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)

Thoracic disease in the HIV negative immunocompromised host is most frequently caused by infection. Patterns of involvement produced on the chest radiograph include (1) lobar or segmental consolidation, (2) nodules with rapid growth and/or cavitation, and (3) diffuse lung disease. The lung also may be directly involved by lymphoma, metastases, drug reactions, radiation pneumonitis, or nonspecific interstitial pneumonitis. The lung is a frequent target organ for opportunistic infections in AIDS patients, particularly of Pneumocystis carinii pneumonia and tuberculosis. Computed tomography may be particularly helpful in these patients in the detection of early disease and in the characterization of patterns and extent of involvement as well as complications.
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PMID:Thoracic disease in the immunocompromised patient. 157 Mar 94

An 88-year-old woman presented with fever, a neck ulcer, and multiple subcutaneous nodules on her upper extremities and thorax. Her condition was initially diagnosed as malignancy associated with metastatic disease to the skin. A subcutaneous nodule was aspirated. A gram stain of the aspirate revealed weakly gram-positive bacilli, and a stain for acid-fast bacilli was positive. Mycobacterium tuberculosis was isolated from a culture of a specimen of the skin lesion.
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PMID:Cutaneous tuberculosis: a rare presentation of malignancy. 161 55

Chemotherapy does not only affect the viability of the tumor cell. It may also cause alterations in normal organs. Thus, tumor-free areas within human lung parenchyma of 63 surgical specimens of intrapulmonary metastases were analyzed to assess the extent of morphologic changes in response to previous cytostatic therapy. The material included 34 cases of sarcoma, 20 cases of germ cell tumors, 6 cases of hypernephroid carcinoma, two cases of mammary carcinoma and one case of metastatic melanoma. All patients had received cytostatic therapy in generally applied regimens for more than two years. Morphologic analysis was carried out by routine procedures. In addition to conventional staining procedures including HE, PAS, and Sirius stain, further tools were employed to extend the array of determined characteristics. To evaluate any changes in the tissue in order to specifically recognized carbohydrate structures, labeled neoglycoproteins or proteoglycans with specificity for endogenous receptors that bind to mannose, maltose, L-fucose, lactose, N-acetyl-D-glucosamine, and heparin were used. A monoclonal antibody binding the HLA-DR receptor was also included in the study. As a control, sections of 20 cases with intrapulmonary metastases without exposure to previous cytostatic therapy were included. To address the further question whether cytostatic therapy may induces changes in tumor-free lung that show similarities to the organ in question, sections from 18 cases with tuberculosis and from 37 cases suffering from sarcoidosis were similarly examined. Focal interstitial fibrosis was seen in 28/63 (44%) of the patients receiving chemotherapy. In contrast, only 2/20 (10%) patients of the untreated group exhibited this alteration. An active fibrosis with proliferating smooth muscle cells was found in two cases, dysplastic pneumocytes in 10 cases (16%) in the group with cytostatic therapy, but in no cases in the untreated group. Expression of the HLA-DR receptor in the pneumocytes was observed in 27/63 cases (43%) of the cytostatic cohort, in 21/37 (57%) patients of the sarcoidosis cohort, in 15/18 (83%) patients of the tuberculosis cohort, and in 1/20 (5%) of the untreated patients. In contrast to sections from treated patients, binding of neoglycoproteins was low in the untreated cohort. Interestingly, similarities between the tuberculosis cohort and the cytostatic cohort were seen for receptors that are specific for fucose and lactose, respectively. The results suggest that long-lasting cytostatic therapy induces focal fibrosis in 40%-50% of the patients, mainly via unspecific interstitial inflammatory infiltrates. A hypersensitivity reaction or direct toxicity may less frequently lead to pathologic alterations.
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PMID:Alterations in human lung parenchyma after cytostatic therapy. 200 Dec 78

We present a 6-year experience on 307 stereotactic biopsy specimens of the central nervous system using Leksell's and Talairach's systems independently and either Leksell or Sedan needles. Patients with deep cerebral lesions (basal ganglia, parasellar, pineal, or third ventricle), those located in highly functional areas or those poorly defined on imaging studies, as well as candidates for brachytherapy, were selected. Smear examination during surgery was a routine procedure followed by conventional histologic methods. Ages ranged from 8 months to 81 years (mean, 33.64 years). The series comprised 258 tumors, 28 nonneoplastic cases, and 21 nondiagnostic samples. Of the 258 tumors, 179 were supratentorial, 28 were infratentorial, 36 were of the pineal area, and 15 were from sellar and suprasellar regions. Results of the histologic examination showed the following: astrocytic tumors, 148 (57.36%); oligodendroglial, 25 (9.68%); ependymal, six (2.32%); primitive neuroectodermal tumors, 17, including 14 pineoblastomas (5.45%) and three medulloblastomas (1.16%), seven lymphomas (2.71%), seven meningiomas (2.71%), four schwannomas (1.55%), eight craniopharyngiomas (3.10%), 12 germinomas (4.65%), and 20 metastases (7.78%). Nontumoral cases included six arteriovenous malformations, six pyogenic lesions, seven infarcts, two hematomas, one multiple sclerosis plaque, one Fahr, one progressive multifocal leukoencephalopathy, one tuberculosis, one cysticercosis, and one Chagas' encephalitis. Awareness of the cerebellar granular layer in infratentorial targets as well as glial reaction around craniopharyngiomas is essential to avoid misdiagnosis. Difficulties were basically differential diagnosis between well-differentiated astrocytomas vs glial reaction, as well as poorly differentiated neoplasms vs metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clues and pitfalls in stereotactic biopsy of the central nervous system. 203 44

Radiation-induced skin cancers can be difficult to diagnose and treat. Typically, a patient who has received orthovoltage radiotherapy for disorders such as acne, eczema, tinea capitis, skin tuberculosis, and skin cancer can expect that aggressive skin cancers and chronic radiodermatitis may develop subsequently. Cryptic facial cancers can lead to metastases and death. Prophylactic widefield excision of previously irradiated facial skin that has been subject to multiple recurrent skin cancers is suggested as a method of deterring future cutaneous malignancy and metastases. The use of tissue expanders and full-thickness skin grafts offers an expedient and successful method of subsequent reconstruction.
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PMID:Facial reconstruction for radiation-induced skin cancer. 213 63

Altogether 345 patients with pleural effusion were investigated; 22 nosological entities were diagnosed. Of them four diseases (tuberculosis, metastatic cancer, pneumonia, and pleural mesothelioma) accounted for 79.7%. Failures of outpatient clinical investigation and late referral of patients to special diagnostic departments were noted. Possibilities to diagnose the type of disease on the basis of x-ray symptoms, clinical and laboratory tests and their combinations were analyzed. A necessity of the use of various types of biopsy with respect to an x-ray picture was recommended. Early thoracoscopic biopsy was indicated for progressive or stable pleural effusion of obscure etiology.
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PMID:[Differential diagnosis of an accumulation of fluid in the pleural spaces]. 227 Jun 54

To determine the incidence and causes of hypercalcaemia in a hospital population in Hong Kong, all 29,107 samples received in the laboratory in one year were analysed for plasma calcium and albumin, and samples with a plasma calcium concentration adjusted for albumin greater than 2.55 mmol/l were investigated. Plasma calcium greater than 2.55 mmol/l was found in 462 patients. Repeat samples were received from 302 of these and hypercalcaemia was confirmed in 183. The main causes of hypercalcaemia were malignancy (72.1 per cent), tuberculosis (6.0 per cent), and primary hyperparathyroidism (5.5 per cent). In the malignant hypercalcaemia group, carcinoma of lung was the most common (31.8 per cent) and carcinoma of breast was uncommon (3.0 per cent). Secondary deposits in bone were detected in 35 of the 122 solid tumours. In order to identify the mechanism of hypercalcaemia the contributions of renal tubular reabsorption and increased bone resorption to the plasma calcium concentration were calculated. Increased tubular reabsorption was the main contributor to hypercalcaemia in primary hyperparathyroidism and carcinoma of liver (none of whom had bony metastases) and it contributed significantly to hypercalcaemia in carcinoma of lung without bony metastases and carcinoma of oesophagus. We conclude that in Hong Kong (a) primary hyperparathyroidism is uncommon, (b) tuberculosis is an important cause and (c) humoral factors may be responsible for a relatively high proportion of cases of malignant hypercalcaemia.
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PMID:Incidence, causes and mechanism of hypercalcaemia in a hospital population in Hong Kong. 229 Sep 21

The complications and mortality rate of R3 radical gastrectomy using a left thoracoabdominal approach were studied in 38 patients with adenocarcinoma of the gastric cardia. There were two hospital deaths and two anastomotic leaks. There was a high rate of complications following surgery (subphrenic abscess, eight; severe chest infection, five; aspiration pneumonia, two; wound infection, two; and reactivation of tuberculosis, one). The hospital stay ranged from 11 to 39 days (median 21 days). Thirty-five patients had microscopic evidence of serosal involvement (S2). Thirty-three of the patients had lymph node metastases and 17 patients had involvement of N2 nodes. Four patients had histological evidence of residual suture line tumour, but only two of these returned with recurrence at the anastomosis. Follow-up (median 3 years) revealed that splenic artery nodal involvement (N2) did not worsen the prognosis after radical resection. Despite a high complication rate, thoracoabdominal radical gastrectomy is associated with an acceptable perioperative mortality rate, adequate symptom palliation and encouraging medium-term survival. The left thoracoabdominal approach gives excellent exposure for radical resection of cancer of the gastric cardia and should be the procedure of choice for curative resection of this tumour.
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PMID:Adenocarcinoma of the cardia: treatment by thoracoabdominal R3 radical gastrectomy. 239 23

A study was made of the effect of the discontinuation of population screening for tuberculosis, on January 1, 1982, on the referral pattern and therapeutic results in patients with bronchial carcinoma. In 1981 only a few patients were referred because of lesions detected at the screening. Accordingly, discontinuing the screening had no demonstrable effect. Also, there was no difference between patients referred because of a fortuitous finding and those who consulted because of symptoms. Nevertheless the results, especially the 5-year survival rates, were far better for those whose tumours had favourable TNM classifications. This applied in particular if resection of parts of the lung was feasible and operation revealed no metastases in mediastinal lymph nodes and no infiltrating growth. For this group of patients the 5-year survival rate amounted to 59.4%. With only symptomatic treatment the rate was 16.7% and for patients with small-cell anaplastic carcinomas given chemotherapy, it was 5.6%.
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PMID:[The probability of survival of patients with bronchial carcinoma]. 259 22

In the last 8 years, 511 patients (267 men and 244 women) were investigated. It was found that 44 cases (8.6%) were false adenopathies (various types of tumoral masses) but placed in the nodes areas (localized, generalized or deep). There were 467 cases of true lymphadenopathies, 58 new cases yearly (2.32% of all admitted patients and 6.9% of those with blood diseases). Out of these 467 cases, 330 (70.6%) were malignant neoplastic diseases: malignant lymphomas--206 cases (62.4% of all malignancies), leukemias--99 cases (30%), carcinomatous metastases--25 cases (7.6%). Nonmalignant lymphadenopathies were found in 137 cases (29.4%): specific infections (tuberculosis) and nonspecific ones in 87 cases (63.5%), nonimmune diseases (SLE, PAN, sarcoidosis) in 50 cases. Generalized adenopathies were recorded in 47% of the cases, the involvement of a single node group in 21.8% of the cases, other types of distribution being rare. The general symptoms were absent in 20.5% of the cases, being present in the remainder of 79.5%, especially in the malignant lymphomas, leukemias, nonimmune diseases. The main complications occurring against the background of the etiological affections of lymphadenopathies were: infections (respiratory, urinary, tegumental) in 19.7% of the cases and cardiovascular disturbances (myocardiopathies, rythm and conduction disturbances) in 9.6% of the cases.
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PMID:[The experience of the 3rd Medical Clinic with lymph node pathology]. 263 63


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