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PubMedDate not supplied

Radiotherapy-induced lymphocytopenia: changes in total lymphocyte count and in lymphocyte subpopulations under pelvic irradiation in gynecologic neoplasms.

Lymphocytopenia is one of the most negative biological prognostic factors in cancer patients. Lymphocytopenia may depend on tumor progression, or on various anticancer therapies. In particular, radiotherapy (RT) may induce direct lymphocyte damage. The present study was carried out to evaluate the influence of pelvic irradiation on lymphocyte number and lymphocyte subpopulations in patients with gynecologic tumors. The study included 40 patients affected by locally limited or advanced uterine tumors, who underwent pelvic irradiation for a total dose of 50.4 Gy. RT induced a significant decline in total lymphocyte number, with values lower than 500/mm3 in 29/40 (73%) patients and with a mean decrease of 71 +/- 4%. In the same way, T lymphocyte, CD4, CD8 and NK cell mean numbers significantly decreased under RT. The decline in NK and CD8 cells was limited to the first 2-3 weeks of irradiation, whereas that involving T lymphocytes and CD4 cells was progressive and persistent until the end of RT. Finally, the decline in total lymphocyte number was significantly greater in patients who had no tumor regression in response to RT. This study confirms that pelvic RT may induce severe lymphocytopenia which could negatively influence the efficacy of RT itself.

Adult↗

PubMed1999

High-resolution imaging of gynecologic neoplasms using optical coherence tomography.

BACKGROUND: A modality capable of imaging the female reproductive tract, at or near the cellular level, could lead to the detection of diseases at earlier stages than currently possible. Optical coherence tomography achieves high resolutions in the cellular range (4-20 microm) and could accomplish that level of detection. METHOD: Optical coherence tomography imaging of gynecologic tissue was studied in vitro on normal and neoplastic human cervical and uterine tissue. EXPERIENCE: The structures of the normal ectocervix and endocervix, including epithelium, basal membrane, and glands, were identified clearly. These findings were compared with changes associated with carcinoma in situ and invasive carcinoma. The optical coherence tomography images of the uterus also showed changes between microstructural features of normal tissue and endometrial adenocarcinoma. CONCLUSION: Optical coherence tomography of tissue microstructures showed potential for powerful, minimally invasive assessment of the female reproductive tract at a resolution greater than any current clinical imaging method.

Feasibility Studies↗

PubMed1990

[The recurrence of a gynecological neoplasm as a solitary thyroid nodule].

We present a case of a patient who sought medical assistance because of a single thyroid nodule and had a history of cervix carcinoma and hysterectomy three years earlier not having had any signs of progression of that disease since. The aspiration puncture of the thyroid nodule revealed atypical squamous cells suggestive of metastasis of the gynecological neoplasia. The rareness of the clinical presentation of the thyroid metastasis as well as of the involvement of this gland in the dissemination of cervix neoplasia are discussed, noting on the possible role of radiotherapy on the variation of the progression patterns of the disease. Similarly, the usefulness of cytology obtained by aspirative puncture with a thin needle, in the diagnosis of thyroid nodule is highlighted.

Biopsy, Needle↗

PubMed1994

A supraumbilical incision for gynecologic neoplasms in the morbidly obese patient.

BACKGROUND: Surgical treatment of the pelvic area in obese patients can be extremely difficult. It is accompanied by a higher rate of complications, during and after the operation. A new approach aimed to facilitate exposure and to decrease the rate of postoperative complications is presented. STUDY DESIGN: Various surgical procedures were performed upon 23 patients with benign and malignant gynecologic disease. The panniculus were pulled down to localize the umbilicus over the symphysis pubis. The pelvis and upper part of the abdomen were explored through a supraumbilical incision. RESULTS: There were no vascular, neurologic or urinary injuries. The mean operating time was relatively short, and there was no excessive blood loss. No patient had postoperative ileus. Incisional hernia did not develop in any of the patients during three years of follow-up study. CONCLUSIONS: This incision provides excellent exposure. It heals well and has a very low complication rate.

Abdominal Muscles↗

PubMed1989

Transcatheter arterial embolization in the management of gynecological neoplasms.

Six patients were treated with transcatheter arterial embolization (TAE). Three patients suffered from intractable genital bleeding; the other three patients were preoperative cases of a stage III adenocarcinoma of the uterine cervix and two of these had gestational trophoblastic disease. Bleeding was stopped in all three cases of intractable hemorrhage; one patient rebled after 6 days. In the three preoperative cases, transcatheter arterial embolization was thought to be effective in decreasing intraoperative blood loss. There are no other reports of application of this technique to preoperative cases to decrease intraoperative blood loss in gynecological cases.

Adenocarcinoma↗

PubMed1988

[Detection of liver metastases in gynecologic neoplasms by sonography, scintigraphy, computerized tomography and liver enzymes].

In a retrospective study the diagnostic validity of sonography (US), computer-tomography (CT), scintigraphy (SC) and serum alkaline phosphatase (AP) in the detection of liver metastases was evaluated in 929 patients with malignant tumors: ovary (n = 367), mamma (n = 189), endometrium (n = 181), cervix (n = 162), fallopian tube (n = 10), vulva (n = 20). Definitive diagnosis was confirmed by autopsy (n = 51), surgical intervention (n = 297) or follow-up (n = 581). Specificity, sensitivity and overall accuracy of the different methods in the indication of liver metastasis were as follows: CT (n = 58) 81%, 98%, 93%, US (n = 929) 70%, 94%, 90%, SC (n = 512) 66%, 85%, 81%, AP (n = 325) 68%, 93%, 87%. In the last examination period, US and CT reached comparable results. In view of efficiency, AP and US would appear suitable for routine control in gynecological malignancies.

Alanine Transaminase↗

PubMed1966