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[Malignant schwannoma with the microscopic features of a malignant fibrous histiocytoma].

A case of malignant schwannoma is described in which the primary tumor showed morphologic signs of malignant fibrous histiocytoma, but these were not confirmed by immunohistochemical assays which were negative for markers of histiocytic tumors such as alpha 1-antitrypsin and alpha 1-antichymotrypsin. In the recurring tumor, typical palisade structures were found. Difficulties attending the diagnostic differentiation of these two tumors are discussed. It is concluded that histogenetic characteristics of malignant fibrous histiocytomas must be known to be able to establish more precise criteria on which the differentiation may be based.

Biomarkers, Tumor↗

Alterations in the activity and isozymic profile of human phosphofructokinase during malignant transformation in vivo and in vitro: transformation- and progression-linked discriminants of malignancy.

6-Phosphofructokinase (PFK) plays a central role in the regulation of glycolysis in both normal and neoplastic cells. Since PFK also mediates the Pasteur effect, it coordinates the two modes of energy production in most cell systems, i.e., glycolysis and respiration. The energy production in the cancer cell is characterized by a predominance of aerobic glycolysis (the Warburg effect) and a diminution or lack of the Pasteur effect. Previous studies from this laboratory have demonstrated that PFK in humans and in the rat exists in multiple tetrameric isozymic forms consisting of three unique subunits under separate genetic controls, M, L, and P types. These isozymes are distinguishable from one another by ion-exchange chromatography and subunit-specific antibodies. Various organs exhibit unique isozyme distribution patterns which essentially reflect the preferred mode of carbohydrate metabolism utilized, i.e., glycolysis or gluconeogenesis or both. In order to investigate whether the high aerobic glycolysis of the cancer cell can be explained on the basis of a lack of the regulatory function of PFK due to an altered isozyme distribution pattern, we compared the activity and isozymic profile of the enzyme from malignant cells of human leukemias, lymphomas, virus-transformed cell lines, and established malignant cell lines of lymphoid, myeloid, erythroid, and fibroblastic origin and their normal counterparts. The myeloid and erythroid cell lines were also investigated after in vitro differentiation induced by dimethyl sulfoxide, sodium butyrate, hemin, etc. Our results show that, as is the case with hexokinase and pyruvate kinase, the other two rate-limiting enzymes of glycolysis, PFK shows both quantitative increases and isozymic alterations secondary to altered gene expression during neoplastic transformation, both in vivo and in vitro. In contradistinction to the isozymic alteration in hexokinase and pyruvate kinase, where highly regulated liver-type isozymes decrease or disappear and are replaced by the nonregulated ones, in the case of PFK, the highly regulated liver-type isozyme not only persists but actually increases, followed by an increase in the platelet-type isozyme. These isozymic alterations closely parallel the quantitative increases in total PFK activity, which in turn is closely related to the rate of replication of cancer cells and hence an increase in metabolism. Thus, human PFK is both a transformation- and a progression-linked discriminant of malignancy (For definitions of these terms, see Weber et al., N. Engl. J. Med., 296: 486-493, 1977.).(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine Triphosphate↗

Notifiable malignant lesions in the RSA, 1979-1983--trends and mortality. II. Primary malignant neoplasms of the pleura.

From August 1979 to December 1983, 22 cases of and 17 deaths due to primary malignant neoplasms of the pleura were notified to the Department of National Health and Population Development. Correspondingly, 458 deaths due to mesothelioma and malignant neoplasms of the pleura were registered at Central Statistical Services; 4% of these deaths were notified. Most of the deaths due to mesothelioma and malignant neoplasms of the pleura registered were in white males, who showed a mortality rate of 15.8/1,000,000.

Adult↗

Evaluation of colposcopy in the screening of pre-malignant and malignant lesions of uterine cervix.

In an attempt to evaluate the effectiveness of colposcopy in screening pre-malignant and malignant lesions of uterine cervix, one hundred cases of atypical colposcopical findings were cytologically and histologically analysed along with one hundred individuals with typical colposcopical appearance. It was observed that moderate dysplasia, severe dysplasia and malignant lesions of uterine cervix reveal certain distinct changes in the colposcopic "Transformation Zone" which are well related to the cytological and histological findings. The results suggested that colposcopy might be undertaken as a rapid, reliable and complementary tool for cancer screening in a vastly populated country like India.

Colposcopy↗

Diagnosis of malignant tumors on the basis of the current generating capacity of malignant tumorous tissue. I. Examination in vitro, animal experiments and endoscopic measurements.

On the basis of the different electrolyte composition and lactic acid content of malignant tumorous tissue an electrochemical measuring method was worked out for the quick-diagnosis of malignant tumors. The in vitro model experiments and the measurings carried out on mice with Crocker's sarcoma proved the practicability of the electrochemical technique. The present study contains the measuring results of 55 adenocarcinomas and 12 scirrhous carcinomas. The current generating capacity of adenocarcinomas -- both with endoscopic measuring and that performed of samples excised -- exceeds the values measured in the healthy surrounding tissue with 45 to 50%. On the other hand, the generating capacity of scirrhous carcinoma is with 50% lower as the value measured in the healthy tissue. The generating capacity of gastric ulcer and polyp is virtually identical with that of the healthy gastric mucosa. The difference in generating capacity between the healthy tissue and malignant tumorous tissue is statistically significant.

Adenocarcinoma↗

Cytogenetic approaches to the clarification of pathogenesis in lymphoid malignancies: clinicopathologic characterization of 14q+ marker-positive non-T-cell malignancies.

The clinicopathologic features of 53 patients with various types of non-T-cell malignancies were compared with the karyotypic findings. Although all chromosomes underwent numerical and structural rearrangements, a 14q+ marker chromosome (14q32 translocation), which was found in 31 patients, was the single most common abnormality. In terms of survival, no significant difference was noted between the 14q+ positive and negative patients. Donor chromosomes of a 14q32 translocation, which were identified in 27 patients, were quite variable. However, certain chromosomes were predisposed to act as donor chromosomes in the 14q32 translocation. An 8;14 translocation [t(8;14) (q24;q32)] was found in six patients with diffuse non-Burkitt's lymphoma and in four patients with Burkitt's lymphoma-leukemia; in all these patients a stem line or the subline with a t(8;14) had partial trisomy for 1q. An 11;14 translocation [t(11;14) (q13;q32)] was observed in one patient each with diffuse or follicular lymphoma and in two with myeloma; three of the four patients had also structural rearrangements of chromosome 1 in the same cells. A 14;18 translocation [t(14;18) (q32;q21)] was found in six patients with follicular lymphoma and in one with diffuse lymphoma; however, no common involvement of other chromosomes was detected among clones of these abnormal cells with a t(14;18). The median survival was 8 months for patients with a t(8;14) and 39 months for patients with a t(11;14). The difference between the two survival curves was of borderline significance [p = 0.06]. In contrast, patients with a t(14;18) survived significantly longer than those with a t(8;14) [p less than 0.001] or those with a t(11;14) [p = 0.03]. These findings revealed that in non-T-cell malignancies, the clinicopathologic features of the patients with a 14q+ marker depend upon the precise 14q32 translocation and the subsequent karyotypic evolution, although the translocation was not always correlated with a particular type of lymphoid malignancy.

Adult↗

Clonal evolution of malignant and non-malignant T cells carrying t(14;14) and t(X;14) in patients with ataxia telangiectasia.

People with ataxia telangiectasia (AT) are at a higher than normal risk of T cell leukaemia and often have either non-malignant or malignant T cells with chromosomal abnormalities, typically t(14;14), inversion 14 or more rarely t(X;14). This provides a chance to study the pre-leukaemic phase of the disease. T cells have been studied with either t(14;14)(q11;q32.1) or t(X;14)(q28;q11) from two AT sisters of which the latter developed T cell leukaemia. The telomeric breakpoint of the t(14;14) was cloned and found to occur at 14q32.1 where known tumour-associated breakpoints are located, but the patient remains asymptomatic for leukaemia. Analysis of T cell populations in both patients showed that the cells containing the translocation became oligoclonal with respect to T cell receptor beta rearrangement and complete T cell receptor beta clonality was only established in the patient with t(X;14) by onset of overt disease. Therefore in these chronic diseases, chromosomal translocations can precede T cell receptor rearrangement suggesting a role for these abnormalities as early events of malignant outgrowth.

Ataxia Telangiectasia↗

[Chemotherapy for Ewing's sarcoma, malignant fibrous histiocytoma and malignant lymphoma].

Recent advances in adjuvant chemotherapy for malignant bone tumor have been improving the survival rate and making limb-salvage surgery a reliable technique. Ewing's sarcoma is treated by multiple agent chemotherapy. We treat Ewing's sarcoma by Rosen's T-11 protocol (CYT.ADM.MTX.VCR.ACT-D.BLM). This protocol is very effective, but results are poorer than for osteosarcoma. Newly developed protocols such as EICESS (European Intergroup Cooperative Ewing's Sarcoma Study)-92, including new drugs, should be investigated. The results with malignant fibrous histiocytoma are comparable to those for osteosarcoma. We have performed an original chemotherapy protocol, called "K-1 protocol." Patients were treated with three courses of intraarterial infusion of cisplatin (120 mg/m2) and caffeine (1.0-1.5 mg/m2/day for three days continuously) at two-week intervals. If the effect was insufficient, ADM (30 mg/m2/day for two days continuously) is added to this protocol. We treat malignant lymphoma in collaboration with a hematologist and radiologist. The 5-year survival rate of non-Hodgkin's lymphoma in our series was 56% in clinical stage III and 34% in clinical stage IV. We are trying third-generation chemotherapy to improve the survival rate.

Adolescent↗

A preliminary report on the prognostic value of selected diagnostic enzymes among certain malignant and schistosomal malignant patients.

The study is a trial to test certain biochemical parameters as differential diagnostic markers between some pathological malignant cases. The first part of the present article was carried out in order to investigate the effect of both cancerous infestation and schistosomal infection on Lactate dehydrogenase (LDH), two transaminases (ALT and AST) activities and total proteins in both serum and tumor tissue isolated from bladder carcinoma patients. The activities were measured in neighboring mucosa to carcinoma tissues together with bladded tissues excised because of malignant lesions and malignant tissues excised because of urinary schistosomiasis, in Egyptian human patients. The second part was design in order to estimate the effect of cancerous disorders on the previous parameters in serum and isolated tumors among colonic carcinoma patients. In addition, the study was extended to explore the changes that might occurred in serum LDH isoenzymatic pattern among some selected cases from these patients.

Adult↗

An autopsy case of intravascular malignant lymphoma presenting with intracranial B-cell type malignant lymphoma.

This report concerns a 79-year-old man with intravascular malignant lymphoma who was admitted to our hospital for slight right side hemiparesis. Radiological examinations showed a mass in the left parietal lobe, and a brain biopsy revealed a B-cell type malignant lymphoma. The tumor could not be detected on magnetic resonance images following focal radiotherapy, but the patient died of acute progressive pneumonia about 3 months after the onset of symptoms. An autopsy was performed. Microscopic examinations disclosed proliferation of neoplastic cells in the small and medium-sized blood vessels of the adrenal glands, liver, spleen, pancreas, kidneys and epididymis. A diagnosis of intravascular malignant lymphoma was established on the bases of these autopsy findings.

Aged↗

Malignant carcinoid tumor and synchronous malignant extraadrenal paraganglioloma.

Gastrointestinal carcinoid tumor is often considered the most common neuroendocrine tumor of the small intestine. The overall incidence of 1% in the general population is quite low. Extraadrenal paragangliomas are rarer still, and the incidence of both of these tumors in the malignant state is exceedingly rare. This article describes the case of a patient who had both a malignant carcinoid tumor as well as a malignant retroperitoneal paraganglioma occurring synchronously. A review of the literature concerning these tumors is also presented.

Carcinoid Tumor↗

Diagnostic performance of machine learning models for malignant and non-malignant pleural effusion: Systematic review and meta-analysis.

BACKGROUND: Accurately distinguishing malignant pleural effusion (MPE) from non-malignant pleural effusion is clinically important, but the generalisability and methodological quality of machine-learning (ML) models remain uncertain. METHODS: We searched eight databases to 23 April 2026. Diagnostic performance was pooled using random-effects and Reitsma bivariate models, and study quality was assessed using PROBAST+AI. RESULTS: Forty-two studies were included; 17 contributed to the AUC meta-analysis and 14 to the bivariate analysis. The pooled AUC was 0.90 (95 % CI 0.85-0.94; 95 % prediction interval 0.62-0.98), with sensitivity of 0.80 (95 % CI 0.77-0.83) and specificity of 0.87 (95 % CI 0.79-0.92). Only nine studies reported external, temporal or independent validation. Externally validated studies had a lower pooled AUC than studies without external validation (0.83 vs 0.92), with lower specificity observed in the two externally validated studies contributing sensitivity and specificity data. All 42 development assessments had high overall quality concerns, and all 42 model evaluations were judged at high risk of bias. CONCLUSIONS: ML models showed good apparent accuracy for distinguishing MPE from non-MPE, but the evidence was limited by substantial heterogeneity, high risk of bias and scarce external validation. The pooled estimates reflect the average performance of different selected models rather than the expected accuracy of a single clinical test. ML models should be regarded as adjuncts to existing diagnostic pathways until they are confirmed by rigorous multicentre prospective external validation and clinical-impact studies.

Humans↗

[Lack of sensitivity to per-anesthetic malignant hyperthermia in 32 patients who developed neuroleptic malignant syndrome].

The aim of this study was to verify whether a relationship exists between neuroleptic malignant syndrome (NMS) and anaesthetic-induced malignant hyperthermia (MH) or not. The in vitro halothane-caffeine tests were performed on muscle tissue obtained from 32 patients with documented NMS episodes. The diagnosis of NMS relied on Levenson's criteria. The results, expressed in accordance with the criteria of the European MH Group, defined 29 subjects as MH non-susceptible. Three patients were classified as MH equivocal. These findings demonstrate the lack of any link between NMS and MH. Therefore, patients with a history of NMS are not likely to be at risk of developing MH and special measures against MH are not required for anaesthesia in these patients.

Adolescent↗

[Differential diagnosis of malignant hyperthermia, febrile catatonia and neuroleptic malignant syndrome. A case comparison].

Malignant Hyperthermia (MH), Lethal Catatonia (LC), and Neuroleptic Malignant Syndrome (NMS) are known as rare potential lethal diseases. MH and NMS--both being drug-induced--have in common some main symptoms. LC and NMS, on the other hand, are hardly distinguishable by clinical means. After presentation of the case reports the differential diagnosis of the syndromes is discussed. While there is strong evidence for the MH to be drug-induced, the NMS cannot be explained sufficiently in this way. Clinically both can be differentiated. Lethal catatonia is a syndrome rather than a specific disease. Differential diagnosis for NMS is possible by the neuroleptic withdraw-trial.

Adult↗

Malignant hyperthermia susceptibility in neuroleptic malignant syndrome.

The relationship between neuroleptic malignant syndrome (NMS) and malignant hyperthermia (MH) was investigated using the in vitro skeletal muscle contracture test to screen for MH-susceptibility in NMS patients. The maximum contracture tension which developed following exposure to halothane (1-3%), and incremental doses of fluphenazine (0.2-25.6 mM) was measured in muscle obtained from seven NMS, six MH, and six control patients. Comparison of the cumulative responses to fluphenazine revealed no significant differences among the groups. However, the response (mean +/- SEM) to halothane in the NMS group (1.7 +/- 0.7 g), which was similar to the response in the MH group (1.5 +/- 0.2 g), was significantly greater than the response found in controls (0.2 +/- 0.1 g). In addition, five of seven NMS patients could be diagnosed as MH-susceptible, based on the development of muscle contractures greater than 0.7 g in response to 1-3% halothane. In contrast, none of the controls were MH-susceptible. These findings appear to correlate with clinical evidence suggesting an association between NMS and MH.

Adult↗

The association between the neuroleptic malignant syndrome and malignant hyperthermia.

The neuroleptic malignant syndrome (NMS) is an uncommon but dangerous complication of treatment with neuroleptic drugs. A primary defect in skeletal muscle has been suggested in view of similarities in the clinical presentations of NMS and anaesthetic-induced malignant hyperthermia (MH). The in vitro halothane-caffeine contracture tests are the most reliable method of identifying individuals susceptible to MH. The aim of this study was to define if a relationship exists between NMS and MH susceptibility. Hence, the in vitro halothane and caffeine contracture tests were performed on muscle tissue obtained from eight NMS, ten MH-susceptible and ten control patients. The results, which are expressed in accordance with the criteria of the European MH Group, defined the eight NMS subjects as MH non-susceptible. The response to halothane and caffeine exposure of skeletal muscle from NMS and control subjects was the same and significantly different from that of muscle from patients susceptible to MH. Furthermore, muscle from subjects in NMS and control group responded similarly to increasing concentrations of chlorpromazine. These results do not point towards an association between NMS and MH.

Adult↗