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PubMed1992

Lymphadenopathy, oligoclonal T cell receptor rearrangement and systemic lupus erythematosus.

To investigate the cause of generalized lymphadenopathy in case of systemic lupus erythematosus (SLE), we performed a molecular genetic analysis of lymph node, peripheral blood mononuclear cell and bone marrow specimens with T cell receptor and immunoglobulin gene probes. Oligoclonal T cell receptor rearrangements were detected in the lymph node cells. The oligoclonal T cell expansion observed is the first such example reported in SLE, and may be indicative of an immune response to specific antigenic challenge. Alternatively, these changes may represent the earliest phases of a malignant process. Molecular genetic investigations in autoimmune disease such as SLE can provide opportunities to enhance our understanding of the underlying condition, or reveal unexpected abnormalities requiring further assessment.

Blotting, Southern↗
PubMed2003

Lymphoscintigraphic analysis in chromoblastomycosis.

BACKGROUND: One of the main complications of chromoblastomycosis is lymphedema. The purpose of this study was to evaluate the lymphatic system of the limbs of patients with chromoblastomycosis using lymphoscintigraphy. It is a reliable, objective and noninvasive means of supporting the diagnosis of lymphedema. METHODS: Lymphoscintigraphy was performed in seven patients with chromoblastomycosis, six with lesions in the lower limb and one in the upper limb. Tc-99 m dextran was injected into the interdigital spaces of the upper or lower extremities. The qualitative parameters analyzed were the visibilization of the lymph vessels and the lymph nodes, dermal backflow, and existence of collateral vessels. All patients were treated with the association of itraconazole and cryotherapy with liquid nitrogen. RESULTS: Three out of the 14 extremities examined had lymphedema clinically, and the lymphoscintigraphy showed abnormalities in the qualitative parameters; whereas these parameters were normal in the extremities without lymphedema. During the treatment of chromoblastomycosis, a second lymphoscintigraphy exam was performed on 10 limbs and did not show any improvement of the previous lymphoscintigraphic alterations. CONCLUSIONS: The qualitative lymphoscintigraphy was a reliable method to show the morphology of the lymph vessels and confirm objectively the diagnosis of lymphedema secondary to chromoblastomycosis. The association of oral itraconazole and cryotherapy did not modify the lymphatic alterations in chromoblastomycosis.

Adult↗
PubMed2002

Promoter methylation and silencing of PTEN in gastric carcinoma.

The PTEN/MMAC1/TEP1 gene (phosphatase and tensin homolog deleted on chromosome 10/mutated in multiple advanced cancers/TGF-beta regulated and epithelial cell enriched phosphatase 1), which regulates the signaling pathways of Akt, is a novel tumor suppressor gene implicated in multiple cancers. Because a number of tumor suppressor genes are known to be silenced by aberrant promoter methylation, we examined the methylation status of the 5' CpG islands of PTEN using methylation-specific PCR. The altered expression of PTEN in 310 gastric carcinomas was analyzed by immunohistochemical staining using tissue-array and clinicopathologic profiles related to PTEN expression were characterized. Of 310 consecutive gastric carcinomas, 62 cases (20%) showed expression loss of PTEN. Altered PTEN expression was significantly associated with tumor depth and size, lymphatic invasion, advanced stage, pTNM stage, and patient survival (p < 0.001). The promoter methylation frequency of PTEN was found to be present in 26 (39%) of 66 cases examined, and 19 (73%) of 26 gastric cancer tissues showing promoter methylation exhibited the loss of PTEN expression. Abnormalities in the expression of PTEN significantly correlated with promoter methylation (p < 0.001). In conclusion, silencing of the PTEN gene occurs frequently in gastric carcinoma and aberrant promoter methylation is a major mechanism of silencing of the PTEN gene. The abnormalities of the PTEN gene are associated with tumor progression, metastasis, and survival.

Adenocarcinoma, Mucinous↗
PubMed1975

Thymic origin of abnormal lymphoid cells in Sézary syndrome.

A patient with a 5-year history of pruritus and progressive and generalized erythroderma was found to have abnormal lymphocytes in the peripheral blood and mononuclear dermal infiltrate, all of which are features consistent with those described in Sézary syndrome. Systemic chemotherapy produced an almost complete resolution of skin lesions and pruritus. Serial studies on the abnormal cells included responses to phytohemagglutinin, cytogenetics, and immunofluorescence tests for identification of B or T lymphocytes. The abnormal cells demonstrated hyperdiploidy; the ratio of B to T cells fell whenever abnormal lymphocytes appeared in the peripheral blood, and returned to normal when abnormal cells disappeared from circulation. Lymphocytes separated from a skin nodule labeled as T cells. We conclude that the abnormal lymphocytes in this patient are of thymic origin.

Biopsy↗
PubMed1996

The use of sonography in differentiating cervical lymphomatous lymph nodes from cervical metastatic lymph nodes.

Lymphoma and metastases are common causes of cervical lymphadenopathy. Clinical examination alone is unable to differentiate the two. Ultrasound (US) with its high sensitivity and specificity when combined with a find needle aspiration cytology (FNAC) is therefore the ideal initial investigation. We present the spectrum of findings in 19 patients with non Hodgkins lymphoma (NHL), 15 patients with pharyngeal, laryngeal and oesophageal (PLO) carcinomas, 22 patients with oral cavity tumours and 12 patients with infraclavicular carcinomas. The US features found consistently useful in differentiating NHL from other metastases were the distribution of the nodes, distal enhancement and lack of intranodal necrosis. Other US features of abnormal nodes helped identify abnormality but did not help in differentiation.

Adolescent↗
PubMedDate not supplied

A comparison of MRI and PET scanning in surgically staged loco-regionally advanced cervical cancer: potential impact on treatment.

The aim of this study was to assess whether positron emission tomography (PET) or magnetic resonance imaging (MRI) could obviate the need for surgical staging in patients with locally advanced cervical carcinoma being planned for radiotherapy (RT). Imaging findings were compared to surgical staging in 27 patients including three with recent resection of the primary tumor. Both PET and MRI visualized all 24 residual cervical tumors. Primary tumor volume, as measured by MRI scan, ranged from 1.25 cc to 140 cc. In 24 patients evaluable for pelvic nodal status, PET had sensitivity, specificity, and positive and negative predictive values of 83%, 92%, 91% and 85%, respectively, with 88% accuracy. MRI detected only six in 12 (50%) patients with confirmed pelvic nodal disease, all of which were also seen by CT and PET, with an overall accuracy of 75%. PET detected only four in seven (57%) cases with confirmed para-aortic (PA) involvement. All histologically confirmed sites not visualized on PET were <1 cm. Without surgical staging, six in 10 (60%) patients with histologically proven pelvic nodal disease would not have received pelvic boost if guided by MRI alone, compared to two in 10 (20%) patients guided by PET alone or in combination with MRI. All four patients with positive PA on PET were confirmed on histology or clinical follow-up, including one case that proved to be a false negative one on surgery. However, in three cases, PET would have yielded an inadequate radiation volume. In conclusion, the positive predictive value of PET in the pelvis and para-aortic region appears sufficient to obviate lymph nodal sampling, but sampling is still required to exclude small-volume disease cranial to sites of abnormality on PET. MRI has insufficient accuracy for nodal staging to impact management.

Adenocarcinoma↗
PubMed1983

Histiocytoid hemangioma with features of angiolymphoid hyperplasia and Kaposi's sarcoma. A study by light microscopy, electron microscopy, and immunologic techniques.

We examined by light and electron microscopy 99 vascular lesions removed on 17 occasions over a 2-year period from a 55-year-old black man. The lesions all showed histologic features of a vascular neoplasm composed of enlarged "histiocytoid" endothelial cells and overlapping features of angiolymphoid hyperplasia with eosinophilia and Kaposi's sarcoma. An apparently unique feature was early loss of melanin from the overlying epidermis and a mononuclear inflammatory-cell infiltrate. The patient also had an abnormal immunologic state very similar to that seen in homosexuals with Kaposi's sarcoma.

Endothelium↗
PubMed1994

Abdominal abnormalities in AIDS: detection at US in a large population.

PURPOSE: The authors studied the prevalence of abnormalities at abdominal ultrasonography (US) in patients with acquired immunodeficiency syndrome (AIDS), the temporal change in prevalence, and the use of US to correlate clinical indications with these abnormalities. MATERIALS AND METHODS: From 1983 to 1991, 899 AIDS patients were seen, representing 89.36% of the 1,006 AIDS patients in the province during that time. Of these, 414 underwent 684 US studies, 399 of which were able to be reviewed. RESULTS: US results showed abnormalities in 264 of the 399 studies, including splenomegaly (n = 124), lymphadenopathy (n = 83]), gallbladder and bile duct abnormalities (n = 80), hepatomegaly (n = 77), and ascites (n = 54). Clinical indications with the highest frequency of abnormal findings included hepatosplenomegaly (n = 337) and abnormal liver function tests (n = 270). Lymph nodes more than 3 cm in diameter (in 10 of 83 patients with enlarged nodes) always represented an abnormality other than reactive hyperplasia. The percentage of abnormal results went from 25% in 1984 (two of nine studies) to 81% in 1990 (77 of 95 studies). CONCLUSION: The prevalence of abdominal abnormalities depicted at US in AIDS patients has increased since 1983.

Abdomen↗
PubMed1981

Antegrade spermatic phlebography in the diagnosis of metastases from testicular tumors.

Antegrade spermatic phlebography was performed in 18 patients in connection with orchiectomy because of testicular expanding lesions and was compared with other diagnostic methods. Fifteen of the cases were teratomas or seminomas. In 6 patients metastases were demonstrated at phlebography and later confirmed. In one case no abnormality was found at phlebography, nor at CT, but at lymphography metastases were found in not enlarged lymph nodes. Due to technical error at phlebography one case was falsely considered abnormal. The technique is described and its use as a screening procedure for metastases is advocated.

Adult↗
PubMed1982

Pre- and postoperative abdominal examinations in testicular carcinoma.

The histopathologic findings at retroperitoneal lymph node excision in 29 patients with a non-seminomatous germ cell tumour were compared with the findings at preoperative computed tomography, ultrasound and lymphography. The possibilities of detecting retroperitoneal metastases are somewhat greater with computed tomography than with lymphography. In the present material ultrasound was less reliable than computed tomography for demonstrating small metastases. At postoperative follow-up, in more than half of the patients computed tomography could not discriminate benign postoperative abnormalities from recurrent tumours. Ultrasound seemed to be a more reliable method for postoperative evaluation of the retroperitoneal space.

Adolescent↗
PubMed2002

Histopathological correlates of abnormal pericolic fat on CT in the assessment of colorectal carcinoma.

The aim of this study was to assess the pathological significance of abnormal pericolic fat shown by CT in the context of colorectal carcinoma. CT and histopathological findings of 63 resected colorectal carcinomas were retrospectively reviewed. CT examinations were assessed by two observers for the presence or absence of abnormal pericolic fat (typically linear or nodular opacities) at tumour sites. Specimens were reviewed histopathologically for depth of tumour invasion, extramuscular tissue reaction, and number and largest size of tumour-involved and tumour-free lymph nodes. The sensitivity, specificity, positive predictive value and negative predictive value of pericolic fat in identifying extension of tumour infiltration beyond the muscle coat were 79% (42/53), 33% (2/6), 91% (42/46) and 15% (2/13), respectively. Despite these indicators of efficacy, the association between the presence of pericolic fat abnormality on CT and extramuscular extension of tumour (infiltration and/or nodal disease) or tissue reaction alone or in combination did not reach statistical significance (p>0.3 in all cases). Abnormal ("misty" or "mucky") pericolic fat in the assessment of colorectal cancer on CT is not a precise indicator of extramuscular extension of tumour, as it cannot clearly distinguish between tumour infiltration and tissue reaction beyond the muscle coat, or pericolic nodal involvement. However, it is a very helpful CT sign that may draw attention to the presence and site of a potential colonic abnormality.

Adipose Tissue↗
PubMed1989

[Contact thermography as a prognostic indicator of breast cancer].

Ninety-seven primary, operable cancer patients were followed after surgery with a median follow-up of 44 months. Thermograms were classified into 3 categories: normal, equivocal and abnormal. There has been no recurrence in patients with normal thermographic pattern. Patients with abnormal thermographic pattern showed poor prognosis: 88% survival and 80% recurrence-free survival rate at 3 years. Normal thermographic pattern favored the survival curves and recurrence-free survival curves, even if stratified by nodal states. There seems to be no correlation between thermographic patterns and sites of recurrence, but patients with abnormal thermographic patterns tend to have recurrences at more than one site.

Breast Neoplasms↗
PubMed1997

[Hygroma colli (cervical neck edema) as an ultrasonographic parameter of fetal chromosome anomalies].

A two year retrospective study of 57 women with fetal hygroma colli between 2 and 15 mm was carried out at the University Women Hospital in Heidelberg. In this study maternal age, week of gestation, thickness of the nuchal oedema and the genetic results of amniocentesis were documented. Chromosomal abnormalities were found in 20 cases (35%), monosomy X in eleven, trisomy 21 in five and trisomy 18 in four. No connection between an individual syndrome and a particular week of gestation could be found. An increase of the thickness of the nuchal oedema showed a significant correlation to the incidence of aneuploidies. Chromosomal abnormalities were not observed in cases of less than 3 mm thickness (0/5). Between 3 and 4.9 mm one abnormal karyotype (4 mm) was found (1/18) whereas in the group of 5-6.9 mm approximately one third (6/15) of all fetuses showed chromosomal abnormalities. Aneuploid karyotypes were found in two thirds of cases (14/20) with a fetal nuchal translucency of 7 mm and more. Surprisingly, a correlation between maternal age and incidence of fetal chromosomal abnormality could be seen, but it was not significant. While a chromosomal aberration could be connected to age in 50% of mothers under the age of 25 and over 34, only a third of women aged 25-29 and only one fifth aged 30-34 showed chromosomal abnormalities in combination with hygroma colli. Our results confirm the recommendation of previous studies for extensive ultrasound examination during the first and second trimester in order to improve early detection of fetal chromosomal abnormalities particularly in women not normally covered by the age-related indication for amniocentesis.

Adult↗
PubMedDate not supplied

Genital manifestations and reproductive health in female residents of a Wuchereria bancrofti-endemic area in Tanzania.

To assess the significance of lymphatic filariasis for the development of chronic genital manifestations and for reproductive health in women, we conducted a cross-sectional study of 2 villages in north-eastern Tanzania including interview and gynaecological examination of adult women, focusing primarily on reproductive history and genital health. In a population of 2165 residents, prevalence of Wuchereria bancrofti microfilaraemia was 28%, and geometric mean intensity of microfilariae (mf) was 722 mf/mL. Leg lymphoedema (elephantiasis) was present in 4.2% of adults aged > or = 15 years, and hydrocoele in 26.5% of adult males. Five hundred and thirty women completed an interview, and 404 of these completed a gynaecological examination. Most women were Muslims (72%), polygamy was common (29%), and 49% of women had undergone circumcision (clitoridectomy). Presence of microfilaraemia did not influence fertility or fertility-related variables including age at menarche, parity, spontaneous abortion, stillbirth, Caesarean section and premature labour, nor presence of primary or secondary infertility. Mf status was strongly correlated with abnormal menstruation pattern in the 30+ years age-group (P = 0.001), but not in the < 30 years age-group. Cervical, vaginal and vulval pathology was unrelated to mf status. Two women, aged 46 and 77 years, had vulval oedema of probable filarial origin, both were mf negative. Overall, microfilaraemia appeared to have no influence on genital disease or reproductive health, and chronic manifestations of lymphatic filariasis of the genitals does not appear to be a substantial problem in women.

Adolescent↗
PubMedDate not supplied

Head and neck neoplasia following irradiation for benign conditions.

A retrospective review of 143 patients with head or neck tumors who had received radiation therapy in the head and neck area for benign conditions during childhood or adolescence was conducted. This included an analysis of 1,080 patients from the Evanston Hospital Irradiated Thyroid Evaluation Clinic, which was established to define the relationship between irradiation and the subsequent development of thyroid neoplasia. The data support the following concepts of irradiation-induced neoplasia: (1) The thyroid, parathyroid, and salivary glands can develop benign and malignant changes after irradiation for benign conditions, with latent periods averaging about 30 years; (2) Once a glandular abnormality within the irradiated field appears, the risk of other glands in the field developing neoplastic changes is significantly increased.

Adenoids↗
PubMed2005

Localization of chyle leakage site in postoperative chylothorax by oral administration of I-123 BMIPP.

The authors present a 71-year-old woman who had a right chylothorax after right upper lobectomy for lung cancer. As the chylothorax was considered to be due to thoracic duct injury at the time of operation, lymphoscintigraphy was performed by oral administration of I-123 beta-methyl-iodophenyl pentadecanoic acid (BMIPP). After visualization of the stomach and intestine, abnormal accumulation of the radiotracer was found initially around the right pulmonary hilum and then spread laterally in the upper pleural cavity, indicating chyle leakage in the region of the right pulmonary hilum. Scintigraphic finding was well correlated with the subsequent thoracoscopic observation, showing chyle leakage from a lymphatic tributary near its confluence to the thoracic duct at the level of the azygos continuation. The disruption site was ligated by video-assisted-thoracoscopic-surgery procedure with successful termination of the chyle leakage. Lymphoscintigraphy by oral administration of I-123 BMIPP is thought to be a useful method for localization of chyle leakage in patients with chylothorax induced by thoracic surgery.

Administration, Oral↗