[Differential diagnosis of splenic neoplasms].
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The successful management of cancer with high energy radiation requires precise knowledge of the tumor position relative to the body surface and normal organs. Diagnostic ultrasound assists in determining the size and location of tumors and vital normal structures in patients undergoing radiation therapy. Radiation fields can be established dynamically under direct ultrasound imaging, and anatomical information about the tumor, normal organs, and body contour utilized in dosimetry calculations. Diagnostic ultrasound is a safe, noninvasive technique of acquiring anatomical information that cannot be obtained by other routine diagnostic methods. Its application in clinical radiation therapy planning has the potential of improving cure rates and decreasing complication rates.
A case of Kaposi's sarcoma which presented as a warm type of immune hemolytic anemia is described. The malignancy was discovered at the time of splenectomy, which was required for control of the hemolytic anemia. Three other cases of immune hemolytic anemia in patients with Kaposi's sarcoma have been reported. An association between Kaposi's sarcoma and immune hemolytic anemia is suggested. Careful examination of the skin for Kaposi's sarcoma seems appropriate in cases of immune hemolytic anemia.
Cell detachment from and around Walker 256 tumors grown in rats is quantitated by a standardized in vitro shaking procedure. The volume of cells detached from cancers of similar size is virtually the same in tumors growing in the liver, the spleen, in intramuscular and in subcutaneous sites. In cystic tumors, greater volumes are detached from the innermost regions of the walls adjacent to necrotic material than from the outermost parts. More liver perenchymal cells are shaken free of liver adjacent to a tumor interface than from regions 0.5 and 1.0 cm distant from it. Detachment of tumor and liver cells is also enhanced by prior incubation of tissue samples with necrotic extracts. It is suggested that the necrotic regions of tumors, and products derived from them, facilitate the detachment of tumor cells and cells composing the normal tissues surrounding them, thereby potentially promoting metastasis and invasion.
Results are described of in vitro biological experimentation using a new through-transmission ultrasonic camera system developed at the Stanford Research Institute. The camera system produces real-time focused, orthographic images of a 15 times 15 cm field. The in vitro studies, which demonstrate the diagnostic potential of the new technique, include transmission images of selected excised organs such as liver, kidney, spleen, and uterus. In addition, preliminary studies evaluating ultrasonic image quality and the effect of out-of-focus structures are discussed.
Burkitt lymphoma uncommonly presents as a acute leukemia. We describe the clinical course and findings of a 14-year-old female with Burkitt lymphoma who presented with acute leukemia. splenomegaly and an abdominal mass. She responded initially to prednisone alone and later achieved full remission with combination chemotherapy. Established morphologic criteria and clinical course were consistent with the diagnosis of Burkitt lymphoma (1), although B-cell determinants were not present on her tumor cells.
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A cystadenoma of the pancreas within the spleen from pancreatic heterotopia is described. The tumor was located in the hilum of the spleen and completely separated from the normal pancreatic tail. This fact strongly supports the possibility that this tumor arose from pancreatic heterotopia.
Selective transcatheter intravascular occlusion in the treatment of cancer patients is a valuable extension of interventional diagnostic radiology. Intra-arterial embolization may be performed with various substances, including autologous clot, autologous subcutaneous tissue, Gelfoam, and stainless steel coil. Clinical applications in cancer patients include control of gastrointestinal and genitourinary hemorrhage, preoperative reduction of tumor vascularity, control of local symptoms, and therapeutic reduction of tumor bulk. The technique has been used for preoperative and palliative treatment of neoplasms of the head and neck, kidney, liver, spleen, and soft tissue and bone. Transcatheter intravascular occlusion should be performed only by radiologists experienced in angiographic techniques. Inadvertent occlusion of a normal vessel and thromboembolism are possible complications.
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Angiography was performed in 8 patients with peripancreatic lymph node disease. The findings were similar to those caused by pancreatitis and pancreatic carcinoma. The angiographic characteristics of the disease, respectively, are discussed.
The findings in a patient with pseudomyxoma peritonei, probably of appendicular origin, are reported. As a rule, pseudomyxoma peritonei remains limited to the peritoneal cavity, but in this case, dissemination occurred to the right pleural cavity and to the pericardium. In addition, invasion of the spleen (to our knowledge, nor previously described) was noted.
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Differences noted in enzyme II directed RNA synthesis under varying salt conditions in nuclei isolated from uninfected and Friend virus (FV)-infected spleen cells, have been attributed to chromosomal modifications (Babcock and Rich 1973). This investigation was undertaken to determine if compositional changes occur in the chromatin of FV-infected spleens, which correlate with an altered rate of synthesis by enzyme II. A quantitative study of the chromatin constituents at various times after infection indicated that they vary in the same temporal manner as the rate of RNA synthesis in isolated nuclei. Relative to DNA, RNA, histone, and nonhistone protein reached a maximum at 14 days postinfection. This was followed by a gradual decrease during the remainder of the infection. Chromatin endogenous DNA-dependent RNA polymerase activity varied in the same manner, suggesting that RNA synthesis directed by enzyme II is modulated by chromosomal proteins.
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Peritoneoscopy revealed in 15 patients with malignant lymphomas splenomegaly (13 patients), hepatomegaly (10 patients, 8 of them with impressive or suspicious alterations of the liver surface) and enlargement of retroperitoneal lymph nodes or localised infiltration of a jejunal loop (3 patients). Aimed biopsy of liver, spleen or lymph nodes frequently established the diagnosis definitively. The various features of malignant lymphomas observable at peritoneoscopy are described. Based on these experiences peritoneoscopy is recommended in suspected malignant lymphomas as a real diagnostic aid.