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At least 739 records · Page 41Linked to original sources
PubMed1996

Cutaneous lymphangiectases associated with severe photoaging and topical corticosteroid application.

We report an elderly patient with lymphangiectases arising within skin affected by photoaging, steroid atrophy, and inflammation. Bullous lesions appeared in several sites following a year of topical corticosteroid applications for neurodermatitis. Light and electron microscopy showed that the bullae consisted of dilated lymphatic vessels within the dermis. There was also marked nodular elastosis and attenuation of dermal collagen. We suggest that this patient's lymphangiectases resulted from abnormal structure and function of the dermis due to photoaging and steroid atrophy.

Administration, Topical↗
PubMed2005

Early colon cancer detected by 18F-FDG PET.

Positron emission tomography (PET) is a noninvasive functional imaging modality that can disclose the presence of a malignant disease. It has recently been reported that PET may be useful to detect primary colorectal cancer (CRC). We present the case of a 47-yr-old man with early colon cancer detected by 18F-fluorodeoxyglucose (FDG) PET. The patient consulted us because of a positive fecal occult blood test and focal FDG uptake in the pelvic cavity detected at a physical check-up. After the usual work up, he was diagnosed as having a sigmoid polyp, 16 mm in diameter. Subsequently, colonoscopic polypectomy was carried out. The surgical specimen was histologically diagnosed as a well-differentiated adenocarcinoma, invading the submucosal layer with lymphatic invasion. Therefore, the involved portion of the sigmoid colon was laparoscopically resected. The FDG PET carried out 1 yr after the operation, showed no abnormal FDG uptake. PET can noninvasively detect an early colon cancer as small as in our patient, as well as other cancers in the whole body. Therefore, we consider it suitable as a screening examination.

Adenocarcinoma↗
PubMed1983

Serological and immunological investigations in patients with gross splenomegaly from the Gabon.

Serological investigations (immunoglobulin, haptoglobin, cryoglobulin, and antibody determination against Plasmodium falciparum and P. malariae antigens) were performed in 64 adults of the Albert-Schweitzer-Hospital, Lambarene, Gabon. The patients were referred consecutively for ultrasound examination of the upper abdominal tract. 31 patients had clinically and sonographically an enlarged spleen, whereas 34 had a normal-sized spleen. 18 patients were regarded as having a gross splenomegaly without an obvious underlying cause (tropical splenomegaly (TSS]. No significant differences were seen between the patient groups with regard to immunoglobulin M or antiplasmodial antibody concentration. Thus, a causal association of splenomegaly with chronic malaria infections could not be established. The haptoglobin levels were significantly (P less than 0.01) reduced in patients with splenomegaly. Peripheral T-lymphocyte subsets as defined by monoclonal antibodies showed in all 4 cases with gross splenomegaly examined distinct abnormalities. Tropical splenomegaly is thought to encompass a variety of diseases, most of them presenting an intermediate stage of reactive to autonome disorders of the lymphatic system.

Adolescent↗
PubMed1993

[Hemodynamics of massive obesity].

Congestive heart failure is a frequent complication of massive obesity and a major cause of death. Prior to the cardiac decompensation stage, infraclinical haemodynamic disturbances can be observed in obese subjects with normal blood pressure: the cardiac output and cardiac index increase, due to a rise in systolic ejection volume, the total peripheral resistance falls and the intravascular volume augments. Cardiac adjustment takes place in the form of excentric left ventricular hypertrophy. Ventricular extrasystoles, often associated with this hypertrophy, might be the cause of sudden death in some obese patients. Arterial hypertension is about 3 times more frequent in obese subjects than in subjects of normal weight, and even more frequent in those with massive obesity. To the high preload due to obesity hypertension adds an increased after-load. This results in augmentation of the mass and work of the left ventricle with progressive alteration of its function. The incidence of coronary disease is increased in obese subjects, notably those with abnormal adiposity. Finally, the return circulation is very often perturbed, notably in gynecoid obesity: there is venous insufficiency with a higher risk for thromboembolism, and lymphatic insufficiency or capillary permeability disorders. A low-calorie diet and a physical rehabilitation of sedentary obese subjects facilitate weight reduction and at the same time tend to correct the associated metabolic disturbances; they reduce blood pressure and also seem to reduce the left ventricular hypertrophy.

Cardiovascular Diseases↗
PubMed1998

Klippel-Trenaunay syndrome.

Patients with Klippel-Trenaunay (KT) syndrome have a complex constellation of anomalies that includes cutaneous capillary malformation (usually on an affected limb), abnormal development of the deep and superficial veins, and limb asymmetry, usually enlargement. Mixed vascular malformations may be present and include capillary, venous, arterial, and lymphatic systems. The records of 79 patients referred for vascular anomalies were reviewed and 49 were found to have the three "cardinal" anomalies of KT syndrome. Twenty-six females and 23 males had 46 affected legs (27 right legs), 23 affected arms (15 right), 21 affected trunks, and 10 affected heads. Thirty-six had only one affected quadrant, 8 had two, and 5 had three or more. Although 40 patients had increased limb girth, measurable length discrepancy was noted in only 17 individuals. Patients were evaluated using a noninvasive imaging strategy including color duplex ultrasonography, MRI, lymphoscintigraphy, and plain radiographs. Treatment included compression, pulsed-dye laser treatment, reduction of arteriovenous malformations, and orthopedic procedures for overgrowth. All KT cases in this series occurred sporadically. We speculate that KT syndromes may be due to a somatic mutation for a factor critical to vasculogenesis and angiogenesis in embryonic development.

Adolescent↗
PubMedDate not supplied

Treatment of circulating neoplastic cells.

The differentiation of tissues and organs during ontogeny increases the necessity of integration of the different structures. These developmental processes of integrations by body fluids, immunologic, endocrine and nervous systems culminate in mammals, since they possess the most diversified system of body fluids. Typical of the most developed mammals are the bone marrow, the lymphatic system with regional lymph nodes and consequently the pathologic development of the diversity of leukemias, malignancies without stroma. In the German literature the leukemias are considered systemic diseases because the floating cells they discharge are more or less uniformly pathologically underdeveloped. The leukemias are named according to the major abnormal cell type (e.g. monocytic acute leukemia). Acute and chronic is the distinction of the time limitation regarding the development and duration of the disease. More complicated is the discharge of motile cells from primary tumors or daughter tumors deriving from solid tumors. These motile cells enter into the circulation via the lymphatic spaces or by penetration of the endothelium of the blood vessels. They move freely in the circulatory system until settling in a more or less distant region. The process of detecting these cells is known as carcinocythemia. Other movable cells during neoplastic progression are those populating effusions in the coelomic cavities. Non-movable, that is only growing in succession like a tissue chain are those tumors which distribute by direct tumor spread within the veins, keeping the connection with the primary tumor. This condition is especially well-known in renal cell carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Influence of computed tomography scanning and lymphography on the management of testicular germ-cell tumours.

Seventy-eight patients with seminoma and 66 patients with teratoma had computed tomography (CT) of the thorax and abdomen performed as part of initial staging following orchidectomy. Four of 65 (6%) seminoma and 13 of 66 (20%) teratoma patients were upstaged by the addition of CT scanning. No seminoma patients with Stage I disease according to abdominal CT and lymphography had an abnormal thoracic CT scan. Seven of 52 (13%) seminoma and 4 of 21 (19%) teratoma patients who were Stage I according to the CT scan had their staging altered by lymphography. CT was of particular value for defining the exact extent and bulk of metastatic disease prior to and following chemotherapy and radiotherapy, prior to surgical excision of residual disease following chemotherapy, and for investigating potential sites of disease relapse. For all patients with teratoma, we recommend CT of the thorax and abdomen, with bipedal lymphography for those with normal CT scans. For seminoma patients, we suggest lymphography followed by abdominal CT and if either is abnormal, thoracic CT.

Dysgerminoma↗
PubMed1979

Ganglioneuroma, heterochromia iridis, and Horner's syndrome.

A child with mediastinal and supraclavicular ganglioneuroma, heterochromia iridis, and Horner's syndrome is described. The authors postulate that the thoracic neoplasm originated as a congenital neuroblastoma with metastasis to the supraclavicular lymph nodes and subsequent benign transformation, and that the ocular abnormalities resulted from sympathetic ganglion injury by the tumor in infancy. This seems to be the first published report of such ocular abnormalities associated with mediastinal ganglioneuroma.

Child↗
PubMed1993

Chest staging in testis cancer patients: imaging modality selection based upon risk assessment as determined by abdominal computerized tomography scan results.

We compared chest computerized tomography (CT) to chest x-ray as chest staging modalities in testis cancer patients on the basis of abdominal CT findings. We identified 92 patients who presented with negative staging abdominal CT scans and 52 with abnormal abdominal CT scans. Of these patients 42 and 32, respectively, underwent a chest x-ray and chest CT concurrently as part of the initial staging evaluation. Dictated x-ray reports were used to compare study findings. Findings on chest x-ray and chest CT were considered concordant if both studies identified similar chest abnormalities. Findings were considered discordant if either study failed to identify an abnormality noted on the other test. Patient outcome during followup, response to therapy or chest pathology was used to discriminate benign from malignant radiological abnormalities. Radiographic chest abnormalities (chest x-ray and/or chest CT) were identified in 12 of the 42 patients with negative abdominal CT scans. Three of these 12 studies represented metastasis with the remainder being benign. Imaging results were concordant in all 3 patients with chest metastasis and 5 of 9 with benign chest disease. Chest x-ray identified abnormalities not observed on chest CT in 1 patient, with chest CT identifying abnormalities not observed on chest x-ray in 3. Radiographic chest abnormalities (chest x-ray and/or chest CT) were identified in 15 of 32 patients who had a positive abdominal CT. All chest lesions identified in these patients were believed to represent metastatic disease. Chest x-ray failed to identify abnormalities present on chest CT in 4 of the 15 patients. The use of chest CT as a staging modality in abdominal CT negative patients failed to increase diagnostic sensitivity relative to chest x-ray alone. However, in 32 patients with abnormal abdominal CT scans the use of chest x-ray alone would have missed intrathoracic metastatic disease in 4. These data suggest that chest x-ray may be the preferred initial chest staging study for testis cancer patients with negative abdominal CT, while chest CT is mandated in patients with abnormal abdominal CT.

Abdomen↗
PubMed1998

Lymphadenopathy: differential diagnosis and evaluation.

Although the finding of lymphadenopathy sometimes raises fears about serious illness, it is, in patients seen in primary care settings, usually a result of benign infectious causes. Most patients can be diagnosed on the basis of a careful history and physical examination. Localized adenopathy should prompt a search for an adjacent precipitating lesion and an examination of other nodal areas to rule out generalized lymphadenopathy. In general, lymph nodes greater than 1 cm in diameter are considered to be abnormal. Supraclavicular nodes are the most worrisome for malignancy. A three- to four-week period of observation is prudent in patients with localized nodes and a benign clinical picture. Generalized adenopathy should always prompt further clinical investigation. When a node biopsy is indicated, excisional biopsy of the most abnormal node will best enable the pathologist to determine a diagnosis.

Algorithms↗
PubMed2002

Analysis of the phenotypic abnormalities in lymphoedema-distichiasis syndrome in 74 patients with FOXC2 mutations or linkage to 16q24.

INTRODUCTION: Lymphoedema-distichiasis syndrome (LD) (OMIM 153400) is a rare, primary lymphoedema of pubertal onset, associated with distichiasis. Causative mutations have now been described in FOXC2, a forkhead transcription factor gene. Numerous clinical associations have been reported with this condition, including congenital heart disease, ptosis, varicose veins, cleft palate, and spinal extradural cysts. SUBJECTS: We report clinical findings in 74 affected subjects from 18 families and six isolated cases. All of them were shown to have mutations in FOXC2 with the exception of one family who had two affected subjects with lymphoedema and distichiasis and linkage consistent with the 16q24 locus. RESULTS: The presence of lymphoedema was highly penetrant. Males had an earlier onset of lymphoedema and a significantly increased risk of complications. Lymphatic imaging confirmed the earlier suggestion that LD is associated with a normal or increased number of lymphatic vessels rather than the hypoplasia or aplasia seen in other forms of primary lymphoedema. Distichiasis was 94.2% penetrant, but not always symptomatic. Associated findings included ptosis (31%), congenital heart disease (6.8%), and cleft palate (4%). Other than distichiasis, the most commonly occurring anomaly was varicose veins of early onset (49%). This has not been previously reported and suggests a possible developmental role for FOXC2 in both venous and lymphatic systems. This is the first gene that has been implicated in the aetiology of varicose veins. CONCLUSION: Unlike previous publications, the thorough clinical characterisation of our patients permits more accurate prediction of various phenotypic abnormalities likely to manifest in subjects with FOXC2 mutations.

Abnormalities, Multiple↗
PubMed1987

Acute myelofibrosis in megakaryoblastic leukemia with translocation between chromosomes 8 and 14.

In a 45-year-old woman with severe normochromic anemia (Hb 2.8 g%) an extensive myelofibrosis and infiltration of the bone marrow with small blasts was observed histologically. Cytochemical examination of the blasts showed a negative peroxidase and a strongly positive alpha-NE reaction. PAS reaction was slightly granular positive in the cytoplasmic protuberances of the blasts and in the platelets. Marker analysis yielded no evidence of lymphatic origin of the blasts. In flow-cytometric studies of 230,000 cells a homogeneous 2c blast population could be identified. Cytogenetic analysis revealed an abnormal pseudo-diploid karyotype characterized by 2 acrocentric marker chromosomes caused by a translocation of chromosomes 8 and 14, as usually seen in Burkitt type lymphoma. Finally the reaction product of platelet-specific peroxidase could be demonstrated in the perinuclear cisternae of the endoplasmic reticulum by electron microscopy. Highly elevated beta-thromboglobulin and platelet factor 4 plasma levels were also measured. Following an ineffective treatment with daunoblastine and ARA-C, the patient died of pseudomonas aeruginosa septicemia after having received high-dose ARA-C treatment.

Biopsy, Needle↗
PubMed2002

Microlissencephaly in microcephalic osteodysplastic primordial dwarfism: a case report and review of the literature.

Microcephalic osteodysplastic primordial dwarfism (MOPD) is defined as a syndrome presenting with intrauterine and postnatal growth retardation, typical facial appearance, skeletal dysplasia and brain abnormalities. Autosomal-recessive inheritance is suspected. Sharing clinical manifestations, the former type III has been accepted to be the same entity as type I. We present the case of a male infant with MOPD I and micrencephaly with simplified gyral pattern to a degree defining it as microlissencephaly (MLIS). The brain abnormalities in MOPD I have not yet been classified. Reviewing the literature, we conclude that microlissencephaly appears to be the distinct developmental brain abnormality in MOPD I. Conversely, osteodysplastic changes have to be taken into consideration in the differential diagnosis of microlissencephaly. In addition, our patient suffered from acute lymphatic leukaemia which has not previously been described in association with MOPD I.

Agenesis of Corpus Callosum↗
PubMed1980

Roentgenographic changes during long-term diphenylhydantoin therapy.

Diphenylhydantoin (Dilantin) is a well known anticonvulsant with well documented effectiveness. The complications, unfortunately, are multiple and well recognized clinically. This paper deals with the roentgenographic changes encountered in long-term diphenylhydantoin use. Some of these changes, which are not clinically readily apparent, may alert unwary physicians in the recognition of diphenylhydantoin-induced disease.

Abnormalities, Drug-Induced↗
PubMed1989

Interstitial lymphangiography: initial clinical experience with a dimeric nonionic contrast agent.

Interstitial lymphangiography performed with intradermal injection of a new nonionic dimeric contrast agent was used to examine 34 normal lower extremities and 35 lower extremities with proved lymphedema. An infusion pump was used to inject 2 mL of the contrast agent into the intradermal interdigital space at a rate of 0.1 mL/min. In all normal extremities, the injection deposit appeared homogeneous, and one to five lymph vessels could be identified. Diffusion of contrast agent into perilymphatic tissue occurred 30-40 cm proximal to the injection site; inguinal lymph nodes were, therefore, not routinely visualized. The findings at interstitial lymphangiography were abnormal in all extremities with advanced lymphedema. The results indicate that interstitial lymphangiography with the use of a nonionic dimeric contrast agent allows morphologic assessment of lymphatic vessels and facilitates the diagnosis of lymphatic obstructive disease.

Adolescent↗
PubMed2003

The grade of acute thymus involution in neonates correlates with the duration of acute illness and with the percentage of lymphocytes in peripheral blood smear. Pathological study.

In various stressful conditions, the thymus is subjected to incidental involution, mostly due to the thymocytolytic effect of secreted glucocorticosteroids. The aim of this study was to examine acute thymic involution in sick neonates and to compare the morphological grade with some clinical and laboratory parameters. The influence of the illness on thymus tissue was investigated in 100 neonates who were treated and died in a neonatology intensive care unit. The preterm infants (n = 73) were born before the 37th week of gestation. Analysis of 57 placentas showed inflammation in 32% and circulatory disturbances in 23% of the cases. The causes of death were confirmed by autopsy: 35 were preterm infants with respiratory distress syndrome without infection, 22 were malformed, and 10 had birth trauma or asphyxia. In contrast, 29 of the preterm infants had an infection, mostly pneumonia or sepsis, and 4 of the term infants had such infections. Acute thymus involution was histologically graded (0-4) according to the method of van Baarlen (see text). Resting state (grade 0) was found in 25 of 38 neonates who lived <12 h. In 13 of 38 neonates who lived <12 h, thymus involution suggested prenatal stress. The grade of thymus involution related to the duration of illness (p < 0.001). Placental inflammation was associated with features of thymus involution (p < 0.048). Infection as a cause of death was connected to advanced thymus involution (p < 0.001). In preterm newborns, infection was more often connected with acute thymus involution than was respiratory distress syndrome (p < 0.003). Among the parameters measured in all available peripheral blood samples taken 24 h before death, only the lymphocyte count related to the grade of acute thymus involution (p < 0.05), with an increase in percentage of lymphocytes in peripheral blood smears from grade 0 to 2 and a decrease from grade 2 to 4. Although the white blood cell count is highly variable, a low percentage of lymphocytes might be a sign of advanced accidental thymus involution following acute stress.

Acute Disease↗