Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe a rare example of inflammatory pseudotumor of the pancreas in a 42-yr-old woman, which developed following chemotherapy for lymphoma of the uterine cervix. The patient had developed fatigue, weight loss, abdominal pain, and anemia; abdominal CT scan showed a large mass in the pancreas. Examination of the resected specimen revealed a fleshy, well-circumscribed, 7-cm mass. Histologically, there was a hypocellular to moderately hypercellular, bland spindle-cell proliferation admixed with a prominent infiltrate of lymphocytes, histiocytes, and plasma cells. The spindle cells were vimentin positive but negative for muscle markers; electron microscopy revealed only fibroblastic cells. DNA analysis revealed a diploid population with low S-phase fraction. The patient was well at 6-mo follow-up. It is important for the pathologist to be aware of the existence of this entity in unusual locations such as the pancreas so as to avoid a mistaken diagnosis of malignancy.
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PMID:Inflammatory pseudotumor of the pancreas. 870 1

A 76-year-old man presented with the chief complaints of appetite loss and general fatigue. He was admitted with the initial diagnosis of empyema necessitatis, and right thoracic drainage was performed. Nevertheless, the subcutaneous mass in the right side of the chest wall did not shrink, and examination of a specimen obtained by percutaneous needle biopsy resulted in the diagnosis of non-Hodgkin's lymphoma, intermediate lymphocytic type. The patient was treated with Adriamycin, vincristine, prednisolone, and cyclophosphamide, but died of pneumonia and cachexia five months after symptoms first appeared. The diagnosis of intermediate lymphocytic lymphoma, B cell type was made at autopsy. Only 53 cases of malignant lymphoma associated with chronic empyema have been reported in Japan. Surgery was often not done because of the patient's advanced age or poor pulmonary function; diagnosis was often difficult. However, review of the 53 reported cases suggested that resection of the tumor, if possible, would improve the prognosis. Malignant lymphoma should be considered when there is chronic empyema, because such cases are now being reported more frequently.
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PMID:[Malignant lymphoma of the chest wall in a patient with chronic empyema]. 875 18

A 62-year-old Japanese man complained of fever, general fatigue, anorexia and watery diarrhea during remission of adult T-cell leukemia-lymphoma. Laboratory examinations showed severe hypoproteinemia (2.9 g/dl). However, neither intestinal lesions associated with ATL nor findings suggesting protein losing gastroenteropathy were observed. Cytomegalovirus (CMV) antigen detection assay using peripheral blood leukocytes revealed that he had an active CMV infection with hemophagocytic syndrome. Treatment with ganciclovir and methylprednisolone led to an improvement of hypoproteinemia. CMV disease and associated hemophagocytic syndrome should be considered as a cause of hypoproteinemia in an immunocompromised host.
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PMID:[Cytomegalovirus disease accompanied by severe hypoproteinemia in a patient with adult T-cell leukemia-lymphoma]. 884 9

A 66-year-old female presented with anorexia, fatigue, skin pigmentation, weight loss and low grade fever. Imaging studies demonstrated bilateral bulky masses confined to the adrenal glands. Ultrasonography guided needle biopsy of the mass showed findings of diffuse large B-sell lymphoma. Low levels of serum cortisol, urinary 17-OHCS and 17-KS, a high level of ACTH and a non-reactive pattern on the rapid ACTH test led to a diagnosis of Addison's disease. Only a partial regression was achieved by the first chemotherapy. She died due to disease progression, while the next course of chemotherapy had been postponed because of interstitial pneumonitis due to methotrexate.
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PMID:[Bilateral non-Hodgkin's lymphoma of the adrenal glands with adrenal insufficiency]. 891 78

Cognitive function items are increasingly included in quality of life measures, and complaints of concentration and memory difficulties are often reported by cancer patients. The aim of this study was to examine the factors influencing patients' level of complaint by comparing subjective reports with objective test performance of a sample of adult lymphoma patients, disease-free and > or = 6 months after treatment. There was no significant difference between complainers and non-complainers in sociodemographic or clinical characteristics or in their performance on standard neuropsychometric tests of concentration and memory. Those reporting concentration and memory difficulties had significantly higher scores on measures of anxiety, depression and fatigue. This calls into question the validity of including cognitive function items in self-report quality of life measures. Patients who report concentration and memory difficulties should be screened for clinically significant and potentially remediable mood disorder. Objective testing remains the method of choice for assessing higher mental function.
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PMID:What do cancer patients mean when they complain of concentration and memory problems? 893 54

Fifty-four former patients, in remission after acute leukaemia or highly malignant lymphoma, responded to a questionnaire covering their physical problems, their view of the help they received, who was most helpful to them during the treatment phase, and the impact of the disease and treatment on their current life. Energy loss and nutritional problems were most troublesome during the treatment phase, signifying many other physical problems. Patients with acute leukaemia had more problems, and thought the care was worse than did patients with highly malignant lymphoma. Serious physical problems correlated with low satisfaction with practical help received, indicating that the nurses failed to meet the needs of those suffering the most. Reduced psychological and sexual energy persisted in remission, showed no correlation with the extent of physical problems during the treatment phase, but correlated with co-existing problems and sensitivity to infections, with a great need for intimate help and counselling and with a low sense of coherence. Family relationships were said to have improved, while work and finances were negatively affected. The results indicate that nursing care should actively focus on physical problems, especially on energy loss and nutritional problems. The overwhelming fatigue hinders patients in taking physical care of themselves, and may be overlooked by the nurse since their motor capability seems intact. The long-term effect of the illness means a reduced psychological and sexual energy and a high degree of existential problems and sensitivity to infections, which indicates the importance of follow-up care, and perhaps especially of counselling for the long-term reactions and disturbance of equilibrium.
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PMID:Survivors of acute leukaemia and highly malignant lymphoma--retrospective views of daily life problems during treatment and when in remission. 900 13

We describe, to our knowledge, the first native Finnish patients with Kikuchi's histiocytic necrotizing lymphadenitis. The diagnosis was based in all cases on histopathological findings in open biopsy. The disease was first detected in Japan in 1972, but in Scandinavia, until this decade, there had been no cases reported. Our patients were young, otherwise healthy women who had cervical lymphadenopathy, fever, and fatigue as their main symptoms. In two of them, the disease was mild and subsided spontaneously within 2-6 months. One patient with more fulminant lymphadenopathy was treated with antimicrobial and antiinflammatory drugs. She became symptomless in 3 months. The cause of Kikuchi's disease is unknown. A viral or postviral hyperimmune reaction has been proposed as its etiology. Malignant lymphoma and systemic lupus erythematosus are differential diagnoses. Histopathological findings are pathognomonic and pathologists must be aware of its typical characteristics.
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PMID:Kikuchi's disease: report of three cases and an overview. 902 55

Menetrier's disease (MD) or polyadenomes en nappe is a form of hypertrophic gastropathy occurring primarily in middle-aged males. Patients generally present clinically with dyspepsia and, on occasion, with hypoproteinemic edema and anemia. The latter feature, when combined with the radiographic appearance of the stomach in MD, can lend to confusion with carcinoma and malignant lymphoma. To illustrate this diagnostic problem, a case is reported of a 41-year-old female who initially presented to her family physician with symptoms of easy fatigue and dyspnea on exertion and signs of pallor and ankle edema. Pertinent laboratory findings included a hemoglobin of 2.8 g/dL, hematocrit of 10.3 percent, mean corpuscular volume of 63.4 mu 3, a serum albumin of 2.7 g/dL, and heme positive stools. Endoscopic examination revealed a circumferential polypoid mass involving the cardia and fundus of the stomach with relative sparing of the antrum. A CT scan of the abdomen and pelvis showed a large mass in the stomach which the radiologists and gastroenterologists believed probably represented a lymphoma or gastric carcinoma. A total gastrectomy specimen exhibited features of MD. Routine bright-field microscopy and immunohistochemical reactivity for transforming growth factor-alpha confirmed the diagnosis of MD. Moreover, ulceration of the tips of some of the hypertrophied gastric folds provided an explantation for the iron deficiency anemia. Awareness that MD may present with anemia will help in the differential diagnosis with lymphoma and carcinoma.
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PMID:Menetrier's disease presenting with iron deficiency anemia. 951 79

The primary cutaneous CD30 positive large cell lymphoma is a rare tumor, confined to the skin. The characteristic clinical picture is a large, often exulcerating sometimes spontan regressing tumor or nodule. Dense infiltration of large, anaplastic or non-anaplastic T or non T, non B cell of the dermis is characteristic. Generalization, lymph node or internal manifestation is rare, the prognosis is favourable. A 25-year-old male patient is presented, in whom generalised skin symptoms-itching, reddish-brownish papules with central necrosis developed. Two years later general symptoms-fever, fatigue, lymph node and spleen enlargement, increased in white blood cell count with prominent eosinophilia, increase in CD4 number occurred. The histology and immunohistology of the skin and peripheral lymph node showed large, anaplastic, CD30 positive T cell infiltration. CHOP, then BACOP treatment resulted in regression of the skin and the internal symptoms.
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PMID:[CD30 positive large T-cell primary cutaneous lymphoma]. 963 25

Acute tumor lysis syndrome (ATLS), a condition which results from a rapid destruction of tumor cells with massive release of cellular breakdown products, has been well described following the treatment of various malignancies. However, only a handful of cases of spontaneous ATLS have been reported in the literature. We describe the first reported case of spontaneous ATLS in acute myeloid leukemia (AML). A previously healthy 63 year old woman presented with a two month history of fatigue and a one week history of easy bruising. On admission she had oliguric acute renal failure, with marked elevation in serum uric acid and phosphate. A bone marrow biopsy showed AML M7 with fibrosis. The renal failure resolved with supportive care and institution of allopurinol therapy. Following this, AML induction chemotherapy resulted in complete remission. Her biochemical and clinical course were very similar to the classical ATLS seen in patients after chemotherapy. Therefore, this case represents a rare instance of acute renal failure from spontaneous ATLS, and in our opinion the first reported occurrence of spontaneous ATLS associated with AML.
Leuk Lymphoma 1998 May
PMID:Spontaneous acute tumor lysis syndrome in acute myeloid leukemia? A single case report with discussion of the literature. 964 77


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