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At least 1,153 records · Page 64Linked to original sources
PubMed1998

Two cases of intrapulmonary lymph node presenting as a peripheral nodular shadow: diagnostic differentiation from lung cancer.

We present two cases of intrapulmonary lymph node. The patients were a 44-year-old woman and a 71-year-old man each with a small peripheral nodule in the lung. On computed tomography (CT) scans, both nodules were spiculated. Since histological diagnosis could not be obtained by bronchoscopic examination or CT-guided needle biopsy, they underwent video-assisted thoracoscopic surgery. Histological examination of the resected material revealed that both nodules were composed of lymph node. Intrapulmonary lymph node has until recently been assigned no clinical significance; however, differential diagnosis of this lesion from lung cancers and other metastatic tumors is now clinically important.

Adult↗
PubMed2005

[Which is the most appropriate diagnostic algorithm for prostate cancer screening?].

Since the use of PSA to detect prostate cancer was generalised in the late 1980's, prostate cancer diagnosis has increased considerably. Although there is now indirect evidence pointing to the beneficial effect of screening, there are no data justifying PSA screening in the general population. There is also a controversy concerning the most appropriate algorithm, should screening be performed. Therefore, our aim was to review the literature and, based on our experience, attempt to define the best algorithm for prostate cancer screening. We have made a search on Medline using the following terms: prostate biopsy, screening, algorithms, radical prostatectomy, PSA and prostate cancer. After analysing the literature, we can confirm that there is no "definitive" algorithm, due to the rapid appearance and use of new technical and biological breakthroughs, although it appears that at this time, without ceasing to include a rectal examination, more value should be given to personal risk factors, including PSA, at ages under 50, with individual monitoring based on these factors. The algorithms applied to a population have first to be validated for the population concerned.

Algorithms↗
PubMedDate not supplied

[Distribution of polyps in the inside region of Vizcaya (Spain): implications for diagnostic tests and colorectal cancer screening].

INTRODUCTION: The importance of colonic polyp is increasing because colorectal cancer (CRC) screening is based on their identification. However, consensus is lacking on which technique should be used in CRC screening, whether colonoscopy or other methods such as sigmoidoscopy, which shows good sensitivity only in distal segments of the colon. We studied the characteristics and localization of polyps in our environment to verify their tendency to change localization and determine the implications of this in screening. MATERIAL AND METHODS: We reviewed the prevalence and characteristics of colonic polyps in 3604 patients who underwent colonoscopy for various causes in our service, as well as their distribution in 837 patients with a diagnosis of polyps who underwent complete colonoscopy. Localization proximal or distal to the splenic flexure and polyp size (less than or more than 1 cm) were analyzed. RESULTS: Polyps were found in 28.3% of 3604 patients (11.7% showed polyps > or = 1 cm). Of the 837 patients who underwent complete colonoscopy, proximal polyps were found in 44.9% (14.6% showed polyps > or = 1 cm), while distal polyps were found in 79.9% (30.3% showed polyps > or = 1 cm). Both proximal and distal polyps were found in 24.8%. The probability of finding both proximal and distal lesions was 31%. Proximal lesions without distal lesions were found in 20% of the patients (5.6% presented polyps > or = 1 cm), and consequently sigmoidoscopy would miss 15.6% of polyps > or = 1 cm. CONCLUSIONS: A relatively high percentage of patients with proximal polyps > or = 1 cm would remain undiagnosed if complete colonoscopy were only performed in patients with distal polyps. Because of the well-known increase in the frequency of proximal polyps and because a considerable number of these present without distal sentinel lesions, there are increasing arguments for considering colonoscopy as the basic technique for CRC screening.

Colon↗
PubMed2000

[The diagnostic situation with prostatic cancer in primary care].

OBJECTIVES: To evaluate the quality of diagnosis in primary care (PC) of prostate cancer (CP) and to analyse the factors linked to late diagnosis. DESIGN: Retrospective, cross-sectional study. SETTING: Five PC centres and a hospital (covering about 130,000 inhabitants). PATIENTS: All CP diagnosed in PC between April 1989 and October 1996. MEASUREMENTS AND MAIN RESULTS: PC clinical history, hospital records and request for specialist consultation in 41 cases were reviewed. In cases coming from PC (71%), the most frequent clinical picture was mixed prostate syndrome (44.8%). PSA (20.7%) and urine sediment (17.2%) were the most commonly requested investigations. Rectal touch (RT) occurred in one case (3.4%) and four cases were diagnosed as CP. In the urology service, RT occurred in 68% of cases, with PSA determined in 59% of those who had not had it. After the first visit, 44% were diagnosed as CP. Two time intervals in common between PC and hospital were studied: referral-specialist visit and specialist visit-diagnosis. In PC there were mean delays of 50 days (SD, 53; percentile [P] 25 = 14; P50 = 35; P75 = 75) and 420 days (SD, 595; P25 = 72; P50 = 194; P75 = 490), respectively. In the hospital the times were 6 days for the first (SD, 6; P25 = 2; P50 = 5; P75 = 8.5), and 168 for the second (SD, 176; P25 = 34; P50 = 130; P75 = 271). The differences were statistically significant: p = 0.0006 and p = 0.05. CONCLUSIONS: Doing RT and PSA determination in primary care would favour diagnosis in the cases of CP. The creation of training programmes and rapid referral routes to hospital could reduce the delays looked at.

Cross-Sectional Studies↗
PubMed1985

CT scan as a diagnostic tool to detect cancer invasion in the carotid artery.

The presence of cervical lymph node metastasis in head and neck tumors is usually determined by manual neck palpitation. However, this method cannot ascertain whether carotid artery invasion is present or not. Actually, fixed lymph node metastasis means nothing but deep fascia invasion of the metastasis. Contrast CT scan, on the contrary, can present exact information about the carotid artery. We investigate the comparison between CT scan results and surgical results in this paper.

Carotid Artery Diseases↗
PubMed1996

HPV infection and disease in men.

Penile HPV infection and disease are very common in sexually active men, and may be manifest in many forms. Treatment of clinically detectable lesions is advisable not only to relieve symptoms but also to prevent the spread of HPV infection to new sexual partners. Treatment of subclinical disease is more controversial but also may be advisable in some cases given the evidence that these lesions may also harbor infectious virus. In addition, subclinical disease may demonstrate intraepithelial neoplasia, which if left untreated may progress to invasive cancer in a small number of cases. Anal HPV infection and ASIL are very common in high-risk homosexual and bisexual men, particularly among those who are HIV positive. Parallels with cervical HPV infection and disease suggest that anal HSIL may be precancerous, and indeed anal cancer may be as common or more common in this high-risk group as cervical cancer is in women. Further studies are needed to elucidate the natural history of ASIL, the role of immunosuppression in progression to invasive cancer, optimal diagnostic methods, and optimal treatment regimens. Like cervical cancer, anal cancer may be a preventable disease, and implementation of a well-targeted screening program similar to that in place for cervical disease should be considered in the future when appropriate supporting data become available.

Adult↗
PubMed1997

Clinical manifestations and diagnostic approach to metastatic cancer of the mandible.

In a 12-month period, metastatic cancer was diagnosed in eight patients. Six of them presented with pain mimicking toothache, temporomandibular joint disorders or trigeminal neuralgia, while two showed osteopenic bone lesions in the panoramic radiography, and perimandibular swelling. Anesthesia of the lower lip was the only common clinical feature. In seven of the eight patients, a whole body bone scintigraphy and single photon emission computed tomography (SPECT) of the skull in combination with a whole body and SPECT anti-granulocyte (Tc-99m MAK 250/183) bone marrow scintigraphy was performed. One patient did not have combined scintigraphy performed secondary to severe systemic illness. In six of the seven, the results were conclusive for a metastatic bone lesion. Biopsies confirmed three patients to have a previously unrecognized primary cancer, one patient to have previously unrecognized recurrent cancer, and three patients to exhibit new metastatic spread of an already diagnosed cancer. Histology revealed breast, lung, renal cancer and a malignancy of inconclusive origin. In the remaining patient, combined scintigraphy suggested osteomyelitis, yet biopsy revealed a prostate cancer metastasis with acute inflammatory cell infiltration. Thus, the scintigraphy pattern of a hot spot in the bone scan and a cold lesion in the bone marrow scintigraphy is highly suggestive of a mandibular metastasis, if accompanied by anesthesia of the lower lip.

Aged↗
PubMed1996

CAM 17.1--a new diagnostic marker in pancreatic cancer.

CAM 17.1-Ab is a recently described monoclonal antibody that detects a mucus glycoprotein with high specificity for intestinal mucus, particularly in the colon, small intestine, biliary tract and pancreas. We investigated the expression and release of CAM 17.1 in pancreatic carcinoma cell lines and tissue specimens of normal pancreas, chronic pancreatitis and pancreatic cancer. CAM 17.1 was weakly expressed on normal ductal cells and chronic pancreatitis, whereas it was overexpressed in pancreatic cancer. Serum analysis using a new enzyme-linked antibody sandwich assay (CAM 17.1/WGA) of patients with chronic pancreatitis, pancreatic cancer or other gastrointestinal cancer and of healthy blood donors revealed a high sensitivity (67%) and excellent specificity (90%) of CAM 17.1/WGA assay in pancreatic cancer. In comparison with the tumour marker CA19-9, the sensitivity of the CAM 17.1/WGA assay was similar to the sensitivity of CA 19-9 (67% and 76%, P = 0.22), whereas the specificity of CAM 17.1/WGA assay was higher than in CA 19-9 (90% compared with 78% in chronic pancreatitis, P > 0.05).

Adult↗
PubMed1997

Detection of telomerase activity in human prostate: a diagnostic marker for prostatic cancer?

OBJECTIVE: To assess the role of telomerase activity as a marker for the development of prostate cancer in men with existing benign prostatic hyperplasia (BPH), a known risk factor for prostatic carcinoma. MATERIALS AND METHODS: Telomerase activity was assayed, using a highly sensitive polymerase-chain reaction-based assay, in nine biopsies from patients with prostatic cancer, 16 from patients clinically diagnosed with BPH and 11 from patients with no evidence of prostatic disease. RESULTS: Telomerase activity was detectable in eight of the nine prostate cancer biopsies, in none of the normal prostates and in six of the 16 BPH biopsies. CONCLUSION: The finding of telomerase activity in six of 16 biopsies from patients with BPH could indicate early prostate cancer and suggests that telomerase activity may be of use as a biomarker in patients diagnosed with BPH and who may subsequently develop prostate cancer.

Aged↗
PubMed2001

Identification of potential diagnostic markers of prostate cancer and prostatic intraepithelial neoplasia using cDNA microarray.

The identification of novel genes or groups of genes expressed in prostate cancer may allow earlier diagnosis or more accurate staging of the disease. We describe the assembly and use of a 1877-member microarray representing cDNA clones from a range of prostate cancer stages and grades, precursor lesions and normal tissue. Using labelled cDNA from tumour samples obtained from TURP or radical prostatectomy, analysis of expression patterns identified many up-regulated transcripts. Cell lines were found to over-express fewer genes than diseased tissue samples. 17 known genes were found to over-express more than 4-fold in 4 or more cancers out of 15 cancers. Only 2 genes were over-expressed in 6 out of 15 cancers or more, whilst no genes were consistently found to be over-expressed in all cancer samples. Novel prostate cancer associations for several well characterized genes or full length cDNAs were identified, including PLRP1, JM27, human UbcM2, dynein light intermediate chain 2 and human homologue of rat sec61. Novel associations with high-grade PIN include: breast carcinoma fatty acid synthase and cDNA DKFZp434B0335. We shortlist and discuss the most significant over-expressed genes in prostate cancer and PIN, and highlight expression differences between malignant and benign samples.

Aged↗