1/14. The role of trisomy 8 in the pathogenesis of chronic eosinophilic leukemia.A case of chronic eosinophilic leukemia (CEL) manifesting as spinal cord compression by an extradural eosinophilic chloroma in a 32-year-old Chinese man was presented, who subsequently developed extramedullary transformation at the skin and then peritoneal cavity. Cytogenetic study of bone marrow cells at diagnosis showed a clonal karyotypic abnormality of trisomy 8 ( 8), which on fluorescence in situ hybridization (FISH) was shown to be present in a clone of abnormal eosinophils, hence showing the neoplastic nature of the eosinophilic proliferation. There was another population of abnormal eosinophils that did not show 8. At blastic transformation, all blast cells in ascitic fluid were shown by FISH to harbor 8. These findings suggest that 8 in this case may have arisen from clonal evolution and is not the primary genetic event in leukemogenesis, but 8 most probably imparts a further survival advantage to the clone responsible for subsequent blastic transformation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/14. endometriosis ascites: a case report.This is a case presentation of an usual nature, a 43-year-old Hispanic female, multigravida presenting with physical findings of massive ascites. In most instances, the presence of massive ascites is associated with malignancies, tuberculosis or perforated visous. In this case, the diagnosis of extensive endometriosis with ascites is reported as a very rare complication of the disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/14. Lessons to be learned: a case study approach: ascites and elevated serum CA 125 due to a pancreatic carcinoma. A diagnostic dilemma.A 72 year-old lady with unrecognised cancer of the body of the pancreas presented with a 4-month history of progressive loss of weight and ascites. The results of laboratory investigations were either negative or within normal limits--apart from a raised serum CA 125 level; no tumour mass was detected on diagnostic imaging. She underwent exploratory laparotomy for a suspected ovarian tumour, but this proved not to be the correct diagnosis. A serum CA 19-9 level was subsequently requested and found to be significantly raised; a second contrast CT scan then showed the presence of ill-defined peri-aortic tissue. A further exploratory laparotomy was carried out in order to establish the true nature of the problem; a large pancreatic carcinoma was revealed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/14. Bilateral ovarian fibromatosis presenting with ascites and hirsutism.BACKGROUND: Ovarian fibromatosis is a very rare nonneoplastic disease. Due to the rarity and atypical clinical presentations, they may give rise to a misdiagnosis of malignancy and unnecessary extensive surgical interventions. literature lacks definitive data about this rare disease and its preoperative evaluations. MRI together with the intraoperative frozen section may help us to define the benign nature of the disease. In this report, we aimed to review the literature and give a highlight to the gynecologic oncologists about this rare disease. CASE history: A 19-year-old female patient admitted to our hospital with the complaints of menstrual irregularity, hirsutism, and increased abdominal girth. physical examination revealed bilateral ovarian mass, hirsutism, and ascites. serum CA-125 levels were slightly elevated. Preoperative MRI study showed bilateral hypointense lobulated ovarian masses. With the initial diagnosis of ovarian tumor, we performed explorative laparotomy and excised both masses. Final pathology was reported as bilateral ovarian fibromatosis. CONCLUSION: Ovarian fibromatosis commonly presents with ascites and solid pelvic mass and can be misdiagnosed as a malignant ovarian tumor. In young patients, clinicians should consider ovarian fibromatosis in differential diagnosis of pelvic mass. Preoperative MRI findings and intraoperative frozen examination may be used to avoid unnecessary aggressive surgical management.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/14. Transudative chylothorax: report of two cases and review of the literature.Transudative chylothorax is a rare entity that has been associated with a limited range of clinical settings. To date, transudative chylothoraces have been described in only 13 patients, most commonly as a result of hepatic cirrhosis. Recognition of the transudative nature of these effusions is important to avoid unnecessary diagnostic testing and inappropriate management strategies. This report describes the presentation, diagnosis and management of two patients with transudative chylothoraces, and provides a brief review of the relevant literature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/14. Tumor progression despite massive influx of activated CD8( ) T cells in a patient with malignant melanoma ascites.Although melanoma tumors usually express antigens that can be recognized by T cells, immune-mediated tumor rejection is rare. In many cases this is despite the presence of high frequencies of circulating tumor antigen-specific T cells, suggesting that tumor resistance downstream from T cell priming represents a critical barrier. Analyzing T cells directly from the melanoma tumor microenvironment, as well as the nature of the microenvironment itself, is central for understanding the key downstream mechanisms of tumor escape. In the current report we have studied tumor-associated lymphocytes from a patient with metastatic melanoma and large volume malignant ascites. The ascites fluid showed abundant tumor cells that expressed common melanoma antigens and retained expression of class I MHC and antigen processing machinery. The ascites fluid contained the chemokines CCL10, CCL15, and CCL18 which was associated with a large influx of activated T cells, including CD8( ) T cells recognizing HLA-A2 tetramer complexes with peptides from Melan-A and NA17-A. However, several functional defects of these tumor antigen-specific T cells were seen, including poor production of IFN-gamma in response to peptide-pulsed APC or autologous tumor cells, and lack of expression of perforin. Although these defects were T cell intrinsic, we also observed abundant CD4( )CD25( )FoxP3( ) T cells, as well as transcripts for FoxP3, IL-10, PD-L1/B7-H1, and indoleamine-2,3-dioxygenase (IDO). Our observations suggest that, despite recruitment of large numbers of activated CD8( ) T cells into the tumor microenvironment, T cell hyporesponsiveness and additional negative regulatory mechanisms can limit the effector phase of the anti-tumor immune response.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/14. Demonstration of abnormal peritoneal communication in patients with ascites.patients with ascites are known to have complications such as pleural effusions and hernias. Special diagnostic procedures are occasionally necessary to determine the nature of the abnormality and to determine the corrective medico-surgical approach. The two cases described illustrate the usefulness of intraperitoneal as well as intrapleural injection of a radionuclide in diagnosing the leakage of ascitic fluid.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/14. False-positive liver scan due to ascites.Extrahepatic structures (breast, costal margin, kidney, pleural effusion, right lower lobe lung mass) may occasionally result in a false-positive liver scan by causing attenuation of the gamma rays emenating from the liver, thereby simulating an apparent intrahepatic lesion. A false-positive diagnosis of intrahepatic pathology may often be avoided by simple maneuvers such as elevating the breast, obtaining another projection, etc. A case of false-positive liver scan due to loculated ascites is presented in which these maneuvers failed to resolve the problem. Ultrasound or CT examination may be helpful in this circumstance due to the cross-sectional nature of the information they provide.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/14. Pancreatic ascites: a rare complication of distal splenorenal shunt.Ascites has become recognized as a common postoperative complication of the distal splenorenal shunt. On rare occasions the ascites has been chylous in nature. The present report is the first documented case of pancreatic ascites occurring after this operation. This complication developed in the combined setting of chronic pancreatitis and surgical trauma to the pancreas. Since the management of pancreatic ascites differs from that of cirrhotic or chylous ascites, it is recommended that this diagnosis be considered whenever a patient develops severe ascites after a distal spenorenal shunt.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/14. Malignant mediastinal teratoma in a 15-year-old girl.A well-differentiated anterior mediastinal teratoma was removed from the right hemithorax of a 15-year-old girl presenting initially with ascites. death followed a precipitous clinical deterioration from widespread sarcomatous metastatic disease. The true malignant nature of this tumor was not apparent on initial resection and evaded detection until shortly before death. These unique features prompted a review of the pertinent literature on malignant mediastinal teratoma in children. A similar case had not been reported previously.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
| | Next -> |