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PubMed1982

Internal mammary lymphoscintigraphy in breast carcinoma: possible significance in relation to current treatment.

A diagnostic modality to study parasternal lymph nodes was examined at the Cancer Control Agency of British Columbia, Vancouver. Forty-five patients with carcinoma of the breast were studied. The data correlate well with that from other centres in regard to anatomic validity, lymph node distribution, cross drainage and findings in relation to the stage of disease. The frequency of lymphoscintigraphic abnormalities was almost twice as high in relation to lesions situated in the centre and inner half of the breast as compared with outer half lesions. Twenty-eight per cent of patients demonstrated cross drainage between parasternal lymphatics. In 11% of the patients, nodes were situated at locations greater than 4 cm from the midline. Work is in progress to study the correlation of lymphoscintigraphy with disease in the nodes. The data indicate that this study can be used in other centres in the management of patients with mammary carcinoma.

Adult↗
PubMed1975

Radiation enteritis in children. A retrospective review, clinicopathologic correlation, and dietary management.

The clinicopathologic features of radiation enteritis are reviewed in 44 children receiving whole abdominal radiation therapy between 1961-1972 at the Institut Gustave-Roussy. Five of 14 long-term survivors (36%) developed severe delayed radiation injury with small bowel obstruction, occurring within 2 months after completion of irradiation. All had previously had acute radiation reaction during therapy. Histologic appearance in the small bowel at the time of delayed radiation injury revealed severe villus blunting, lymphatic dilatation, and moderately dense inflammatory infiltrate. All patients with delayed radiation injury showed marked clinical improvement coincident with a fractionated low-residue, low-fat diet, free of gluten and free of milk and milk products. The abnormal small bowel roentgenographs and small bowel biopsies reverted to a normal appearance in association with the diet. No exacerbation of radiation enteritis has been seen following dietary therapy.

Adolescent↗
PubMed1994

Anatomic abnormalities of the retroperitoneum encountered during aortic and pelvic lymphadenectomy.

OBJECTIVE: Our purpose was to describe retroperitoneal abnormalities and related surgical problems encountered during lymphadenectomy. STUDY DESIGN: A prospective study was carried out on 309 consecutive patients with cervical, endometrial, and ovarian cancer treated with systematic aortic and pelvic lymphadenectomy at the Department of Gynecological Oncology of the Catholic University, Rome. RESULTS: Urinary and vascular anomalies were observed in five (1.6%) and 42 (13.6%) cases, respectively. Preoperative diagnosis was made by intravenous pyelography and computed tomographic scan in 14.9% (seven of 47) of patients with malformations. In three cases abnormal vessels were accidentally injured during lymphadenectomy with no postoperative sequelae. CONCLUSIONS: Preoperative diagnosis of retroperitoneal abnormalities is rarely made during routine preoperative workup. Thus during surgery an accurate surgical technique including adequate exposure of retroperitoneal organs and careful blunt dissection together with a knowledge of both normal and abnormal anatomy are necessary to avoid accidental injury to abnormal retroperitoneal organs.

Adult↗
PubMed1980

Internal mammary lymphoscintigraphy in the conservative surgical management of breast carcinoma.

Radiocolloid internal mammary lymphoscintigrams were carried out in 249 women who had undergone partial mastectomy. Only 39 patients, or 15%, had axillary sampling; of these, 19 were positive. At last follow-up, a minimum of two years from the date of study, the overall recurrence rate was 67% for patients with an abnormal lymphoscintigram and 34% for those with a normal lymphoscintigram. Actuarial survival rates projected to five years indicate a statistically significant difference in the prognostic implications of the normal and abnormal internal mammary lymphoscintigram, with 83 and 59% survival rates, respectively.

Adult↗
PubMed2000

Bone metastasis after a resection of stage I and II primary lung cancer.

In the present study, we reviewed the patients who developed bone metastases after a surgical resection of primary lung cancer and evaluated their clinicopathological features. From 1992 to 1995, 177 patients with stage I and II primary lung cancer underwent a surgical resection at the Kitakyushu Municipal Medical Center. Bone metastases were detected in 14 patients (7.9%) by follow-up examinations including bone scintigraphy (scan). Bone metastasis was one of the most frequent extra-thoracic recurrent forms. Patients with adenocarcinoma tended to develop bone metastases more frequently than those with squamous cell carcinoma. In the preoperative bone scans, an abnormal uptake was observed in 76 patients (42.9%), and 10 (13.1%) of them were found to develop bone metastases in the follow-up studies. A microscopic examination of the primary tumor demonstrated close correlation between intratumoral and peritumoral lymphatic vessel invasion and postoperative development of bone metastases. A bone scan is a very useful and indispensable procedure for diagnosing bone metastases. However, this scan may also show false positive finding in a number of benign conditions. Therefore, a surgical resection should be considered as the first-line treatment for patients with positive findings in the bone scan when the diagnosis of bone metastasis can not be confirmed based on both their symptoms and other clinical examinations.

Adenocarcinoma↗
PubMed1998

Mediastinal mature teratoma with coexistence of angiosarcoma, granulocytic sarcoma and a hematopoietic region in the tumor: a rare case of association between hematological malignancy and mediastinal germ cell tumor.

An association between mediastinal germ cell tumors (MGCT) and hematological malignancies (e.g. acute leukemia, malignant histiocytosis) has been recognized since 1984. A rare case of mediastinal mature teratoma with angiosarcoma, a hematopoietic region and granulocytic sarcoma is reported in a 29-year-old male. The resected tumor was 9.0 x 6.5 cm, weighed 65 g and showed extensive necrosis, forming a cyst. The histological features of the tumor showed a mature teratoma, which contained a large gland lined by ciliated epithelium, hyalinous cartilage, a paraganglion-like structure, well-differentiated angiosarcoma with atypical hematopoiesis composed of CD34-positive cells, and malignant round cells. The malignant round cells did not stain for CD34 but were positive for leukocyte common antigen (LCA) and c-kit product. From these findings, the round cells were diagnosed as granulocytic sarcoma. The patient died of metastasis of the granulocytic sarcoma in the tonsils and cervical lymph nodes 8 months after surgery. A leukemic condition was not present throughout the clinical course. The association between MGCT and hematological malignancy is a distinctive syndrome. However, its pathogenesis is still obscure and the origin of the hematopoietic malignancy has not been fully elucidated. In this particular case, it is suggested that the granulocytic sarcoma might have arisen from the abnormal hematopoietic area in the mediastinal teratoma.

Adult↗
PubMed1988

Hodgkin disease: clinical utility of CT in initial staging and treatment.

One hundred seven consecutive new cases of Hodgkin disease were evaluated with chest radiography and computed tomography (CT) for initial staging. The data were evaluated with regard to five popular treatment protocols for Hodgkin disease. Thoracic CT scans were normal in 30 of 31 patients who had normal radiographs. In the remaining 76 patients, CT demonstrated 194 new sites of disease and disproved 25 suspected sites of disease. The use of CT scans changed the staging of disease in 20 patients, 16 of whom had extranodal extension. The effect of using CT findings on treatment depended on whether radiation therapy was used, and, if so, which treatment protocol was followed. The use of CT findings would have changed the treatment in 6.5%-62.7% of new cases of Hodgkin disease. The authors recommend that CT scans be obtained in all patients with Hodgkin disease, especially those with abnormal chest radiographs.

Adult↗
PubMed1975

Cardiac lymph flow and composition in acute myocardial ischemia in dogs.

Cardiac lymph was obtained from 12 normal dogs (group 1) for two consecutive 2-h control periods and from 7 dogs (group 2) for 2 h before and 2 h after occlusion of the circumflex branch of the left coronary artery. Lymph composition was studied with reference to pH, red blood cell (RBC) concentration, total protein content, potassium and sodium ion concentrations, and creatine phosphokinase (CPK) and acid phosphatase enzyme activities. No significant difference was noted in any variable between the two groups during the firts 2-h period. In group 1, no significant changes occurred in any variable as a result of the passage of time alone. In group 2, 2 h of myocardial ischemia produced increases of 53.3 plus or minus 5.1% in lymph flow, 67 plus or minus 5% in protein content, and 418 plus or minus 27% in the RBC concentration, suggesting increased blood capillary permeability. Lactate rose 120.5 plus or minus 27%, potassium concentration increased 16.9 plus or minus 2.4%, acid phosphatase increased 30 plus or minus 3%, and CPK rose 61.6 pluse or minus 10.9%, suggesting ischemic injury of myocardial cells. These changes in lymph were statistically significant (P LESS THAN 0.05) and reflect both capillary and myocardial cell abnormalities.

Animals↗
PubMed2001

Cotton-wool spots associated with pancreatic carcinoma.

BACKGROUND: Malignant tumors of different organs may cause changes in the eye. PATIENTS: A 62-year-old woman and a 47-year-old man who both had a metastasizing carcinoma of the pancreas suffered from visual disturbances. RESULTS: The 62-year-old woman experienced cloudy vision in her left eye. The 47-year-old man noticed a left visual deterioration. Both patients exhibited cotton-wool spots in both eyes. In addition, the man revealed a metastasis of the choroid in the right eye. The woman was treated with Gemcitabine (1999), and the man with 5 Fluo-Uracil/Leukovorin (1997). The cotton-wool spots were reduced in size in the woman after treatment with Gemcitabine. The patients had no diabetes mellitus and no arterial hypertension. After termination of treatment, their general condition deteriorated and they died within a few weeks. CONCLUSION: Cotton-wool spots are unusual findings in the retina of a metastasizing carcinoma, suggesting the presence of a retinal ischemia. Therefore, early screening of patients with metastasizing pancreas carcinoma for retinal abnormalities may be important.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Radiologic double-contrast aspects of small esophageal cancers. 38 cases].

Double contrast radiological features of thirty eight small esophageal carcinoma are described. Double contrast study is essential in the detection of small esophageal carcinomas: localized thickening of the folds (29%), localized wall stiffness (23.6%), superficial ulcers (13%), discrete superficial nodule (42%), nodularity (15.7%), and ulcerated nodule (15.7%). In our series, six carcinomas arising from reflux esophagitis have the nodular appearance. As in the majority of the cases, small esophageal carcinomas are asymptomatic, when radiologic study of esophagus is performed in patients over 40 years with heavy alcohol and tobacco use, it is imperative to use the double contrast method and to carefully search for minor mucosal abnormalities.

Adenocarcinoma↗
PubMed1984

Leukocyte involvement in pulmonary localization of blood-borne microparticulates: relationship to altered lung fluid balance.

The lung lymph fistula preparation in sheep was used to study the influence of localization of blood-borne foreign microparticulates in the lung on lymph flow (Qlym); lymph-to-plasma total protein concentration ratios (L/P); pulmonary transvascular protein clearance (Qlym X L/P); and pulmonary hemodynamics. Test particles small enough to readily pass through capillary beds were infused intraarterially to avoid acute lung vascular injury by macroembolism. In sheep, tissue distribution patterns demonstrated that by 15 min after intravenous infusion of the gelatinized reticuloendothelial (RE) test lipid emulsion (0.8-1.0 micron) or gelatinized colloidal carbon (250 A), 30-35% of the injected particle dose localized in the lung, with approximately 15-22% in RE cell-rich organs such as the liver. Particle infusion resulted in an acute neutropenia in the absence of a decline in platelets. Electron microscopy revealed that the increased particulate localization in the lung reflected particle uptake by marginated phagocytic cells as well as the presence of microaggregates within the vascular space. Lung localization of both particulates resulted in approximately a 200-300% increase in both lymph flow and transvascular protein clearance. The hemodynamic response coupled with the pattern of transvascular protein clearance in relationship to lymph flow suggests that the alterations in fluid and protein flux were due to both an increase in microvascular pressure as well as an increase in lung vascular permeability. Marginated phagocytic cells which rapidly ingest the blood-borne foreign test particles may contribute to the altered lung fluid balance seen with the entrance of foreign or abnormal microparticulates in the blood.

Animals↗
PubMed1980

Malignant histiocytosis in adults: report of 7 patients from Northeast Italy.

The clinical records and histologic material of seven adult male patients with malignant histiocytosis (MH), observed consecutively at our center during a four-year period, have been reviewed; four of these cases were seen in a year. All patients were born and lived within a radius of 30 miles from Pordenone, a town in northeast Italy. The diagnosis of MH was made in all cases on lymph node biopsy on the basis of the established histologic criteria [1]. At presentation, abnormal histiomonocytic cells were found in the bone marrow and peripheral blood of four patients, two of whom also showed cerebrospinal fluid involvement with atypical histiocytes at a relatively early stage of the disease. Staging procedures documented extensive disease in lymphatic, as well as in extralymphatic, sites in four patients; in three patients, the disease was confined to the lymphatic system. Combination chemotherapy was the first treatment employed in all cases. Four patients, three of whom had limited disease, achieved complete remission with quadruple combination chemotherapy (ABVD, CHOP, or MOPP); three patients with extensive disease achieved only partial remission of short duration with HOP. These results further support the view that adult MH is not obligatorily and rapidly fatal. Good responses to treatment with combination chemotherapy are possible, particularly in patients with disease limited to only lymphatic sites.

Adult↗
PubMed2001

Histological insight into the pathogenesis of severe laryngomalacia.

OBJECTIVE: To correlate clinical and histological findings in patients with laryngomalacia who required surgical intervention. METHODS: Retrospective study of all patients undergoing supraglottoplasty by a single surgeon (MEG) for severe laryngomalacia between October, 1999 and November, 2000. RESULTS: Nine patients were identified, of which seven had clinical evidence of GER. Seven patients had co-existing abnormalities or delays of neuromuscular development including seizure disorder, agenesis of the corpus callosum, obstructive sleep apnea, primary aspiration, a history of apparent life-threatening events, and craniosynostosis. Varying degrees of subepithelial edema and significant dilation of the subepithelial lymphatics were noted in all specimens. Submucosal inflammation was minimal to mild, and intraepithelial inflammation was rare to absent in all sections. No submucosal gland hyperplasia was seen in the samples from any patient. Two specimens contained cuneiform cartilage, both of which were histologically characterized as fibrocartilage. CONCLUSIONS: In this series, the histopathology of tissue excised during the treatment of severe laryngomalacia was dominated by submucosal edema and lymphatic dilation. Further study is needed to investigate comorbidities that may contribute to the need for intervention in children with laryngomalacia.

Epiglottis↗
PubMed1995

Early prenatal diagnosis of axillary cystic hygroma.

Fetal axillary cystic hygroma has been reported rarely and only as a sonographic finding late in gestation. A retrospective study of 19,200 early second trimester screening ultrasonograms for anomalies revealed five cases of axillary cystic hygroma. All of the axillary hygromas were small, transient, nonloculated cysts. Three cysts were associated with chromosomal abnormalities: trisomy 21 in two cases and a single case of trisomy 18 in which structural abnormalities also were detected. Early fetal axillary cystic hygroma appears to be different from postnatal axillary cysts on the basis of differences in prevalence, structure, and appearance. It also may be a normal variant in the development of the fetal lymphatic system.

Axilla↗
PubMed1990

Nuclear DNA measurements of metastatic melanoma by a computerized digital imaging system.

To determine the extent of nuclear DNA abnormalities and their relationship with prognosis of stage II malignant melanoma, metastatic melanomas in lymphadenectomy specimens of 22 patients were studied by a computerized digital imaging system. The DNA ploidy pattern was aneuploid in 86% of the cases and tetraploid in the remaining 14%. In metastatic melanomas, there was a single clone in one third of patients and multiple clones in the remaining two thirds. Poor survival rate was associated with multiple clones and greater than 30% of mean coefficient of variation of DNA content. With tumor progression stem-cell lines often became heterogeneous with the development of multiple clones and widespread DNA values. These abnormalities, determined by nuclear DNA ploidy analysis, provide useful prognostic information.

DNA, Neoplasm↗
PubMed1990

Allantois as the bursa-equivalent in man.

This article proposes the hypothesis that allantois is the anatomical homologue of bursa of Fabricius in mammalia. This hypothesis is based on immunohistochemical study of sections from hematopoietic organs of three fetuses with cloacal exstrophy. In the complex maldevelopment of cloacal exstrophy the common features are absence of distal midgut and exstrophy of cloaca with an exstropic intervening intestinal band. It has been suggested that gut is of dual origin and in addition to the yolk sac, allantois, absent in this maldevelopment, is involved in the embryogenesis of intestines by developing into distal midgut. There was absence of B-lymphocyte in two of three fetuses with rudimentary midgut and aplastic allantois. Meanwhile, B-cells were identified in the hematopoietic tissues and the prominent Peyer's patches of the more developed exstrophic allantois in the third case presented here. Therefore, it is concluded that allantois as the origin of distal midgut and lymphatic-rich ileocecal portion of digestive system is directly involved in the B-cell formation and represents the bursa of Fabricius in man.

Abnormalities, Multiple↗