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PubMed1989

[A histopathological study of 102 autopsy cases of primary lung cancer with respect to pleural carcinomatosis].

Visceral pleural lesions in primary lung cancer were studied histopathologically in 102 autopsy cases. Pleural carcinomatosis was defined as the presence of cancer cells in the visceral pleura and/or pleural space. Ipsilateral and contralateral pleural carcinomatosis in the primary lung cancer were compared. They were found to be similar in that both were closely related with cancer cell infiltration of blood vessels in the lung parenchyma, lymphangiosis carcinomatosa in the lung parenchyma and multiple extrathoracic organ metastases. However, differences were observed. In the ipsilateral visceral pleura, cancer cells were thought to infiltrate the interstitium in the vascular layer of the visceral pleura from lymphatic vessels in the vascular layer of the visceral pleura with the following frequency; 3.6:8.52:6.52:1. In the contralateral visceral pleura, however, cancer cells were thought to infiltrate the interstitium in the vascular layer of the visceral pleura from lymphatic vessels in the vascular layer of the visceral pleura, the pleural space, the subpleural lung parenchyma and blood vessels in the vascular layer of the visceral pleura with the following frequency; 4:1.9:12.25:1. Disruption of the elastic layer of the visceral pleura was also studied. Twenty-eight of 66 pleural carcinomatosis cases showed no disruption of the elastic layer, and greater than 1-mm disruption was found in only 7 cases. The author thought that the disruption in these few cases was related to the manner of cancer-cell infiltration of the visceral pleura. When cancer cells spread to the visceral pleura from the lung parenchyma, they lost intercellular adhesiveness in four adenocarcinoma cases. Thus we suspected that cancer cells lost intercellular adhesiveness and became single cells or small cancer nests when infiltrating the visceral pleural from the lung parenchyma, and single cells or small cancer nests entered through the elastic layer of the visceral pleura. Therefore only small disruptions are found in the visceral pleura of pleural carcinomatosis cases.

Adult↗
PubMed1992

Five-year survival after pulmonary metastasectomy for adult soft tissue sarcoma.

Determinants of 5-year survival were evaluated after complete resection of pulmonary metastases from adult soft-tissue sarcomas. Fifty-eight patients had complete resection (median survival 25 months, P = 0.0002), with a 25.8% absolute 5-year survival (15 of 58 patients); six patients had unresectable disease (median survival 6 months) and were excluded from additional analysis. Eleven patients remain disease free, with a median follow-up of 76 months. Significant independent prognostic indicators associated with improved survival (P less than 0.05) included metastasis doubling time of 40 days or greater (median survival 37 months versus 15 months if less than 40 days); unilateral disease on preoperative radiography (33 months versus 15 months if bilateral disease); three or fewer nodules on preoperative computed tomography (40 months versus 14 months if 4 or more nodules); two nodules or fewer resected (40 months versus 17 months if 3 or more nodules resected), and tumor histology (33 months for malignant fibrous histiocytoma versus 17 months for all others). Multivariate analysis identified the number of nodules detected by computed tomography preoperatively as having significant prognostic value.

Adult↗
PubMed1986

Vascular neoplasms.

Explore the source record for details and available documents.

Carotid Body Tumor↗
PubMed1997

Desmoplastic small round cell tumors of the paratesticular region. A report of six cases.

Desmoplastic small round cell tumor (DSRCT) typically occurs in the abdomen but may also present at other sites. We report six cases of paratesticular DSRCT. The patients, who ranged in age from 17 to 37 (mean, 28) years, presented with a scrotal mass (five cases) or testicular pain (one case). Grossly, the tumors were white to tan and firm. Typically, they involved the paratesticular soft tissue, serosal surfaces and the epididymis near the junction with the rete testis. Microscopically, the tumors consisted of nests of mitotically active "small blue cells" with scant cytoplasm embedded in a densely fibrotic stroma. Two tumors showed focal tubule formation; one of these also formed rosettes. The tumors exhibited the typical immunophenotype of DSRCT (positivity for keratin, vimentin, desmin, and neuron-specific enolase but nonreactivity with HBA-71 and anti-S-100). Four tumors metastasized to lymph nodes (retroperitoneal, cervical, and two unspecified); pulmonary metastases occurred in one of these cases and in one patient without lymph node metastases. One of the above patients treated with chemotherapy, died of disease at 16 months. The patients with pulmonary metastases (one of whom also had lymph node metastases) were treated with aggressive chemotherapy and are alive and apparently disease-free at 2.5 and 3 years, respectively. Three of the six patients, two of whom had known metastases, were lost to follow-up. The DSRCT of the paratestis has histologic and immunohistochemical features identical to its abdominal counterpart and must be differentiated from other "small blue cell" tumors of the paratesticular region.

Adolescent↗
PubMed1976

Current status of the treatment of gynecologic cancer by site: ovary.

Cancer of the ovary is the leading cause of death from gynecologic cancer. The constant challenge presented by ovarian cancer is that about 11,000 women die from ovarian cancer each year and the results in 1974 are no better than have been achieved in the previous two decades. Standard practice of treatment for truly invasive common epithelial ovarian cancer includes total hysterectomy, bilateral salpingo-oophorectomy, appendectomy, omentectomy, and post-surgical insertion of tubes and administration of P32 (if the disease is of limited extent). Although it is occasionally necessary to resect isolated segments of bowel, exenterative or ultraradical surgery in the management of ovarian cancer is not usually chosen because of the natural history of the disease. However, aggressive surgery is indicated not so much because it is curative, but because it potentiates other forms of treatment. All stages I through IV are treated surgically, to remove as much tumor as possible without running a risk of a gastrointestinal or genitourinary fistula. Radiation therapy has been utilized in addition to the surgical therapy in stage IV to control supraclavicular and/or inguinal node involvement. Single agent alkylating chemotherapy is chosen for the treatment of common epithelial ovarian cancers. Combination chemotherapy does not produce better results at this time, except in the treatment of embryonal tumors. The treatment of the common epithelial tumors by stage is outlined. The treatment of germ cell tumors, gonadal stromal tumors, ovarian tumors in childhood, ovarian tumors in pregnancy, as well as tumors not specific for the ovary, will also be discussed.

Adolescent↗
PubMed1987

Lymph nodes as sites of metastases from sarcomas of soft tissue.

Records of 323 patients with TNM Stage M0 sarcoma of soft tissue treated by the Radiation Medicine Service of the Massachusetts General Hospital over a 14-year period were reviewed to study the incidence and the implication of regional lymph node involvement. Nineteen patients (5.9%) had evidence of sarcoma metastatic to draining lymph nodes, zero of 63 (0%) were Grade 1 sarcomas, two of 118 (2%) were Grade 2, and 17 of 142 (12%) were Grade 3 sarcomas. Among patients with Grade 3 sarcomas, rhabdomyosarcoma (five of 14), vascular sarcoma (two of five), and epithelioid sarcoma (four of five) were associated with a higher incidence of lymph node involvement than synovial sarcomas (zero of four), fibrosarcomas (zero of 16), malignant fibrohistiocytomas (one of 29), neurofibrosarcomas (one of eight), liposarcomas (one of 14), and leiomyosarcomas (one of ten). From the 19 patients who had evidence of metastatic nodes, six (32%) were alive more than 58 months after the treatment of the nodes; four of six patients were without further tumor. The data of this study are compared with those cited in a review of the literature.

Humans↗
PubMed1995

The relationship of macroscopic shape of superficial esophageal carcinoma to depth of invasion and regional lymph node metastasis.

BACKGROUND: There has been considerable controversy with regard to surgical strategies for the treatment of superficial esophageal carcinoma, which is characterized by tumor confined within the epithelium (EP), muscularis mucosae (MM), or submucosa (SM). The relationships among macroscopic shape, depth of invasion, and lymph node involvement in superficial tumors were investigated to devise therapeutic strategies for patients with such disease. METHODS: Thirty-three patients with superficial primary esophageal cancer underwent esophagectomy with regional lymph node dissection (3 EP, 6 MM, and 24 SM). Tumors were divided into two types according to macroscopic characteristics: (1) tumors with elevated components and (2) flat or depressed tumors without an elevated component. RESULTS: Tumors with an elevated component (n = 19) showed invasion of the deep layer, and a high incidence of lymph node metastasis. Conversely, tumors without an elevated component (n = 14) showed varied depths of invasion, and, with one exception, had no lymph node involvement. CONCLUSIONS: The existence of an elevated component in superficial esophageal cancer is an important macroscopic feature suggesting submucosal invasion and a high probability of lymph node involvement. More intensive treatment should be adopted for such tumors, whereas localized resection may be feasible for tumors without an elevated component.

Esophageal Neoplasms↗
PubMed1993

Fine-needle aspiration of epithelioid sarcoma.

The cytologic appearance of epithelioid sarcoma in fine-needle aspiration biopsy (FNAB) has not been extensively described. The authors report the cytologic findings in one case that metastasized to a lymph node. The cells are characterized by irregular nuclei, nuclear folds, macronucleoli, and a high nucleus-cytoplasm ratio. The cells vary in shape and occur singly and in clusters where intercellular spaces are uncommon. The findings allow the diagnosis of malignancy but are nonspecific. History, immunocytochemistry, and tissue cores are helpful in the differential diagnosis.

Adult↗
PubMed1987

Clinicopathological significance of intratumoural variations in elastosis grades and the oestrogen receptor status of human breast carcinomas.

Cryostat sections from seventy-eight female breast carcinomas were assayed for oestrogen receptors by isoelectric focusing. Adjacent cryostat sections stained by Miller's elastic/van Gieson's method were graded for elastosis. Elastosis was similarly graded on near-equatorial paraffin sections from the same tumours. A positive correlation was obtained between elastosis in the near equatorial sections and oestrogen receptor positivity (p less than 0.0005), menstrual status (p less than 0.05) and parity (p less than 0.01) but no correlation was found between these factors and elastosis graded on cryostat sections from the more peripheral areas which had been selected for oestrogen receptor assay. These observations suggest that the central region of breast carcinomas, where connective tissue responses are fully developed, exhibits grades of elastosis with greater clinical significance. This may explain the conflicting published observations on the correlations between elastosis and oestrogen receptor status, which we believe are due to the lack of uniformity in tissue sampling. The possible implications of the absence of significant correlation between elastosis grades and tumour size, nodal status and disease-free interval are discussed.

Breast Neoplasms↗
PubMed2004

Lymphatic drainage of the skin.

A successful sentinel lymph node biopsy (SLNB) in melanoma patients requires an accurate map of the pattern of lymphatic drainage from the primary site. Lymphoscintigraphy (LS) can provide such a map. LS needs an understanding of lymphatic physiology, an appropriate small-particle radiocolloid, high-resolution collimators, and imaging protocols that detect all sentinel nodes (SNs). Patterns of lymphatic drainage from the skin are not clinically predictable. Unexpected drainage has been found from the skin of the back to SNs in the triangular intermuscular space (TIS) and the paraaortic, paravertebral, and retroperitoneal areas. It can also occur from the base of the neck up to nodes in the occipital or upper cervical areas or from the scalp down to nodes at the neck base, bypassing many node groups. Upper limb drainage can be to SNs above the axilla. Interval nodes not uncommonly can be SNs, especially on the trunk. Lymphatic drainage may involve SNs in multiple nodal fields, and drainage across the midline of the body is quite common. Because micrometastatic disease can be present in any SN regardless of its location, all true SNs must be biopsied. LS is an important first step to ensure this goal is achieved.

Back↗
PubMed2003

Genesis and pathogenesis of lymphatic vessels.

The lymphatic system is generally regarded as supplementary to the blood vascular system, in that it transports interstitial fluid, macromolecules, and immune cells back into the blood. However, in insects, the open hemolymphatic (or lymphohematic) system ensures the circulation of immune cells and interstitial fluid through the body. The Drosophila homolog of the mammalian vascular endothelial growth factor receptor (VEGFR) gene family is expressed in hemocytes, suggesting a close relationship to the endothelium that develops later in phylogeny. Lymph hearts are typical organs for the propulsion of lymph in lower vertebrates and are still transiently present in birds. The lymphatic endothelial marker VEGFR-3 is transiently expressed in embryonic blood vessels and is crucial for their development. We therefore regard the question of whether the blood vascular system or the lymphatic system is primary or secondary as open. Future molecular comparisons should be performed without any bias based on the current prevalence of the blood vascular system over the lymphatic system. Here, we give an overview of the structure, function, and development of the lymphatics, with special emphasis on the recently discovered lymphangiogenic growth factors.

Animals↗
PubMed2006

[Pathogenesis and genetics of vascular anomalies].

Vascular anomalies, divided into vascular tumors and vascular malformations, are localized defects of angiogenesis. Hemangiomas appear soon after birth, grow quickly, and then spontaneously, but slowly, disappear. In contrast, vascular malformations are congenital defects of vascular development that grow proportionately with the child. Most vascular anomalies are considered non-hereditary. However, due to detailed analysis inherited forms have been observed, which has led to identify mutations in three genes causing familial vascular malformations: in the angiopoietin receptor TIE2 in mucocutaneous venous malformations (VMCM), in glomulin in glomuvenous malformations (GVM) and in RASA1 in the newly recognized phenotype capillary malformation-arteriovenous malformation (CM-AVM). Identification of the causative genes has permitted more precise diagnosis and differential diagnosis, evaluation of phenotypic variability among patients with a proven mutation, study of used treatments in more homogeneous patient groups, and elucidation of the etiopathogenic mechanisms behind vascular malformations. Further studies are needed to unravel the role of genetic variations in the various vascular malformations and to unravel the precise molecular mechanisms that lead to development of these vascular lesions. This should provide development of new-targeted therapies.

Adaptor Proteins, Signal Transducing↗
PubMed1997

Complications following definitive irradiation for cancers of the oral cavity and the oropharynx (in a series of 1134 patients).

PURPOSE: To study the rate and severity of complications in a series of 1134 patients treated by definitive irradiation for tumors of the oral cavity (772 cases) or the oropharynx (361 cases). METHODS AND MATERIALS: Patients were staged as 29.5% T1, 42% T2, 26% T3, 2.5% T4-Tx, and 74.5% N0 tumors. We treated 364 patients with brachytherapy only (192Ir) for the primary lesion. External irradiation and brachytherapy were combined for 770 patients. RESULTS: The results included local control and survival. Out of 1134 patients, 330 had 376 complications. Grade 1 complications occurred in 20% of the patients, Grade 2 in 9%; Grade 3 in 4%; and Grade 4 in 0.2%. Of the Grade 1 complications, 78% were soft tissue and only 24% were bone complications. For the more severe grades (2, 3, and 4), there were 56 soft tissue complications and 90 bone complications out of 1340 patients. The statistical analysis included tumor-related factors and treatment-related factors. For the first two factors, only tumor location was significant. The treatment-related factors significant for complications were studied in univariate and multivariate study. This multivariate study confirmed that for soft tissue complications dose rate and volume treated were important (p < 0.001). It also confirmed that for bone complications, total dose > 80 Gy, dose rate > 0.7 Gy/h, and the absence of leaded protection of the mandible were all important factors. CONCLUSION: This statistical study should allow future reduction of severe complications (Grades 2, 3, 4), if treatment factors inducing them can be taken into account. This is not always possible for very large tumors.

Analysis of Variance↗