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)

Pathological examinations during autopsy of 1457 cases of cancer demonstrated the presence of metastatic pulmonary emboli in 10 p. cent (148 cases). The were divided, as a function of their site and histological type of the primary neoplasm, as follows: hepatoma 33 p. cent, chorioepithelioma 25 p. cent, endocrine glands 19 p. cent, biliary tract 17.6 p. cent, hypernephroma 15.6 p. cent, sarcoma 13 p. cent, and various other tumors such as cancer of the pancreas, and breast. Two anatomical types of these emboli can be distinguished: one mixed type associated with a pulmonary cancerous lymphangitis (90 cases), and observed at a later stage in the disease. This may be latent or cause a subacute cor pulmonale. The other type is not associated with lymphangitis (58 cases), results from hematogenic cancers (hepatoma, hypernephroma, etc...), is often seen at an early stage, and causes sudden death. Histological examination enabled the consequences of any infarct developing as a result of the emboli to be demonstrated, and the origin of the emboli from neoplasmatic thromboses in the primary cancer drainage routes or from metastases in the liver to be determined.
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PMID:[Metastatic pulmonary emboli: clinical types and incidence (author's transl)]. 625 4

Patients with thick primary melanomas, (Stage I) or regional nodal spread (Stage II) are at substantial risk for recurrence following usual definitive surgical excision of the primary tumor with or without lymphadenectomy. Trials of nonspecific adjuvant agents such as bacille Calmette Guerin (BCG) in experimental animals and man suggest that antitumor effects are greatest when the agent is injected near tumor of limited mass. We report a new approach to adjuvant therapy using preoperative intralymphatic injections and intraoperative local instillations of the nonviable methanol extraction residue of bacille Calmette Guerin (MER). Thirteen individuals with thick primaries, regional metastases, or recurrent melanoma of the extremities have entered the experimental program. We report here one complication of this immunotherapy observed in four of 13 treated individuals, granulomatous lymphangitis. The clinical presentation, course, and treatment of this complication are described. Its potential relation to the success of this therapy is discussed.
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PMID:Granulomatous lymphangitis. A complication of intralymphatic immunotherapy with methanol extraction residue of BCG (MER). 710 73

BCG-CWS was administrated into lymphatic vessels in the treatment of advanced malignant melanoma metastasized to the lymph node of the posterior peritoneum. Side effects consisted of fever, lymphangitis, a decrease in urinary output and a slight rise in serum GOT, there being no serious side effects. Clinically, tumor mass in the abdomen cleared but metastases to the other organs increased, and the patient died of general dispersion of the disease. At autopsy, the abdominal mass became flat, with the cut surface of yellowish brown color. Histologically, this mass formed necrosis made up of destroyed tumor cells and histiocytes. BCG-CWS mediated histiocyte response appeared to destroy tumor cells. Thus, it is possible that local administration BCG-CWS could elicit a potent response even in advanced carcinoma. Since the contact of BCG-CWS with tumor cells produced this response, administration of BCG-CWS into the lymphatic vessels may be indicated where the lymph current to the metastasized lymph node is not obstructed. This treatment would be effective particularly in the case of micrometastasis, and there is a possibility that it could elicit a specific response.
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PMID:[Intralymphatic administration of BCG-CWS in advanced malignant melanoma]. 718 64

We report our experience with bronchoalveolar lavage (BAL) and its value in the diagnosis of malignant lung infiltrates. A total of 162 patients with biopsy- or autopsy-proven cancer had an analysis of BAL fluid performed. Cytologic examination showed malignant cells in 123 (76%) patients. The diagnostic accuracy varied depending on the neoplastic nature and growth pattern of the disease. BAL disclosed cancer cells in 93% of 44 bronchioloalveolar carcinomas. Carcinomatous lymphangitis due to metastatic cancer was diagnosed in 83% of 69 cases. Hematogenous metastases (with sharply circumscribed nodules on chest radiography) were diagnosed in 45% of 22 such cases. We recognized 67% of 15 non-Hodgkin's lymphomas and 3 of 9 cases of Hodgkin's disease with pulmonary involvement. Immunocytochemistry using monoclonal and/or polyclonal antibodies was of value in the identification and classification of cells in non-Hodgkin's lymphoma.
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PMID:Bronchoalveolar lavage in the diagnosis of disseminated lung tumors. 776 34

Swainsonine, an alpha-mannosidase inhibitor which blocks Golgi oligosaccharide processing, represents a new class of compounds that inhibit both rate of tumor growth, and metastasis, in murine experimental tumor models. In this first phase I study, the quantitative and qualitative toxicities of swainsonine have been studied in patients given a continuous i.v. infusion over 5 days, repeated at 28-day intervals. Dose levels were escalated in increments of 100 micrograms/kg/day from 50-550 micrograms/kg/day. Nineteen patients with both solid tumor and hematological malignancies were given a total of 31 courses. Hepatotoxicity, particularly in patients with liver metastases, was the dose-limiting toxicity. The maximum tolerated dose (MTD) and the recommended starting dose (MTD -1 level) were 550 and 450 micrograms/kg/day, respectively. Common side effects included edema, mild liver dysfunction, a rise in serum amylase, and decreased serum retinol. Acute respiratory distress syndrome possibly precipitated by swainsonine resulted in a treatment-related death in a patient with significant pretreatment hepatic dysfunction. One patient with head and neck cancer showed > 50% shrinkage of tumor mass for 6 weeks after treatment. Two patients with lymphangitis carcinomatosis on chest X-ray noted improvement in cough and shortness of breath during the infusion of swainsonine and for 1 week thereafter. Clearance and serum half-life for swainsonine were determined to be approximately 2 ml/h/kg, and 0.5 day, respectively. Golgi oligosaccharide processing, a putative anticancer target for swainsonine was inhibited in peripheral blood lymphocytes as evidenced by a marked decrease in leukoagglutinin binding after 5 days of treatment. Oligomannosides in patient urine increased 5-to 10-fold over the 5 days of treatment, indicating that tissue lysosomal alpha-mannosidases were also blocked by swainsonine. Urine oligomannoside accumulation reached steady state at 3 days, approximately 1 day after serum drug levels reached steady state. The fraction of HLA-DR-positive cells in peripheral blood lymphocytes increased following 5 days of swainsonine treatment, an effect similar to that observed for peripheral blood lymphocytes from normal subjects cultured with swainsonine. No significant changes in CD3, CD4, CD8, CD16, and CD25 were observed. Swainsonine produces minimal toxicity when administered i.v. to cancer patients at dosages that inhibit both Golgi alpha-mannosidase II and lysosomal alpha-mannosidases. Detection of hepatic metastases or liver enzyme abnormalities prior to treatment predict for more significant toxicity.
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PMID:A phase I study of swainsonine in patients with advanced malignancies. 813 47

The chest radiographic appearances of patients with intrathoracic metastases from breast cancer are variable and their relationship to patient outcome is unknown. This study aimed to classify and determine the frequency of various radiographic patterns and, in addition, to establish whether these patterns can be used to predict patient prognosis. A retrospective study was made of the patients of a major breast unit who over a 3 year period were found to have developed intrathoracic metastases. In each case, the earliest plain chest X-ray showing signs of metastasis was reviewed and the frequency of the different radiographic patterns determined. Comparison was made between these patterns and patient mortality. The chest radiographs of 92 patients who developed intrathoracic metastases during a 3 year period were analysed. Pulmonary nodules were found in 66%, pleural effusions in 41% (bilateral in 18%), lymphadenopathy in 25%, lymphangitis in 18% and pleurally-based nodules in 11%. Median survival of the whole group was 13.5 months. Patients with bilateral, but not unilateral, effusions had a significantly poorer prognosis (median survival 3 months). Although the median survival of patients with lymphangitis seemed poor (5.5 months), this difference was not statistically significant. Multivariate analysis showed bilateral effusions to be the only independent predictor of worse outcome. We have found that of the plain radiographic patterns seen in intrathoracic metastasis from breast cancer, only bilateral pleural effusions can be used to predict a worse prognosis than that associated with intrathoracic metastasis as a whole.
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PMID:Radiographic patterns of intrathoracic disease in breast carcinoma: prognostic implications. 824 2

1. Experimental models of carcinomatous lymphangitis have not been described. This is an important clinical entity which usually results in the patients' death, although its natural history is still controversial. This study was undertaken to investigate whether the pattern of lung involvement after Walker 256 tumor inoculation through the trachea is a good model of carcinomatous lymphangitis. 2. Fifty male Wistar rats were inoculated through the trachea with 2.5 x 10(6) Walker 256 tumor cells and killed in groups of 5 animals each at 6 h and on days 1, 3, 7, 14, 21, 28, 35, 45, and 60 of the experiment. The lungs and thoracic lymph nodes were examined by light microscopy. 3. There were no tumors in the 25 animals killed before the 21st day of the experiment. The remaining 25 rats were sacrificed after 3 weeks of the experiment; 52% of them displayed thoracic lymph node metastases, and 40% developed a mild carcinomatous lymphangitis. The lung involvement did not correlate with respiratory distress, tumor dissemination or additional histological abnormalities. 4. We conclude that invasion of the lung is possible after intratracheal tumor cell inoculation, and that spreading follows a lymphatic pattern. This finding establishes this approach as a viable experimental model of carcinomatous lymphangitis. New approaches to increase the intensity and frequency of lung involvement, as well as the development of respiratory distress should be pursued in order to improve the efficiency of this model.
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PMID:Thoracic lymph node metastasis and carcinomatous lymphangitis after inoculation of Walker 256 tumor through the trachea. 825 20

Extracranial metastases arising from primary brain tumors are very unusual. We report a case of glioblastoma with intra-thoracic spread characterized by mediastinal lymph nodes metastasis and bronchial, lung parenchyma and pleura carcinomatous lymphangitis. Pathologic findings are consistent with non-differentiated cell proliferation but Glial Fibrillary Acidic Protein immunodetection can be helpful to relate such a non-differentiated cell proliferation to its glial origin. The mechanisms of extra-cerebral spread are discussed according to autopsic findings and to the data reported in the literature.
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PMID:[Pulmonary metastases of glioblastoma]. 856 81

Intrathoracic metastases occur in 30-40% of patients with malignant disease. In this group 6-8% have lymphangitis carcinomatosa. This review examines the pathogenesis, investigation and treatment of lymphangitis carcinomatosa. The 40-49 years age group is most commonly affected. In 46% of patients respiratory symptoms are the initial presentation of the underlying carcinoma. The most common underlying primary tumours are breast (33%), stomach (29%) and lung cancers (17%). Approximately 50% die within 3 months of their first respiratory symptoms but those with a prostatic primary carcinoma may have good remission with adjuvant hormonal therapy.
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PMID:Lymphangitis carcinomatosa: a literature review. 893 34

We analyze a series of 896 thoracoscopies for pleural effusion, of which 78% (662/896) were due to pleural carcinomatosis, primary or metastatic. Pleural malignancy was observed mainly, in the right hemithorax (65%), arising from tumors within the diaphragm. The likelihood of finding pleural metastasis in lung cancer was 77%. When the pleural effusion is slight (less than 500 ml) the likelihood falls to 22%. We therefore advise thoracoscopy in the former and thoracotomy in the latter. Blood-stained effusion continues to have the worst prognosis (84% stemming from metastasis) and signifies an advanced stage of pleural metastasis. The pleura parietal is involved in 69% of pleural carcinomatosis cases, and in 80% when the lower hemithorax or the area around breast or lung tumors are involved. The cytology yield was 45.9%, though always depending on extent of metastasis. When metastasis was slight, the likelihood of positive cytology was less (19%) and when metastasis was generalized throughout the entire pleura the likelihood increased to 73%. We found no reason to think that the cells in most pleural liquids are able to nest and form tumoral niches. The origin of such cell nests was rather found to be in shedding from the metastases themselves, from lung tumors or from carcinomatous lymphangitis by lymphatic obstruction. The diagnostic yield of thoracoscopy once again proved to be superior to that of pleural biopsy.
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PMID:[The so-called malignant pleural effusion: a new review of direct data obtained with diagnostic pleuroscopy]. 906 83


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