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MR findings of ovarian tumours with cystic components.

This article depicts the MR findings of ovarian tumours with cystic components. MRI can predict the cyst contents and evaluate the potential for malignancy when an irregular solid portion or a papillary nodule is observed within the cystic tumour. Post-contrast T1 weighted MRI is helpful for the identification of solid areas that enhance. Fat suppression imaging is useful for differentiation between mature cystic teratoma and other pathology. Fat suppressed post-contrast T1 weighted MRI may demonstrate contrast enhancement, reflecting inflammatory or neoplastic processes in the pelvis.

Contrast Media↗

Plexiform neurofibroma of the oesophagus: a mimicker of malignancy.

We report the first case of a plexiform neurofibroma of the oesophagus, presenting with dysphagia in a 67-year-old man known to suffer from von Recklinghausen's neurofibromatosis. The clinical symptoms and radiological findings mimicked malignancy, and raised considerable concern. Numerous investigations failed to elucidate the benign nature of the condition. The diagnosis was finally achieved at surgery and the patient was successfully treated by oesophageal resection. Plexiform neurofibromas, though only found in 20-30% of affected individuals are pathognomonic of von Recklinghausen's neurofibromatosis. This report highlights the tendency of plexiform neurofibromas to grow extensively and encase surrounding structures, thereby mimicking a neoplastic process.

Aged↗

Primary spindle cell lesions of the thyroid gland; an overview.

Spindle cell lesions of the thyroid gland (T-SCL) are not encountered routinely in clinical practice or in the context of thyroid pathology. They commonly are classified as primary or secondary to metastatic disease. Primary T-SCL can be derivedfromfollicular, C-cell (parafollicular), or mesenchymal components and may be the result of reactive or neoplastic processes, including post-fine-needle aspiration spindle cell nodules, Riedel thyroiditis, solitary fibrous tumor, leiomyoma, peripheral nerve sheath tumor, hyalinizing trabecular tumor, spindle epithelial tumor with thymus-like differentiation, follicular dendritic cell tumor, medullary carcinoma, papillary carcinoma, anaplastic carcinoma, sarcoma, squamous cell carcinoma, and carcinoma showing thymus-like differentiation. Because T-SCL may represent the expression of benign and highly malignant neoplasms, distinction among these processes is crucial because it dictates therapy and defines prognosis. The present article reviews the clinical, imaging, pathologic, and immunohistochemical characteristics of primary T-SCL.

Adenocarcinoma, Papillary↗

"Gas and fat embolic syndrome" involving a mass stranding of beaked whales (family Ziphiidae) exposed to anthropogenic sonar signals.

A study of the lesions of beaked whales (BWs) in a recent mass stranding in the Canary Islands following naval exercises provides a possible explanation of the relationship between anthropogenic, acoustic (sonar) activities and the stranding and death of marine mammals. Fourteen BWs were stranded in the Canary Islands close to the site of an international naval exercise (Neo-Tapon 2002) held on 24 September 2002. Strandings began about 4 hours after the onset of midfrequency sonar activity. Eight Cuvier's BWs (Ziphius cavirostris), one Blainville's BW (Mesoplodon densirostris), and one Gervais' BW (Mesoplodon europaeus) were examined postmortem and studied histopathologically. No inflammatory or neoplastic processes were noted, and no pathogens were identified. Macroscopically, whales had severe, diffuse congestion and hemorrhage, especially around the acoustic jaw fat, ears, brain, and kidneys. Gas bubble-associated lesions and fat embolism were observed in the vessels and parenchyma of vital organs. In vivo bubble formation associated with sonar exposure that may have been exacerbated by modified diving behavior caused nitrogen supersaturation above a threshold value normally tolerated by the tissues (as occurs in decompression sickness). Alternatively, the effect that sonar has on tissues that have been supersaturated with nitrogen gas could be such that it lowers the threshold for the expansion of in vivo bubble precursors (gas nuclei). Exclusively or in combination, these mechanisms may enhance and maintain bubble growth or initiate embolism. Severely injured whales died or became stranded and died due to cardiovascular collapse during beaching. The present study demonstrates a new pathologic entity in cetaceans. The syndrome is apparently induced by exposure to mid-frequency sonar signals and particularly affects deep, long-duration, repetitive-diving species like BWs.

Animals↗

Feline systemic reactive angioendotheliomatosis: eight cases and literature review.

A rare, multisystemic intravascular proliferative disorder was identified postmortem in eight cats. The majority of these cats died or were euthanized following episodes of dyspnea, lethargy, and anorexia. Microscopic examination revealed occlusive, intraluminal proliferations of spindle cells within small vessels. The heart was consistently involved, and myocardial dysfunction was the probable cause of illness in all cats. Immunohistochemically, the majority of intravascular cells expressed von Willebrand factor, and a smaller number expressed smooth muscle actin, compatible with a dual population of endothelial cells and pericytes, suggesting a reactive rather than a neoplastic process. Four cases of a similar feline vascular disorder from the veterinary literature are reviewed. The histopathology resembles reactive angioendotheliomatosis in humans, a benign cutaneous intravascular endothelial and pericytic proliferative condition. However, in contrast, this feline disease is multisystemic and fatal. We propose the name "feline systemic reactive angioendotheliomatosis" for this unique, idiopathic disorder of domestic cats.

Animals↗

Imaging of the gastrointestinal tract.

Gastrointestinal imaging has undergone immense and profound changes since the days when radiologists had only plain abdominal radiography, barium studies and cholecystography to offer as a means of investigating the gastrointestinal tract. Advances in technology have made huge differences in the ways and means of investigating the various pathologies afflicting the gastrointestinal tract. Ultrasound provides assessment of the solid organs and the intestine without the use of ionizing radiation. Computed tomography (CT) provides unparalleled imaging of congenital, inflammatory, traumatic and neoplastic processes, providing information on the solid organs and tubular structures, including the vasculature. Information is provided to aid immediate management or to stage lesions for subsequent or combined therapies. Magnetic resonance imaging (MRI) gives unprecedented multiplanar images and soft tissue resolution. There is still a place for plain radiography and barium studies but this is decreasing as technology advances.(c) 2001 Prous Science. All rights reserved.

Journal Article↗

The epidemiologic, pathologic, and clinical features of AIDS-associated pulmonary Kaposi's sarcoma.

AIDS-related Kaposi's sarcoma (KS) occurs principally in homosexual or bisexual men infected with the newly identified human herpes virus-8, also called KS-associated herpes virus. Unlike classical forms of the disease, AIDS-associated KS is a multicentric entity that frequently involves lymph nodes and the GI tract. KS may also occur in the lung, commonly in the setting of extensive mucocutaneous disease and very rarely as an isolated event. The exact incidence of intrathoracic KS in patients with AIDS is unknown. Before the advent of highly active antiretroviral therapy (HAART), pulmonary KS had been reported in approximately 10% of patients with AIDS, 25% of patients with cutaneous KS, and in roughly 50% of postmortem examinations of patients with AIDS, KS, and respiratory infections. In the HAART era, the incidence of KS has declined precipitously in North America and Europe but not in third world countries where HAART is largely unavailable. Pulmonary KS may cause radiographic infiltrates and respiratory symptoms that mimic a variety of other infectious and neoplastic processes. An aggressive diagnostic evaluation of patients who have this condition is essential because chemotherapy and radiation therapy may provide significant palliation, particularly if used in conjunction with HAART. This review briefly explores the changing epidemiology of KS. The pathology and pathogenesis of KS is also reviewed, along with the clinical and radiographic presentation, diagnosis, and management of pulmonary KS.

Acquired Immunodeficiency Syndrome↗

The origin of the pseudoglandular spaces in metastatic smooth muscle neoplasm of uterine origin. Report of a case with ultrastructure and review of previous cases studied by electron microscopy.

The entity known as "leiomyomatous hamartoma," a term that has been used in reference to metastatic smooth muscle neoplasms of uterine origin (MSMNUO), is uncommon. Several articles have dealt with clinical and light microscopic aspects of this lesion. Four reports on the ultrastructure of this type of neoplasm have been published, but they have been primarily concerned with its smooth muscle component. Much controversy exists as to whether the glandular elements are part of the neoplastic process or preexisting pulmonary elements. This ultrastructural study confirms that the gland-like spaces represent entrapped alveoli and terminal respiratory bronchioles.

Female↗

Imaging of rhinosinusitis and its complications: plain film, CT, and MRI.

Conventional plain-film radiography may be used as a screening method for various pathological conditions of the sinonasal cavities. However, CT scanning remains the study of choice for the imaging evaluation of acute and chronic inflammatory diseases of sinonasal cavities. MRI is superior to CT in differentiating inflammatory conditions from neoplastic processes. The most common complications of rhinosinusitis in children occur in the orbit. The information obtained from the CT scan and MRI, together with clinical findings, may be the best guidelines for clinical management and the mode of treatment. Although intracranial complications of sinusitis are relatively rare, prompt recognition of these disease states is important to prevent permanent neurological deficit or fatality. It is prudent to obtain MRI of the sinuses, orbits, and brain whenever extensive or multiple complications of sinusitis are suspected, in addition to CT scanning. Chronic rhinosinusitis is a clinical diagnosis, confirmed and staged with the CT scan of sinonasal cavities. Chronic inflammatory disease is often associated with mucosal thickening and sclerosis of the bone, particularly within the sinuses. Chronic extramucosal fungal sinusitis develops as a saprophytic growth in retained secretions in a sinus cavity. The imaging manifestations of chronic mycotic rhinosinusitis may be nonspecific or highly suggestive of the presence of fungal infection. The presence of diffuse increased attenuation within the paranasal sinuses and nasal cavity should be considered as chronic allergic hypersensitivity aspergillosis (chronic noninvasive aspergillosis) or chronic hyperplastic sinusitis and polyposis associated with desiccated, retained mucosal secretions. The MRI characteristics of fungal sinusitis depend on the stage of the disease.

Humans↗

Asymptomatic, nonulcerated, freely movable nodule in the anterior floor of the mouth.

Small, localized aggregations of lymphoid tissue can occur commonly in the oral cavity, especially in the soft palate, the floor of the mouth, and the ventral surface of the tongue. They normally appear clinically as asymptomatic, small, soft, pink, and discrete swellings situated immediately beneath the surface epithelium. Chronic irritation may cause the tissue to enlarge and become symptomatic. Clinicians should be aware of the existence of these rather common oral lesions and include them in a differential consideration of small, freely movable, nonulcerated subepithelial swellings in the oral cavity. Microscopic examination is indicated to rule out a more serious disease, especially a developing neoplastic process.

Adult↗

An unusual cause of facial trismus in a child: report of case.

Nasopharyngeal carcinoma should be considered in the differential diagnosis of facial pain, especially in patients of Asian descent. The foregoing case describes an unusual cause of a symptom often associated with temporomandibular joint dysfunction. It also emphasizes the need to eliminate an underlying neoplastic process when dealing with patients who have temporomandibular joint dysfunction or who have atypical facial pain. Malignancies of the temporomandibular joint and the periarticular area, although rare, do occur. This case shows the usefulness of computed tomography in the evaluation of a patient with temporomandibular joint dysfunction.

Carcinoma↗

Alcoholic parotid sialadenosis.

Alcoholism is a primary cause of sialadenosis, which is an asymptomatic, bilateral enlargement of the parotid glands. The authors outline the pathogenesis, symptoms and testing involved in diagnosing sialadenosis. Recognizing sialadenosis is important because it may point to the unsuspected presence of underlying systemic disease. Therefore, dental practitioners need to be able to differentiate sialadenosis from an inflammatory or neoplastic process to prevent unnecessary treatment.

Alcoholism↗

Antigenic profile of human bronchial gland.

Bronchial glands have been regarded as modified salivary glands. It is well known that there no previous reviews concerning the antigenic profile of the bronchial wall. The aim of this study is a systematic survey of the antigenic profile and to describe the histology of normal human bronchial glands. Six formalin-fixed, paraffin-embedded surgical specimens were studied using a panel of 22 polyclonal and monoclonal antibodies by the avidin-biotin-peroxidase method. Bronchial glands disclosed a tubuloacinar structure. The smallest ducts intercalated originated from a cluster of secretory acini and converge to form an excretory duct. No striated duct was observed. Acinar united is composed by mucous, serous and mixed units. Myoepithelial cells are found in relation to the intercalated ducts and secretory acinis. Secretory cells of bronchial glands reacted strongly with cytokeratin AE1 and moderately for CK7, CK18. Additionally, serous acinar cells reacted with AE3, CK19, CK5/6/8/18, CK8/18/19, and Leu7. Myoepithelial cells reacted strongly with a-smooth muscle actin, CD10 and CK34betaE12. Ductal system cells differed from acinar secretory cells in expressing CK34betaE12 and HSP27. In conclusion, the detailed knowledge of the immunohistochemical reactivities of normal cell types of normal human bronchial glands will prove useful in studies of bronchial pathology, especially of neoplastic processes.

Actins↗

Pattern of plasma cyclic nucleotides and related hormones in liver cirrhosis and hepatocellular carcinoma.

To evaluate the pattern of plasma cyclic adenosine 3',5'-monophosphate, cyclic guanosine 3',5'-monophosphate, atrial natriuretic factor and glucagon levels in different stages of chronic liver diseases, we measured these variables in 20 normal subjects, 25 patients with genetic hemochromatosis, associated with liver cirrhosis in 19 cases and not in six, eight patients with compensated and 15 with decompensated alcoholic or posthepatitic cirrhosis, and 12 with hepatocellular carcinoma. All variables were within the normal range in non-cirrhotic hemochromatotic patients. Cyclic adenosine 3',5'-monophosphate levels were within the normal range (9.5-15.7 nmol/l) in hemochromatotic cirrhotics and elevated in other patients. Cyclic guanosine 3',5'-monophosphate, atrial natriuretic factor and glucagon were above the normal ranges (1.92-5.91 nmol/l, 8.8-62.7 ng/l, and 39-165 ng/l, respectively) in most patients with cirrhosis both with and without hemochromatosis and in most individuals with hepatocellular carcinoma. Cyclic guanosine 3',5'-monophosphate correlated with atrial natriuretic factor in the former groups but not in the latter. These findings indicate that glucagon and atrial natriuretic factor hypersecretion is an early event in cirrhosis, regardless of its etiology. In hepatocellular carcinoma, the underlying cirrhosis may account for most hormonal and metabolic changes although cyclic guanosine 3',5'-monophosphate increases could also be due to the neoplastic process per se.

Adult↗

Antigen levels of urokinase type plasminogen activator and its inhibitors in primary breast cancer.

Primary Breast Cancer, Urokinase-Type Plasminogen Activator, Inhibitors The aim of the study was to monitor urokinase plasminogen activator antigen concentrations and its type 1 (PAI-1) and type 2 (PAI-2) inhibitors in histologically defined forms of primary breast cancer and a comparison with these antigens levels in normal tissue. Another goal was a search for a relationship/or its lack/between the occurrence of the new generation markers of neoplastic disease and a presence/or absence/of lymph node metastases. U-PA, PAI-1 and PAI-2 antigen levels were determined by ELISA tests in protein extracts of breast cancer tissues. Among the studied breast tumors 32 specimens were ductal carcinomas, 15 specimens were lobular carcinomas and the remaining 13 were other rare histological forms. In comparison to the obtained values of u-PA antigen levels in normal tissue, the values in neoplastic tissues were elevated several times: 11-fold, 6-fold and 15-fold in ductal c., lobular c. and other rare neoplasms. The values of PAI-1 antigen levels were about 20-fold higher for all studied, histologically defined primary breast cancers. The greatest differences of PAI-2 antigen levels growth was observed in histologically defined primary breast cancer forms. It was augmented 10-fold, 40-fold and 20-fold, respectively, for ductal carcinoma, lobular carcinoma and rare forms of neoplasms. In various forms of invasive breast cancer and those without lymph node metastases the content of u-PA, PAI-1 and PAI-2 were also significantly elevated. Among the new generation of independent markers of the neoplastic process, PAI-2 seems to be the most reliable marker for the identification of primary breast cancer. The goal of the present study was to evaluate a possible combined prognostic value of the three major components of the u-PA system (u-PA, PAI-1 and PAI-2) in patients with defined histopathological forms of primary breast cancer.

Adult↗

Chylous ascites and pleural effusion secondary to constrictive pericarditis presenting with signs of lymphatic obstruction.

Chylous ascites is a clinical entity characterized by accumulation of milky fluid containing high amounts of triglycerides in the peritoneal cavity. The cause is usually lymphatic obstruction secondary to neoplastic processes. Constrictive pericarditis rarely causes cylous ascites through elevated venous pressure and lymphatic stasis. To the best of our knowledge, there is no report of constrictive pericarditis leading to chylous ascites in a patient presenting with objective lymphangiographic findings of lymphatic obstruction rather than stasis. We present a case of chylous ascites and pleural effusion secondary to constrictive pericarditis presenting with signs of lymphatic obstruction in lymphangio-graphy, in whom complete clinical and laboratory improvement was achieved after pericardiectomy.

Chylous Ascites↗

Microarray comparative genomic hybridization reveals genome-wide patterns of DNA gains and losses in post-Chernobyl thyroid cancer.

Genetic gains and losses resulting from DNA strand breakage by ionizing radiation have been demonstrated in vitro and suspected in radiation-associated thyroid cancer. We hypothesized that copy number deviations might be more prevalent, and/or occur in genomic patterns, in tumors associated with presumptive DNA strand breakage from radiation exposure than in their spontaneous counterparts. We used cDNA microarray-based comparative genome hybridization to obtain genome-wide, high-resolution copy number profiles at 14,573 genomic loci in 23 post-Chernobyl and 20 spontaneous thyroid cancers. The prevalence of DNA gains in tumors from cases in exposed individuals was two- to fourfold higher than for cases in unexposed individuals and up to 10-fold higher for the subset of recurrent gains. DNA losses for all cases were low and more prevalent in spontaneous cases. We identified unique patterns of copy variation (mostly gains) that depended on a history of radiation exposure. Exposed cases, especially the young, harbored more recurrent gains that covered more of the genome. The largest regions, spanning 1.2 to 4.9 Mbp, were located at 1p36.32-.33, 2p23.2-.3, 3p21.1-.31, 6p22.1-.2, 7q36.1, 8q24.3, 9q34.11, 9q34.3, 11p15.5, 11q13.2-12.3, 14q32.33, 16p13.3, 16p11.2, 16q21-q12.2, 17q25.1, 19p13.31-qter, 22q11.21 and 22q13.2. Copy number changes, particularly gains, in post-Chernobyl thyroid cancer are influenced by radiation exposure and age at exposure, in addition to the neoplastic process.

Adolescent↗

Multiple myeloma of the periodontium. A case report.

Multiple periodontal lesions were the presenting features leading to a diagnosis of multiple myeloma in a 38-year-old male. Ulceration and bleeding from a rapidly growing retromolar myelomatous mass, multiple foci of alveolar bone destruction and cortical expansion together with multifocal skeletal destruction were the hallmarks of the neoplastic process. Radiotherapy and chemotherapy brought a substantial, but temporary, remission with improvement of the periodontal condition. A sudden exacerbation of the died 22 months after the diagnosis was made.

Adult↗