1/27. Pleuropulmonary blastoma: A case report documenting transition from type I (cystic) to type III (solid).BACKGROUND: Pleuropulmonary blastoma is a rare, aggressive neoplasm that typically occurs in young children. It has been classified as type I, II, or III on the basis of the cystic versus solid nature of the lesion as well as the histologic appearance. Although it has been speculated that type I lesions may have a tendency to progress into type III lesions, no such case has been reported to date. methods: A case of type I pleuropulmonary blastoma in a girl age 2 years 9 months was found in our departmental archive. This case, originally diagnosed as a hamartoma over 20 years ago, predated the description of this pathologic entity. Over a 3-year period, the patient underwent excisions of a primary tumor and 3 subsequent recurrences, thus allowing us to follow the natural history of this neoplasm. RESULTS: The primary tumor was a large, multicystic mass (roughly 90% cystic by volume) with benign histologic appearance except for occasional foci with bland, embryonal rhabdomyosarcomatous features. In subsequent recurrences, the resected specimens became increasingly solid and had an anaplastic, multiphasic mesenchymal pattern. CONCLUSIONS: The course of the patient described here represents the first case in which transition from type I (cystic) to type III (solid) was documented.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/27. Deletion of the NF2 region in both meningioma and juxtaposed meningioangiomatosis: case report supporting a neoplastic relationship.We report a case of juxtaposed atypical meningioma and meningioangiomatosis (MA) in an 8-year-old boy with no clinical stigmata or family history of neurofibromatosis. We studied the proliferative activity and genetic changes in the two lesions in an attempt to define their biologic and pathogenetic relationships. The MIB-1 index was 11% in the meningioma and <1% in the MA, indicating increased proliferative activity in the meningioma. fluorescence in situ hybridization was done for two chromosomal regions commonly deleted in meningiomas. There was loss of the neurofibromatosis 2 locus (22q12) in both the meningioma and MA. Conversely, the region of 1p32 was not deleted. Our results indicate that both the meningioma and MA arose from the same clonal process, with the meningioma probably undergoing additional, but undefined, genetic alterations that confer upon it a more proliferative potential. This loss of 22q12 in the MA raises doubt about the presumed hamartomatous nature of MA.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/27. Columnar-lined lower esophagus: an acquired lesion with malignant predisposition. Report on 140 cases of Barrett's esophagus with 12 adenocarcinomas.The analysis of a series of 1,225 cases of reflux esophagitis shows the serious nature of this condition. A liberal use of antireflux operations therefore seems justified. Extensive columnar metaplasia of the distal esophagus, or columnar-lined lower esophagus (CLLE), represents a late irreversible stage of reflux esophagitis. Repeated esophagoscopies demonstrate the acquired nature of the lesion. It is caused by the progressive healing, from below upward, of peptic ulcerations on the squamous epithelium by metaplasia of columnar mucosa. Antireflux operations stop the progressive ascent of heterotopic epithelium and thus stabilize reflux esophagitis and cure complications such as ulcerations and strictures. The premalignant character of this condition is established by a 10 per cent incidence of adenocarcinomas in a series of 140 cases of extensive columnar metaplasia. The transition toward malignancy seems to be irreversible and cannot be arrested by an antireflux operation. Therefore, repeated esophagoscopic controls and biopsies are an absolute necessity in all cases of extensive columnar metaplasia, even after cure of active reflux esophagitis by Nissen fundoplication.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
4/27. Characteristics of the tumours of the urinary tract in patients with endemic nephropathy.The authors have studies in detail the development of tumours in the urinary tract of patients with endemic nephropathy (EN). They have found tumours in about 40% of these patients. They have performed operations for tumours of the urinary tract in 88 patients with EN, with a different localization in the upper part of the urinary tract. In 10% of the cases they have found bilateral tumours. The histological examination has revealed papillary tumours of a malignant character. They have shown specific symptoms of these tumours, not found with other tumours of the urinary tract. The main symptom is renal insufficiency which causes the death of the patients. The evolution of these tumours is comparatively slow and the nature of EN has determined the operative approach of the authors, a radical operation with haemodialysis when indicated. The paper is illustrated with four typical cases.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/27. Primary adenovillous carcinoma of the bladder.Two cases of primary adenovillous carcinoma of the bladder are presented: one in a normally placed bladder and the other in an exstrophied bladder. The close association of these 2 neoplasms with coexistent cystitis glandularis would seem to support the possible precancerous nature of the latter entity. The remarkable similarity of these neoplasms to villous adenocarcinomas of the rectum is also described, a finding which may reflect the close embryologic origin of the rectum and bladder neck. A brief review of the classification of vesical adenocarcinomas is also given.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/27. Genetic evaluation of the dysplasia-carcinoma sequence in chronic viral liver disease: a detailed analysis of two cases and a review of the literature.Hepatocellular carcinoma (HCC) is one of the most frequent human malignancies, especially in Asia and africa, but also in the western world its incidence is increasing. HCC is a complication of chronic liver disease with cirrhosis as the most important risk factor. Viral co-pathogenesis due to hepatitis b virus (HBV) and hepatitis c virus (HCV) infection seems to be an important factor in the development of HCC. Curative therapy is often not possible due to the late detection of HCC. Thus, it is attractive to find parameters which predict malignant transformation in HBV- and HCV-infected livers. In the past decade, preneoplastic lesions, i.e. dysplastic foci or nodules, have gained interest as possible markers for imminent malignancy. Noteworthy, dysplastic liver lesions are increasingly detected by imaging techniques. We describe here two cases of chronic viral liver disease, one HBV-and one HCV-related, in which dysplastic lesions were present adjacent to HCC. In the HBV case, a (smaller) satellite of HCC was present as well. The neoplastic specimens were investigated by comparative genomic hybridization (CGH) and in situ hybridization (ISH). Both methods revealed multiple genetic alterations in the HCCs. The genetic patterns of the HBV-related HCC and the satellite tumor showed many shared alterations suggesting a clonal relationship. A subset of genetic changes were already present in dysplasias illustrating their preneoplastic nature. Surrounding liver cirrhosis samples did not display chromosomal aberrations. A literature survey illustrates the relative paucity of information concerning genetic alterations in preneoplastic liver lesions. However, all the data strongly suggests a role for liver cell dysplasia as a precursor condition of liver cell cancer.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/27. Multiple squamous cell carcinomas complicating linear porokeratosis.Linear porokeratosis is a distinctive variant of porokeratosis with malignant transformation, a known but infrequently reported complication. We report a case of linear porokeratosis on the right leg of a 57-year-old man present since infancy that, over a 2-year period, developed two squamous cell carcinomas within the lesion. Concurrent right inguinal lymphadenopathy was demonstrated on biopsy to be reactive in nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/27. Temporary dysplastic hematological features due to iron deficiency in a case of poland syndrome.poland syndrome has been sporadically associated with hematological conditions, primarily acute leukemias. The authors report a child with this syndrome coexisting with temporary hematological dysplasia due to iron deficiency. Further hematological evaluation failed to demonstrate malignancy. Because of its premalignant nature, in patients with poland syndrome, hematological dysplastic features should be an indication for further investigation. However, in addition to the well-known hematological malignancies, treatable causes may be responsible.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/27. Proliferative verrucous leukoplakia and field cancerization: report of a case.Proliferative verrucous leukoplakia (PVL) is a multi-focal oral pre-malignant lesion, proliferative in nature, with a tendency to recur despite adequate therapy, and a high rate of malignant transformation. The field cancerization phenomenon may explain the characteristic behaviour of PVL. A case of PVL is presented and the field cancerization concept is discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/27. Detecting oral cancer: a new technique and case reports.The VELscope is an important aid in patient assessment, and when added to a well-thought out clinical assessment process that takes into consideration the age of the patient and risk factors that include tobacco, alcohol, and immunologic status, it increases the clinician's ability to detect oral changes that may represent premalignant or malignant cellular transformation. False positive findings are possible in the presence of highly inflamed lesions, and it is possible that use of the scope alone may result in failure to detect regions of dysplasia, but it has been our experience that use of the VELscope improves clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Where tissue changes are generalized or cover significant areas of the mouth, use of the scope has allowed us to identify the best region for biopsy. As with all clinical diagnostic activities, no single system or process is enough, and all clinicians are advised to use good clinical practice to assess patients and to recall and biopsy lesions that do not resolve within a predetermined time frame. Lesions that are VELscope-positive and absorb light need to be followed with particular caution, and if they do not resolve within a 2-week period, then further assessment and biopsy are generally advised. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. In our fight to protect patients from cancer, the VELscope improves our odds for early detection, hopefully resulting in fewer deaths from oral cancer.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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