1/18. Identifying differentially expressed genes associated with metastasis of follicular thyroid cancer by cDNA expression array.patients with follicular thyroid carcinoma have a higher incidence of metastasis than papillary thyroid carcinoma when thyroid cancer is diagnosed. The cDNA expression array technology is utilized herein to profile differentially expressed genes from metastatic human follicular thyroid carcinoma and reveal new tumor markers as well as target genes for therapeutic intervention. Tissue samples were obtained during surgical resection of the thyroid follicular carcinoma and metastatic tissue in the brain of the same patient. Two identical Atlas human cDNA expression arrays were hybridized with 32P-labeled cDNA probes derived from rna of either primary thyroid cancer or metastatic tissue. Parallel analysis of the hybridized signals allowed us to identify the alteration of gene expression in the metastasis process. Eighteen genes significantly overexpressed and 40 genes significantly underexpressed were identified in the metastatic thyroid cancer. genes that displayed an altered expression were associated with the processes of cell cycle regulation, apoptosis, dna damage response, angiogenesis, cell adhesion and mobility, invasion, and immune response. An expression profile of genes that are associated with metastasis process of follicular thyroid cancer was also discussed. Further investigation is required to understand the precise relationship between the altered expression of these genes and the metastasis process of follicular thyroid cancer.- - - - - - - - - - ranking = 1keywords = thyroid (Clic here for more details about this article) |
2/18. Pancreatic neuroendocrine tumor with extensive vascularisation and parathyroid hormone-related protein (PTHrP)--associated hypercalcemia of malignancy.We report the case of a 34 year old male presenting with symptomatic hypercalcemia due to excessive PTHrP secretion from a pancreatic neuroendocrine carcinoma with extensive hypervascularization and without any evidence for metastatic disease. In the early phase of the disease conventional chemotherapy with streptozocin and doxorubicin was able to control functional activity as well as tumor growth. However, after 2 years tumor escape was indicated by severe therapy-resistant hypercalcemia. Therapeutic options were reduced due to the excessive tumor vascularization and the patient died from his disease after a short period of intensified therapy. The role of PTHrP in hypercalcemia of malignancy (HHM) and its association with neuroendocrine pancreatic tumors as well as possible therapeutic options are reviewed.- - - - - - - - - - ranking = 0.30769230769231keywords = thyroid (Clic here for more details about this article) |
3/18. Inflammatory pulmonary nodules in Kawasaki disease.Symptomatic pulmonary manifestations of Kawasaki disease (KD) are uncommon. However, epidemiologic, radiologic, and histologic studies have indicated that respiratory symptoms and findings occur in KD and suggest that the KD agent may have a respiratory portal of entry. We report on three young infants with KD who developed pulmonary nodules, in addition to coronary artery aneurysms. Two patients had pathologic specimens available, one from biopsy and the other from autopsy. The nodules had predominantly mononuclear cell infiltrates, which were within the lung parenchyma and infiltrating vessel walls. Immunohistochemical studies of the nodules, using antibodies to common leukocyte antigen (LCA) and factor viii-related antigen, confirmed the inflammatory nature of the lesions and showed capillary proliferation. IgA plasma-cell infiltration was observed in the nodule, consistent with previous KD findings of IgA plasma-cell infiltration in the vessel walls, kidneys, pancreas, and upper respiratory tract. The two patients with nonfatal KD were treated with intravenous immunoglobulin and aspirin, with resolution of the nodules. We propose that when pulmonary involvement occurs in KD, it ranges from subclinical interstitial micronodular infiltrates to larger inflammatory pulmonary nodules. These pulmonary infiltrates and nodules likely reflect the host response to the etiologic agent of KD, and may resolve with the disease process. Recognition of this pulmonary complication of KD may enable cautious observation of such lesions for spontaneous resolution.- - - - - - - - - - ranking = 1.0259699801601keywords = nodule (Clic here for more details about this article) |
4/18. Spindle cell hemangioendothelioma exhibits the ultrastructural features of reactive vascular proliferation rather than of angiosarcoma.A patient with spindle cell hemangioendotheliomas was followed from 1964 to the present time, allowing the authors the opportunity to examine the lesions in the early, mature, and old phases. Organizing thrombi of different stages associated with slit-like vascular proliferation were always observed, whereas cavernous vascular spaces predominated as the lesions became older. Each spindle cell hemangioendothelioma initially developed relatively rapidly and was sometimes painful but then persisted as a silent nodule for decades. Transmission and scanning electron microscopic studies revealed that endothelial cells tended to digitate into the slit-like proliferating channels, became attached to other cells by means of tight junctions, and thus obstructed the channels at sites where thrombi developed repeatedly. The vascular spaces, ranging in nature from slit-like to cavernous, were outlined further by a relatively sparse mantle of ramified or dendritic interstitial cells that corresponded to spindle cells. Most of the cells appeared simply to be fibroblasts, but they developed the features of pericytes when they were close to the endothelial lining of well-developed vascular lumens. Large vascular spaces and phleboliths were surrounded by smooth muscle cells. Approximately 20% of the interstitial cells were dendritic macrophages characterized by phagocytic activity, presence of many lysosomes, and factor xiiia expression. The long and characteristic clinical course, the histologic evidence that thrombosis and its organization was continually occurring within the lesions, and the ultrastructural finding that spindle cell hemangioendotheliomas were composed of different microvascular segments from capillaries to veins, suggest that spindle cell hemangioendotheliomas may develop from a cycle of recanalization after thrombosis that occurs repeatedly because of the unique endothelial growth that was noted. This is in contrast with the previous conception that they were low-grade angiosarcomas.- - - - - - - - - - ranking = 0.093269998196369keywords = nodule (Clic here for more details about this article) |
5/18. Tapioca melanoma of the iris mimicking a vascular tumour: a clinicopathological correlation.Although vascular iris processes are usually benign, they may be a clinical manifestation of iris melanoma, and this should be considered in the differential diagnosis. The case is reported of a 20-year-old man with a highly vascularized tapioca melanoma of the left iris without involvement of the anterior chamber angle or ciliary body, but with observed growth tendency. Sector iridectomy was performed 2 months after first examination. In addition, two separate floating tumour nodules were observed in the anterior chamber angle at 6 o'clock and were removed by aspiration. After 1 year follow up, no recurrence of melanoma cells was observed. In tapioca iris melanomas, diagnostic differentiation from congenital, inflammatory, vascular and neoplastic iris processes is required. Careful biomicroscopic examination of the iris in patients with vascular iris tumours may help the ophthalmologist to identify malignant iris melanomas (tapioca type) and plan appropriate surgical treatment.- - - - - - - - - - ranking = 0.093269998196369keywords = nodule (Clic here for more details about this article) |
6/18. Haemangiopericytoma of the thyroid gland in combination with Hashimoto's disease.We present a hitherto unique case of haemangiopericytoma (HP) of the thyroid gland in a 15-year-old female patient suffering from Hashimoto's disease for several months. Since angiogenesis has been discussed to play a major role in both diseases, we examined the expression of vascular endothelial growth factor (VEGF), VEGF receptors (VEGFRs) and platelet-derived growth factor receptors (PDGFRs). Most interestingly, strong expression of PDGFR alpha and beta was found in spindle-shaped tumour cells and tumour vessels in HP, while VEGF and VEGFR type I and -II were negative in these regions. In contrast, VEGF was expressed in the lymphoid infiltrate of Hashimoto's disease. Since PDGFR-beta is commonly expressed in pericytes, we suggest that the strong expression discovered in this study further supports the view that HP is derived from pericytes. The combination of HP and Hashimoto's disease is most probably a coincidental event. However, this case confirms previous reports demonstrating that in patients with Hashimoto's disease different neoplasias can occur.- - - - - - - - - - ranking = 0.38461538461538keywords = thyroid (Clic here for more details about this article) |
7/18. Extreme hypervascularity and bruit in a treated hypothyroid goitre.A child in early puberty, who presented with a modestly enlarged thyroid gland and confirmed hypothyroidism, was successfully treated with thyroxine. Subsequently a widespread bruit developed in the neck caused by bilaterally dilated superior thyroid arteries with increased blood flow to the goitre. At thyroidectomy, histopathology showed features of dyshormonogenesis with greatly increased vascularity and widespread diffuse staining for vascular endothelial growth factor (VEGF). It is likely that VEGF in association with other angiogenetic factors was associated with enlargement of the gland and its hypervascularity.- - - - - - - - - - ranking = 0.61538461538462keywords = thyroid (Clic here for more details about this article) |
8/18. Colonic lipoma with florid vascular proliferation and nodule-aggregating appearance related to repeated intussusception.A unique case of repeatedly intussuscepted colonic lipoma mimicking an epithelial tumor in a 50-year-old man is reported. The tumor was located in the ascending colon and was approximately 5 cm in diameter. Colonoscopic and barium-enema examinations suggested a huge epithelial tumor because of its nodule-aggregating appearance. In contrast, computed tomography examination showed a fatty element in the core of the lesion. The biopsy specimens suggested a primary angiomatous lesion because of its pronounced vascular proliferation. Because the presumed diagnoses based on the examinations were different, the preoperative diagnosis was not confirmed. The tumor was composed of intramural lipoma with a multiple polypoid mucosa overlay. This lesion was unique in that the lipoma appeared to be within the muscularis propria and the multiple polypoid appearance of its covering mucosa. The mucosal changes including florid vascular proliferation, fibromuscular obliteration and epithelial regeneration suggested a reparative process, with ischemic damage due to the effects of intussusception being the most likely event. It should be kept in mind that even a simple lipoma can have a unique appearance reminiscent of epithelial tumor when it repeatedly experiences intussusception.- - - - - - - - - - ranking = 0.46634999098184keywords = nodule (Clic here for more details about this article) |
9/18. Multiple hypervascular liver nodules in a heavy drinker of alcohol.A case of hypervascular nodules in the liver, but without hepatitis b or C virus infection in a 38-year-old woman with a history of alcohol abuse is presented. An ultrasound disclosed 1-2-cm hypoechoic tumors in the right and left lobes. magnetic resonance imaging showed high-intensity tumors at both the T1-weighted and T2-weighted sequences. Incremental dynamic computed tomography and hepatic angiography revealed hypervascular tumors. Ultrasound-guided needle biopsy revealed no evidence of hepatocellular carcinoma, metastatic liver cancer, hemangioendothelioma, inflammatory pseudotumors or pseudolymphoma, but demonstrated stellate-scar fibrosis septa, which contained small unpaired arteries without hyperplasia dividing the nodule. Moreover, marked pericellular fibrosis, neutrophilic infiltration and mallory bodies were observed in the cytoplasm. There was no evidence of bile duct proliferation. From these findings, the diagnosis of alcohol-induced fibrosis, distinctly different from focal nodular hyperplasia, was tenable. Further studies may provide insights into the pathogenesis of nodule formation and hypervascularity in heavy drinkers of alcohol.- - - - - - - - - - ranking = 0.65288998737458keywords = nodule (Clic here for more details about this article) |
10/18. Relapsing polychondritis: bone marrow and circular fibrous nodules in the aorta.A case is reported of extensive aortic calcification, bone formation, and haemopoietic tissue in a woman with relapsing polychondritis. An additional feature was 'clock face' nodules of collagen in the aorta.- - - - - - - - - - ranking = 0.46634999098184keywords = nodule (Clic here for more details about this article) |
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