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PubMed1983

[Heterotopic ossification in the skeletal muscle metastases of advanced stomach cancer].

The formation of heterotopic bone tissue in carcinomas of the gastrointestinal tract and/or their metastases is extremely rare. In a 74-year-old female with gastric adenocarcinoma, we observed extensive bone formation within metastases in the skeletal muscles. There are only 7 other cases of heterotopic bone formation in gastric cancer reported in the world literature. We suggest that heterotopic ossification in primary cancers and/or their metastases is probably the result of metaplasia of stromal fibroblasts into osteoblasts.

Adenocarcinoma↗
PubMed2004

[Surgical treatment for bone and soft tissue sarcoma].

There are many kinds of wide excision or wide resection, which are methods to remove the tumor with surrounding tissues. The curability of wide resection depends on the range and characteristics of the normal surrounding tissues. The fascia, periosteum and perivascular sheath act as barriers against invasion of tumors. Therefore, evaluation of the surgical margin is essential in surgery for malignancy. Some sarcomas characteristically show invasive growth patterns while others have a discrete border. Causes of the local recurrence are 1) insufficient surgical margin, 2) skip metastasis, 3) tumor thrombus, and 4) lymph node metastasis. The so-called "Safety surgical margin" is the margin that prevents local recurrence due to insufficient surgical treatment. Local recurrence due to other causes can not be treated by surgery alone as chemotherapy is also required. For example, the infiltrative type of malignant fibrous histiocytoma requires a curative procedure. On the other hand, non-infiltrative types of sarcoma or high-grade sarcoma, which are good responders to preoperative treatment, are locally controlled by an adequate wide margin procedure. When the tumor is close to the bone, main vessels and/or nerves, it is sometimes very difficult to preoperatively decide whether or not to sacrifice these important organs. A new surgical method, "In Situ Preparation (ISP)," is a useful method to solve such problems. ISP makes it possible to evaluate the surgical margin without contamination. And additional procedures including alcohol soaking or pasteurization can be achieved according to the surgical margin. Because ISP can prevent overtreatment, the number of our cases that require resection of the nerves or vessels have decreased. After a wide resection, there have been many possible complications, including infection, deep venous thrombosis, loosening of prosthesis, skin necrosis, and arterial occlusion. Once postoperative complications occur, patients must remain in the hospital for a long time. To prevent this, the preservation of normal tissue, meaning reduction of surgical margin, is important.

Blood Vessel Prosthesis Implantation↗
PubMed1992

Visceral metastases from melanoma: findings on MR imaging.

Typical ocular and CNS melanomas are hyperintense on T1-weighted MR images and hypointense on T2-weighted MR images. We performed MR imaging in 48 patients with melanoma metastatic to visceral organs. Images were reviewed retrospectively in order to determine whether there were predominant MR features specific for visceral melanoma and to see if visceral metastases have MR characteristics similar to metastases in the CNS. Eleven patients also were examined after injection of gadopentetate dimeglumine to evaluate the enhancement characteristics of these tumors. Two hundred sixty-one lesions were found. Lesions were classified according to their signal intensities relative to uninvolved liver on T1-weighted, T2-weighted, and short TI inversion recovery (STIR) pulse sequences. Most commonly, lesions were either hypointense or isointense on T1-weighted sequences and hyperintense on T2-weighted and STIR sequences (185 lesions). Less frequently, lesions were hyperintense on T1-weighted sequences and hypointense or isointense on T2-weighted and STIR sequences (59 lesions). A mixed pattern was seen on T1- and T2-weighted sequences in 17 lesions. The patterns did not correlate with lesion size. Of the three sequences studied by subjective comparison, the STIR sequence in our series had the highest sensitivity for lesion detection and yielded the highest lesion conspicuity. Injection of gadopentetate dimeglumine in 11 patients did not increase either the number or the conspicuity of lesions seen. Our results show that visceral metastases from melanoma have a wide variety of appearances on MR images. The STIR sequence appears to be optimal, and the metastases do not enhance with gadopentetate dimeglumine.

Abdominal Neoplasms↗
PubMed1976

Aspiration cytology in Perth: experience of 673 cases.

The experience gained from the investigation of 673 patients by aspiration cytology is reviewed. The diagnostic accuracy of the technique is not satisfactorily demonstrated in this series owing to incomplete follow-up information. However, the almost unlimited application of aspiration cytology as a preliminary diagnostic test in focal lesions of most organs and tissues is emphasized. The chief merit of the technique is it simplicity which shoudl put it into the very front line of diagnostic procedures in suspected neoplastic disease.

Biopsy, Needle↗
PubMed1993

Neural cell adhesion molecule (NCAM) and perineural invasion in bile duct cancer.

Perineural invasion is associated with tumor spreading and an unfavorable prognosis in a variety of cancers. Recently, neural cell adhesion molecule (NCAM) has been reported to be affinitive to neural tissues, which suggests some relationship between NCAM and perineural invasion. This study was designed to elucidate the role of the expression of NCAM on the development of perineural invasion in bile duct cancer. A histopathologic study was performed on 24 patients with bile duct carcinoma who underwent resections. The overall incidence of NCAM expression in the resected specimen was 66.7% and that of perineural invasion was 87.5%. Furthermore, NCAM expression was shown to be positive in 16 (76%) out of 21 cases in whom perineural invasion was observed. A significant positive correlation was found between the expression of NCAM and perineural invasion in bile duct cancer. These results highlight an important role of NCAM in the development of perineural invasion in bile duct cancer.

Adenocarcinoma↗
PubMed2002

Lymphadenopathy at the medial epitrochlear region in cat-scratch disease.

Our objective was to describe the imaging features of lymphadenopathy at the medial epitrochlear region as frequently seen in cat-scratch disease (CSD) and to compare these features with those seen in non-CSD. Ten patients (four males and six females) presented with a subcutaneous soft tissue mass at the medial epitrochlear region. Three patients were younger than 15 years. Magnetic resonance imaging was performed in all patients. All lesions turned out to be regional lymphadenopathy instead of soft tissue neoplasm. They were caused by benign disorders in eight cases, including seven CSD and one other infection, and in two cases by metastatic disease. All lesions, except for three benign ones, were solitary. On MRI, high signal intensity (SI) strands in the surrounding soft tissue on T2-weighted images (WI) were present in all cases. Three cases of CSD showed homogeneous SI on both T1- and T2WI. After contrast administration, a moderate, homogeneous enhancement was seen. The other seven lesions, except for one metastasis, had both solid and liquid components. Liquid components showed high SI on T2WI without enhancement, whereas solid components had intermediate SI on T2WI and marked enhancement after contrast administration. Pathological findings in seven patients, including four with CSD, supported the tentative diagnosis made on MRI. One of two patients with CSD had positive serological test. Cat-scratch disease is a major cause of a soft tissue swelling at the medial epitrochlear region. Identification of lymphadenopathy and its presentation on MRI may be helpful in eliciting an animal-scratch history and achieving diagnostic and therapeutic aims in patients without primary cancer.

Adolescent↗
PubMed1993

Prognostic features of primary and metastatic testis germ-cell tumors.

Careful pathologic analysis of a germ-cell tumor provides important prognostic data. The author describes the histopathologic features of the various types of germ-cell tumors that have prognostic implications and discusses the pitfalls in the sampling and examination of tissue specimens.

Humans↗
PubMed2004

Interdigitating dendritic cell sarcoma: a report of four paediatric cases and review of the literature.

AIMS: To report a series of four paediatric cases of interdigitating dendritic cell sarcoma (IDCS) and add to the known extranodal sites of occurrence for this tumour. Neoplasms derived from interdigitating dendritic cells are rare, with only 33 cases being reported in the literature (Medline search). These tumours usually occur in lymph nodes in the adult population. METHODS AND RESULTS: The patients were a 10-year-old girl with a large soft tissue mass bulging into the left chest, a 12-year-old girl with a right paraspinal mass, a 21-month-old boy with generalized lymphadenopathy and hepatosplenomegaly and a 6-year-old girl with a large bladder mass. Paraffin blocks and haematoxylin and eosin slides were available in all cases. In addition, immunohistochemistry and electron microscopy were performed. A diagnosis of IDCS was made in all cases. CONCLUSION: The diagnosis of IDCS can rarely be entertained on clinical information alone. Microscopically, there is a wide spectrum of features. Thus, immunohistochemistry and electron microscopy are crucial in making the diagnosis. The differential diagnosis includes inflammatory pseudotumour, follicular dendritic cell sarcoma, true histiocytic lymphoma, malignant Langerhans cell histiocytosis, anaplastic large-cell lymphoma, melanoma, and a range of sarcomas. IDCS displays aggressive behaviour and approximately half of the patients die of the disease.

Child↗
PubMed1999

Update of the Texaco mortality study 1947-93: Part I. Analysis of overall patterns of mortality among refining, research, and petrochemical workers.

OBJECTIVE: To update information on the workers of the Texaco mortality study to determine if the patterns of mortality have changed with 16 additional years of follow up. SUBJECTS AND METHODS: All workers were employed for > or = 5 years at company refineries, petrochemical plants, and research laboratories from 1947-93. The cohort now consists of 28,480 employees with an average of > or = 20 years of follow up. RESULTS: The overall mortality, and most cause specific mortalities were lower than or similar to those for the general population of the United States. For white men (86% of the cohort), there were 8873 observed deaths and 11,181 expected resulting in a significantly lower standardised mortality ratio (SMR) of 79. There were significant deficits for all the leading causes of death in the United States including all cancers, cancer of the lung, stroke, heart disease, respiratory disease, and accidents. Slightly increased mortality was found for cancer of the pancreas, cancer of the brain and central nervous system, leukaemia, and cancer of other lymphatic tissue. For cancer of the bone, the SMR was 162 (95% confidence interval (95% CI) 86 to 278), and for benign and unspecified neoplasms, it was 152 (95% CI 109 to 206). Overall mortality patterns for non-white men and women were similar to those for white men. Mortality patterns for white men were also examined by duration of employment, time first employed, location, and by job and process unit. There were significantly increased SMRs for brain cancer for those people employed as laboratory workers and on units with motor oil and for cancer of other lymphatic tissue for people employed on the fluid catalytic cracking unit. CONCLUSIONS: The results of the updated study showed a favourable mortality experience for employees in the Texaco mortality study compared with the United States population. There were a few increases found consistently including, but not limited to, brain cancer and cancer of other lymphatic tissue. These increases led to additional analyses that will be discussed in the accompanying paper.

Brain Neoplasms↗
PubMed1985

Multiple forms of plasminogen activator in human breast tumors.

Total plasminogen activator (PA) activity, tissue-type PA (t-PA) activity, urokinase-like PA activity, and immunoreactive t-PA were measured in benign breast tumors (fibroadenomas), primary breast carcinomas, axillary node metastases, and chest wall recurrences. Total PA activity did not differ significantly in the different types of tumors. However, benign tumors contained predominantly t-PA activity. Urokinase-like PA activity was significantly higher in the malignant tumors compared with the benign group. Both t-PA activity and immunoreactive t-PA were significantly lower in chest wall recurrences compared with primary carcinomas. The ratio of t-PA to urokinase activity was significantly decreased between stages 1 and 3 in the primary tumors. Also, immunoreactive t-PA levels were significantly lower in stages 2 and 3 compared with stage 1. No correlation was found between PA (either total or its different forms) and tumor grade, histological type, or the presence or absence of axillary node metastases.

Adenofibroma↗
PubMedDate not supplied

Hodgkin's disease: treatment and secondary neoplasms.

Hodgkin's disease is a lymphoma which occurs in man in the lymph nodes or in extra-lymphatic tissue. The disease was first described in 1832 by Thomas Hodgkin, a British physician. The disease develops with different patterns of histology in several types which a varying degree of malignancy: stages of the disease processes may be encountered. Lymph nodes appear phylogenetically first in the mesentery of crocodiles and reach the top of their development in the mammal. Here they are important during the neoplastic development as regional stations thereof. The treatment, depending on the cellular make-up of the type, may vary from advantageous to very toxic. Successful treatment in several cases on the one hand, in contrast to high therapeutic toxicity, and the development of secondary neoplasms on the other, are outlined.

Adult↗
PubMed2000

Ultrasound of the adult hip.

The adult hip is a new and challenging site for evaluation with ultrasound (US). Clinically, diseases involving the hip region may be difficult to diagnose without the help of imaging. The hip region is a crossroad for numerous vascular, nervous, and muscular structures that pass between the trunk and the lower extremity. Thus, inflammatory processes and neoplasms may spread to and from the hip, buttock, thigh, pelvis, and retroperitoneum, and trauma may also effect the adjacent areas of the trunk and thigh. Because it is a crossroad, many conditions that are not specific to the hip occur in this area, including inguinal lymphadenopathy, pathology from the abdomen or the genitalia (intestinal hernia, inflammation, and infection), and even referred pain from spinal disorders. The goals of US imaging are the detection and localization of these pathological processes, the differentiation of intra-articular andextra-articular pathology, and the performance of diagnostic and therapeutic interventional procedures. This article reviews the hip anatomy, followed up by a discussion of the US evaluation and differential diagnosis of common pathology occurring in the hip area. This includes joint effusion, arthritis, loose bodies, bursitis, pseudoaneurysm, muscle and tendon diseases, as well as tumor and tumor-like lesions such as hematoma, abscess, and lymphadenopathy.

Abscess↗
PubMedDate not supplied

Sonography of soft tissue masses of the neck.

In many clinical conditions, high-resolution sonography and color (power) Doppler sonography can be used as the first-line modality for evaluating cervical soft tissue masses. Cervical cysts, lipomas, paragangliomas, neurogenic tumors, hemangiomas, and lymphangiomas often exhibit characteristic sonographic appearances. Sonography can be used for lymph node assessment, and most salivary gland diseases can be diagnosed sonographically. Sonography can be used to guide needle biopsy of soft tissue neoplasms and lymph nodes. In addition, the relationship between a cervical mass and the great vessels can be evaluated.

Branchioma↗
PubMed1997

Development of donor-derived prostate cancer in a recipient following orthotopic heart transplantation.

OBJECTIVE: To report the development of metastatic prostate cancer in a heart transplant recipient without a primary focus in the recipient prostate gland; to present genetic evidence suggesting transplantation of the malignancy from the donor. DESIGN: Histological analysis of donor prostate and recipient prostate and rib. Molecular genetic analysis of prostate and kidney tissue from the donor and peripheral blood leukocytes and rib tissue from the transplant recipient. SETTING: University of Pennsylvania Medical Center. RESULTS: Multiple biopsies of recipient prostate were negative for malignancy but recipient rib contained prostatic adenocarcinoma with osteoblastic bone response. Molecular genetic analysis of recipient rib specimen, which contained both histologically normal and neoplastic cells, was shown to contain a combination of alleles from the donor and recipient at 4 loci. CONCLUSION: Although this is a single case report of an uncommon event, genotyping of polymorphic dinucleotide repeat elements from 4 different chromosomal regions provides strong evidence that the tumor cells arose from donor tissue and were transplanted along with the cardiac allograft.

Adenocarcinoma↗
PubMed1993

Secretogranin IV immunoreactivity in medullary thyroid carcinoma: an immunohistochemical study of 62 cases.

The presence and intracellular distribution of secretogranin IV (Sg IV) was determined on light microcop by the avidin-biotin peroxidase complex method with the monoclonal antibody (mAb) Hisl-19 in normal and hyperplastic C-cells, in 62 primary medullary thyroid carcinomas (MTCs) and in 17 MTCs in tissue from synchronous and/or metachronous lymph node metastases and in one liver metastasis. Sg IV immunoreactivity was present in almost all normal-looking and hyperplastic C-cells, in 59 of 62 (96%) of the primary tumours, in 18 of 26 (69%) lymph node metastases and in distant metastasis. Sg IV reactivity ranged from small foci of positive tumour cells to a reaction in virtually every malignant cell. Two different staining patterns were obvious: a granular cytoplasmic reactivity and a perinuclear cluster-type signal. Normal-appearing and hyperplastic C-cells were characterized by a uniform granular staining often coexisting with discrete cluster-type immunoreactivity. Various combinations of these staining patterns were observed in C-cell carcinomas. The pure cluster-type reactivity was restricted to malignant C cells and was not detected in normal-appearing and hyperplastic C-cells. In serial sections immunohistochemical results for Sg IV, calcitonin (Ct) and chromogranin A (Cg A) showed only partial correlation. Depending on the area of the tumour chosen, immunohistochemical reactivity for Ct and Cg A might not be demonstrated in neoplastic C-cells, while staining for Sg IV was retained. The amount and type of Sg IV reactivity of MTCs was not correlated with the biological behaviour of the tumours. These results indicate that mAb Hisl-19 is an excellent marker for normal, hyperplastic and neoplastic C-cells. MAb Hisl-19 is especially useful in cases with weak or questionable reactivity for Ct and Cg A. The switch from the granular pattern to the perinuclear distribution seems to indicate a malignant transformation of C-cells and might prove useful an an additional diagnostic clue.

Antibodies, Monoclonal↗