Biomedical subjects
Publications and source records attributed to I S Engelberg.
Urinary tract lymphoma is usually reported when the secondarily stem is affected by widespread non-Hodgkin lymphoma. We describe an 83-year-old woman who presented with secondary lymphoma of the bladder 3 years after diagnosis when it initially infiltrated her breast. Treatment included local transurethral excision followed by chemotherapy, during which she died of disseminated disease.
Ureteral obstruction is a frequent complication of transitional cell carcinoma (TCC), known as a poor prognostic sign and indicative of advanced disease. We investigated retrospectively the medical records of 122 consecutive patients who suffered from invasive TCC of the urinary bladder during a 6-year period. Unilateral or bilateral ureteral obstruction was found in 66 patients (54.1%). High stage (T3-T4) and grade (III-IV) tumors were correlated with ureteral obstruction in 89.4% and 83.3% respectively compared to 67.9% and 66.1%, respectively, among patients with normal upper tracts (P < 0.001); 10.6% of the patients with ureteral obstruction had low stage disease, and all of them proved to have involvement of the ureteral orifices on the affected side. The 5-year survival rate of patients with and without ureteral obstruction was 32.2% and 65.9%, respectively (P < 0.001). The presence of ureteral obstruction, particularly in the absence of intravesical involvement of the ureteral orifices, signified a high stage, muscle invasive, and often metastatic tumor in more than 90% of the patients. Ureteral obstruction was an accurate criterion for poor prognostic and was associated with significantly lower, overall and stage-specific, survival rates, despite of radical surgery. We conclude that evidence of ureteral obstruction is an important staging standard and significant prognostic indicator in transitional cell carcinoma of the urinary bladder.
Adrenocortical rests are uncommon in adults and infrequently undergo malignant changes. Most of the published cases are those of functional tumors allowing preoperative diagnosis on the basis of the resulting endocrinopathy. Most nonfunctioning tumors were found accidentally at operation or autopsy. A case is presented of a parapelvic nonfunctioning adrenocortical rest carcinoma situated in the renal hilus in a fifty-year-old woman. No such tumor has been described previously.
Thirty-four cardiac patients, treated with nifedipine (Adalat, Procardia) during a period of 1 year or more, developed slight to severe gingival epithelial hyperplasia, and five cases presented nodular overgrowth of the gingiva. In terms of histopathologic and clinical morphology, nifedipine-induced gingival hyperplasia is similar to that known to be caused by phenytoin (Dilantin). Both drugs have the ability to alter calcium metabolism. We believe that the hyperplastic condition is related to calcium imbalance.
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The effects of treatment and depths of penetration of a 5-fluorouracil and salicylic acid preparation (Solcoderm) were studied in 24 patients treated for basal cell carcinoma with this compound. Two thirds of the patients in our study showed islands of residual tumor in the dermis following treatment, whereas total disappearance of the tumor was observed in one third. The depth of the fibrotic changes induced by the drug varied from 0.34 to 0.40 cm for the morphea type of basal cell carcinoma and from 0.52 to 0.88 cm for the conventional types. It is recommended that treatment with this compound be reserved only for superficial basal cell carcinomas and that it be avoided altogether in basal cell carcinomas of the morphea type.
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.
We observed marked gingival hyperplasia, similar clinically and histologically to the hyperplasia caused by 5:5 sodium diphenylhydantoin (Dilantin) during the last 18 months in five patients treated by nifedipine. Histologically, marked epithelial hyperplasia-acanthosis, with moderate inflammatory reaction in the lamina propria, was observed in all the biopsy specimens. Evidence points to a strong relationship between the gingival hyperplasia and the administration of nifedipine.