SEARCH · PubMed Health

Results for “Metastatic patterns”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources

PubMed1998

Host TIMP-1 overexpression confers resistance to experimental brain metastasis of a fibrosarcoma cell line.

Within the tumor-stromal microenvironment a disrupted balance between matrix metalloproteinases (MMPs) and their inhibitors compromises the integrity of the extracellular matrix and promotes malignancy. Tissue inhibitors of metalloproteinases (TIMPs) have been linked to tumor suppression in studies of genetically altered tissue culture cells and in analyses of clinical specimens in situ. We generated transgenic mice as a model system to test the relationship between TIMP-1 levels in a host organ and susceptibility to experimentally targeted metastasis. Ectopically overexpressed TIMP-1 in the brain resulted in a tissue microenvironment with elevated protein levels of this natural MMP inhibitor. Metastatic challenge provided by lacZ-tagged fibrosarcoma cells permitted high-resolution analysis of metastatic load and pattern. We found that elevated host TIMP-1 imposed resistance to experimental metastasis of fibrosarcoma: In TIMP-1 overexpressing mice, brain metastases were significantly reduced by 75% compared to wild-type littermates. Our findings demonstrate that ectopic TIMP-1 expression efficiently exerts a suppressive effect on metastasizing tumor cells.

Animals↗

PubMed2003

Undifferentiated (embryonal) sarcoma of the liver in middle-aged adults: smooth muscle differentiation determined by immunohistochemistry and electron microscopy.

Undifferentiated (embryonal) sarcoma of the liver (UESL) is a rare pediatric liver malignancy that is extremely uncommon in middle-aged individuals. We studied 2 cases of UESL in middle-aged adults (1 case in a 49-year-old woman and the other in a 62-year-old man) by histology, immunohistochemistry, and electron microscopy to clarify the cellular characteristics of this peculiar tumor. One tumor showed a mixture of spindle cells, polygonal cells, and multinucleated giant cells within a myxoid matrix and also revealed focal areas of a storiform pattern in a metastatic lesion. The other tumor was composed mainly of anaplastic large cells admixed with few fibrous or spindle-shaped components and many multinucleated giant cells. In both cases, some tumor cells contained eosinophilic hyaline globules that were diastase resistant and periodic acid-Schiff positive. Immunohistochemically, the tumor cells showed positive staining for smooth muscle markers, such as desmin, alpha-smooth muscle actin, and muscle-specific actin, and also for histiocytic markers, such as alpha-1-antitrypsin, alpha-1-antichymotrypsin, and CD68. Electron microscope examination revealed thin myofilaments with focal densities and intermediate filaments in the cytoplasm of tumor cells. Our studies suggest that UESL exhibits at least a partial smooth muscle phenotype in middle-aged adults, and this specific differentiation may be more common in this age group than in children. Tumor cells of UESL with smooth muscle differentiation in middle-aged adults show phenotypic diversity comparable to those of malignant fibrous histiocytoma with myofibroblastic differentiation.

Actins↗

PubMed1983

A flow cytometric DNA analysis of medullary thyroid carcinoma.

Flow cytometric DNA analysis of biopsy specimens from 10 patients with medullary carcinoma of the thyroid (MCT) was performed to evaluate the possible value of such data as indicators of the biologic behavior of these tumors. Some of the tumors had a unimodal distribution of nuclear DNA content, whereas others were bimodal. The mean modal DNA content in the cells of unimodal medullary carcinomas was not higher than that in the cells of thyroid parenchyma with a normal histologic appearance. This finding contradicts previous reports based on conventional cytophotometry. Bimodal DNA histograms were found in biopsy specimens from four patients, and the two patients with predominantly spindle-shaped cells belonged to this group. The total of nine biopsy specimens with bimodal DNA distributions were all from metastatic foci. Bimodal patterns were found, however, to co-exist with unimodal patterns, when several samples were examined from the same case. Bimodality or more severe aneuploidy did not seem to be related to shorter survival of the patients. The mean value of the percentage of cells in S-phase in our MCT series was higher than in follicular but lower than in anaplastic carcinomas. This fits well with clinical studies, where medullary carcinoma patients have been found to live longer than patients with follicular carcinomas but for a shorter time than those having anaplastic carcinomas.

Adult↗

PubMed1989

Osteosarcoma with prominent epithelioid features.

Osteosarcoma in the metaphysis to epiphysis of the left femur of a 17-year-old male is reported. The lesion appeared osteolytic with sclerotic foci on roentgenographs, accompanied by an extensive tumor shadow in the surrounding soft tissue. While 60% of the tumor was necrotic, histological examination of the remaining viable tissue revealed that it consisted almost entirely of a sheet of epithelioid cells, separated by thin, fibrovascular septa with an alveolar-like pattern, suggestive of metastatic carcinoma. Only a few areas were characterized by malignant osteoid tissue intermingled with the above cells, showing significant positivity for bone-specific alkaline phosphatase and 5'-nucleotidase, thus permitting a diagnosis of osteosarcoma. Autopsy findings revealed that the metastatic foci were histologically similar to those of the primary tumor. Electron microscopy revealed poor development of cytoplasmic organelles, supporting possible derivation from an osteoblastic cell lineage at an early stage.

Acid Phosphatase↗

PubMed1979

Ultrasonographic evaluation of chemotherapeutic response in hepatic metastases.

Three hundred and thirty-four hepatic ultrasonograms were obtained in 93 patients to evaluate the chemotherapeutic response of their metastatic lesions. Four patterns of response were noted. The ultrasonographic results were correlated with those of other diagnostic modalities and found to be extremely accurate when lesions were judged to have improved, worsened, or remained unchanged. However, a fourth type of response, a change in the initial ultrasonographic pattern, was difficult to evaluate, and its significance is discussed.

Adolescent↗

PubMed1999

Extracapsular spread and desmoplastic pattern in neck lymph nodes: two prognostic factors of laryngeal cancer.

The influence of extracapsular spread (ECS) and a desmoplastic pattern (DP) of metastatic cervical lymph nodes in patients with laryngeal cancer is presented. The study includes 128 patients surgically treated between 1984 and 1992 for squamous cell carcinoma of the larynx with pathologically proven lymph node metastasis. The results were studied from 2 major standpoints: survival and recurrence. The 3-year survival rates were as follows: patients without ECS 73.4%, and with ECS 28.9% (p < .001); patients without a DP 76.9%, and with a DP 43.3% (p < .03). Also, the 3-year recurrence rates in the neck showed significant differences: patients without ECS 10.7%, and with ECS 49.6% (p < .001); patients without a DP 10%, and with a DP 31.6% (p = .1142). Postoperative radiotherapy did not appear to improve the outcome.

Actuarial Analysis↗

PubMed2004

Asbestos-induced peritoneal mesothelioma in a construction worker.

Occupational and environmental asbestos exposure continues to represent a public health problem, despite increasingly restrictive laws adopted by most industrialized countries. Peritoneal mesothelioma is a rare and aggressive asbestos-related malignancy. We present the case of a 65-year-old man who developed recurrent ascites after having been exposed to asbestos in the building industry for > 40 years. Liver function and histology were normal. Abdominal computed tomography initially excluded the presence of expansive processes, and no abnormal cells were found in the ascitic fluid. Laparoscopy showed diffuse neoplastic infiltration of the peritoneum. Histopathology of bioptic samples revealed epithelioid neoplastic proliferation with a tubulopapillary pattern, falsely suggesting metastatic adenocarcinomatosis. In consideration of the occupational history, and after further diagnostic procedures had failed to identify the hypothetical primitive tumor, immunostaining of the neoplastic tissue was performed. Results were negative for carcinoembrionary antigen and the epithelial glycoprotein Ber-EP4, whereas results were positive for the mesothelial markers cytokeratins, calretinin, epithelial membrane antigen, and HBME-1, thus leading to the correct diagnosis of peritoneal epithelial mesothelioma. The Italian Workers' Compensation Authority recognized the occupational origin of the disease. Cytoreductive surgery associated with continuous hyperthermic peritoneal perfusion (cisplatin at 42 degrees C, for 1 hr) was performed. The disease relapsed after 4 months and was later complicated by a bowel obstruction requiring palliative ileostomy. The patient died 23 months after diagnosis. This case illustrates the insidious diagnostic problems posed by peritoneal mesothelioma, a tumor which often simulates other malignancies (e.g., metastatic carcinomas) at routine histopathological examination. Occupational history and immunohistochemistry are helpful for the correct diagnosis, which, in turn, is important in relation to prognosis and treatment (adoption of new integrated procedures that seem to promise prolonged survival and increased quality of life), and in relation to medicolegal issues and occupation-related compensation claims following asbestos exposure.

Aged↗

PubMed1999

Metastases to the pancreas from renal cell carcinoma: findings on three-phase contrast-enhanced helical CT.

OBJECTIVE: Our goal was to define the lesion enhancement characteristics of renal cell carcinoma metastases to the pancreas using three-phase helical CT. MATERIALS AND METHODS: Thin-section three-phase contrast-enhanced CT scans of nine patients with renal cell carcinoma metastases to the pancreas were evaluated. The helical CT protocol included 3-mm collimation and a 2:1 pitch. Scans through the pancreas were obtained in three series beginning 25, 60, and 120 sec after the start of administration of i.v. contrast material delivered at 3 ml/sec. The Hounsfield densities of the pancreatic lesions and normal pancreatic parenchyma during each of the enhancement phases were recorded and compared. RESULTS: The enhancement patterns of the metastatic deposits and the normal pancreas differed. Thirty-four lesions ranging in size from 6 to 110 mm were identified. All metastases showed rapid enhancement during the early (arterial and portal) phases, resulting in differential attenuations (compared with normal pancreatic parenchyma) of approximately 50-100 H. The differential attenuations were approximately 5-45 H on delayed-phase scans, resulting in poorer conspicuity of the lesions. Multifocal metastases were clearly identified on the early-phase scans in seven patients. CONCLUSION: Renal cell carcinoma metastases to the pancreas enhance most conspicuously during the early phases of helical CT. Such metastases may fail to be appreciated in the delayed phase. In patients with suspected renal cell carcinoma metastases to the pancreas, early-phase scanning after i.v. contrast administration should be performed.

Aged↗

PubMed2003

Radionuclide bone scan in initial staging of breast cancer.

Radionuclide bone scans of 100 patients with newly diagnosed breast cancer were retrospectively analysed. The number and topography of increased area of uptake were noted. Diagnosis criterion was defined by at least four foci of increased uptake, outside peripheral articular joints. In case of a number between one and three, the result was considered doubtful and radionuclide bone scan was confronted to available standard X Rays or/and radionuclide bone scan follow-up. Correlations of radionuclide bone scans with T, N and the clinical stage were assessed using chi-square methods. Metastases were present in 9 patients (9%). In five of these cases, the pattern was manifestly metastatic without the need to other investigation. In the other cases, interpretation required complementary investigation. The yield of metastases was very low in localized stages, this pointed out the difficulty in interpretation of radionuclide bone scans for localized stages, probably due to a less skeletal extension.

Adult↗

PubMed1954

Thyroid carcinoma; an approach to management of the disease.

A clinical and pathological study was made of a series of 34 consecutive patients with thyroid carcinoma. Carcinoma occurred only in nodular goiters, and in the majority of cases was found in a gland with a solitary nodule. The degree of firmness to palpation of a thyroid nodule is unimportant in the diagnosis of carcinoma of the thyroid since hardness was an infrequent finding. In the diagnostic use of radioactive iodine, scintigram studies of a nodular goiter usually revealed an area of decreased function at the site of a thyroid carcinoma.Twenty-three per cent of the 34 patients with thyroid carcinoma died within five years. The duration of survival for various patients was compared with the type of treatment administered. It is believed that solitary thyroid nodules are best treated by lobectomy. Total thyroidectomy is indicated in cases of large thyroid carcinoma and also for smaller tumors if papillary adenocarcinoma. Radical neck dissection is warranted if lymph node metastasis is present and limited to the neck; and also in the absence of metastasis if the tumor is papillary in histologic pattern. Surgically inaccessible metastatic lesions are best palliated by radioactive iodine or external irradiation.

Adenocarcinoma, Papillary↗

PubMed1991

Multivariate analysis of metastasis risk in laryngeal carcinoma. I. Tumor factors.

A multivariate analysis with a logistic regression model was performed in 181 cases of patients affected by laryngeal cancer, in order to evaluate the histologic tumor factors in predicting metastatic risk. The patterns used were: grading, localization, extension to the extralaryngeal structures, mode of growth. Nodal metastases are less influenced by the localization and the differentiation grade of the tumor. Cancer extended to the extralaryngeal tissues and with "infiltrating" type of growth are significantly correlated with nodal involvement. Multivariate analysis seems to be the best method to identify the exact value of each histological parameter used in prognosis of laryngeal carcinoma.

Carcinoma↗

PubMed1978

Serum prealbumin, retinol-binding protein, transferrin, and albumin levels in patients with large bowel cancer.

In a study of the levels of serum prealbumin (PALB), retinol-binding protein (RBP), transferrin (TF), and albumin (ALB) in patients with large bowel cancer, critical values were established as (g/liter): PALB, 0.15; RBP, 40 X 10(-3); TF, 2.0; and ALB, 30. Values consistently below these were taken as a sign of malnutrition. The proteins in this system were interrelated and tended to show a similar pattern of change. Metastatic colon cancer caused a relatively small decline of ALB compared to the mean in tumor-free patients. PALB was the most sensitive indicator of nutrition, and its levels and rates of change had a prognostic significance. A rapid fall of PALB often occurred 2--3 months prior to the patients's death; this preterminal phase in ambulant patients was frequently heralded by a progressive rise in the level of C-reactive protein in the absence of any obvious infection.

Carcinoembryonic Antigen↗

PubMed1988

Growth factors as novel therapeutic targets in neoplastic disease.

The emerging concept of autocrine/paracrine control of tumour cell proliferation coupled with the identification of several polypeptide mitogens has created new opportunities for the discovery of novel classes of antineoplastic drugs. Growth factors (for example, transforming growth factor alpha, fibroblast growth factor and platelet-derived growth factor) and, in certain cases, their receptors have been identified in a number of human tumours and their expression may contribute to unregulated cell proliferation. Selective antagonists that block the activity of these mediators may have important therapeutic utility in the management of cancer patients, particularly in metastatic disease where patterns of tumour cell dissemination may be strongly influenced by paracrine mediators. However, since many, if not all, of these growth factors are polypeptides with molecular weights over 5 kDa, the discovery of potent antagonists represents an important pharmacological challenge. Advances in understanding protein structure-function relationships will be essential in guiding rational attempts at generating growth factor antagonists through site-directed mutagenesis and peptide synthesis, while better insights into the mechanisms by which growth factors are synthesized, processed, released and exert their mitogenic effects may also reveal new sites for pharmacological assault. The availability of (low molecular weight) potent growth factor antagonists will allow the autocrine/paracrine hypothesis to be clinically tested and in the process will throw considerable light on the function of these growth regulatory molecules in vivo.

ErbB Receptors↗

PubMed1986

The significance of double phenotypic patterns and markers in human sarcomas. A new model of mesenchymal differentiation.

Six soft-tissue sarcomas with two separate and juxtaposed histologic patterns were selected for immunohistochemical analysis. The first pattern was represented by five phenotypes (schwannian-skeletal muscle [Triton], cartilagenous, synovial, adipocytic, and smooth muscle). In each case the second histologic pattern resembled the fibrohistiocytic phenotype, ie, malignant fibrous histiocytoma (MFH). No other histologic patterns were identified. Appropriate cell markers were demonstrated in each of the first patterns; these were not detected in the second patterns. In contrast, the second pattern in all cases expressed alpha 1-antichymotrypsin, a marker commonly found in fibrohistiocytic lesions; this was not identified in any of the first patterns. This loss of one cell-specific marker and gain of another is termed the "antigenic shift" phenomenon and appeared to foretell the emergence of a true second phenotype (the same in each of these cases, which could be termed "dedifferentiated" sarcomas). Therefore, it is hypothesized that MFH is a final common pathway for some types of sarcomas and is the result of tumor progression or "dedifferentiation." The practical implications of this hypothesis concern the approach to sarcoma differential diagnosis and the meaning of an MFH pattern in both metastatic and primary sites. On a theoretic level, this hypothesis and the antigenic shift phenomenon force a reconsideration of the pathways of soft-tissue differentiation. A new model of mesenchymal differentiation incorporating these concepts is described and supported. It provides an explanation for a number of facts in soft-tissue pathology, and its predictions can be tested.

Aged↗

PubMed1995

Malignancies in the lung and pleura mimicking benign processes.

As pathologists, we are most concerned about overcalling reactive changes in the lung as carcinoma and the fact that malignant processes may be misinterpreted as benign processes in the lung is less well recognized. This review covers five such lesions. Well-differentiated adenocarcinomas, especially bronchioloalveolar carcinomas, are frequently undercalled, particularly in small biopsy and cytology specimens. In such cases, one must pay particular attention to the uniformity and monotony of the epithelium even though it may be extremely well differentiated. Spindle cell carcinomas may have necrosis and cavitation, interstitial growth, and a reactive fibroblastic reaction, and thus be mistaken as organizing inflammatory processes. Careful attention to the atypical cytological features, prominent vascular invasion, and getting immunohistochemical supports helps in recognizing them. Lymphoid lesions of the lung present a number of problems; small lymphocytic lymphomas and Hodgkin's disease are often misinterpreted as inflammatory processes. Intravascular lymphomatosis in the lung may be misinterpreted as an interstitial pneumonia if one does not appreciate the atypical lymphoid cells within the capillaries. The desmoplastic variant of sarcomatous mesothelioma may be extremely difficult to diagnose, because large portions of the tumors are composed of bland-appearing fibrous tissue. A case of desmoplastic mesothelioma presenting predominantly as a mediastinal mass is discussed, and problems in differential diagnosis are outlined. Angiosarcomas are rare tumors, but an appreciable percentage of them present as pulmonary metastases which may be interpreted as pulmonary hemorrhage or organizing infarction. The clinical and radiographic pattern, usually mimicking metastatic disease, and the fact that atypical spindle cells occlude small pulmonary arteries with surrounding alveolar hemorrhage are clues to the recognition of these lesions.

Adenocarcinoma↗

PubMed1993

Role of autotransplantation in neuroblastoma.

Neuroblastoma is the most enigmatic disease treated by pediatric oncologists. The same pattern of apparent metastatic spread is associated with a high rate of spontaneous regression in children under 1 year of age (stage IVS) but an invariably fatal course in older children. For these children with truly advanced neuroblastoma, recent studies have demonstrated that the possibility of complete remission and disease-free survival is increased with more intensive conventional combination chemotherapy. Supportive care with autologous marrow has enabled further significant dose escalation of cytotoxic therapy active against neuroblastoma, resulting in disease-free survival in between 25% and 50% of patients at 2 years, an improvement over historical experience with conventional chemotherapy. The development of more effective cytotoxic combinations active against neuroblastoma, improvements in ex vivo techniques to purge marrow of neuroblastoma cells, and the application of cytokines to hasten marrow recovery should further enhance the effectiveness of autotransplantation in the treatment of advanced neuroblastoma and further improve the chances for complete remission and longer remission duration. Whether this improved remission induction and duration will translate into an increased cure rate remains to be determined. Parallel advances in therapies not involving autologous marrow support will undoubtedly modify the role of autotransplantation in neuroblastoma. Currently, however, autotransplantation offers one potential solution to a major challenge in the treatment of advanced neuroblastoma--obtaining and maintaining complete remissions--and a promising basis for future therapeutic studies.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1997

[Ultrasonic diagnosis of nodal lesions of the axillary-jugular lymphatic plexus and their evolution].

Axillary lymph nodes of three levels may be adequately differentiated on the basis of the TNM classification by application of layer-by-layer tomographic examination of axillary fossa and thoracic and clavicular-thoracic triangles in the axillary cavity. Echographs show musculus thoracis minor as a distinct point of reference. Topographic features of deep lateral cervical lymph nodes may be used in anatomical identification of internal jugular nodes, transverse cervical artery, accessory nerve and suprajugular lymph nodes. In cases of multiple involvement of lymph nodes, their shape (chain or cluster) may be identified. It can be shown Whether lymph flows are in series, collateral centripetal, collateral centrifugal (recirculatory) or run parallel in metastatic areas. Varying patterns of lymph flow through collateral pathways formed in the axillary-jugular lymph plexus are responsible for the variety of patterns of lesion clusters in the lymph nodes system.

Axilla↗

PubMed1998

Problems in lymphoma management: special sites of presentation.

The staging and treatment of the common presentations of malignant lymphoma are readily familiar to experienced medical oncologists and hematologists. However, because of their rarity and variable and unusual behavior, certain special sites of lymphoma present a major challenge even to experienced clinicians. This article focuses on five such special sites of presentation: the eye, paranasal sinuses, central nervous system (CNS), testicle, and stomach. In each case, an appreciation of the usual histologic types, unique mode of metastatic spread, special patterns of resistance to systemic treatment, and, in the stomach, the remarkable association with a causative organism, Helicobacter pylori, is needed to optimize management. Only if these special characteristics are understood can the clinician plan a multiphase treatment course that offers each patient the best chance of disease control or cure.

Central Nervous System Neoplasms↗