1/98. Cytology of ascitic fluid in a patient with granulocytic sarcoma (extramedullary myeloid tumor). A case report.BACKGROUND: Granulocytic sarcoma (GS) is the rare extramedullary manifestation of acute myeloid leukemia that may precede or be concurrent with leukemic infiltration of bone marrow or herald blastic transformation of a chronic myeloproliferative disorder. It has been found in most body sites and shows no age or sex predilection, necessitating its inclusion in the differential diagnosis of undifferentiated neoplasms. CASE: A 36-year-old female presented with a three-year history of abdominal pain, jaundice and fluctuating abdominal girth. Cytology of the ascitic fluid revealed myeloid cells of eosinophilic lineage at all stages of differentiation, with many undifferentiated cells. Immunohistochemical studies on a cell block confirmed the diagnosis of granulocytic sarcoma, which excluded the differential diagnoses of Hodgkin's disease, non-Hodgkin's lymphoma and Langerhans histiocytosis. CONCLUSION: Granulocytic sarcoma may present as a serous effusion and can be diagnosed on a cytologic specimen.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/98. Massive pleural effusion and ascites resulting from esophagectomy with extensive lymphadenectomy for cancer of the abdominal esophagus.chylothorax is an uncommon but well recognized complication of esophagectomy. We present the case of a 57 year-old man with squamous cell carcinoma of the abdominal esophagus who underwent subtotal esophagectomy by right thoracotomy. Post-operatively, the volume of pleural effusion from the right chest was increased (1600-2000 ml/day). The effusion was straw colored, not changing to milky after meals. The characteristics and composition of the pleural fluid were similar to those of chyle. We therefore treated this patient using methods for treatment of chylothorax, conservatively, by administration of OK-432 and minocycline/hydrochloride into the pleural cavity from the chest tube with success. We discuss the pathophysiology of this unusual condition and its treatment.- - - - - - - - - - ranking = 0.013541245882039keywords = chest (Clic here for more details about this article) |
3/98. Peripheral T-cell lymphoma presenting as ascites: a case report and review of the literature.Here we report an unusual case of T-cell lymphoma presenting as ascites. A 49-yr-old woman was admitted to the hospital for abdominal discomfort associated with increasing abdominal girth over the course of 3 mo. She also complained of nausea, vomiting, and diarrhea. On physical examination, a tense and distended abdomen and edema of the lower extremities were noted. Neither hepatosplenomegaly nor lymphadenopathy was found. A CT scan of the abdomen and pelvis showed a large abdominal/pelvic mass surrounding the small bowel and omentum and small nodes in the para-aortic and mesenteric regions. The cytospin prepared from the peritoneal fluid was hypercellular and composed of a population of monotonous, noncohesive cells with a high nuclear/cytoplasmic ratio and a single prominent central nucleolus. The cells were positive for leukocyte common antigen and Leu-22 (CD43) but negative for keratin, L26, UCHL-1, kappa, lambda, CD3, Ki-1 (CD30), S-100, and carcinoembryonic antigen. Morphologic and immunologic findings were suggestive of T-cell immunoblastic lymphoma. Peripheral T-cell lymphomas rarely present as ascites; this case demonstrates the value of effusion cytology in making this diagnosis.- - - - - - - - - - ranking = 0.31293268115681keywords = discomfort (Clic here for more details about this article) |
4/98. CA-125 tumor-associated antigen in a patient with tuberculous peritonitis.A 64-year-old woman with a history of chronic hepatitis b had abdominal pain and ascites, a serum albumin ascitic gradient (SAAG) of 0.8, and an elevated serum CA-125 value. Exploratory laparotomy revealed ascites and obliteration of the abdominal cavity by advanced adhesive disease consistent with carcinomatosis. Surgical biopsy revealed noncaseating granulomas. She responded well to antituberculous therapy and is presently asymptomatic.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/98. Primary malignant lymphoma of the central nervous system presenting with ascites and pleural effusion.A 70-year-old woman was admitted to our hospital owing to ascites and pleural effusion. Though malignant cells (B-cell type lymphoma) were detected in both the ascites and pleural effusion, neither lymph node swelling nor a tumor was detected upon chest, abdominal and pelvic computed tomography (CT). After weekly THP-COP therapy for 8 weeks, the ascites and pleural effusion completely disappeared. Two years after the first admission, she was re-admitted because of a disturbance of consciousness, and a brain tumor was detected on CT scan. The immunohistological and genetic data for the brain tumor were identical to those of the malignant cells in the pleural effusion and ascites detected 2 years previously. Whereas the symptoms at onset of a primary lymphoma of the central nervous system (CNS) are usually neurological ones, in this rare case of primary CNS lymphoma, the symptoms at onset were the ascites and pleural effusion without neurological symptoms.- - - - - - - - - - ranking = 0.0067706229410193keywords = chest (Clic here for more details about this article) |
6/98. Hemorrhagic ascites associated with endometriosis. A case report.BACKGROUND: endometriosis associated with massive, bloody ascites is an unusual occurrence. This report draws attention to this condition as a complication of endometriosis, with the description of a case and a review of 31 others. CASE: A 41-year-old, black nulligravida with massive, bloody ascites and a pelvic mass underwent laparotomy, and an intraoperative microscopic examination ruled out malignancy. The histologic report was compatible with endometriosis. The patient was treated with a GnRH analog, with progressive reduction of ascitic fluid and full remission after six months. CONCLUSION: Bloody ascites should be considered a complication of endometriosis, especially in nulliparous women of childbearing age with abdominal distention, a pelvic mass, dysmenorrhea, abdominal pain, weight loss and eventual pleural effusion, suggesting a diagnosis of ovarian malignancy.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
7/98. A case of eosinophilic peritonitis in which ascites interleukin 5 presented at a high level.A 17-year-old girl was admitted to Handa City Hospital presenting with nausea, vomiting, diarrhea, and abdominal pain. Cytological examination of the ascites and the increased eosinophil count in the peripheral blood led to the diagnosis of eosinophilic peritonitis. Serum concentrations of interleukin 5 and interleukin 3 were normal, while only interleukin 5 level in the ascites presented at a high level; interleukin 5 at the affected part may be specifically related to the intestinal recruitment of eosinophils in this disease.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/98. CD3 CD4-CD8-TCR-alphabeta T-cell lymphoma with clinical features of primary effusion lymphoma: an autopsy case.We report an unusual case of T-cell lymphoma presenting as ascites. A 72-year-old hiv-negative woman was admitted to our hospital for abdominal discomfort associated with increasing abdominal girth over the course of 1 month. physical examination showed a tense and distended abdomen and edema of the lower extremities. There was no hepatosplenomegaly or lymphadenopathy. A computed tomographic scan of the abdomen and chest showed massive ascites and pleural effusions, but there was no evidence of tumor masses or lymph node enlargement. The cytospin prepared from the peritoneal fluid was hypercellular and composed of a population of monotonous, large cells containing fine chromatin. No herpesvirus-8 (HHV-8) dna was detected by polymerase chain reaction in the cells. immunohistochemistry showed the neoplastic cells to be CD3 , CD4, CD7 . CD8-, CD34-, CD56, and TCR-alphabeta . Repeated cytogenetic studies showed common abnormalities of del(1) (p11p22), i(7)(ql0), and t(11:14)(q23;q11). The morphologic and immunologic findings were suggestive of peripheral T-cell lymphoma (PTCL), unspecified. This case suggests that some PTCLs with clonal chromosomal aberrations can exhibit peculiar serosal spreading in the absence of HHV-8 infection.- - - - - - - - - - ranking = 0.31970330409783keywords = discomfort, chest (Clic here for more details about this article) |
9/98. Eosinophilic gastroenteritis in children-report of one case.Eosinophilic gastroenteritis is rare in pediatric patients. The three main manifestations, defined by Klein et al. in 1970, were (a) predominant mucosal, (b) predominant muscular-layer, and (c) predominant subserosal disease. The predominant subserosal type is the rarest of the three. We report on a 43-month-old boy who, on admission, suffered from recurrent abdominal pain, vomiting and diarrhea for one week, with ascites and pleural effusion noted. The white blood cell (WBC) count of ascites fluid was 8,000/mm3, with a differential count of 99% eosinophils. The peripheral WBC count was 44,000/mm3, with 78% eosinophils. Three days after diagnosis, ascites, pleural effusion and other gastrointestinal symptoms were gradually relieved using steroid therapy, with the peripheral eosinophil count returning to normal. The steroid therapy was discontinued after two months with tapering dose. The boy was in good health with no recurrence of symptoms in a follow-up conducted after one year.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
10/98. Intraoperative placement of a self-retaining Foley catheter for continuous drainage of malignant ascites.Malignant ascites in advanced cancer is usually treated by repeated paracentesis, causing both discomfort and inconvenience to patients in the terminal stages of disease. We present a case of advanced ovarian carcinoma in which intraoperative placement of a Foley's self-retaining catheter into the peritoneal cavity was used to facilitate long-term continuous drainage of malignant ascites. This is a simple, convenient and cost-effective method which decreases the need for repeated hospital admissions. The aim complication might be peritonitis, but with proper care of the device and the use of antibiotics, this was not seen in our patient.- - - - - - - - - - ranking = 0.31293268115681keywords = discomfort (Clic here for more details about this article) |
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