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

We present 25 cases of a primary pulmonary sarcoma bearing histological, immunohistochemical, and ultrastructural features indistinguishable from those of monophasic synovial sarcoma of soft tissue. The patients were 11 men and 14 women between the ages of 16 and 77 years. Clinically, the most common symptoms were chest pain, cough, shortness of breath, and hemoptysis. The lesions involved all lung segments. Grossly, they varied in size from 0.6 to 20 cm and were described as soft to rubbery tumors with areas of necrosis and hemorrhage, some with cystic changes. Two lesions involved the bronchial wall and in one case the tumor was described as encircling the bronchial tree. Histologically, all of the lesions were characterized by an atypical spindle cell proliferation with a solid growth pattern. Areas of myxoid, neural, hemangiopericytic, and epithelial-like growth pattern were observed. Mitoses, necrosis, and hemorrhage were seen in all lesions in varying proportions. Immunohistochemical studies for epithelial membrane antigen (EMA) and keratin showed strong focal positivity in 25 of 25 and 23 of 25 lesions, respectively. Immunohistochemical study for vimentin showed diffuse strong positivity in all lesions. Other immunostains, including desmin, smooth muscle actin, and S-100 protein, were negative. Electron microscopy in three cases showed spindle cells with elongated nuclei containing abundant cytoplasmic rough endoplasmic reticulum and well developed desmosome type intercellular junctions. Follow-up information ranging from 2 to 20 years was obtained in 18 patients. Six patients died of their tumors, whereas four patients died of unrelated causes without evidence of recurrence or metastases. Eight patients were alive with disease (recurrence and/or metastases) from 1 to 7 years after diagnosis. Four patients were alive and well without evidence of recurrence or metastases from 2 to 20 years (mean follow-up, 12.5 years). The present group of lesions appears to constitute a distinctive and as yet previously undescribed primary sarcoma of the lung, which probably represents the visceral counterpart of monophasic synovial sarcoma of soft tissue in a pulmonary location. Because of their distinctive biology these lesions should be distinguished from a variety of primary and metastatic malignancies of the lung.
 ...
PMID:Primary pulmonary sarcomas with features of monophasic synovial sarcoma: a clinicopathological, immunohistochemical, and ultrastructural study of 25 cases. 775 Sep 31

Pulmonary artery rhabdomyosarcomas are rare lesions, with a small number of cases reported in the literature. We report a case of pulmonary artery rhabdomyosarcoma that arose in the right pulmonary artery. The patient presented with cough, chest pain, and hemoptysis and was found to have a sarcoma arising in the right pulmonary artery and extending distally within the pulmonary vasculature into the right lung. The gross pathologic features, microscopic appearance, immunohistochemical profile, and computed tomographic and electron microscopic findings are presented. The site of origin and differential diagnosis of these lesions are discussed.
 ...
PMID:Pleomorphic rhabdomyosarcoma arising in association with the right pulmonary artery. 797 18

To determine the clinical presentation of patients with malignancies metastatic to the lung, the diagnostic utility of fiberoptic bronchoscopy (FB), and the primary site of malignancies metastasizing endobronchially, we retrospectively reviewed 1,853 FB records (1987 to 1991) and selected 111 cases for review. Cases were divided on the basis of FB findings into abnormal (44 patients) and normal (67 patients). Pulmonary symptoms (cough, hemoptysis, and chest pain) prompted referral significantly more often in the abnormal FB group (34/44) than in the normal FB group (24/67). The finding of atelectasis on chest radiograph occurred more frequently in patients with endobronchial abnormalities. The spectrum of extrapulmonary malignancies that metastasize endobronchially has changed during the AIDS epidemic. Our study shows the most frequent causes of endobronchial mass lesions were Kaposi's sarcoma and the lymphoma group (Hodgkin's disease, nonHodgkin's lymphoma, chronic lymphocytic leukemia) and the most common malignancies causing submucosal metastases were breast and the lymphoma group. In summary, the highest yield from FB can be expected in patients experiencing symptoms of cough or hemoptysis and/or having radiographic evidence of atelectasis. We propose a new mnemonic "KLAS" (Kaposi's sarcoma, Lymphoma, Adenocarcinoma, Sarcoma) to describe the malignancies most likely to metastasize endobronchially in the 1990s.
 ...
PMID:Fiberoptic bronchoscopy in the evaluation of carcinoma metastatic to the lung. 830 46

A previously healthy gravida developed chest pain and progressive dyspnea several months after delivery. A right ventricular mass rising from the septum and floating through the pulmonary valve was detected, with multiple lung nodules. With the suspicion of a primary sarcoma of the heart, she was referred for cardiac surgery. Microscopic observation of the cardiac neoplasm revealed malignant trophoblast. There was no evidence of disease in the uterus and adnexa. Combination chemotherapy with EMA-CO schedule was instituted because of the high-risk score. A complete recovery was achieved after 20 weeks of treatment and the patient is free of disease 4 years after the end of chemotherapy and is now pregnant again.
 ...
PMID:Right ventricular metastasis from choriocarcinoma: report of a rare case and review of the literature. 835 86

Thirty-four cases of primary cardiac tumors, consisted of 11 men and 23 women, aged between 26 and 80 years have been operated on in our institution. A total of 30 myxomas and four malignant tumors were resected. The clinical presentations included congestive heart failure in 25 patients, tachyarrhythmia in 6, chest pain in 4, and embolism in 10. All 30 myxoma lesions were completely resected, although none of the malignant tumors could be resected completely because of invasion of the tumor to the surrounding tissues. Four patients with malignant tumors died of tumor recurrence within 9 months after operation. Histological diagnosis was rhabdomyosarcoma in two patients, round cell sarcoma in one and malignant fibrous histiocytoma in one. All patients with myxoma survived operation. Follow-up was completed in 28 patients (range 1 month to 15 years, mean 5.5 years): Twenty-four were in New York Heart Association Class I, and the remaining two in Class II. Actuarial survival rate was 89% at 15 years after operation. No recurrent myxoma have been identified clinically or by echocardiography. For malignant primary tumors, more effective adjuvant therapy with aggressive resection will be inevitable to improve long-term prognosis.
 ...
PMID:[Surgical treatment of primary cardiac tumors]. 838 35

A case of pulmonary artery leiomyosarcoma in a 37 year old Japanese man is reported. The patient complained of chest pain and hemosputum. CT scan and angiography revealed that a tumor arose from the right main branch of the pulmonary artery. The surgical specimen was interpreted as an undifferentiated sarcoma at this time. The tumor recurred 6 months after the resection, and he died of right-sided heart failure. At autopsy, the pulmonary artery truncus was distended by the tumor, which protruded into the lumen. The tumor was composed of pleomorphic cells, giant cells and spindle-shaped cells. Many of the tumor cells were immunohistochemically positive for alpha-smooth muscle actin and vimentin. Electron microscopy revealed microfilaments with dense bodies in the cytoplasm and a discontinuous basement membrane around the cells. Although adenocarcinoma was also observed in the colon, the authors conclude that the present tumor is not a metastasis but a primary leiomyosarcoma arising from the pulmonary artery. Imaging techniques were very useful for differentiating sarcoma from thrombus in this site, and immunohistochemical demonstration for alpha-smooth muscle actin was necessary for making a histological diagnosis of leiomyosarcoma.
 ...
PMID:An autopsy case of pulmonary artery leiomyosarcoma. 846 60

Nine cases of primary non-lymphoblastic, non-Hodgkin's large cell lymphomas of the mediastinum characterized by a highly pleomorphic histologic appearance are described. The patients, four women and five men, were aged 30 to 65 years. All patients presented with symptoms referable to their tumors, including cough, chest pain, dyspnea, pleural effusion, and superior vena cava syndrome. Clinical and pathologic staging in all patients showed that the bulk of the tumor was confined to the chest cavity at the time of initial diagnosis, with local infiltration into the neck, lung hilum, and surrounding mediastinal structures. Three different histological growth patterns were observed: one composed of a diffuse proliferation of pleomorphic, highly atypical cells with bizarre nuclear features that closely resembled a high grade sarcoma; another one composed of sheets of large, epithelial-appearing atypical cells suggestive of anaplastic carcinoma; and another pattern characterized by a pleomorphic proliferation of large lymphoid cells admixed with numerous scattered Reed-Sternberg-like cells reminiscent of the lymphocyte-depleted variant of Hodgkin's disease. Immunohistochemical studies on paraffin-embedded tissue sections in all cases showed positive staining of the tumor cells with CD20 and CD45 antibodies and negative staining with a large panel of markers, including broad-spectrum keratin, CAM 5.2, carcinoembryonic antigen, epithelial membrane antigen, vimentin, actin, desmin, HMB 45, S-100 protein, CD3, CD15, CD30, and CD45RO. Because of their location restricted to the anterior mediastinum, frequent lack of recognizable lymph node architecture, and bizarre cytologic features, the present group of lesions posed difficulties for diagnosis, their correct identification was achieved through the application of a panel of immunohistochemical markers. An awareness of these unusual histologic appearances of primary large cell lymphoma in the mediastinum and inclusion of a broad panel of lymphoid markers are therefore recommended for the evaluation of pleomorphic, undifferentiated malignant neoplasms of this anatomic region.
 ...
PMID:Pleomorphic large cell lymphomas of the mediastinum. 855 12

A 43-year-old man was admitted to Nara Medical University Hospital because of right-sided chest pain. Computed tomographic examination revealed a right pleural effusion and diffuse pleural thickening. Malignant mesothelioma was diagnosed from the results of a percutaneous pleural biopsy, and the patient then underwent right pleuro-pneumonectomy. The resected specimen was examined by light and electron microscopy, which revealed scattered sarcoma-like malignant cells with some epithelial differentiation, in abundant extracellular collagen with storiform derangement. Therefore, desmoplastic malignant mesothelioma (mixed type) was diagnosed. This is a rare histological subgroup of malignant mesotheliomas. The patient died 2 months after the operation, due to multiple and rapidly growing metastases. After lung tissue was dissolved, ferruginous (asbestos) bodies were counted, and the results were consistent with occupational exposure to asbestos (413 asbestos bodies per 5 g of lung tissue).
 ...
PMID:[A case of desmoplastic malignant mesothelioma]. 858 23

Fortunately, primary tumors of the heart and great vessels are rare. These primary tumors include angiosarcoma, malignant fibrous histiocytoma, high-grade and pleomorphic sarcoma, and paraganglioma with pericardial and myocardial invasion. Symptoms are often nonspecific and include chest pain and dyspnea. Although these tumors are often diagnosed with echocardiography and computed tomography, magnetic resonance (MR) imaging currently appears to be the imaging modality of choice because of its diverse capabilities, which include multiplanar imaging for excellent anatomic definition of the heart, pericardium, mediastinum, and lungs; improved morphologic differentiation between tumor tissue and surrounding cardiovascular, mediastinal, or pulmonary tissues; dynamic imaging with a gated cine-loop acquisition; and assessment of tissue perfusion. The use of gadopentetate dimeglumine is helpful in achieving tumor enhancement on MR images but is not required. MR imaging is also useful in assessing tumor response to surgery, radiation therapy, and chemotherapy.
 ...
PMID:Malignant tumors of the heart and great vessels: MR imaging appearance. 901 5

We present the case of a 36 yr old woman with a persisting complaints of left chest pain. A chest radiograph revealed multiple left pleural thickenings. Classical exploration was negative. Thoracic surgery allowed the subtotal removal of a huge pleural tumour. The histological examination revealed a clear cell sarcoma. The literature on this extremely rare tumour is reviewed.
 ...
PMID:Clear cell sarcoma: an extremely rare cause of pleural disease. 942 10


<< Previous 1 2 3 4 5 6 7 8 9 Next >>