus of Brugia malayi in the coastal region of west Bengal.

Random night blood samples were examined from 528 subjects in an endemic zone of lymphatic filariasis, in the coastal region of West Bengal. There were 136 cases out of 528 who were symptomatic, with or without recurrent episodes of fever, lymphangitis and lymphadenitis and with various degrees of lymphoedema. Examination of blood samples revealed microfilaria in 43 cases of which 42 were asymptomatic and only one was symptomatic with lymphoedema. All the microfilariae were of the species Brugia malayi.

Adolescent↗
PubMed1996

Combined therapy with Ukrain and chemotherapy in ovarian cancer (case report).

A patient with adenocarcinoma in the right ovary with lymphangitis carcinomatosa, staged as G II-G III pT3, pNX, pMX, was treated after palliative surgery by chemotherapy and, simultaneously, with Ukrain. Two and a half years after treatment the patient is without any signs of tumour recurrence. Her condition is excellent.

Adenocarcinoma↗
PubMed1996

[Diagnostic approach of chronic diffuse infiltrative diseases of the lung in non-immunosuppressed patients].

Diagnosis in non-immunosuppressed subjects with chronic diffuse infiltrative lung disease is a progressive process. Because of the large number of diseases involved, the relative frequency of certain causes (for example sarcoidosis, primary pulmonary fibrosis, carcinomatous lymphangitis) is of prime importance. Generally, history taking and physical examination are essential to guide exploratory examinations required for diagnosis. Standard radiography often gives the first indication of chronic diffuse infiltrative lung disease, but the recent development of high-resolution computed tomography which provides a better visualization of the predominant elementary aspects and their anatomic distribution has been a major step forward. Bronchoalveolar lavage is also highly contributive and although certain diagnosis may not be achieved, the type of cells involved in the development of alveolitis can be identified. Pathology examination of a surgical biopsy specimen is sometimes required for certain diagnosis. Videothoracoscopy is generally used and should be guided by CT scan data to optimize the probability of sampling in areas of "active" inflammation. Indications for videothoracoscopy must be made on an individual basis according to the team's experience with this type of pathology.

Bronchoalveolar Lavage Fluid↗
PubMed1997

Late infection of hand implant after a dental procedure: a case report.

A 78-year-old woman with a silicone implant in her first carpometacarpal joint had acute inflammation and lymphangitis beginning 24 hours after a dental root canal procedure. The infection resolved after implant removal and debridement of the residual carpometacarpal space. Although this is a rare event, the use of prophylactic antibiotics to protect implants in the hand should be reviewed.

Aged↗
PubMed1996

[Is there an age limit for laparoscopic cholecystectomy? Apropos of 61 patients over 85 years of age].

Bilary surgery in the elderly is associated with high morbidity and mortality. The aim of this prospective study was to determine benefits of laparoscopic cholecystectomy in patients over 85 years. From August 1990 to January 1996, 61 patients (50 women, 11 men) aged over 85 years had laparoscopic cholecystectomy. Thirty seven (60.6%) were at high surgical risk (ASA III). In more than 40% of cases complications were present (acute cholecystitis, gallbladder empyema). Nine patients (14.7%) had choledocholithiasis. Ten (16.3%) conversions were necessary, in 5 cases for choledocholithiasis. Overall morbidity was 9.8%: 2 bibary leaks, 1 pneumonia, 1 urinary injection and 1 lymphangitis. There was no mortality. With excellent pre-operative risk evaluation, laparoscopic cholecystectomy is better than laparotomy cholecystectomy. Laparoscopic cholecystectomy has a low morbidity in the elderly and it allows curative treatment of gallstones complicated or not.

Age Factors↗
PubMed1997

[The endobronchial metastases of a prostatic neoplasm with normal radiology].

Prostatic cancer is the most frequent neoplasm in man, usually it is revealed in the course of study of unknown origin bone metastasis. Pulmonary involvement is normally detected through clinical symptoms or an chest X-ray altered showing intraparenchymatous nodules or a carcinomatous lymphangitis pattern. We present a case of a patient with prostatic cancer and bone metastasis in whom during the extension study we detected endobronchial metastasis. Endobronchial involvement is exceptional in prostatic cancer; through bibliographical review we have only found 12 similar cases published.

Adenocarcinoma↗
PubMed1997

Pulmonary carcinomatous arteriopathy--a rare cause of dyspnoea and pulmonary hypertension.

Pulmonary carcinomatous arteriopathy was seen at autopsy in three patients who presented with sub-acute cor pulmonale. All had adenocarcinomas of unknown origin. The arteries and arterioles showed fresh and organizing thrombi with narrowing or occlusion. Large muscular arteries also showed tumour cells within the thrombi. Lymphangitis carcinomatosis was also present to a variable extent.

Adenocarcinoma↗
PubMedDate not supplied

[The heart: a spectator or participant in neoplasms? Neoplastic subacute cor pulmonale].

Neoplastic subacute cor pulmonale is a distinct clinical syndrome that is often not too easily diagnosed. Such rapid development of cor pulmonale is observed in a patient with lymphangitis carcinomatosa of the lung consecutive to a cancer of the stomach with splenic, pancreatic and lymph nodes invasion. Diagnosis was established on transition of the normal ECG to a typical pattern of cor pulmonale and was revealed by chest roentgenographic examination (interstitial syndrome finding) and fatal evolution of severe respiratory failure. Necroptic and pathological studies confirmed histologic lung involvement by tumoral emboli and lymphangitic carcinoma the tosis and documented neoplasm in the stomach.

Acute Disease↗
PubMed1997

[Radiation- and chemically-induced respiratory manifestations].

There are frequently respiratory complications with cancer particularly in primary lung carcinoma. Among these are bronchopulmonary infections with or without endobronchial obstruction, carcinomatous lymphangitis, thromboembolic disease and haemorrhagic disease as well. Radiotherapy and chemotherapy may induce various respiratory complications which diagnosis can be of varying shades of difficulty. The classical post radiation pneumonitis occurring exclusively in the field of radiation hardly poses any problem unless it could be masking a recurrence. Certain clinical manifestations address very difficult problems of differential diagnosis by their lack of specificity and by their often unforeseeable character (except for bleomycin fibrosis which is perfectly dose dependent). Moreover patients often have multiple treatments and the identification of the single responsible agent becomes very difficult. We will not discuss here the infectious or secondary haemorrhagic complications of radiotherapy or chemotherapy but rather the anaphylactic manifestations, diffuse interstitial pneumonia with lymphocytic alveolitis or fibrosis, eosinophilic pneumonia, non-cardiogenic pulmonary oedema, bronchiolitis obliterans with organising pneumonia and the rare pulmonary vascular disorders such as pulmonary veno-occlusive disease.

Alveolitis, Extrinsic Allergic↗
PubMed1998

[Radiologic and ultrasonographic assessment in staging and in the evaluation of therapeutic effectiveness of non-Hodgkin lymphomas].

The data on the radiological and ultrasound examination of 912 patients with non-Hodgkin's lymphoma (NHL) are presented. Involvement of thoracic and abdominal lymph nodes and organs was recorded in two-third of NHL cases, with aggressive pattern, particularly, those involving the intestines, skeleton, pleura and pericardium prevailing (80%). In the nodular disease of the lung, pleura, breast and exophytic tumors of the gastrointestinal tract, the end results were much better. Prognosis was less favorable with perinodal infiltration and lymphangitis in the lungs, wet pleurisy and pericarditis, infiltrative disease of the gastrointestinal tract, breast and involvement of the small intestine. Sonography proved most effective in the evaluation of lymph nodes status (sensitivity--85.8; specificity--99.4%). However, only 10% of focal lesions in parenchymal organs were reliably detected.

Adult↗
PubMed1998

High resolution computed tomography in sarcoidosis: a clinical perspective.

In this review, the contribution of high resolution computed tomography (CT) to the diagnosis of pulmonary sarcoidosis, the possible role of CT in defining reversible disease, and the potential use of CT to obtain pathophysiological insights are discussed. The role of CT in the diagnosis of sarcoidosis remains contentious, as the CT manifestations of sarcoidosis are highly variable, and typical appearances are often associated with a classical clinical and chest radiographic profile. The greatest diagnostic utility of CT lies in difficult cases of diffuse lung disease, especially advanced disease; sarcoidosis can often be excluded with confidence when CT appearances are pathognomonic of an alternative disorder (such as extrinsic allergic alveolitis, lymphangitis carcinomatosis, or fibrosing alveolitis). CT patterns indicative of reversible and irreversible disease have been identified, through CT-histological correlations and serial imaging studies; a nodular pattern is almost invariably reversible, reti-cular abnormalities and anatomic distortion denote and irreversible fibrotic histological picture, ground-glass opacification is variably reversible and may be indicative of alveolitis or fine fibrosis. However, CT influences therapeutic decisions in a minority of cases in clinical practice. The potential use of CT to gain pathophysiological insights is discussed briefly.

Biopsy↗
PubMed1998

[Disseminated carcinomatosis of the bone marrow occurring 11 years after subtotal gastrectomy for gastric cancer].

A 44-year-old man was admitted to our hospital because of purpura, increased serum alkaline phosphatase, and thrombocytopenia. He had undergone subtotal gastrectomy for gastric cancer 11 years earlier. A biopsy specimen of the bone marrow revealed metastatic mucin-forming, moderately differentiated adenocarcinoma. Because the primary tumor was not detected in any other organ, the gastric cancer the patient was treated for 11 years earlier was suspected as the primary tumor. Microangiopathic hemolytic anemia and disseminated intravascular coagulation developed during the clinical course, and the patient deteriorated despite treatment with anticoagulants. Finally, he died of pulmonary carcinomatous lymphangitis. Autopsy revealed a small number of adenocarcinomatous cells in the lymphoduct of the remaining stomach in spite of its mucosa being intact. We concluded that the bone marrow was infiltrated by cancer cells which originated in the stomach 11 years before. It is unclear why adenocarcinoma cells remained dormant for as long as 11 years in the gastric lymphoduct and bone marrow.

Adenocarcinoma↗
PubMed1998

[Tuberculosis in circulation system].

Tuberculous pericarditis develops either via hematogenous or lymphangeal spread, or directly from pulmonary lesions. Tuberculous pericarditis begins with fibrin deposits, granuloma formation, and the presence of live acid-fast bacilli. A pericardial effusion, which is serous but often contains some blood with a high level of protein. Recently, PCR technology has been employed to amplify M. Tuberculosis DNA from pericardial fluid. The elevation of ADA (> 45 U/l) is supportive of the diagnosis. Tuberculous pericarditis is detected clinically either in the effusive stage by nonspecific systemic syndrome or after the development of constrictive pericarditis. The short-course treatment of tuberculous pericarditis should consist of three-drug regimen, such as INH, RFP, PZA, SM, EB. The use of prednisolone is controversial. Tuberculous myocarditis is extremely rare because of low affinity between M. Tuberculosis and myocardium. Most cases of tuberculous pericarditis are clinically silent and diagnosed at autopsy.

Humans↗
PubMed1998

[Joint symptoms in primary hypertrophic osteoarthropathy].

Joint manifestations of hypertrophic osteoarthropathy are arthritis and arthralgia. Those occur at the all joints, but often at the lower extremities and usually are asymmetric. Swelling of the distal parts of the extremities was found in 52 patients (68.4%). Perimaleolar swelling proceed from periostal accumulation. Swollen fists are present in all patients and that phenomenon is characteristic sign of the disease. Swelling of the joints, perimaleolar edema and swelling of the distal parts of the limbs reminds of the other conditions (tumor, osteomyelitis, lues, Reiter's syndrome, psoriasis, lymphangitis, miksedema, thrombophlebitis, Caffey's disease, Engel's disease, hypervitaminosis A, RA, thyroid acropathia etc.), which must be taken into consideration.

Adolescent↗