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)

A clinico-morphological analysis of two observations of cryptococcomas of the lungs are presented. In one case the diagnosis was established on the basis of cytological examinations of the sputum. This form of pulmonary cryptococcosis as well as identification of cryptococci in the sputum by cytological examinations are first described in the Soviet literature. The attention is drawn to the difficulties of clinico-roentgenological and morphological diagnosis of this disease and to the necessity to differentiate it from metastases of hyperneophroma, diseases of parasitic origin, and mycoses by other fungi.
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PMID:[Pulmonary cryptococcosis]. 9 58

In the immunocompromised patient, even mild forms of any combination of headache, meningismus, altered mental status, or focal neurologic signs should initiate an evaluation for possible CNS infection. The limited signs and symptoms of acute CNS infection are not due to specific organisms but to pathologic changes at the neuroanatomic site of infection. The initial clinical history, examination, laboratory, and neuroradiographic data will narrow the problem to one of several groups of agents, although it may not be possible to specify a single causative agent. It should be remembered that several concurrent infections (i.e., CMV and toxoplasmosis, aspergillosis, and bacterial sepsis) may be present. Thus, the clinician should rely on broad antibiotic coverage appropriate to the suspected causative agent or agents at the site of infection. It may be necessary to offer broad-spectrum antibiotic coverage for a CSF presentation that is subsequently found to result from a viral illness or from a noninfectious cause. However, one should avoid undertreating those infections for which specific therapy can be offered, and broad-spectrum treatment usually will not be regretted. Uncertainty in diagnosis following noninvasive procedures should lead to a brain biopsy. Although many of the infections discussed in this article have a poor prognosis, some of the most common pathogens, such as Cryptococcus, Listeria, and Toxoplasma, have effective specific therapies to which the patient should have access as rapidly as possible. The clinician who has successfully treated a patient with CNS infection should remain vigilant for late sequelae or recurrence of infection. Chronic treatment of some infections, such as toxoplasmosis or aspergillosis, may be necessary. The reintroduction of steroids for the treatment of an underlying cancer may reactivate previously treated disease, such as cryptococcosis, and periodic CSF surveillance is appropriate under these circumstances. Recurrence of the symptoms should raise the suspicion of recurrent or new infection, and the patient also should be evaluated with CT or MRI for the development of hydrocephalus or for new metastatic disease. In patients who have had varicella-zoster infection, postherpetic neuralgia and delayed arteritis may develop. Seizures, hearing loss, and neuropsychologic sequelae may follow any meningoencephalitis. The patient should always be reevaluated for the possibility of infection with a different opportunistic organism. CNS infections remain a major cause of morbidity and mortality in immunosuppressed patients with malignancies. In one series, 60% of such patients died as a result of their CNS infection, many at a time when the underlying disease had an otherwise good prognosis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Central nervous system infections in cancer patients. 175 29

Of 71 intrapulmonary coin lesions seen at The Prince Charles Hospital during 1982-1984, 48 were primary pulmonary malignancies and six were metastases. There were two cases each of tuberculosis, cryptococcosis, hamartoma and granuloma. Overall, 76% of the lesions were malignant and only 3% were tuberculous. These findings contrast with those from the same institution published 20 years ago, when malignancy comprised only 38% and tuberculosis 27% of lesions. Malignancy now seems to be the major cause of coin lesions in Australia. In this survey, 82% of solitary pulmonary nodules that occurred in patients of over 50 years of age were malignant.
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PMID:Intrapulmonary coin lesions: the changing patterns. 394

Recently the identification of small-sized peripheral lung lesions has rapidly increased due to advancements in roentgenology. But for smaller lesions, definitive diagnoses by means of transbronchial or percutaneous biopsy have become more difficult. So we must resort to thoractomic or thoracoscopic biopsy. However, for thoracoscopic surgery palpation is inadequate, so the identification of deep or small lesions is difficult. Thoracotomy seems to be too invasive when used only for examination and not for therapy. Therefore, we tried CT-guided localization for thoracoscopic pulmonary wedge resection. Thus far we have performed CT-guided localization in 24 cases. Immediately prior to thoracoscopic surgery we placed marking devices in or beside the lesions after percutaneous puncture. As marking devices we used Kopans spring hook wire or a Naruke point marker. Pathological diagnoses of these lesions indicated 13 primary lung cancers (11 adenocarcinomas, 1 carcinoid, 1 squamous cell carcinoma), 4 focal fibroses, 2 metastases of renal cell carcinoma, 1 hamartoma, 1 tuberculoma, 1 cryptococcosis, 1 interstitial pneumonia, and 1 subpleural lymph node. The tumor diameters at their greatest dimension ranged from 3 to 33 mm (9.0 +/- 6.6 mm). The distance from the viceral pleura to the tumor surface ranged from 0 to 24 mm (10.9 +/- 6.7 mm). In one case pneumothorax occurred due to the shallow position of the tumor and the loss of the marking device. If these problems (pneumothorax, bleeding, loss of marking devices and others) are prevented, CT-guided localization should be performed as soon as possible before surgery. The identification of small peripheral lesions can almost be determined by CT now, so such identification may be the most reliable technique to employ during surgery.
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PMID:[CT-guided localization for thoracoscopic pulmonary wedge resection]. 899 Aug 10

Of primary importance in the differential diagnosis of multiple circular foci in the lungs are the lung metastases. This study involves a patient with three circular foci, each of which could have been metastases. They proved, however, to be a rare coincidence of three benign lung affections, namely, an old tuberculoma, a chondrohamartoma, and a seldom encountered pulmonary cryptococcoma. Computerized tomography utilizing the spiral technique was valuable diagnostically, as it led to the discovery of the smallest of the three circular foci in the basodorsal left lower lobe. The form of the cryptococcosis among immunocompetent patients--only rarely localized in our experience--must be included in the differential diagnostical considerations of a circular focus in the lungs. In the event there are multiple circular foci with an unknown primary tumor, surgical intervention with a pathohistological clarification regarding a possible malignancy is absolutely necessary.
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PMID:[Coincidence of pulmonary cryptococcoma in an immunocompetent patients with a chondrohamartoma and chronic tuberculoma--differential diagnostic considerations concerining pulmonary coin lesions]. 917 18

A patient with hepatocellular cancer developed pulmonary cryptococcosis due to infection with a capsule-deficient Cryptococcus neoformans. Pulmonary lesions initially diagnosed as metastatic cancer by chest x-ray film and CT scan were subsequently found to be fungal granulomas by autopsy. Although morphologic studies of the fungi were insufficient to render a specific mycologic diagnosis because of the absence of encapsulated yeasts, fluorescent antibody studies confirmed the diagnosis of cryptococcosis. The use of various stains and electron microscopy for the pathological differential diagnosis of cryptococcosis caused by capsule-deficient yeasts is discussed.
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PMID:Pulmonary cryptococcosis due to a capsule-deficient strain confused with metastatic lung cancer. 964 9

A 67-year-old diabetic man presented with progressive multifocal myeloradiculopathy for 6 months, with no pulmonary symptoms. A chest x-ray and CT scan of the lungs revealed bilateral multiple nodular infiltrates in the right upper lobe and the lower lobes bilaterally, mimicking metastases. A thoracoscopic lung biopsy demonstrated bronchiolitis obliterans organizing pneumonia caused by capsule-deficient cryptococcosis.
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PMID:Bronchiolitis obliterans organizing pneumonia caused by capsule-deficient cryptococcosis. 1590 63

A 71-year-old man who had undergone surgery for stage II adenocarcinoma of the lung followed by adjuvant tegafur-uracil (UFT; 300 mg/day) therapy was admitted. Multiple nodules were found in both lungs on chest radiographs obtained 1.5 years after the surgery. Imaging characteristics of the nodules resembled those of pulmonary metastases. Histologic assessment of a biopsy specimen obtained during thoracoscopic resection revealed pulmonary cryptococcosis. The patient was administered 200 mg/day fluconazole for 6 months. Physicians need to be aware of the possibility of pulmonary cryptococcosis mimicking pulmonary metastases in patients treated with UFT after surgery for lung cancer.
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PMID:Pulmonary cryptococcosis mimicking pulmonary metastases in a patient treated with Tegafur-uracil after lung cancer surgery. 1609 37

Peripheral lymphadenopathy is commonly present in HIV-infected patients and has a wide spectrum of differential diagnoses. We carried out a cross-sectional study of peripheral lymph node biopsies performed from January 2004 to December 2008 in HIV-infected patients who attended a tertiary-care hospital in southern Brazil. Only 60 of 210 peripheral lymph node biopsies performed (28%) were non-diagnostic. The most common diagnoses included: mycobacteriosis (105 cases; 50.2%); lymphoma (19 cases; 9.0%); systemic mycosis (12 cases; 5.7%) including histoplasmosis, cryptococcosis and histoplasmosis; and metastatic cancer (2.9%). Peripheral lymph node biopsy is a simple and useful tool to diagnose opportunistic diseases in HIV-infected patients.
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PMID:Biopsy of peripheral lymph nodes: a useful tool to diagnose opportunistic diseases in HIV-infected patients. 2094 Feb 91

The radiologic appearance of multiple discrete pulmonary nodules in immunocompetent patients, with cryptococcal infection, has been rarely described. We describe a case of pulmonary cryptococcosis, presenting with bilaterally and randomly distributed nodules on a computed tomography, mimicking hematogeneous metastases. Positron emission tomography does not demonstrate 18F-fluorodeoxyglucose (FDG) uptake, suggesting a low probability for malignancy, which is a crucial piece of information for clinicians when making a management decision. We find the absence of FDG uptake correlates with the pathologic finding of an infectious nodule, composed of fibrosis and necrosis.
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PMID:Case of pulmonary cryptococcosis mimicking hematogeneous metastases in an immunocompetent patient: value of absent 18F-fluorodeoxyglucose uptake on positron emission tomography/CT scan. 2369 Jul 26


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