1/180. Progression of a Nelson's adenoma to pituitary carcinoma; a case report and review of the literature.A 25-year-old woman developed Nelson's syndrome, 3 years after successful bilateral adrenalectomy for Cushing's disease. Despite pituitary surgery and radiotherapy the tumour showed invasive growth, leading to visual disturbance, paresis of the oculomotor nerve and, 34 years after adrenalectomy, to death by widespread purulent leptomeningitis. autopsy revealed a large adenohypophyseal carcinoma with a metastasis attached to the dura, both tumours showing immunocytochemical staining for ACTH and TSH. We review the literature on metastatic adenohypophyseal carcinoma in Cushing's disease and Nelson's syndrome and discuss the role of proliferation markers as indicators of malignant progression.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/180. The place of irradiation in the treatment of malignant tumors of the salivary glands.1. radiation therapy is not indicated after surgical removal with adequate margins of low-grade tumor. 2. radiation therapy is indicated with a) Inadequate surgical margins in low-grade tumors b) All high-grade tumors c) All recurrent malignant tumors 3. Irradiation of nerve pathways is indicated with demonstrated nerve and perineural invasion and/or with adenoicystic carcinoma. 4. Irradiation of the entire ipsilateral neck is indicated a) Wtih high-grade tumors unless radical neck dissection shows negative nodes b) In the place of radical neck dissection.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
3/180. bone marrow metastases in disseminated alveolar rhabdomyosarcoma: case report with ultrastructural study and review.A case of desseminated alveolar rhabdomyosarcoma in an 18-year-old male with leuco-erythroblastic anaemia is described. Numerous bizarre malignant cells, including frequent multinucleated giant cells, were seen in bone marrow aspirates, and osteolytic lesions appeared late in the clinical course. The primary site of the neoplasm remained undertermined during life and also at necropsy, which revealed minute pulmonary metastases and extensive lymph nodal, pleural and skeletal deposits. The diagnosis was confirmed on necropsy tissue by ultrastructural examination which demonstrated numerous thin (5 nm) and thick (15 nm) intracytoplasmic filaments in tumour cells, sometimes organized in bundles; scattered dense Z-band-like bodies, and rod-shaped structures were also seen. The fine structure of the rhabdomyosarcoma in the present case is compared with previous ultrastructural studies. Elongated, thick intracytoplasmic filaments whose diameter corresponds to that of myosin myofilaments are strong evidence for rhabdomyoblastic differentiation and are considered to be the sine qua non of a positive electron microscopic diagnosis of rhabdomyosarcoma. Orgaized bundles of filaments and Z-band-like dense bodies are usually present, and rod-shaped structures are found infrequently, but none of these are necessary for the ultrastructural diagnosis.- - - - - - - - - - ranking = 1.1909591554764keywords = organ (Clic here for more details about this article) |
4/180. Primary cancer of the larynx associated with primary lung cancer. Report of 21 cases, 14 with autopsy findings and 7 biopsies.The present paper reports 21 cases (14 autopsies and 7 biopsies) of associated primary cancers of the larynx and the lung. This association is by no means uncommon, the laryngeal lesion being usually the first to appear. Mulitple primary cancers--of the same or of a different histologic type--tend to occur in the same organ or organ system, either simultaneously or after a time interval. In case of synchronous primary malignant tumour of the larynx and lung the most lethal cancer (the lung cancer) must be managed first. Cancer patients are more likely than other individuals to develop a second primary malignant tumour. Laryngectomized patients should be followed-up possibly by means of cytologic examinations of bronchial secretions and chest x-rays at short intervals for early detection of a possible second primary malignant pulmonary lesion.- - - - - - - - - - ranking = 2.3819183109528keywords = organ (Clic here for more details about this article) |
5/180. Immunoreactivity of prostate-specific antigen in male breast carcinomas: two examples of a diagnostic pitfall in discriminating a primary breast cancer from metastatic prostate carcinoma.Prostatic-specific antigen (PSA) is regarded as a specific marker secreted by normal and neoplastic acinar epithelial cells of the prostate gland; its detection by immunocytochemistry has been accepted as an indication of metastatic prostate cancer. This is ascribed to the commonly held belief that PSA is not found in extraprostatic tissues. However, this concept has recently been challenged, based on the observations that certain nonprostatic tissues and their neoplasms can also secrete PSA. Such a questionable belief could result in a diagnostic pitfall when using immunostaining for PSA on fine-needle aspiration (FNAC) cytology samples to differentiate metastatic prostate cancer from a primary carcinoma of an extraprostatic organ. In this communication, two cases of primary carcinomas of the male breast are reported in which PSA immunopositivity on FNAC led to the suggestion of a diagnosis of metastatic carcinoma of the prostate. Diagn. Cytopathol. 1999;21:167-169.- - - - - - - - - - ranking = 1.1909591554764keywords = organ (Clic here for more details about this article) |
6/180. dna ploidy alterations detected during dedifferentiation of periosteal chondrosarcoma.dna ploidy of a case with dedifferentiated periosteal chondrosarcoma was analyzed by dna cytofluorometry. The diagnosis of primary periosteal chondrosarcoma was made on the basis of the radiographic and histological findings. At 4 years after marginal resection, the tumor recurred locally and metastasized to various organs. The patient died of disease 2 years later. Histologically, there were two components, chondrosarcoma and malignant fibrous histiocytoma, in the recurrent and metastatic tumors. dna ploidy analysis of multiple samples revealed that the primary lesion was composed of many diploid cells with some tetraploid and octaploid cells, whereas in the dedifferentiated area, there were many aneuploid cells which were not recognized in any area of the primary tumors. This case illustrated that dna ploidy alteration of euploidy to aneuploidy is closely correlated with the process of dedifferentiation in chondrosarcoma.- - - - - - - - - - ranking = 1.1909591554764keywords = organ (Clic here for more details about this article) |
7/180. Low-grade malignant perineurioma of the paravertebral column, transforming into a high-grade malignancy.A demarcated 6 x 5 cm right paravertebral tumor at the level of T6 in a 39-year-old male was removed surgically. Histologically, the tumor consisted of monomorphous benign-looking, low-cellular spindle cells embedded in desmoplastic stroma. Ten years later, the tumor recurred locally with metastasis to systemic organs, including the occipital skin. Malignancy was histologically evident by the increased cellularity, cellular atypia and mitotic activity. The patient died of respiratory failure at the age of 49. Retrospectively reviewed, the primary lesion was low-grade fibrosarcoma-like spindle cell tumor, with secondary transformation into a highly malignant form. The differential diagnoses included sclerosing epithelioid fibrosarcoma, low-grade fibromyxoid sarcoma and malignant peripheral nerve sheath tumor. Immunohistochemically, the spindle cells in the primary and recurrent tumors consistently expressed epithelial membrane antigen, vimentin, type 4 collagen and laminin. The tumor cells in the present case showed a differentiation toward perineurial cells, which are normally positive for these immunohistochemical markers. Hence, the appropriate diagnostic term should be 'malignant perineurioma', a subtype of malignant peripheral nerve sheath tumor.- - - - - - - - - - ranking = 3.1909591554764keywords = organ, nerve (Clic here for more details about this article) |
8/180. Mental neuropathy: report of five cases and review of the literature.Mental nerve neuropathy, also referred to as numb chin syndrome, is a rare, seemingly harmless symptom. It is more often associated with cancer, either as first symptom or during the outcome, than with benign diseases. In this review, we will focus on the numb chin syndrome presenting as an isolated neurological symptom. We report five patients with mental nerve neuropathy associated with metastatic disease (small cell lung cancer, prostatic cancer and breast cancer). In one patient, numb chin syndrome preceded the discovery of the disease, while, in the four others, it occurred as a sign of relapse or progression. Isolated mental nerve neuropathy, frequently associated with breast cancer and lymphoproliferative diseases, is generally thought to be the consequence of bone metastases or leptomeningeal seeding, but may also present without an obvious cause, most often secondary to the involvement of the mental nerve itself. Although various therapies may lead to the resolution of this symptom, median survival after diagnosis is generally less than 1 year. The appearance of a mental nerve neuropathy should never be considered as a 'banal' symptom and investigations to detect a possible cancer should be mandatory.- - - - - - - - - - ranking = 5keywords = nerve (Clic here for more details about this article) |
9/180. Non-Hodgkin's lymphoma presenting with osseous lesions.Eight cases of non-Hodgkin's lymphoma presenting with bone symptoms are reported. The radiological appearances of these tumours are described. The importance of radiology in differentiating a primary lymphoma of bone from a lymphoma arising from other organs which has subsequently metastasised to the skeleton is briefly discussed.- - - - - - - - - - ranking = 1.1909591554764keywords = organ (Clic here for more details about this article) |
10/180. prolactin-producing pituitary adenoma and carcinoma with neuronal components--a metaplastic lesion.Recent studies indicate that cells of various epithelial tumors are capable of transformation to neurons. Observing both neurons and neuropil in two prolactin-producing adenohypophyseal tumors, one benign and one malignant, we sought to assess their cellular differentiation, the presence of nerve growth factor receptor, and expression of the dopamine receptor gene using immunocytochemistry, electron microscopy, and in situ hybridization. light and electron microscopy clearly revealed cells morphologically transitional between adenoma/carcinoma cells and neurons. Large neurons lacked proliferative activity. neurons in varying number showed immunoreactivity for pituitary hormones including prolactin, growth hormone and alpha subunit in the adenoma and prolactin alone in the carcinoma. The distribution of nerve growth factor receptor staining was similar. In both tumors, in situ hybridization showed mRNAs for prolactin and dopamine receptor within adenohypophyseal cells and neurons. Our results indicate that the occurrence of neurons and neuropil in growth hormone and prolactin-producing pituitary tumors appears to be the result of metaplasia. The process is not limited to benign tumors and may be due to the production of tropic substances by the adenohypophysial cells, which by paracrine/autocrine mechanisms result in transformation of adenoma cells to nerve cells.- - - - - - - - - - ranking = 3keywords = nerve (Clic here for more details about this article) |
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