1/61. calciphylaxis associated with metastatic breast carcinoma.calciphylaxis is a rare disorder associated with calcification of small- and medium-sized blood vessels, and progressive skin necrosis usually seen in the setting of end-stage renal disease (ESRD) and secondary hyperparathyroidism. It has also been observed in primary hyperparathyroidism, hypercalcemia of malignancy (extensive bony metastasis of breast cancer), and an isolated case reported with end-stage liver disease. We report an unusual case of calciphylaxis associated with metastatic breast carcinoma in the absence of renal or parathyroid disease. calciphylaxis has generally been associated with end-stage renal disease and hyperparathyroidism. One previous case report described calciphylaxis occurring in a patient with metastatic adenocarcinoma of the breast and hypercalcemia. Our case represents the second reported case of calciphylaxis associated with osteolytic, metastatic breast cancer. Although ESRD with secondary hyperparathyroidism is the most common presentation of calciphylaxis, this case demonstrates that other conditions that alter normal calcium metabolism must be considered in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
2/61. Spindle cell lipoma of the breast.Spindle cell lesions, which commonly arise in the soft tissues, may present in the breast and be difficult to distinguish from primary mammary spindle cell tumors. We present the case of a 28 year old woman with a 1.5 cm circumscribed spindle cell lipoma lying deep within the tissue of the right breast. Thin, uniform spindle cells were associated with collagen bundles, mature adipocytes and entrapped normal mammary ducts, lobules, vessels and nerves, appearances which simulated an aggressively infiltrating tumor. The spindle cells proved immunoreactive to CD34 and vimentin but non-reactive for cytokeratin, S100, desmin, smooth muscle actin and factor viii. Although surgical resection was incomplete, the patient is alive and without evidence of tumor recurrence 12 months postoperatively. In our case, a conservative approach to management was justified and supported by the patient's subsequent clinical course. This case exemplifies the diagnostic challenge of spindle cell lesions arising in breast tissue and the value of immunoperoxidase stains.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
3/61. angiolipoma of the breast with microcalcification. Mammographic, sonographic, and histologic appearances.angiolipoma of the breast is a rare benign fatty tumor that can be mammographically confused with breast carcinoma. We herein report such a case presenting as a partial obscured mass with microcalcification on mammogram. Sonogram revealed an encapsulated hyperechoic nodule with homogeneous internal echo. Microscopic evaluation revealed abundant adipose tissues with evidence of proliferating vessels and intravascular hyaline thrombi. To our knowledge, angiolipomas of the breast containing microcalcification secondary to intravascular thrombi had not been previously reported.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
4/61. Primary bilateral mucosa-associated lymphoid tissue lymphoma of the breast with atypical ductal hyperplasia and localized amyloidosis. A case report and review of the literature.Primary non-Hodgkin lymphoma of the breast is a rare disease. Primary mucosa-associated lymphoid tissue lymphoma is even rarer, and bilateral involvement is exceptional. We describe a case of primary bilateral breast mucosa-associated lymphoid tissue lymphoma with bilateral atypical ductal hyperplasia and bilateral localized amyloidosis in a 64-year-old woman with a history of arthritis and systemic lupus erythematosus and its clinical, histologic, and immunohistochemical features. Microscopic examination of the breast lesion showed dense periductal and perilobular small and plasmacytoid lymphocytes with eosinophilic amyloid in the vessels and the stroma. Bilateral single foci of atypical ductal hyperplasia were also noted. Fine needle aspiration showed small and large lymphocytes and plasma cells. Molecular analysis demonstrated a heavy chain immunoglobulin H gene rearrangement. flow cytometry studies showed an abnormal B-cell population. The combined histologic, paraffin immunohistochemistry, flow cytometry, and molecular results were considered diagnostic for low-grade mucosa-associated lymphoid tissue lymphoma. The patient underwent bilateral local breast radiation without other organ or site involvement.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
5/61. Bilateral blindness and lumbosacral myelopathy associated with high-dose carmustine and cisplatin therapy.PURPOSE: To report the early ocular pathologic findings associated with high-dose carmustine and cisplatin therapy. methods: A patient with metastatic breast carcinoma developed an acute onset of branch retinal artery occlusion, bilateral blindness, and a myelopathy involving the lower extremities after high-dose chemotherapy and bone marrow transplant. RESULTS: Histopathologic examination of the eye and optic nerves at autopsy disclosed nerve fiber layer infarction secondary to right inferior temporal retinal artery thrombosis. Patchy necrosis of both optic nerves, medulla oblongata, and spinal cord was associated with focal small-vessel thrombosis. CONCLUSIONS: The syndrome of retinal vascular occlusion, optic neuropathy, and myelopathy is associated with the high-dose chemotherapeutic agents carmustine and cisplatin. The distribution of necrosis suggests an ischemic event rather than direct neurotoxic effects.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
6/61. Radionuclide studies in bronchogenic carcinoma of the Hilum. Scintigraphy and tomography: their complementary features.Thirty-eight cases with direct or indirect signs of hilar masses were investigated by roentgenologic, radioisotopic and surgical methods. Reasonable correlation between tomography and scintigraphy was confirmed, substantiating their complementary nature. Bronchogenic carcinoma of the central airways was most frequent among the hilar masses. Masses as well as other involvement of the bronchovascular structures of the hilum on conventional tomography were confirmed by the gallium-67 scan, and inhalation and perfusion scintigraphy. Some cases which simulated bronchogenic carcinoma were presented. Hilar masses without destruction of the bronchovascular structures showed normal inhalation and perfusion scintigrams with positive gallium-67 accumulation. These lesions were metastatic cancer, malignant lymphoma, and sarcoidosis. If these diseases involve the airways and the vessels of the hilum, differentiation from bronchogenic carcinoma may naturally be difficult.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
7/61. radiation injury involving the internal carotid artery. Report of two cases.radiation therapy is an uncommon cause of stenosis and occlusions of the cervical internal carotid artery (ICA). We describe two cases of cerebral ischemia due to ICA stenosis in patients irradiated for malignant tumors (lymphoma and breast cancer). The first patient, a 32-year-old man, presented with an episode of cerebral ischemia. Six years previously he had received irradiation therapy for a left laterocervical mass histologically diagnosed at biopsy as a Hodgkin's lymphoma. cerebral angiography on entry revealed bilateral occlusion of the cervical ICA, with a 2-cm stump at the origin of the left ICA. Despite anti-platelet aggregation therapy the ischemic attacks persisted, necessitating a stumpectomy. After vascular-repair surgery the patient had no further ischemic symptoms. The second patient, a 42-year-old woman, began to experience the sudden onset of pain in the right arm and left hemiparesis five years after surgery plus irradiation (4500 rad) for breast cancer, and three years after excision of a single cerebral metastasis. cerebral angiography obtained on admission showed occlusion of the right ICA and right subclavian arteries, both lesions necessitating thrombectomy. After surgery the right radial pulse immediately re-appeared and the hemiparesis regressed. In both patients, 2-year follow-up assessment by Doppler ultrasonography and magnetic resonance angiography (MRA) confirmed that the operated arteries remained patent. These two unusual cases underline the potential risk of irradiation-induced ischemic cerebrovascular symptoms, suggesting that patients who have received radiation therapy to the neck and mediastinum who survive for more than 5 years should undergo regular non-invasive imaging of neck vessels (Doppler ultrasonography and MRA).- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
8/61. Surgical repair of superior vena cava syndrome.We present the case of a 53-year-old woman with a history of breast cancer, chemotherapy, and a long-term central venous access catheter, who presented with acute, severe superior vena cava syndrome. Angiography showed fibrous obstruction of the superior vena cava with thrombosis of the innominate, both axillary subclavian and internal jugular veins. Surgical repair consisted of thrombectomy of all the involved vessels and patch repair of superior vena cava and innominate vein. The patient had an uneventful recovery and remains asymptomatic 12 months after the procedure.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
9/61. Hemolytic uremic syndrome with intracranial hemorrhage following mitomycin C administration.A 50-year-old woman treated for breast cancer with mitomycin C developed severe hypertension, followed by deep coma 3 days later. Computed tomography of the brain showed frontoparietal intracranial hemorrhage accompanied by subarachnoid hemorrhage. The patient was diagnosed additionally with hemolytic uremic syndrome (HUS) based on hemolytic anemia with schistocytosis, thrombocytopenia, and acute renal failure. The patient underwent hemodialysis and plasmapheresis with no improvement. We present the pathologic findings of the general vessels, which has been reported rarely. This case represents the first reported intracranial hemorrhage in HUS following mitomycin C administration. We emphasize the need to control blood pressure in patients with HUS.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
10/61. interferon-gamma in 5 patients with cutaneous radiation syndrome after radiation therapy.BACKGROUND: Irradiation can cause acute inflammatory responses as well as chronic fibrotic alterations of the skin. Cutaneous radiation fibrosis evokes a complex of therapeutic problems. However, therapeutic options, apart from surgical approaches, are limited. patients AND methods: Five female patients suffering from severe cutaneous fibrosis were treated with interferon-gamma on a low-dose regimen, 3 x 100 microg/week subcutaneously for 6 months, then once per week for another 6 months. In 4 patients, skin thickness was measured with high-frequency (20 MHz) ultrasound in a clinically well-defined target skin lesion. In 1 patient, nuclear magnetic resonance imaging was performed to quantify the extent of cutaneous radiation fibrosis and to monitor the therapeutic outcome. RESULTS: All patients suffered from radiation-induced cutaneous fibrosis. Additionally, in 1 patient, a fistula, as assessed by lymph vessel scintigraphy, and in another patient a radiation ulcer was diagnosed. In all patients, reduction of radiation-induced fibrosis could be documented. Both fistula and radiation ulcer regressed completely under interferon-gamma therapy. CONCLUSION: Low-dose interferon-gamma therapy is a new and effective treatment modality for cutaneous radiation fibrosis caused by radiation therapy. The positive impact of interferon-gamma on our patients warrants randomized double-blind trials on therapy of radiation fibrosis.- - - - - - - - - - ranking = 0.18593261731572keywords = vessel (Clic here for more details about this article) |
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