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)

Pulmonary artery sarcomas (PAS's) are extremely rare malignant tumors that arise from the endothelial lining of the pulmonary arteries. On CT scans PAS's appear as intraluminal filling defects in the pulmonary arteries, mimicking pulmonary embolism (PE). Due to the similarities in radiographic features as well as in clinical presentation, PAS's are usually misdiagnosed as pulmonary embolism. Since PASs are F-18 FDG avid, F-18 FDG PET/CT scan is a useful imaging tool for differentiating between these two conditions, as shown in this case report. We report a case of a 60-year-old woman presented with a 6-month history of chest pain, dyspnea on exertion, non-productive cough and weight loss. The initial CT pulmonary artery angiography showed extensive intraluminal mass in the pulmonary trunk and left pulmonary artery, diagnosed as massive pulmonary embolism. Since there was no clinical improvement after anticoagulant therapy, CT pulmonary angiography was repeated, and with no change observed in the intraluminal filling defect in pulmonary trunk, the possibility of tumor was raised. For further evaluation of a possible malignancy, F-18 FDG PET/CT was performed. It showed increased FDG uptake, suspicious for an aggressive tumor, in the intraluminal lesion of the pulmonary trunk and along the wall of the left pulmonary artery. There was no extrathoracic abnormality seen on PET/CT scan. Histopathological finding after complete pulmonary artery resection showed high grade undifferentiated pleomorphic sarcoma. F-18 FDG PET/CT is a useful tool for differentiating between pulmonary embolism and malignant intraluminal mass, and at the same time it enables the proper staging of the malignancy. < p > < /p >.
 ...
PMID:F-18 FDG PET/CT in pulmonary artery sarcoma: clinical vignette. 2944 47

An 84-year-old man, who had received artificial pneumothorax for pulmonary tuberculosis 67 years previously, complained of severe chest pain. Chest CT revealed chronic pyothorax with multiple heterogeneously enhanced cavity lesions in the wall of the right intrathoracic space. 18FDG-PET revealed that the lesions showed an abnormal uptake. CT-guided biopsy was performed and he was diagnosed with pyothorax-associated lymphoma (PAL); the histological diagnosis was diffuse large B cell lymphoma (DLBCL). Furthermore, immunohistochemical staining revealed that the tumor cells were positive for EBNA-2 and LMP-1, suggesting that the latent gene products of Epstein-Barr virus were associated with the development of PAL. The patient was treated with chemotherapy, including rituximab; however, the treatment was discontinued due to the development of severe delirium after chemotherapy. We should keep in mind that elderly patients with a long history of chronic pyothorax are at risk of developing malignant lymphoma. We report the present case with a brief review of the literature.
 ...
PMID:[Pyothorax-associated lymphoma with the expression of Epstein-Barr virus latent genes]. 2950 58

We report a rare case of a mediastinal malignant granular cell tumor in a 41-year-old man presenting with dyspnea, retrosternal chest pain, and recurrent pericardial effusion under treatment with corticosteroids. Because of recurrent episodes, further investigations with chest MRI and F-FDG PET/CT revealed a large infiltrating and strongly hypermetabolic mass in the mediastinum with pericarditis. Histopathology and immunohistochemical analysis showed large cells with greater pleomorphism and eosinophilic granular cytoplasm with positive staining for S100 protein and CD68 as well as high Ki67 proliferative index (15%) confirming the diagnosis of a malignant granular cell tumor.
 ...
PMID:18F-FDG PET/CT and MRI of a Mediastinal Malignant Granular Cell Tumor With Associated Recurrent Pericarditis. 2984 20

Uterine leiomyoma is the most common benign gynecological tumor. Rarely, it has benign extra-uterine growth patterns, including benign metastasizing leiomyoma (BML), with lungs being the most common metastatic site. We present a case of a 47-year-old female who, 3 years prior to presentation, underwent abdominal supra-cervical hysterectomy for benign leiomyoma. Approximately 6 months prior to presentation, she was seen for shortness of breath and chest pain. A CT of the chest revealed multiple new non-calcified pulmonary nodules bilaterally. PET/CT demonstrated mild FDG uptake in multiple lung nodules, with no significant extra-thoracic sites of abnormal FDG uptake. A CT guided lung biopsy showed a low grade, smooth muscle tumor. Immunohistochemical staining was positive for smooth-muscle actin and desmin, estrogen and progesterone receptor and was negative for CD117, HMB-45, CD34, pan cytokeratin and EMA. She underwent wedge resection of one of the nodules which confirmed the above findings. A cytogenetic analysis was also performed, which was consistent with pulmonary BML. She ultimately underwent left lower lobe resection and was started on a daily aromatase inhibitor. BML is a rare disease usually seen in women of reproductive age. The pathogenesis and treatment remain controversial. BML mostly tends to have an indolent course and a favorable outcome.
 ...
PMID:Pulmonary benign metastasizing leiomyoma: A case report. 2997 77

A 76-year-old woman with a history of hypertension and dyslipidemia was admitted to our hospital because of chest pain. On the basis of an electrocardiogram showing ST elevation in V1-3 leads, the patient was diagnosed with acute anterior myocardial infarction. Coronary angiography (CAG) revealed occlusions of the mid portion of the left anterior descending artery (LAD) and distal portion of the left circumflex artery (LCX). A paclitaxel-eluting stent was implanted in the LAD. Two weeks later, the patient complained of abdominal pain. A computed tomography (CT) scan showed a perivascular cuff around the abdominal aorta and F18-fluorodeoxyglucose positron-emission tomography with CT (FDG-PET/CT) scan showed increased tracer uptake around the abdominal aorta and aortic arch, suggestive of retroperitoneal fibrosis. The second CAG, performed on day 46, revealed occlusion of the posterolateral branch of the LCX and rapidly progressing stenosis of the proximal portion of the LCX. The patient was suspected of coronary arteritis and received oral corticosteroid therapy. The third CAG, performed on day 77, revealed occlusion of the posterior descending branch of the right coronary artery. The corticosteroid therapy was gradually tapered after discharge. The fourth CAG, performed 5 months later, did not show progression of the coronary lesions.
 ...
PMID:Rapid progression of coronary artery disease in a patient with retroperitoneal fibrosis. 3054 9

Diagnosis of pulmonary mass lesions can be challenging with several possible differentials. A 41-year-old Caucasian woman presented with intermittent non-specific chest pain on a background of 30 pack years of smoking history. A CT scan of the chest confirmed an opacity in the right lower lobe suspicious for primary pulmonary malignancy and PET scan showed moderate FDG avidity of the lesion. Conventional flexible bronchoscopy did not demonstrate an endobronchial lesion, Using Endobrochial Ultrasound (EBUS) Guide sheath technique, the lesion was localized in the posterior segment of the right lower lobe. Brushings, biopsies and washings were taken through the guide sheath, along with transbronchial cryobiopsy. Culture of bronchial brushings from the lesion on Ashdown's agar medium showed Burkholderia pseudomallei, confirming melioidosis. Treatment was with intravenous ceftazidime for 4 weeks, followed by oral sulphamethoxazole/trimethoprim for 3 months. During the follow up visits, the patient demonstrated significant improvement both clinically and radiologically.
 ...
PMID:Chronic Pulmonary Melioidosis Masquerading as lung malignancy diagnosed by EBUS guided sheath technique. 3131 98

The Ewing's sarcoma family of tumors (ESFT) incorporates both the wellrecognized primary bone and the extraskeletal soft tissue sarcomas. Primitive neuroectodermal tumors (PNET) and ESFT have a similar neural phenotype and can be considered in the same entity. Here, we will present 28 years old patient with Ewing Sarcoma. Patient was admited chest pain. Chest radiograph showed a suspicious lesion in the left paracardiac area. Computed tomography (CT) scan and positron emission tomography (PET)/CT result were compatible with malignant tumor. The patient was underwent surgical resection as the bronchoscopic result couldn't a malignant finding and pathological finding was detected as Ewing's sarcoma. Ewing's sarcoma should be considered in patients who are very fast growing in the lungs, are properly confined and suspected of malignancy in FDG-PET/CT.
 ...
PMID:Ewing's sarcoma of the lung: A rare case. 3141 47

A 77-year-old man with symptoms of chest pain was diagnosed with immunoglobulin G4 (IgG4)-related disease. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) revealed an intense uptake in the submandibular gland, lymph nodes and abdominal aortic wall. Diffusion-weighted imaging with background body signal suppression (DWIBS) revealed signal enhancements at the same location as those of the FDG-PET/CT findings. The DWIBS signal intensity decreased after steroid treatment, so we decreased the steroid dosage. Relapse did not occur. DWIBS makes it possible to adjust the medicine dosage while confirming the therapeutic effects and will likely be a useful method for monitoring IgG4-related disease.
 ...
PMID:Clinical Utility of Diffusion-weighted Whole-body Magnetic Resonance Imaging with Background Body Signal Suppression for Assessing and Monitoring IgG4-related Disease. 3178 98

In this report, we present two cases of ectopic thymoma, aiming to explore the clinicopathologic features, diagnosis, and differential diagnosis of ectopic thymoma. Case 1 was a female 56-years-old. For 6 months' time, there was no obvious cause of cough, expectoration, chest tightness, or asthma with chest pain. PET-CT showed a right middle lung and lower lung mass with increased FDG metabolism. Postoperative pathology was diagnosed as right middle and lower lung ectopic thymoma, type B2, invading the chest wall. Case 2 was a male of 54-years-old. By physical examination the right chest cavity had a mass present for 1 week and he was admitted to hospital. Postoperative pathology was diagnosed as right thoracic ectopic thymoma, type AB. No recurrence has been found to in the follow-up of these two patients. In conclusion, ectopic thymoma occurs outside the anterior mediastinum. It is rare, the clinical symptoms are not typical, and pre-operative diagnosis is difficult. It is easily misdiagnosed as other diseases. Surgical treatment is the best method. According to the pathologic type and invasion of the tumor, radiotherapy may be considered.
 ...
PMID:Ectopic thymoma: report of 2 cases and review of the literature. 3193 30

Amyloidosis is a rare disease especially the localized form involving pulmonary parenchyma. We report the case of a 74 years old woman who presented with chest pain and dyspnoea. CT scan showed pulmonary embolism and bilateral nodules. Laboratory examinations highlighted circulating Kappa IgM. 18F-FDG PET/CT showed intense activity of the nodules. Histological investigation supported the diagnosis of nodular pulmonary amyloidosis. There were no sign of systemic amyloidosis or autoimmune disease. No treatment was initiated: the patient remains asymptomatic after one year. Localized pulmonary amyloidosis related to MGUS was the most likely diagnosis. Malignancy, a differential diagnosis of pulmonary amyloidosis, must be excluded: histological examinations are overriding. Difference between systemic and localized amyloidosis conditions treatment and prognosis. This observation emphasizes the difficulty to establish the diagnosis of pulmonary nodular amyloidosis and the complex relationship between amyloidosis and thromboembolism.
 ...
PMID:Pulmonary nodules associated with pulmonary embolism: A rare and misleading presentation of amyloidosis. 3254 15


<< Previous 1 2 3 4 5 Next >>