Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cigarette smoking is the leading cause of preventable death in the United States. Smoking adversely affects many organ systems, but especially the lung. Carcinoma of the lung and chronic obstructive pulmonary disease account for most smoking-associated respiratory morbidity and mortality, and their association with smoking is both well established and widely recognized. Cigarette smoking also is associated with differences in the incidence, severity, or natural history of a broad array of other respiratory illnesses, ranging from the common cold to pneumothorax, pulmonary hemorrhage, and various interstitial lung diseases. Interestingly, while the general effect of smoking on respiratory diseases is adverse, in the cases of sarcoidosis and hypersensitivity pneumonitis smoking may actually be associated with a decrease in the incidence of disease. In this article, the author briefly discusses some of the pulmonary and systemic effects of smoking that might mediate its effects on an array of lung diseases, then comprehensively reviews less common or less well-recognized smoking-affected lung diseases such as pulmonary infections, spontaneous pneumothorax, Goodpasture's syndrome, eosinophilic granuloma and other interstitial lung diseases, and pulmonary metastatic disease.
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PMID:Other smoking-affected pulmonary diseases. 1076 94

Insular thyroid carcinoma has become a separate entity among thyroid malignancies. It is regarded as intermediate in aggressiveness between well-differentiated and anaplastic thyroid carcinomas. Reports on the clinical course of children with insular thyroid carcinoma are rare. We report the case of a 14-year-old girl who was admitted to our thyroid outpatient ward in 1975 with a scintigraphic cold thyroid nodule and multiple enlarged cervical lymph nodes. Chest radiography showed metastases in both lungs. After total thyroidectomy and, central and modified unilateral radical neck dissection, the girl was given a dose of 80 mCi 131I. Posttherapeutic scan demonstrated diffuse tracer uptake in both lungs. A second dose of 200 mCi 131I was administered 4 months later and another dose of 150 mCi 131I in July 1976. Subsequently, whole-body scans showed inconspicuous tracer distribution and chest x-rays were normal. The patient was treated with levothyroxine and followed until 1982, when she left Vienna. In 1999, the patient was contacted for reexamination. She has been well and had had two healthy children. The patient was taking 150 microg levothyroxine daily; she had a normal TSH value and her thyroglubulin was 0.3 ng/mL. Chest radiography and sonography of the neck showed no pathological findings. The paraffin sections of the patient's tumor were reexamined in 1999 and demonstrated the histologic characteristics of a poorly differentiated insular thyroid carcinoma (pT4a, pN1a, M1). These findings demonstrate that even in advanced stages, insular thyroid carcinoma treatment can be successful.
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PMID:Advanced insular thyroid carcinoma in a fourteen-year-old girl: twenty-four years of follow-up. 1088 92

Thyroid imaging approach is based on the preliminary clinical evaluation. Lesions that are smaller than 2 cm should be assessed with US, which is capable of discriminating masses as small as 2 mm and distinguishing solid from cystic nodules. US-guided FNAB provides tissue for cytologic examination of thyroid nodules. CT and MR imaging are indicated for larger tumors (greater than 3 cm diameter) that extend outside the gland to adjoining structures, including the mediastinum, and retropharyngeal region. Metastatic lymph nodes in the neck and invasion of the aerodigestive tract are also in the realm of CT and MR imaging. Thyroid nodules are categorized on scintigraphy as hot or cold nodules. Hot nodules are rarely malignant, whereas cold nodules have an incidence of 10% to 20% of malignancy. Calcifications (amorphous, globular, nodular, and linear) occur in adenomas and carcinomas and have no differential diagnostic features except for psammomatous calcifications, which are a pathognomonic finding in papillary carcinomas and a small percentage of medullary carcinomas. Papillary carcinoma is the most common malignant tumor (80%) followed by follicular (20% to 25%); medullary (5%); undifferentiated; anaplastic carcinomas (< 5%); lymphoma (5%); and metastases. Lymph node metastases are common in papillary carcinoma, 50% at presentation, and less common in follicular carcinomas. The metastatic nodes in papillary carcinoma may enhance markedly (hypervascular); show increased signal intensity on T1-weighted images (increased thyroglobulin content or hemorrhage); and reveal punctate calcifications. Localized invasion of the larynx, trachea, and esophagus occurs predominantly in papillary and follicular carcinomas; the incidence is less than 5%. Ectopic thyroid tissue may be encountered in the tongue (foramen cecum); along the midline between posterior tongue and isthmus of thyroid gland; lateral neck; mediastinum; and oral cavity. Goiter and malignant tumors, notably papillary carcinoma, may develop in ectopic thyroid tissue. Carcinomas may also arise in thyroglossal duct cysts, which develop from duct remnants between the foramen cecum and thyroid isthmus. Infectious disease of the thyroid gland is not common and the CT and MR imaging findings are similar as described under neck infection. Other types of inflammatory disorders including Hashimoto's thyroiditis, granulomatous thyroiditis, and Riedel's struma display no specific imaging features. Imaging studies may, however, be indicated to confirm a suspected clinical diagnosis and assess compromise of the airway (Riedel's struma). HPT is a clinical diagnosis in which hypercalcemia is the most important finding. Parathyroid hyperplasia, adenoma, and carcinoma represent underlying lesions. To relieve the patient's symptoms surgical extirpation is indicated. The surgical success rate without imaging is 95%. The indications for imaging studies vary but it is generally agreed that reoperation after a previous failed surgical attempt and suspicion of an ectopic parathyroid adenoma should be investigated by imaging. These consist of US, nuclear medicine studies, CT and MR imaging. US and technetium sestamibi scanning have the highest accuracy rate for localizing an adenomatous gland at and near the thyroid gland. Ectopic adenomas, particularly if they are located in the mediastinum, are preferrably investigated with CT and MR imaging with gadolinium and fat suppression. Carcinomas and parathyroid cysts are optimally evaluated by CT and MR imaging. On MR imaging adenomas are low in signal intensity on T1-weighted images, high in signal intensity on T2-weighted images, and enhance post introduction of gadolinium.
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PMID:The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. 1105 72

A 50-year-old woman had an irregular, mobile, firm right breast mass that became progressively larger in the past 3 months that measured 18 x 15 cm at the time of examination. She had no nipple discharge or skin changes. A 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) showed a ring-shaped breast uptake consisting of high peripheral glycolytic activity and a cold center most likely representing necrosis or hemorrhage despite the absence of a history of trauma, surgical intervention, chemotherapy, or radiation to the breast. Whole-body images did not show any evidence of lymph node involvement or distant metastases. These results were confirmed by computed tomography of the chest, abdomen, and pelvis. Cytologic examination of a fine-needle aspiration of the breast mass showed diffuse large B-cell, intermediate grade, non-Hodgkin's lymphoma. Although it occurs infrequently, primary breast lymphoma should be considered in patients with a breast mass that shows a ring-shaped FDG uptake. A PET scan, in contrast to other imagining techniques, offers the advantage of screening the entire body, excluding the presence of metastases, and confirming the primary origin of the breast lymphoma.
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PMID:F-18 FDG positron emission tomography in primary breast non-Hodgkin's lymphoma. 1129 Aug 87

The role of diagnostic imaging in differentiated thyroid carcinoma is analyzed. 99mTc-pertechnetate 123I and 131I scintigraphy allows the evaluation of nodules with their differentiation in cold (hypofunctioning) and hot (functionally autonomous) nodules; thyroid carcinomas are cold nodules even if most of them are benign. On sonography thyroid nodules are well visualized with the definition of their site, number, size (not very useful parameters for the diagnosis of malignancy), echoic structure, and vascularization on color Doppler. The sonographic findings suggestive of differentiated thyroid carcinoma are: solid and hypoechoic structure, irregular ill-defined margins, absent or discontinuous peripheral ring, microcalcification, intranodular vascularization, local lymphadenopathies. These findings are characteristic but not pathognomonic, mostly for papillary carcinoma, while in the frequently isoechoic follicular carcinoma microcalcification and lymph node metastases are rare. Only the finding, although rather infrequent, of the dissemination to adjacent structures (muscles and vessels) is a definite indication for malignancy of a thyroid nodule. Color Doppler sonography plays a major role in the postoperative staging and follow-up, in combination with thyroglobulin determination and 131I whole body scintigraphy and it allows the detection of local and/or laterocervical lymph node recurrence. The most typical sonographic findings of metastatic lymphadenopathy are the roundish shape (length/anteroposterior diameter ratio-L/A < 1.5), not visible or displaced nodal hilum, thickened cortical layer with echoic structure similar to that of thyroid parenchyma, at times with microcalcification, cortical vascularization and dismantled angioarchitecture. CT and MRI are occasionally more useful to evaluate the substernal or retrosternal extension of voluminous thyroid masses and to identify local or distant metastases.
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PMID:Diagnostic imaging of differentiated thyroid carcinoma. 1137 May 36

In this study, we developed a mouse model of adoptive immunotherapy reflecting immune recognition of syngeneic tumor cells naturally expressing an endogenous rejection Ag. Specifically, in a pulmonary metastases model, we examined the potency and maintenance of an antitumor CD8(+) CTL response in vivo, as well as its effectiveness against an "extensive" tumor burden. The approach taken was to first generate tumor-specific CTL from mice challenged with the CMS4 sarcoma coadministered with anti-CTLA4 mAb, which has been shown to facilitate the induction of Ag-specific T cell responses in vivo. An H-2L(d)-restricted nonamer peptide, derived from an endogenous murine leukemia provirus was identified as a CMS4-reactive CTL epitope based upon the following: CTL cross-recognition of another syngeneic tumor cell line (CT26 colon carcinoma) previously characterized to express that gene product; sensitization of Ag-negative lymphoblasts or P815 targets with the peptide; and by cold target inhibition assays. In vivo, the adoptive transfer of CMS4-reactive CTL (> or =1 x 10(6)) resulted in nearly the complete regression of 3-day established lung metastases. Furthermore, mice that rejected CMS4 following a single adoptive transfer of CTL displayed antitumor activity to a rechallenge 45 days later, not only in the lung, but also at a s.c. distal site. Lastly, the adoptive transfer of CTL to mice harboring extensive pulmonary metastases (> 150 nodules) led to a substantial reduction in tumor burden. Overall, these data suggest that the adoptive transfer of tumor-specific CTL may have therapeutic potential for malignancies that proliferate in or metastasize to the lung.
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PMID:Regression of extensive pulmonary metastases in mice by adoptive transfer of antigen-specific CD8(+) CTL reactive against tumor cells expressing a naturally occurring rejection epitope. 1159 51

Although carcinoma is rarely metastatic to the thyroid gland, it has an established place in the differential diagnosis of cold nodules on radionuclide thyroid scans in patients with known cancers. A case of metastatic pleomorphic liposarcoma with involvement of the thyroid gland adds to the list of cases of metastases to the thyroid gland. A patient with known metastatic pleomorphic liposarcoma with a palpable thyroid nodule of 2 months' duration had a thyroid scan with 130 MBq (3.5 mCi) Tc-99m pertechnetate. The scan showed a cold nodule occupying most of the right lobe of the thyroid. Cytologic analysis of a fine-needle aspirate from this cold nodule confirmed metastasis from the known primary cancer, pleomorphic liposarcoma. In a patient with a known primary tumor, a nodule in the thyroid gland should be considered a metastatic lesion, regardless of the time since the primary tumor was diagnosed and treated, until proved otherwise.
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PMID:Pleomorphic liposarcoma metastatic to the thyroid gland. 1180 76

When treating patients for metastatic cancer, there is always a balance between the benefits of treatment and resulting side-effects. Peripheral sensory neuropathy (PSN) is a side-effect of many anticancer agents used in routine practice. Oxaliplatin is a relatively new agent currently licensed in over 50 countries including France, Germany and the UK for the treatment of metastatic colorectal cancer. Although it is a new agent, it is from the same family of drugs as cisplatin, an agent that has been used for many years. PSN is the most commonly discussed side-effect associated with oxaliplatin. Oxaliplatin-induced PSN is characterized by two distinct syndromes: a transient acute dysaesthesia and a cumulative distal neurotoxicity. Importantly, both are generally reversible after stopping treatment. Oxaliplatin-induced acute PSN is triggered and exacerbated by cold and can be greatly reduced in affected patients simply by avoiding cold conditions. Oxaliplatin-induced cumulative PSN may also be managed by temporary cessation of treatment.
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PMID:An overview of chemotherapy-induced peripheral sensory neuropathy, focusing on oxaliplatin. 1195 4

Previous studies have suggested that thyroid nodules found in patients with Graves' disease (GD) have a higher likelihood of being malignant, and that thyroid cancer behaves more aggressively when associated with GD, although both of these assertions remain controversial. The purpose of this study was to assess the frequency of cold scintiscan (SC) defects in patients with GD, and to determine the prevalence of thyroid cancer in such patients. Our secondary objective was to determine if there are any risk factors for developing cold defects by comparing clinical characteristics of both GD patients with cold SC defects and age and gender-matched GD patients without cold defects. We included in this analysis patients with a confirmed diagnosis of GD for whom SC results and adequate follow-up information were available. Clinic records were available in 772 patients with GD. Of these, 325 patients met eligibility criteria. Cold defects were found in 39 of 325 (12.0%) patients. Among these, 22 (56.4%) were referred for surgery, of whom 6 (1.85% of all GD patients, 15.2% of GD patients with cold nodules, 25% of GD patients with palpable nodules, and 27.3% of those undergoing surgery) had papillary thyroid cancer (PTC) in the location corresponding to the SC defect. In 2 PTC patients, no palpable abnormality corresponded to the cold defect found to contain cancer at surgery. One PTC patient was found to have metastatic disease to bone, and 2 additional PTC patients required multiple therapies with radioiodine. Compared to age and gender-matched control patients with GD and without cold SC defects, there were no differences in radioactive iodine uptake (RAIU), goiter size, duration of disease, degree of elevation in microsomal antibody (MA) titers, or thyroid-stimulating immunoglobulin (TSI). We conclude that thyroid scintigraphy is an important preliminary test in the evaluation of patients with GD, and that the prevalence of thyroid cancer in the location corresponding to a focal cold SC defect provides justification for further diagnostic evaluation or surgical management.
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PMID:Thyroid cancer yield in patients with Graves' disease selected for surgery on the basis of cold scintiscan defects. 1203 55

Thermography is a technique to measure the body surface temperature and is used in medical applications. We evaluated its prognostic value in 340 female patients with unilateral invasive breast cancer without distant metastases. The difference of mean temperatures of the tumor area and corresponding area of the contralateral breast was defined as AT. The patients with hot tumors (delta T > or = 0.9 degrees C) had significantly worse disease free and specific survival than those with cold tumors (delta T < 0.9 degrees C) (p = 0.0003 and p < 0.0001, respectively). AT was significantly correlated with tumor size, histological nodal status and nuclear grade, positively. But AT did not have any relation with estrogen receptor status. Multivariate analyses including those conventional prognostic factors showed that AT was a marginally significant prognostic factor for disease-free survival (hazard ratio (HR) = 1.62; 95% confidence interval (CI) = 0.99-2.66, p = 0.0557) and an independent significant prognostic one for disease specific survival (HR = 1.95; 95% CI = 1.09-3.49, p = 0.0251). However, AT did not have prognostic impact on the node negative patients. AT might be a useful prognostic factor in node positive breast cancer, especially in patients who plan to be treated with preoperative systemic therapy.
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PMID:Prognostic value of thermographical findings in patients with primary breast cancer. 1220 13


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