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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review was carried out on the histopathological diagnosis of peripheral lymph node biopsies processed and reported within a period of 18 years (1979-1996) in the Department of Pathology of University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 751 cases from 468 male and 283 female patients within the age range of 1 year to 80 years were reviewed. Non-neoplastic lesions made up 50.8% while neoplastic lesions constituted 49.2%. Tuberculosis was the commonest cause of peripheral lymphadenopathy (31.4%) followed by metastatic lesions (19.3%). As a group, the lymphomas constituted 28.2% and were made up of Hodgkin's disease 12.6%, non-Hodgkin's lymphoma including Burkitt's lymphoma 15.6% (with Burkitt's alone constituting 3.3%). Few other infectious diseases found included toxoplasmosis, histoplasmosis and onchocerciasis. Non-specific reactive and inflammatory changes (both acute and chronic) collectively formed 17.6%. The primary sites of lymph node metastases could not be determined in 36.6% of netastatic lesions while the breast was the origin in 13.8% and was the highest incidence of metastatis. The commonest lymph node group affected was the cervical (42.6%) followed by inguinal (24.1%).
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PMID:Peripheral lymphadenopathy in Nigeria. 1171 97

The spleen has the same relationship to the circulatory system that the lymph nodes have to the lymphatic system. A wide range of diseases can affect the spleen. Pathologic conditions of the spleen can be classified into the following categories: congenital diseases (accessory spleen, polysplenia, and asplenia); trauma; inflammation (abscess, candidiasis, histoplasmosis, and sarcoidosis); vascular disorders (infarction, diseases affecting the splenic vasculature, and arteriovenous malformation); hematologic disorders (sickle cell disease and extramedullary hematopoiesis); benign tumors (cysts, hemangioma, diffuse hemangiomatosis of the spleen, and hamartoma); malignant tumors (sarcoma, lymphoma, and metastases); and other disease processes that affect the spleen diffusely (portal hypertension, Gaucher disease, and sickle cell disease) or focally (Gamna-Gandy nodules). New magnetic resonance (MR) imaging techniques have increased the role of MR imaging in detection and characterization of splenic diseases. MR imaging is an excellent tool for diagnosis and evaluation of focal lesions and pathologic conditions of the spleen.
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PMID:MR imaging of the spleen: spectrum of abnormalities. 1600 18

We describe the computed tomography and F-18 FDG PET findings of a patient with extensive mediastinal nodal enlargement resulting from histoplasmosis. This patient with known metastatic melanoma presenting for restaging was initially considered to have widespread mediastinal and cervical metastases on the basis of the imaging findings. Bronchoalveolar lavage fluid and transbronchial lymph node biopsy were consistent with histoplasmosis. The imaging findings improved after treatment with antifungal medication. A relatively small area of pulmonary involvement proved to be the clue in the imaging studies that the disease was inflammatory rather than neoplastic.
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PMID:Mediastinal histoplasmosis: F-18 FDG PET and CT findings simulating malignant disease. 1610 Apr 91

Diagnosis of indeterminate mediastinal masses and staging of lung cancer poses a significant challenge. Options for tissue diagnoses include computed tomography (CT)-guided percutaneous biopsy, transbronchial fine-needle aspiration, mediastinoscopy/mediastinotomy or thoracoscopy, but these investigations have limitations in terms of tissue yield, safety profile and cost. Trans-esophageal endoscopic ultrasound scanning (EUS) is a new minimal invasive method that provides high resolution imaging of the mediastinum using high frequency ultrasound probes attached to the tip of a flexible endoscope and offers in addition the facility of fine needle aspiration (EUS-FNA) or tru-cut biopsy (TCB) under real-time ultrasound guidance. EUS-FNA allows access to the posterior mediastinum and tissue acquisition under real-time ultrasound guidance through the oesophageal wall. Indications of EUS-FNA in the mediastinum is to obtain a diagnosis from an unknown primary lesion or to sample tissue from mediastinal lymph nodes in order to stage lung cancer or to diagnose other diseases involving lymph nodes of the mediastinum eg. TB, Sarcoidosis, histoplasmosis or metastases from a vide range of cancers. If lymphoma is suspected EUS-TCB of an enlarged mediastinal lymph node is preferred. EUS- FNA is safe, can be done on an outpatient basis, is well tolerated and provides an excellent diagnostic yield with a sensitivity of more than 90% and a specificity of 100%. Compared to CT, PET, mediastinoscopy as well as transbronchial aspiration, EUS-FNA is found to be significant more accurate for staging of non-small cell lung cancer. However, mediastinoscopy is at present still regarded as the gold standard in the region of the anterior mediastinum since EUS can not image this region due to the air-filled trachea. Recently, endobronchial ultrasound guided transbronchial needle aspiration Biopsy (EBUS-TBNA) has been developed and several publications have now documented high diagnostic values with sensitivities of more than 90% in the staging of NSCLC. A recent publication from our group has documented a sensitivity and specificity of 100% when EUS-FNA and EBUS-TBNA is used in combination for staging of the mediastinum. It seems therefore logical to assume that the combination of EUS-FNA and EBUS-TBNA will replace more invasive methods such as mediastinoscopy for diagnosis and staging of lung cancers in the near future.
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PMID:The complete ''medical'' mediastinoscopy (EUS-FNA + EBUS-TBNA). 1792 46

Tumors and tumorlike lesions that secondarily involve the mesothelial or submesothelial layers of the peritoneum are a diverse group of disorders that range in biologic behavior from benign to highly malignant. The anatomy of peritoneal ligaments and mesenteries and the normal circulation of peritoneal fluid dictate location and distribution of these diseases within the peritoneal cavity. Peritoneal carcinomatosis is the most common secondary tumor to affect the peritoneal cavity. When it arises from carcinomas of the gastrointestinal tract or ovary, the prognosis is grave. However, when low-grade mucinous adenocarcinoma of the appendix spreads to the peritoneal cavity, the consequence is typically pseudomyxoma peritonei, which is a clinical syndrome, characterized by recurrent and recalcitrant voluminous mucinous ascites due to surface growth on the peritoneum without significant invasion of underlying tissues. Carcinomas from elsewhere in the body, as well as lymphomas and sarcomas, may also produce diffuse peritoneal metastasis. Granulomatous peritonitis is the consequence of disseminated infection such as tuberculosis or histoplasmosis, foreign materials, or rupture of a tumor or hollow viscus. Finally, a group of benign miscellaneous conditions that range from common disorders such as endometriosis and splenosis to very rare conditions such as gliomatosis peritonei and melanosis may also affect the peritoneum diffusely. Secondary tumors and tumorlike lesions of the peritoneum have overlapping imaging features when compared with each other and primary peritoneal tumors. Knowledge of peritoneal anatomy, normal fluid circulation within the peritoneal cavity, and clinical and pathologic features of secondary peritoneal lesions is essential for identification of these lesions.
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PMID:Secondary tumors and tumorlike lesions of the peritoneal cavity: imaging features with pathologic correlation. 1932 52

Background. Monoclonal gammopathy of undetermined significance (MGUS) is rarely complicated by amyloidosis. Case. A 66-year-old white male presented to the emergency room (ER) after an unwitnessed fall and change in mental status. Patient was awake and alert but not oriented. There was no focal deficit on neurological exam. Past medical history (PMH) included hypertension, hypercholesterolemia, aortic valve replacement (nonmetallic), incomplete heart block controlled by a pacemaker and IgG- IgA type Monoclonal Gammopathy of Undetermined Significance. The MGUS was diagnosed 9 months ago on serum protein electrophoresis (SPEP) as patient was referred to the outpatient clinic for hyperglobulinemia on routine blood work. In ER, a head-computed tomography (CT) revealed multiple parenchymal hemorrhagic lesions suspicious for metastases. A CT chest, abdomen and pelvis revealed numerous ground-glass and solid nodules in the lungs. Lower extremity duplex and transesophageal echocardiogram were negative. Serial blood cultures and serologies for cryptococcus and histoplasmosis, antineutrophil cytoplasmic antibody (ANCA), antinuclear antibody (ANA), rheumatoid factor (RF), cryoglobulin, and antiglomerular basement membrane (anti-GBM) antibodies were all negative. CT guided lung biopsy was positive for Thioflavin T amyloid deposits. Brain biopsy was positive for eosinophilic material (similar to the lungs) but negative for Thioflavin T stain. The patient's clinical status continued to deteriorate with cold cyanotic fingers developing on day 12 and a health care acquired pneumonia, respiratory failure, and fungemia on day 18. On day 29, family withdrew life support and denied any autopsies. Conclusion. Described is an atypical course of MGUS complicated by amyloidosis of the lung and nonamyloid eosinophilic deposition in the brain. As MGUS might be complicated by diseases such as amyloidosis and multiple myeloma, a scheduled follow-up of these patients is always necessary. Further research is needed in order to better define the optimal treatment and management strategies of MGUS and its complications.
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PMID:Monoclonal gammopathy of undetermined significance with amyloid deposition in the lung and non-amyloid eosinophilic deposition in the brain: a case report. 2030 May 49

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

Our medical staff identified a case of a forty-six years old Armed Force active duty female that presented with multiple systemic and pulmonary signs and symptoms, such as hemoptysis, arthralgias, chest pain and dyspnea after being exposed to a humid and old wooden building one year ago in the state of Georgia. Various imaging studies (cervical & thoracic x-rays and CT Scans), revealed diffuse small nodules at cervical & thoracic areas, osteolytic lesions and lymphadenopathy. Suspecting a malignant process, a PET-CT Scan was performed revealing a right lung lower lobe nodule consistent with a primary malignancy, metastatic disease, active infectious or inflammatory process. She underwent a CT-guided needle biopsy followed by an open thoracotomy. These results were negative for malignancy and positive for chronic granulomatous inflammatory process. Therefore, special immunologic stains were undertaken revealing a granulomatous process with Histoplasmosis capsulatum. This case was diagnosed in the most unusual manner, given the presenting symptoms and pathological findings which suggested a malignant process, later confirmed by multiple specialized imaging studies and tests. This presumptive diagnosis turned out to be an inflammatory/infectious (fungal) process. We must keep in mind that not all mass lesions encountered by special imaging studies should be considered malignant. This case exemplifies the need of clinicians to exercise strong clinical and critical thinking skills to consider the broad diagnostic possibilities of pulmonary nodules presenting as a malignancy.
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PMID:PET-CT scan positive pulmonary nodule revealing histoplasmosis: a case report. 2176 47

Mediastinal lymphadenopathy may be detected by CT-scan or positron emission tomography. Malignant (e.g, lung cancer, metastatic cancer, lymphoma), infectious (e.g, tuberculosis, histoplasmosis), and systemic processes (e.g, sarcoidosis) can cause mediastinal adenopathy. In the posterior and inferior mediastinum, endoscopic ultrasound visualizes and directs transesophageal fine needle aspiration of adenopathy. In the anterior mediastinum, endobronchial ultrasound visualizes and directs transbronchial fine needle aspiration of adenopathy. We discuss the role of EUS and EBUS in the evaluation of mediastinal adenopathy according to their anatomical localization.
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PMID:[Role of endoscopic ultrasound (EUS) and endobronchial ultrasound (EBUS) for the evaluation of mediastinal adenopathy]. 2271 88

Bilateral adrenal lesions include a spectrum of disorders: neoplastic disorders (metastases, lymphoma, bilateral phaeochromocytoma, adrenocortical carcinoma and myelolipoma); longstanding congenital adrenal hyperplasia and macronodular adrenal hyperplasia; infections such as tuberculosis, histoplasmosis and blastomycosis; adrenal haemorrhage; adrenals in hypoperfusion complex and paediatric masses. Bilateral distribution in addition to other imaging characteristics can help narrow differential diagnoses in case of adrenal masses. We present a pictorial review highlighting the adrenal lesions that can present bilaterally.
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PMID:Bilateral adrenal lesions. 2321 May 83


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