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PubMed2004

[Double B-cell malignancies with simultaneous onset].

We encountered a case of a 59-year-old female who simultaneously contracted a non-Hodgkin lymphoma (NHL) and a plasma cell neoplasm. The patient consulted her physician about her abdominal tumor and anemia in March 1999. She was diagnosed as having NHL (follicular center lymphoma, grade I, stage IIA) after an open tumor biopsy, and treated by cycles of CHOP chemotherapy which resulted in complete remission. However, the patient's abdominal tumor appeared again in March 2000 and she was hospitalized at the Ehime University Hospital. A tumor biopsy was performed laparoscopically at that time. Follicular lymphoma (with positive LCA, L-26, and bcl-2 immuno-staining) with the development of retroperitoneal fibrosis was diagnosed again. When a bone marrow puncture was performed because of a condition of monoclonal gammopathy which had continued for two years, a smoldering myeloma was additionally diagnosed. This diagnosis was made after the presence of IgG-lambda M protein when the marrow showed an increase in the number of plasma cells. In a Southern blot analysis which studied the abdominal tumor and the bone marrow cells, each B-cell tumor had a different IgH gene rearrangement pattern. Therefore, this case was diagnosed as an example of the simultaneous existence of two different B-cell tumors. Double cancers in hematological malignancies are very rare and this was thought to be an interesting case.

Abdominal Neoplasms↗
PubMedDate not supplied

[Echography and computerized tomography in the diagnosis of complex abdominal lesions].

Complex abdominal lesions include a variety of pathologies, such as septated, infected, and hemorrhagic cysts, abscesses, tumors, and fluid collections of different etiology. These lesions present diagnostic difficulties with both Ultrasonography (US) and Computed Tomography (CT), since findings may not be present or, when present, are not specific. Keeping these limitations in mind, we evaluated 105 patients (111 abdominal lesions) with both US and CT in order to compare their adequacy in predicting the nature of the lesion. On the basis of US and CT results, complex abdominal lesions were divided in four classes: class I includes 43 cases in which both examinations gave the same contribution to the definition of the nature of the lesion, class II (14 lesions, mainly sepimentated cysts), in which US was superior to CT, class III includes 45 cases in which CT was superior to US, mainly in case of hemorrhagic cysts, abscesses, fluid collections and, less frequently, cystic tumors; class IV includes 9 cases in which US and CT results were complementary, which allowed the nature of the lesion to be defined. In conclusion, US and CT enable the identification and the characterization of complex abdominal lesions; an association of the two investigations enhances their diagnostic value. As a rule, CT is superior when the content of the lesion is either gas or hemorrhage, and in the definition of its peripheral wall. US is always superior in assessing septa, and sometimes even vegetations.

Abdomen↗
PubMed1995

[Abdominal ultrasound as a screening method].

Abdominal ultrasound is increasingly used as part of the initial patient evaluation, without a specific indication. However, such an indiscriminate use of abdominal ultrasound is still controversial. The review of available literature on the value of abdominal ultrasound in clinical screening suggests the following conclusions: 1) The primary screening examination of asymptomatic persons leads to clinically relevant findings in less than 0.5% of cases. However, approximately 50% of the persons examined have abnormal findings without clinical relevance. This high frequency of abnormal findings may cause high costs due to unnecessary follow-up examinations. 2) A sonographic screening of asymptomatic persons may, however, be useful for specific indications in preselected individuals. This has been demonstrated for the detection of abdominal aortic aneurysm in the age group over 65 years. 3) Routine abdominal ultrasound in patients with a known internal disease appears to be useful even in the absence of a specific indication. This 'secondary screening' yields unexpected findings which turn out to be relevant for therapeutic decisions or for the final diagnosis in 6-25% of the cases. Routine abdominal ultrasound of all patients with internal disease may thus be a valuable extension of the initial patient evaluation.

Abdomen↗
PubMed1995

Concurrent abdominal aortic aneurysm and urologic neoplasm: an argument for simultaneous intervention.

This report describes the surgical management of 24 patients with concurrent abdominal aortic aneurysm (AAA) and urinary tract neoplasm. The patient population consisted of 22 men and two women whose average age was 65.5 years. AAA sizes ranged from 3.1 to 9.0 cm (mean 5.2 cm) in diameter. Urinary tract neoplasms included transitional cell carcinoma (TCC) of the bladder (n = 19), adenocarcinoma of the prostate (n = 3), and TCC of the renal pelvis (n = 2). Urologic procedures included radical prostatectomy, radical nephroureterectomy, and radical cystoprostatectomy with continent or ileal loop urinary diversion. The AAA was resected at the time of the urologic procedure in 12 patients (group I) or prior to the urologic procedure in five patients (group II) and was left in situ in seven patients (group III: AAA diameter 3.1 to 5.5 cm). All patients but one in group I recovered without complications. One patient developed an infection postoperatively as a result of fluid collection anterior to the aortic vascular graft; the fluid was successfully drained and the patient subsequently recovered uneventfully. All patients in group II had a marked retroperitoneal desmoplastic reaction at the time of the urologic procedure as a result of prior aneurysmectomy, which complicated the ureteral dissection. One patient later required an ileal ureteral reconstruction for obliterative fibrosis of the ureter. At a mean follow-up of 34 months, no infectious or mechanical complications of the vascular prosthesis occurred in group I or II. Eight patients in group I and two in group II are alive. Three have died of metastatic disease and two of myocardial infarction. Of the seven patients in group III, four subsequently required AAA resection for an increase in AAA size and three have died.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗