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Biomedical subjects

A Czerniak

Publications and source records attributed to A Czerniak.

At least 73 records · Page 4Linked to original sources
PubMed1987

Primary non-Hodgkin's lymphoma of the liver.

A patient with irresectable primary non-Hodgkin's lymphoma of the liver (histiocytic type, Rappaport classification) is presented. Systemic chemotherapy combined with local irradiation were successful in achieving a disease-free interval in a follow-up of 36 months. Review of the literature disclosed 19 other patients previously reported, with considerable variations in extent of disease at presentation. Criteria for the diagnosis of primary non-Hodgkin's lymphoma are proposed, and 11 patients met these criteria. Hepatic resection is advocated for localized tumour, while systemic chemotherapy and local irradiation in patients with irresectable tumours were found effective in achieving local and systemic control in a mean follow-up of 37 months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Carcinoma of the large bowel after a single massive dose of radiation in healthy teenagers.

Three healthy teenagers were exposed to a single pelvic x-ray irradiation as part of sterilization experiments performed in the Auschwitz concentration camp in 1943. Single and multiple carcinomas of the colon and rectum developed 40 years later in the radiation field. Histologic examination of surgical specimens revealed severe radiation-induced changes in all layers of tumor-adjacent areas. In contrast to previous reports of radiation-induced large bowel cancers, these women had not undergone repeated courses of radiation, had no known co-existing disease that might raise the risk for colonic and rectal malignancies, and had an extremely long and remarkably similar latency period. These cases emphasize the need for long-term surveillance in previously radiated patients. Since thousands of teenagers were subjected to similar sterilization experiments, awareness of this association might help in the early diagnosis of additional cases.

Adenocarcinoma↗
PubMed1986

Characteristics of fibrolamellar hepatocellular carcinoma. A study of nine cases and a review of the literature.

Clinical and laboratory data for nine patients with hepatocellular fibrolamellar carcinoma treated at our institution have been summarized with emphasis on the relevance of plasma neurotensin levels as a tumor marker. The mean age of the patients was 22 years. Seven underwent hepatic resection, and two of these had later surgical removal of recurrent disease. Plasma neurotensin levels were initially elevated in five of the seven patients in whom it was measured. Neurotensin levels were within normal limits in three of four patients with recurrent disease, but were elevated in one patient who also had elevated plasma neurotensin levels preoperatively. In addition, a review of 80 patients reported since 1980 was performed. The mean age of these patients was 23 years, and only 6 percent were older than 50. The male to female ratio was 3:4. Eight percent were positive for hepatitis B antigen and 11 percent had elevated alpha-fetoprotein levels. Four percent had cirrhosis of the liver. The resectability rate was 58 percent. Five year survival for patients who underwent hepatic resection was 56 percent. Patients treated nonsurgically had a median survival of 13 months, and none of these patients lived for 5 years. Fibrolamellar hepatoma seems to be a distinct clinical entity that mainly occurs in young patients. The prognosis in patients treated with a curative resection is good. Plasma neurotensin levels may be of value as a tumor marker, but further studies are necessary to substantiate this theory.

Adolescent↗
PubMed1986

Liver atrophy complicating benign bile duct strictures. Surgical and interventional radiologic approaches.

The hepatic atrophy and hypertrophy complex has been described in a selected group of nine patients with benign bile duct stricture. The clinical features common to this group were a high biliary stricture and a long-standing history of cholangitis and intermittent jaundice. A history of multiple surgical procedures and associated vascular damage or portal hypertension is strongly suggestive of the atrophy and hypertrophy complex. The radiologic criteria for the diagnosis of this condition are presented. Computerized tomography and HIDA scintigraphy were valuable as noninvasive means to diagnose lobar liver atrophy. The atrophy and hypertrophy complex described herein poses significant therapeutic problems and demands approaches other than those normally applicable for high biliary strictures. A combined surgical and radiologic approach with additional interventional radiologic procedures may be appropriate in patients in whom hilar anastomosis is difficult or impossible.

Adult↗
PubMed1985

Large hepatocellular cancers: hepatic resection or liver transplantation?

Thirteen patients with primary hepatocellular cancer were studied to outline criteria for resectability in patients with large liver tumours. The mean age was 34 and the mean tumour diameter 13 cm (range 7-18 cm). Five of the tumours had a diameter of 15 cm or more. Extensive radiological investigations showed that seven of the patients had tumours of both right and left lobes of the liver, 10 had evidence of vascular invasion, and three had evidence of extrahepatic spread. Only two of the patients underwent a classically described formal hepatic resection, the rest having extensive resections crossing major anatomical planes. In no instance did the vascular invasion preclude resection, and extrahepatic spread could be verified in only one patient. The traditional criteria of resectability--that is, tumours located to one main lobe of the liver without vascular invasion and extrahepatic spread--can and should be extended. Resection may be preferable to transplantation even in patients with large primary liver tumours.

Adolescent↗
PubMed1985

Focal liver lesions: a plan for management.

A management plan for patients with suspected focal liver lesions which avoids early biopsy includes routine laboratory investigations, ultrasound scanning, and assessment for evidence of extrahepatic metastases and non-hepatic primary tumours. Angiography and computed tomography may also be indicated, and laparotomy or laparoscopy is undertaken to assess any potentially resectable focal liver lesions. The plan requires modification to suit individual circumstances.

Biopsy↗
PubMed1985

The simultaneous coexistence of adenocarcinoma and primary malignant lymphoma in the stomach.

A case of simultaneous adenocarcinoma and primary malignant lymphoma as two independent growths of the stomach is presented. Review of the literature documented two such cases along with nine cases of the collision-tumor type. The differential criteria between this entity and collision tumor and carcinosarcoma are emphasized. Diagnosis and treatment is discussed.

Adenocarcinoma↗
PubMed1985

Free pleuroperitoneal liquid movement indicating diaphragmatic tear.

An unusual radiological feature, not mentioned in the literature, is reported. It has been observed in a patient with traumatic rupture of the diaphragm associated with intra-abdominal bleeding. This injury produced a free pleuroperitoneal movement of liquid demonstrated in the supine and erect chest radiographs. Since there is an associated abdominal injury in most cases of rupture of the diaphragm, this radiological sign might be more common. The importance of supine and erect chest radiography is reinforced in cases of multiple injuries.

Child↗
PubMed1985

Unusual scintigraphic presentation of a shifting Meckel's diverticulum.

A Tc-99m red blood cell (RBC) study in a child with acute gastrointestinal bleeding of unknown origin suggested Meckel's diverticulum because of free pertechnetate uptake in the ectopic gastric mucosa. This finding has not been reported in the literature. A scan with Tc-99m pertechnetate then demonstrated a focal area of uptake with an unusual pattern of abdominal shifting consistent with a Meckel's diverticulum. A large Meckel's diverticulum containing gastric mucosa was found at surgery. A shifting pattern of focal uptake on a meckelogram study should be included among the diagnostic criteria for Meckel's diverticulum.

Child, Preschool↗
PubMed1985

Scintigraphic demonstration of acute gastrointestinal bleeding caused by gallbladder carcinoma eroding the colon.

Massive lower gastrointestinal (GI) bleeding caused by gallbladder carcinoma eroding into the colonic wall was demonstrated accurately by Tc-99m RBCs. In addition, retrograde bleeding into the gallbladder was also identified while arteriography did not show contrast extravasation. This case supports the use of Tc-99m RBCs over Tc-99m sulfur colloid for more accurate localization of lower GI bleeding.

Acute Disease↗
PubMed1983

Spontaneous rupture of the rectosigmoid with small-bowel evisceration through the anus. Report of a case and review of the literature.

A patient with spontaneous rupture of the rectum and evisceration of small bowel through the anus is presented. To the authors' knowledge, this paper represents the third reported case of this type of spontaneous rectal rupture. A discussion of the pathogenesis and treatment of this rather unique complication is presented. It is suggested that rectal or rectosigmoid rupture be considered a rare complication of rectal prolapse.

Anal Canal↗
PubMed1983

Extra-appendicular carcinoid tumors of the gastrointestinal tract.

During the years 1958-1978, seventeen patients were treated for extra-appendicular carcinoid tumors of the gastrointestinal tract in Tel-Hashomer and Belinson hospitals. Most of the tumors were located in the colon (eight cases) and in the rectum (four cases). A direct correlation between the tumor size and invasiveness has been noted, with distant metastases in eight of 12 patients with tumors more than 2 cm in size. Gastrointestinal bleeding was the most frequent clinical symptom, whereas the "carcinoid syndrome" appeared only in three patients. Curative surgery was performed in six patients, palliative procedure in two cases, explorative laparotomy was performed in four cases, and in two patients diagnosis was made in postmortem examination. Eight of the 17 patients (47%) had distant metastases at the time of the diagnosis, and six of the 15 operated patients (40%) died during the first year after the operation. The malignant nature of these tumors, together with the high incidence (23%) of associated malignant neoplasms is stressed. Radical resection is advocated in the cases where the tumor's size is more than 2 cm or in the presence of muscular invasion.

Adult↗