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

In this preliminary study, aiming at the early diagnosis or the confirmation of neoplastic spreading, the levels of sialic acid (TSA and LSA, total sialic acid and "lipid bound" sialic acid) were measured and correlated with the corresponding cytologic findings in 111 body or cystic fluid samples taken from patients with suspected or confirmed cancer. The samples were classified according to the body fluid origin: peritoneal (35), breast cyst (22), pleural (21), thyroid gland cyst (5), renal cyst (5), ovarian cyst (6), bronchial washing (3), douglasic cavity (3) and various other origins (11). It was found that 32.43% of the samples were TSA positive, 44.14% LSA positive, 20.75% cytologic and 8.49% cytology suspect (positive + suspect = 29.24%). Thus, the combination of a tumor biomarker with the corresponding cytology of the body fluid gives the best possible results, as regards both the confirmation of positive cytology and the detection of possible metastases, as well as the monitoring of the disease after treatment.
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PMID:Correlation of total (TSA) and lipid and bound (LSA) sialic acid levels with cytology of cyst or body fluids in cancer patients. 177 47

Multilocular renal cyst is a distinct renal tumor whose gross external appearance and absence of normal renal tissue within the septa of loculi distinguish it clearly from other renal cystic lesions. Interlocular septa may contain either (1) fibrous tissue alone or (2) embryonic tissue separating adjacent loculi. Of 29 patients with multilocular renal cysts, 24 underwent a renal-sparing procedure, and only 5 had radical nephrectomy. None of the histologic specimens showed evidence of immature renal tissue or neoplasia. Patients were followed from three months to eight years (mean, 39 months), and no evidence of local recurrence or metastatic disease was found. Because it is difficult to distinguish multilocular renal cyst from cystic Wilms tumor and multicystic clear cell carcinoma on the basis of imaging studies alone, surgical intervention is the only effective method to differentiate multilocular renal cyst from a malignant lesion of the kidney.
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PMID:Multilocular cysts of kidney. A study of 29 patients and review of literature. 184 92

Acquired cystic kidney disease has become increasingly recognised as a significant risk in patients with end-stage renal disease, especially in those maintained on chronic haemodialysis and peritoneal dialysis. A review of the literature indicates that nearly 50% of patients on dialysis for more than 3 years develop renal cystic changes. The major complications of this condition are neoplasia and spontaneous renal haemorrhage. The risk of developing renal carcinoma has been estimated to be more than 30 times higher in dialysis patients with cystic changes than in the general population. Our experience with 5 patients is reported, including 3 with renal tumours and 1 with metastatic disease. Careful surveillance of dialysis patients using yearly ultrasonography and computed tomography is recommended. The evolving indications for radical nephrectomy in this disease are discussed.
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PMID:Acquired renal cystic disease: implications for the urologist. 203 71

A simple renal cyst will have low signal intensity on T1-weighted SE images with short TE and short TR because of the long T1 values of the cyst fluid. With increasing TE and TR, cysts demonstrate increased signal intensity due to the long T2 values of the cyst fluid. On T1-weighted images a complicated cyst will have higher signal intensity than a simple cyst; it may not be possible to differentiate these complicated cysts from solid masses. MRI seems to be useful in identifying simple cyst fluid and, therefore, has potential in characterization of cystic lesions considered complex by CT or ultrasound. Unfortunately, imaging techniques have not yet been optimized, diagnostic criteria are somewhat vague, and accuracy has not been established in a representative patient population. Solid masses often can be identified and differentiated from simple, uncomplicated cysts on MR images. The inability to differentiate among various types of solid tumors or to separate these from complicated cysts or inflammatory masses remains a limitation. Most lesions are more readily seen on contrast-enhanced CT than on MR images and therefore the role of MRI in the detection and diagnosis of renal cell carcinoma remains limited. Although the high detection rate of renal cell carcinoma is encouraging, CT is still more sensitive than MR in demonstrating solid lesions less than 3 cm in diameter. MRI cannot be used as a screening modality for renal tumors. MRI seems quite helpful in the staging of renal cell carcinoma. Macroscopic extension into the perinephric fat, tumor extension into the renal vein and the inferior vena cava, and macroscopic metastases to other organs are readily seen. Furthermore, differentiation between enlarged nodes and vessels is possible with MRI. Some authors recommended the use of MRI to stage renal cell carcinoma in patients with known contraindication to contrast, prior suboptimal bolus contrast enhanced CT scan, and equivocal CT findings. MRI can replace the inferior vena cavagram in the staging work-up and MR may be superior to CT for planning the surgical approach in Stage IIIA lesions by determining the upper extent of tumor thrombus within the inferior vena cava or the right atrium.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Magnetic resonance imaging of the kidneys and adrenal glands. 269 25

Multilocular renal cyst is a pathologically distinctive lesion of uncertain pathogenesis that usually presents as a large abdominal mass in male infants or middle-aged women. We performed detailed light and electron microscopic studies of three nephrectomy specimens that contained multilocular cysts and attempted to correlate their morphology with various theories of pathogenesis. In one of our cases, a microscopic focus of clear cells that resembled renal cell adenocarcinoma was observed in the wall of one locule. Although such a finding has been reported previously, the lack of well-documented cases with metastases suggests that the prognosis for patients with this lesion remains uniformly excellent.
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PMID:Multilocular renal cyst. A hamartoma with potential for neoplastic transformation? 363 86

A retrospective comparison was made of the capability of magnetic resonance (MR) imaging and CT to display and characterize pathologic abdominal fluid collections. Fluid collections in 41 patients were analyzed: ascites (seven patients), hematoma (five), pancreatic pseudocyst (four), biloma (two), abscess (four), simple renal cyst (nine), hemorrhagic renal cyst (two), hydronephrosis (four), hemonephrosis (two), and cystic metastases (two). Most fluid collections were equally demonstrated by the two modalities. Walls around fluid collections were better demonstrated CT. Six fluid collections appeared heterogeneous on MR but were homogeneous or nearly so on CT.
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PMID:MR imaging of pathologic abdominal fluid collections. 374 43

Two cases of multilocular renal cyst (MRC) are presented with electron microscopic findings. The epithelial cells of the cysts resembled renal collecting tubule cells and not convoluted tubule or Henle's loop cells. Intercystic areas contained only connective tissue elements. Simple MRC appears to be a congenital malformation that results from segmental maldevelopment of the ureteric bud. In some cases of MRC, the intercystic septa contain immature renal elements. The lesion is then called cystic poorly differentiated nephroblastoma (CPDN). However, in both MRC and CPDN, local recurrence or metastases have not been described. Treatment of these lesions should consist of nephrectomy, careful histologic evaluation to rule out obvious foci of Wilms' tumor, and conservative follow-up.
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PMID:Multilocular renal cyst: electron microscopic evidence of pathogenesis. 632 6

The findings at computed tomography (CT) of the adrenal glands in 58 patients are presented. Most patients (50) were referred for suspected adrenal dysfunction. In three, adrenal masses were suspected from other radiological studies. Three patients had palpable abdominal masses, and incidental adrenal metastases were found in two. Pathological findings included pheochromocytomas (nine patients), adrenocortical adenomas (six), adrenocortical carcinomas (three), metastases (two), and one example each of myelolipoma, hemorrhagic renal cyst, and probable granuloma. Of 24 adrenal masses, 23 were clearly apparent in the scans and one was suspected. The smallest tumor diagnosed was 0.5 cm in diameter. There was on false positive diagnosis of a small tumor and no known false negatives. Because of their consistent location and unusual shape and because they are usually surrounded by retroperitoneal fat, the adrenal glands are ideal organs for study by CT, a highly accurate method for detecting and excluding mass lesions that may render arteriography and venography unnecessary. Surgery was performed in five patients with tumors following localization by CT only. Limitations and potential diagnostic pitfalls in interpretation are discussed.
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PMID:The role of computed tomography in assessment of tumoral pathology of the adrenal glands. 735 78

The development of renal cell neoplasms ranging from adenoma to metastatic carcinoma is the most serious complication of acquired cystic kidney disease (ACKD). A comprehensive review of the pertinent literature shows that there is up to 50-fold increased risk of renal cell carcinoma in ACKD compared to the general population. The ACKD-associated renal cell carcinoma is seen predominantly in males, occurs approximately 20 years earlier than in the general population, and is frequently bilateral (9%) and multicentric (50%). Acquired cystic kidney disease-associated renal cell carcinoma is frequently asymptomatic (86%), but may be associated with bleeding, abrupt changes in hematocrit, fever, and flank pain or rarely with hypoglycemia, hypercalcemia, or metastases at presentation. Computed tomography seems to provide a better diagnostic yield than sonography or magnetic resonance imaging; nevertheless, large (up to 8 cm) tumors not visualized by any imaging techniques have been reported. It is generally agreed that there is a need for regular screening of symptomatic ACKD patients for early detection of renal cell carcinoma; however, whether screening is needed for asymptomatic patients remains controversial. Nephrectomy is indicated for tumors larger than 3 cm. Management for tumors smaller than 3 cm with persistent symptoms, such as back pain or hematuria, remains controversial, but nephrectomy may be recommended since many of these tumors turn out to be unequivocal renal cell carcinoma. Asymptomatic tumors smaller than 3 cm should be serially screened, and tumor enlargement may be an indication for nephrectomy. Acquired cystic kidney disease-associated renal cell carcinoma accounts for approximately 2% of deaths in renal transplant patients. A median length of survival of approximately 14 months and a 5-year survival rate of 35% are comparable to the same data for renal cell carcinoma in the general population. Successful renal transplant probably decreases the risk of renal cell carcinoma in ACKD patients, but this preliminary observation needs confirmation. The development of ACKD-associated renal carcinoma is a continuous process with evolving phenotypic expression, including damaged renal tubule, simple cyst, cyst with atypical lining, adenoma, and, finally, carcinoma. The pathogenesis of this continuous process is not entirely known, but growth factor-induced compensatory growth of tubular epithelium initiated by the changes of end-stage kidney disease, and probably perpetuated by activation of proto-oncogenes, seems to be the most significant factor.
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PMID:Renal neoplasm in acquired cystic kidney disease. 761 Dec 40

A 51-year-old man with a 23-year history of hemodialysis-dependant end-stage renal failure presented with pyrexia, malaise, and progressive pancytopenia. Investigations revealed acquired cystic kidney disease, with one cyst being interpreted as showing evidence of recent hemorrhage, and a malignant sarcomatoid bone marrow infiltrate. The patient rapidly deteriorated and died. At autopsy a seminecrotic and cystic sarcomatoid renal cell carcinoma was identified, with metastases in the adrenals, bone marrow, liver, lungs, and abdominal lymph nodes. The case is reviewed with regard to epithelial membrane antigen- and cytokeratin-negative bone marrow immunohistology as well as the immunophenotype of acquired cystic kidney disease and that expected in renal carcinoma, with reference to the literature on acquired cystic kidney disease.
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PMID:Sarcomatoid renal cell carcinoma arising in hemodialysis-associated acquired cystic kidney disease presenting with disseminated bone marrow infiltration. 794 14


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