Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary mucoepidermoid carcinoma (MEC) of the thyroid is very rare, and its origin has not been fully determined. We report a case of MEC, the origin of which was demonstrated by thyroid specific genes expressed in a metastatic lymph node. A 52-year-old male presented with chest pain, weight loss and diffuse goitre. Ultrasonography showed the thyroid to be diffusely enlarged with numerous small calcifications. The tumour was found to be infiltrating the thyroid, lung, lymph nodes and first thoracic vertebra. A variant type of papillary thyroid carcinoma was suspected by fine needle aspiration cytology of the thyroid. An open biopsy specimen from an axillary lymph node revealed the tumour to be composed of three distinct cell types: mucin-producing cells, intermediate cells and a small amount of epidermoid cells with scattered psammoma bodies. Immunohistochemical studies showed the tumour cells to be negative for thyroglobulin and calcitonin, but positive for CEA. To examine the primary origin of the tumour, the expression of thyroid specific genes in the lymph node specimen was examined by RT-PCR. TTF-1, TTF-2, Pax-8, Na-I symporter and thyroid peroxidase mRNA were detected. The presence of these thyroid-specific mRNAs indicates that this MEC originated from thyroid follicular epithelium. This is the first molecular evidence of dedifferentiation from thyroid follicular cells to MEC.
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PMID:A case of primary mucoepidermoid carcinoma of the thyroid: molecular evidence of its origin. 1235 39

A 46-year-old woman was admitted to our hospital because of bloody and chest pain. Chest X-ray and CT scan revealed a 17-mm nodule in the left upper lobe, consolidations in both lower lobes, and mediastinal and hilar lymphadenopathy. CT-guided lung biopsy from the right lower lobe revealed tumor cell embolism, intimal fibrocellular proliferation of small arteries, fibrin thrombi and recanalization. Embolic tumor cells were adenocarcinoma and immunohistologial staining for TTF-1 was positive. The patient was diagnosed as having pulmonary tumor thrombotic microangiopathy (PTTM) associated with clinical stage IV primary lung adenocarcinoma. Although chemotherapy with carboplatin and paclitaxel resulted in improvement of pulmonary consolidations, multiple bone metastatic lesions appeared. The patient was subsequently treated with docetaxel, and gemcitabine thereafter. This was the first reported case of PTTM associated with lung cancer and diagnosed antemortem by CT-guided biopsy. This suggests that CT-guided lung biopsy may be useful for diagnosis of PTTM, and enable establishment of appropriate cancer chemotherapy.
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PMID:[A case of pulmonary tumor thrombotic microangiopathy associated with lung adenocarcinoma diagnosed by CT-guided lung biopsy]. 1906 68

We report a case of pulmonary adenofibroma in a 29-year-old female found by CT scan during work-up for midline chest pain. To our knowledge, the cytological features of this entity have not been previously reported. Cytology demonstrated bland epithelial and stromal cells of varying size without karyorrhexis, pyknosis, or necrosis and with very rare mitoses. Stromal cells were present as either naked bipolar nuclei, as spindle cells with fragile eosinophilic cytoplasm, or as rare larger carrot shaped nuclei. Epithelial cells were present as small loosely cohesive groups with smooth round nuclei and moderate amounts of cytoplasm. Histologically, this lesion consisted of a leaf-like fibroepithelial pattern in which the clefts were lined by a single layer of cuboidal epithelium reminiscent of adenofibroma occurring in the female genital tract. Immunohistochemical analysis demonstrated epithelium that stained positively for pan-cytokeratin and TTF-1. The stroma stained positively for vimentin and desmin, and was weakly positive for SMA-1. The lesion was confirmed to be pulmonary adenofibroma with a smooth muscle component. The differential diagnosis for this lesion includes, but is not limited to, pulmonary hamartoma, pulmonary blastoma, adenomyofibroma, synovial sarcoma, and visceral metastases. It is important for cytopathologists to be aware of this benign entity because it can be encountered on lung FNA specimens. Considering this benign lesion in the differential diagnosis may help plan for minimal lung resection. Confirmatory intraoperative frozen section is a reasonable option.
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PMID:Pulmonary adenofibroma: cytologic and clinicopathologic features of a rare benign primary lung lesion. 2264 35

Sixteen cases of primary thymic adenocarcinoma are presented. The patients are 9 men and 7 women between the ages of 22 and 68 years (average, 45 years) who presented with non-specific symptoms including cough, chest pain, and dyspnea. Diagnostic imaging revealed the presence of an anterior mediastinal mass, which was surgically removed in all of the patients. Histologically, none of the tumors was encapsulated and showed different growth patterns including mucinous, non-mucinous, and papillary features. The majority of cases showed mixed growth pattern, and the tumor was limited to the mediastinum with only a few cases extending to lymph nodes or pericardium. In two cases, the adenocarcinoma was associated with a thymoma. Immunohistochemical stains were performed, and their positive staining varied depending on the histology of the tumors, showing positive staining in some cases for keratin 7, keratin 20, CEA, CD5, CD117, and CDX-2. PAX8 and TTF-1 were negative in all the tumors. Follow-up information was obtained in 10 patients over a period of 1 to 12 years, indicating that three patients had died within a period of 14 months, one with brain metastasis, while seven patients have remained alive without recurrence. The cases herein described span the spectrum of thymic epithelial tumors and highlight the importance of recognizing this particular type of carcinoma, as it may follow a different outcome and require different treatment options.
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PMID:Primary thymic adenocarcinomas: a clinicopathological and immunohistochemical study of 16 cases with emphasis on the morphological spectrum of differentiation. 2933 75

Epithelioid angiosarcoma is a rare soft-tissue sarcoma, which originates from endothelial cells. Herein, we report a case of an uncommon morphology of epithelioid angiosarcoma in the chest wall with diffuse hemorrhage and necrosis. The 52-years-old man suffered from severe chest pain, hemoptysis, and fever. Contrast-enhanced chest CT scans showed a large space-occupying lesion in the right chest cavity. A right thoracotomy was performed for definite diagnosis and surgical resection. Microscopically, the specimen demonstrated extensive hemorrhage and necrosis, while few visible tumor cells were noted. These cells were round to polygonal and even had an epithelioid appearance, with abundant eosinophilic cytoplasm. Vesicular nuclei and prominent nucleoli were observed. Immunohistochemistry indicated that these abnormal cells were positive for cytokeratin, vimentin, CD31, ERG, and FLI-1. They were negative for D2-40, CK5/6, calretinin, WT-1, CK7, TTF-1, napsin A, and CEA. Moreover, Ki-67 with MIB-1 was about 40%. On the whole, histology and immunohistochemistry supported the diagnosis of epithelioid angiosarcoma.
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PMID:Epithelioid angiosarcoma of the chest wall with atypical morphology: report of one case. 3193 87

Most metastatic lung tumors display well-defined, round, multiple nodular shadows, whereas the presence of diffuse ground-glass opacities on chest computed tomography generally suggests non-malignant conditions. Here, we report an unusual case of pulmonary metastasis from gastric cancer in which diffuse ground-glass opacities were observed in all lung segments. A 59-year-old man with a 3-month history of worsening chest pain and shortness of breath was referred to the pulmonary clinic. Chest computed tomography revealed low attenuation areas, suggesting emphysema, along with diffuse ground-glass opacities and interlobular septal thickening in both lungs. A transbronchial lung biopsy specimen revealed signet-ring cell carcinoma infiltrating the alveolar septa. Immunohistochemical staining of the cancer cells was positive for CDX-2, cytokeratin 7, and cytokeratin 20, and negative for surfactant apoprotein-A, TTF-1, and Napsin A. Gastrointestinal endoscopy revealed an ulcerative tumor in the stomach, and a biopsy from the tumor demonstrated malignant cells with similar morphology and immunophenotypes as those in the lungs. The final diagnosis was diffuse lung metastasis from gastric cancer. Our case shows that although multiple, well-defined nodules are typically considered to be the classic presentation of pulmonary metastasis, clinicians should also be aware of the possibility of pulmonary metastasis presenting as diffuse ground-glass opacities.
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PMID:Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities. 3248 52