1/2029. Clinical value of protein-bound fucose in patients with carcinoma and other diseases.Protein-bound fucose content in sera from normal persons and patients with various malignant and non-malignant diseases was measured and statistically analyzed. Normal serum gave a mean value of 6.84 /- 0.13 mg/100 ml, and rarely exceeded 9 mg/100 ml. Although no significant difference was found between sexes, there was a tendency of fucose content to decrease in older persons. It was noted that more than 90% of cancer-bearing patients have significantly higher level than critical value (9 mg/100 ml), while only 8.7% of patients with benign tumor showed positive result. These results were not limited to special organs but in common to all cases studied. The elevation of serum fucose content in malignant tumor was well correlated with its stages of progression, though the levels were less significant in early and in rather locally restricted breast and thyroid cancer. Serial postoperative follow-up study showed that the levels in serum fucose content was a useful parameter for judging the effectiveness of therapy and the prognosis of the patient. The fucose content in malignant tumor tissue and metastasized lymph node appeared to be significantly elevated than that in normal tissue. The practical usage and limitation of the fucose value in various diseases, together with a possible source of serum fucose were discussed.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
2/2029. Mandibular metastasis in a patient with endometrial cancer.Gynecologic cancers metastatic to bone are a rare entity, and a metastasis to the mandible at initial presentation is even more infrequently seen. We present a case of a 71-year-old woman with stage IV endometrial cancer with a metastasis to the mandible, with no other sites of distal spread apparent. The endometrial tumor was a FIGO grade III adenocarcinoma. The pathologic evaluation of the mandibular lesion revealed poorly differentiated adenocarcinoma with focal squamous differentiation. She was treated with a total abdominal hysterectomy and bilateral salpingo-oophorectomy, radiation therapy to the mandible, and chemotherapy consisting of Taxol and carboplatin for six cycles. She had a complete response, but 10 months after the original diagnosis developed spinal cord compression and progressive disease in the pelvis. patients in good clinical condition with a single bone metastasis should be treated aggressively, as survival can be extended.- - - - - - - - - - ranking = 0.16666666666667keywords = disease (Clic here for more details about this article) |
3/2029. Embolic vascular seeding of endometrial adenocarcinoma, a complication of hysteroscopic endometrial biopsy.OBJECTIVE: A case of embolic vascular seeding of endometrial adenocarcinoma following hysteroscopy is reported. methods: This phenomenon was recognized in the uterus specimen from a hysterectomy performed 1 week after hysteroscopic endometrial biopsy. Tissue processing artifact was excluded. RESULTS: Since the patient was otherwise low risk, treatment was limited to hysterectomy. The patient was not given adjuvant therapy. Two years later she remains alive and well with no evidence of disease. The surgical, morphologic, and clinical features of this case are presented and illustrated. CONCLUSION: Previous reports of peritoneal tumor seeding associated with hysteroscopy are reviewed. Tumor embolization during hysteroscopic endometrial biopsy was not followed by tumor recurrence in this case.- - - - - - - - - - ranking = 0.16666666666667keywords = disease (Clic here for more details about this article) |
4/2029. Molecular relationships of helicobacter pylori strains in a family with gastroduodenal disease.OBJECTIVE: Few studies have examined the genetic relationships of helicobacter pylori strains affecting family members. Our aim was to do so. methods: We characterized H. pylori isolates obtained from members of a single family presenting with various gastroduodenal diseases to examine H. pylori bacterial genetic similarity. Endoscopic evaluation with gastric mapping was performed on each individual to establish clinical and histological disease. Genomic dna extracted from each H. pylori isolate was used to generate dna fingerprints for each strain by REP-PCR. vacA genotypes and cagA presence were established by PCR. RESULTS: gastrointestinal diseases among the five members of this family included gastric adenocarcinoma in a 52-yr-old man (index patient), gastric MALT-lymphoma in the 73-yr-old mother; intestinal metaplasia (IV) and atrophic gastritis in the 48-yr-old brother; intestinal metaplasia (I-III) in the 47-yr-old brother, and a duodenal ulcer scar in the 42-yr-old sister. REP-PCR dna fingerprints of H. pylori isolates from the index patient, his mother, and both of his brothers were identical or highly similar. By contrast, the H. pylori dna fingerprint from the sister was markedly different from the H. pylori dna fingerprints from the other family members. All isolates had the genotype cagA-positive and vacA slb/ml mosaic genotype. CONCLUSIONS: The dna fingerprints of H. pylori strains obtained from members of this family with malignancy or premalignant histological disease were identical or highly similar and markedly different from the H. pylori dna fingerprint from the sibling with duodenal ulcer disease. All H. pylori isolates within the family possessed genetic markers of enhanced virulence (presence of the cagA gene and vacA sl/ml mosaicism). In addition to host genetics and environmental factors, these findings suggest that infection with genetically similar H. pylori strains is a significant factor in determining the clinical outcome of an infection with H. pylori.- - - - - - - - - - ranking = 1.5keywords = disease (Clic here for more details about this article) |
5/2029. malacoplakia of the prostate confused with clear cell carcinoma.Primary malacoplakia of the prostate is a rare benign disease, which is frequently mistaken for carcinoma and granulomatous prostatis. The surgical and clinical course of a patient with obstructive hypertrophy of the prostate is reviewed after an initial incorrect diagnosis of clear cell carcinoma. Experience in defining the lesion during the transurethral resection is presented. The pathogenesis, morphological structure and unique microscopic appearance of malacoplakia, characterized by large mononuclear cells associated with small laminated concretions, are described and illustrated.- - - - - - - - - - ranking = 0.16666666666667keywords = disease (Clic here for more details about this article) |
6/2029. Advances in gastrointestinal endoscopy.endoscopy has a rapidly expanding role in diagnosis and management of gastrointestinal disease.- - - - - - - - - - ranking = 0.16666666666667keywords = disease (Clic here for more details about this article) |
7/2029. Synchronous and metachronous gastric adenocarcinoma: case report and literature review.Whilst synchronous adenocarcinoma of the stomach is well documented, metachronous primary disease is exceedingly rare. We report a man with a family history of colonic and gastric cancer, who underwent a resection of a Duke's C adenocarcinoma of the rectum, aged 56 years, and a proximal partial gastrectomy for synchronous stage 1 gastric adenocarcinomas of the lesser curve, aged 61 years. Nine years later, a metachronous gastric primary was discovered in the gastric remnant, necessitating total gastrectomy. Total gastrectomy is the operation of choice for synchronous gastric primaries as it ensures clearance and prevents metachronous growth. However, it may not be appropriate for all gastric cancer as operative morbidity and mortality are increased, and because synchronicity and metachronicity of gastric cancer are uncommon. Moreover, there are no consistent data to demonstrate a survival advantage for total compared with partial gastrectomy for operable gastric cancer. If, after partial gastrectomy, synchronous disease is detected in the resected specimen (as in this reported case), endoscopic surveillance for metachronous disease is advised, since this may be amenable to surgical cure.- - - - - - - - - - ranking = 0.5keywords = disease (Clic here for more details about this article) |
8/2029. learning from case reports: diagnostic issues in an epidemiologic study of pancreatic cancer.epidemiologic studies on exocrine pancreatic cancer show a large heterogeneity in diagnostic criteria applied to define "caseness." Reanalyses conducted after review of diagnostic information have yielded substantially different results than those based on more crude classifications of disease. During a multicenter prospective study on mutations in the K-ras gene in pancreatic and biliary diseases, hospital diagnoses from 602 patients were reviewed by a panel of experts. There were two main motivations to do so: a generic interest for the quality of the diagnostic data, and the anticipation that a firm diagnosis could be needed to assess whether patients whose tumors did not harbor the mutation were true negatives or false negatives. In addition, the review of diagnoses was helpful to minimize tissue misclassification, and it had a high educational value for clinicians and epidemiologists. This article illustrates why and how this was so through a brief presentation of the 10 most significant cases. With respect to selection and classification of subjects, the main issues that studies on pancreatic cancer need to address are the differential diagnosis of exocrine pancreatic cancer and pancreatitis, the differential diagnosis of exocrine pancreatic cancer and other abdominal tumors, and the use of survival as a hallmark of pancreatic cancer. In epidemiologic studies of pancreatic cancer, it is warranted that a panel of experts centrally reviews all the existing diagnostic evidence (cytohistological and other) of all patients, regardless of whether they have cytohistological confirmation and of their hospital discharge diagnosis.- - - - - - - - - - ranking = 0.33333333333333keywords = disease (Clic here for more details about this article) |
9/2029. Mammary Paget's disease with acantholytic features and without any detectable breast tumor.Paget's disease is usually associated with an underlying adenocarcinoma of the breast. The initial manifestation is an eczematous or psoriasiform lesion of the nipple, soon extending to the mammary areola and then to the surrounding skin. The histology of the lesions is characterized by the presence, within the epidermal layer, of the so-called Paget's cells, i.e. large cells with vesicular nucleus and clear cytoplasm. The authors report a recent case of Paget's disease of the breast in a 75-year-old woman, unusual both for clinical course and observed histology. As for the clinico-evolutive aspects, although in the case observed the initial skin lesions appeared 20 years before, the different diagnostic procedures repeatedly performed showed no evidence in this patient of an underlying adenocarcinoma. The histologic aspect, on the other hand, was peculiar since the typical characteristics of an acantholytic disease were evident. The presence of intraepidermal cleavages with lost, at times, of the normal contacts among the cells of the Malpighian layer has been described only once in Paget's disease. This fact caused some diagnostic difficulties: however, the typical finding of the Paget cells, their positivity to histochemical methods such as cytokeratin and acid phosphatase allowed the diagnosis. The authors, at last, evaluate the need of a surgical therapy in Paget's disease of the breast without an underlying adenocarcinoma.- - - - - - - - - - ranking = 1.5keywords = disease (Clic here for more details about this article) |
10/2029. Renal cell carcinoma in children with diffuse cystic hyperplasia of the kidneys.We report the clinical, pathologic, and genetic features of renal malignancy in two children with diffuse cystic hyperplasia. Both presented with massive bilateral nephromegaly. Neither had a family history or clinical findings suggestive of tuberous sclerosis or von hippel-lindau disease. The kidneys of both children were extensively replaced by tubulocystic hyperplasia with large eosinophilic epithelial cells. The masses of hyperplastic tissue were nodular, compressing remnants of uninvolved renal parenchyma. Tubulopapillary carcinoma was present in both children, one of whom had bilateral multicentric carcinoma. No loss of heterozygosity was detected in the tumors at the TSC1, TSC2, or VHL gene regions, and no alterations in the VHL gene were detected using single-strand conformation polymorphism analysis. These cases of bilateral renal enlargement with diffuse cystic hyperplasia appear to represent a new clinical syndrome that may warrant bilateral nephrectomy because of the risk of malignancy.- - - - - - - - - - ranking = 0.20957319812315keywords = disease, tube (Clic here for more details about this article) |
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