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PubMed1989

Staging of rectal carcinoma: prospective comparison of endorectal US and CT.

One hundred two consecutive patients undergoing surgical treatment for rectal cancer were examined by means of endorectal ultrasound (US) for staging before surgery. Eighty-one of these patients also underwent staging with computed tomography (CT). The diagnostic sensitivity of endorectal US in detection of tumor extension into fat was 67%; specificity, 77%; positive predictive value, 73%; and negative predictive value, 72%. The sensitivity of CT for this finding was 53%; specificity, 53%; positive predictive value, 56%; and negative predictive value, 50%. The sensitivity of endorectal US in detection of lymph node infiltration was 50%; specificity, 92%; positive predictive value, 68%; and negative predictive value, 84%. For this finding the sensitivity and negative predictive value, 76%. These findings suggest that endorectal US may be as accurate as CT, or more so, in the preoperative staging of rectal cancer.

Adipose Tissue↗
PubMed1977

Lymphangiomyoma.

A case report is presented of the incidental finding of a lymphangiomyoma in a 50-year-old woman who underwent total hysterectomy for squamous cell carcinoma of the cervix. The condition seems to occur only in women after puberty and so far, has been mainly reported in association with chylothorax or chylous ascites. There is no evidence of any clinical complication more than 2 years after removal of the lesion. The lesion is most likely a hamartoma although the term lymphangiomyoma is acceptable. The term lymphangiomyomatosis is best reserved for the fully developed clinico-pathological syndrome.

Carcinoma, Squamous Cell↗
PubMed2002

PGP9.5 as a marker for invasive colorectal cancer.

PURPOSE AND EXPERIMENTAL DESIGN: We proved recently that PGP9.5-negative pancreatic cancer patients had significantly better survival rates compared with those who were PGP9.5 positive, and PGP9.5 may be a novel marker for indicating the prognosis of pancreatic cancer patients. In this study, we examined the expression of PGP9.5 in primary colorectal cancers using immunohistochemistry and correlated the result with the clinicopathological features. RESULTS: Of 74 colorectal cancer specimens examined, 33 cases (46%) showed positive staining with PGP9.5 in most tumor cells, whereas no PGP9.5 expression was detected in adjacent normal epithelium. Subsequently, we correlated PGP9.5 expression in tumors with the clinicopathological features of affected patients and found two significant differences in maximal tumor size and the extent of tumor (P = 0.035 and 0.019, respectively). CONCLUSION: This result suggests that PGP9.5 expression is related to tumor progression and may be useful as a marker for invasive colorectal cancer.

Adult↗
PubMed1992

Subcutaneous interstitial fluid pressure and arm volume in lymphoedema.

Interstitial fluid pressures were measured by the wick in needle method in the swollen and normal arms of 38 patients with lymphoedema resulting from treatment for breast cancer. The mean increase in arm volume, calculated from sequential circumferential measurements, was 33% (range 0.25 to 85.9). Subcutis interstitial fluid pressure in the swollen arm (2.0 cmH2O range -4.5 cmH2O to 6.8 cmH2O) was significantly greater (p < 0.001) than in the contralateral, non-swollen arm (-2.6 cmH2O range -11 cmH2O to 0 cmH2O). Interstitial fluid pressure in the oedematous arm did not correlate with the duration of the swelling (1-324 months), but did correlate with the increase in volume relative to the normal arm (r = 0.38, p < 0.05), the slope ('apparent compliance') being 28 ml.dl-1.cmH2O-1. The pressure-volume curve was less steep than the classic curve for acute oedema of dog limbs (Guyton, 1965). Vascular pressures were normal. The interstitial fluid pressures were not as high as those reported for lymphoedema of the lower extremity (mean 17.9 mmHg, Christensen et al., 1985). Nevertheless, the rise in interstitial fluid pressure by an average of 4.6 cmH2O constitutes a force opposing further microvascular fluid filtration and perhaps promoting fluid drainage out of the arm.

Adult↗
PubMed2005

[Practice guideline 'Diagnostic techniques for soft tissue tumours and treatment of soft tissue sarcomas (revision)'].

Members of the Dutch working group on soft tissue tumours developed an up-to-standard evidence-based multidisciplinary clinical practice guideline for the diagnosis of soft tissue tumours and the treatment and follow-up of soft tissue sarcomas, in cooperation with the Dutch Association of Comprehensive Cancer Centres and the Dutch Institute for Healthcare Improvement. A soft tissue sarcoma is defined as every non-epithelial tumour that does not originate in haematopoietic or lymphatic system, central nervous system or bone. The guideline lists 'alarm signals' to raise awareness of malignancy and recommends consulting a multidisciplinary team. Non-invasive imaging has to be completed before proceeding to any invasive (diagnostic) procedure or assessment of dissemination. Aspiration cytology can be useful for differentiating between sarcoma and other malignancies. A definite diagnosis is obtained by means of image-guided needle biopsy. Tumours will be classified according to the World Health Organization and graded according to the Federation Nationale des Centres de Lutte Contre le Cancer. Surgical excision with a tumour free margin of 2 cm is the core of therapy, taking into account vital structures when necessary. In case of small superficial tumours (diameter < or = 3 cm) excision biopsy may be justified. Radiotherapy is almost always necessary and certainly indicated when wide margins are impossible even after re-resection. In the case of primary metastatic disease, an individual decision should be taken after multi-disciplinary consultation concerning the possibility of curative or palliative treatment. Neither neo-adjuvant nor adjuvant chemotherapy is standard. Chemotherapy may be useful in metastatic disease. The guideline advises referring patients who are eligible for chemotherapy to a centre and that they should be included in a study protocol.

Diagnosis, Differential↗
PubMed2004

[Helicobacter pylori infection, the invasion and metastasis of the gastric carcinoma, and the expression of MMP-2 and TIMP-2].

OBJECTIVE: To explore the relationship among Helicobacter pylori (H. pylori) infection, the invasion and metastasis of the gastric carcinoma, and the MMP-2 and TIMP-2 expression. METHODS: The Warthin-starry method, rapid urease test and 14C-UBT were used to detect the infection of H. pylori. The expression of MMP-2 and TIMP-2 in 22 patients with gastric carcinoma infected by H. pylori and 22 patients with gastric carcinoma but not infected were detected by immunohistochemistry method. RESULTS: The incidence of serosal invasion and lymph node metastasis in patients with gastric carcinoma infected by H. pylori (81.8% and 72.7% respectively) was significantly higher than that in patients with gastriccarcinoma but not infected (50.0% and 36.4% respectively, P < 0.05). The positive rates of MMP-2 expression in the invasive group (96.6%) and in the metastasis group (100.0%) were significantly higher than that in the non-invasive group (40.0%) and the non-metastasis group (50.0%), whereas the positive rates of TIMP-2 expression in the invasive group (48.3%) and in the metastasis group (45.8%) were significantly lower than that in the non-invasive group (86.7%) and the non-metastasis group (80.0%). The ratios of MMP-2/TIMP-2 in the invasive group (6.86) and in the metastasis group (7.94) were significantly higher than that in the non-invasive group (0.87) and the non-metastasis group (1.07). The positive rate of MMP-2 expression in patients with gastric carcinoma infected by H. pylori (90.9%) was significantly higher than that in patients with gastric carcinoma but not infected (63.6%), whereas the positive rate of TIMP-2 expression in patients with gastric carcinoma infected by H. pylori (36.4%) was significantly lower than that in patients with gastric carcinoma but not infected (P < 0.01). The ratio of MMP-2/TIMP-2 in patients with gastric carcinoma infected by H. pylori (7.73) was significantly higher than that in patients with gastric carcinoma but not infected (P < 0.01). CONCLUSION: associated with the increase of the MMP-2 expression, the decrease of the TIMP-2 expression and the increase of the ratio of MMP-2/TIMP-2 that the incidence of serosal invasion and lymph node metastasis in patients with gastric carcinoma increases by H. pylori infection.

Helicobacter Infections↗
PubMed2005

[Difficulties in diagnostics in recurrent abdominal pains in 71-years-old patient].

Neoplasm of B-cell origin is the most frequent malignant disease of the lymphatic tissue. It is usually presented as enlargement of lymph nodes, hepatosplenomegaly, skeletal pains and gastrointestinal dysfunction. Splenic lymphoma can cause the difficulties in diagnostic procedures (ultrasound and computed tomography). It may be nearly anechoic and mimic a cyst, abscess or parasitic mass. We describe a course of the disease and diagnostic troubles noted in 71-years-old patient, in whom splenic cysts enlarging rapidly were observed. Splenectomy due to presented difficulties in diagnosis such as clinical disquiet about subsequent course of the disease was performed. It let us to recognize malignant lymphoma and initiate a correct treatment strategy.

Abdominal Pain↗
PubMed1990

The diagnostic utility of immunophenotyping and immunogenotyping in the pathologic evaluation of lymphoid proliferations.

One hundred eighty-two specimens of suspected lymphoma and lymphocytic leukemia were examined by morphology, immunophenotype, and immunogenotype (genotype) in order to answer the following questions: How often and in what situations does immunophenotyping help resolve a diagnostic problem that is not resolved by morphology? How frequently does genotyping help resolve a diagnostic problem that is not resolved by morphology and immunophenotyping? Of 182 cases for which fresh tissue was available, sixty-five cases were considered morphological diagnostic problems: There were 32 cases of neoplasia versus non-neoplastic proliferation, 16 cases of neoplasia with undifferentiated or ambiguous morphology, and 17 cases of lymphoma or lymphocytic leukemia with an uncertain subtype. Immunophenotyping helped to resolve 33 of these 65 cases. Of the remaining 32 cases genotyping helped to resolve the diagnosis in 16. These results suggest that immunophenotyping may diagnose approximately 50% of those cases which present a morphological problem, and that genotyping is also helpful in a limited but significant number of problem cases.

Diagnosis, Differential↗
PubMed1979

[Pattern of lymphogenic metastasizing of soft tissue malignant tumors].

The examination performed indicated metastases in regional lymph nodes in 34 (7.5%) of 453 patients with soft tissue malignancies. The presence of metastases aggravates considerably the prognosis: a 5-year survival was 6.6%. Great risk of metastatic proliferation is especially characteristic of rhabdomyosarcoma, non-classifiable blastoma and synovial sarcoma. Primary tumors develop metastases more frequently than recurrent ones. The probability of lymphogenic spread of metastases is the higher the larger the tumor size in young individuals, and also with skin involvement. Tumor infiltration of bones does not result in an increased percentage of lymphogenic metastasization. The proximity of a tumor to regional lymph nodes is not inherent in a higher risk of their metastatic involvement.

Humans↗
PubMed1990

[Surgical and preoperative treatment of soft tissue sarcoma].

Preoperative therapy effects, resected margin and local radicality were investigated in 40 cases of soft tissue sarcoma in which preoperative therapy (mainly radiation therapy) had been given. The results indicated that there was no effect upon prognosis due to postponement of surgery in order to perform preoperative treatment. In cases in which radiation therapy was used for preoperative treatment, even when a surgical margin resulted with in a tumor, no recurrence was found. However, histologically there was concern that some portion of the living tumor cell in marginal area of the tumor might have remained. Thus, at the present stage in cases having undergone initial treatment, radiation limited to the specific area of the resected margin causing non-curative margin should be given. If combined with preoperative radiation therapy, surgical intervention involving "wide margin" can be considered radical. On the other hand, cases having undergone surgery before and receiving preoperative therapy that show good response nevertheless show numerous recurrences. These recurrences, however, invariably occur outside of the irradiated area, and may be attributed to the fact that tumor cell dissemination from the earlier surgery was not within the radiation field. Hence, it was considered that the area for radiation in the case of a recurrence should extend well beyond the scar area.

Combined Modality Therapy↗
PubMed1986

[An autopsy case of epithelioid sarcoma--a review of the cases reported in Japan].

A 48-year-old Japanese woman died of a general metastasis of epithelioid sarcoma originating in the right palm, which had been irradiated for trichophytia therapy 30 years earlier and where a contraction of the fingers and recurrent ulceration for seven years despite several surgical treatments had occurred. Although the tumor cells in the biopsy materials consisted of both large ovoid and polygonal cells with deeply eosinophilic cytoplasm and spindle-shaped cells, no particular appearances for definite diagnosis were obtained. The epithelioid appearance of tumor cells was first recognized in the metastatic foci of the lungs and kidneys at autopsy. In addition, 20 cases of epithelioid sarcoma reported in Japan are reviewed.

Female↗
PubMed1985

[The f-factor (fat infiltration) in breast cancer as a new indicator for predicting the occurrence of bone metastasis].

The correlation between tumor infiltration into extramammary fatty tissues (f-factor) and bone metastasis was retrospectively analyzed in 117 patients with breast cancer. Five (10.6%) and 26 (37.1%) patients developed bone metastases among 47 f-negative and 70 f-positive subjects, respectively, and the frequency of bone metastasis was significantly higher in the f-positive than in the f-negative group (p less than 0.005). Furthermore, bone metastasis was more frequent in the f-positive than in the f-negative group among patients of the same stages, lymph node involvements, or histological types. The f-factor was suggested to be a new indicator for predicting the occurrence of bone metastasis in breast cancer.

Adipose Tissue↗