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)

55 patients with cervical lymph node enlargement were studied prospectively by colour coded duplex sonography. The aim was to demonstrate the perfusion of individual lymph nodes and to determine whether the resistance and pulsatile index are able to show the cause of the enlargement. The lymph nodes were subsequently examined histologically. Useful perfusion measurements were obtained in 177 lymph nodes out of 216. Perfusion index < 1.6 and resistance index < 0.8 distinguishes between reactive lymph node enlargement and lymph node metastases with an accuracy of 91%. Reliable differentiation between lymphoma and metastases was not possible. Tuberculous lymph nodes and cysts showed significantly reduced resistance and pulsatile index when compared with metastases. Further information on the type of disease was obtained from the perfusion patterns. Reactive lymph nodes showed increased central perfusion of the hilum, whereas metastases tended to show increased peripheral perfusion.
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PMID:[Color-coded duplex sonography in the differential diagnosis of cervical lymph node enlargements]. 791 48

Adrenal diseases are uncommon in older patients but can present insidiously. Adrenal masses are often discovered incidentally on abdominal CT scans and are usually benign, but they should be assessed for hormone production. Cushing's syndrome, or cortisol excess, is usually due to exogenous corticosteroids or a hormonally active tumor. The overnight dexamethasone suppression test is an excellent screening test. Adrenal insufficiency can be caused by hemorrhage, tuberculosis, or metastatic cancer. Maintaining a high index of suspicion of hidden adrenal disease, the primary care physician should apply an efficient approach to the diagnosis and initial management of adrenal diseases in older patients.
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PMID:Adrenal disorders: know when to act and what tests to give. 802 Jul 60

The aim of this study was to illustrate some difficulties in distinguishing late recurrence of small cell lung cancer (SCLC), from second primary lung cancer. Three-hundred fourteen SCLC patients were observed at the Institute of Tuberculosis and Chest Diseases in Warsaw, during the period 1976-1985. All patients were treated with chemotherapy and 125 were also treated with radiotherapy on the tumour and mediastinum. Nineteen patients (6%) survived 3 years. This group consisted of eight females (9%) and 11 males (5%). In all of them a complete remission was obtained. In six patients from this group no progression of lung cancer was observed. Four of them are still living, 7.9-16.2 years after the start of treatment. Two patients died of heart infarct. In the remaining 13 patients, progression of SCLC or development of new cancer was noted in the course of observation. In seven of them, histological proof of the character of progression was obtained. In four cases non-small cell lung cancer (NSCLC) was diagnosed after 3-11 years of observation. In one of them SCLC metastases in the liver were unexpectedly found in the autopsy, although adenocarcinoma in the lung diagnosed during bronchoscopy was also confirmed in the autopsy. In three cases SCLC was diagnosed. In one case, 2.7 years from the beginning of treatment, only SCLC metastases were found during laparoscopy. SCLC was found in two other cases after a 7-year cancer-free period. In one of those patients, a new lesion was found in the other lung while the second patient developed a new lesion exactly in the place of the former cancer. In six other patients no histological proof of the character of progression was obtained. Two of the six are still living, 8.2 and 15.1 years later. In the first of these two, a new lesion developed very early in the course of treatment in the same place as the primary tumour and it was regarded as the progression of SCLC. In the second patient, who probably had NSCLC the lesion developed in the contralateral lung after 12.5 years of remission and disappeared after radiotherapy. Four patients died of cancer after 3.2-6.4 years of observation. The cumulative risk of a second primary lung cancer after a 3-year survival period oscillated in our SCLC patients between 4% and 6% for every patient/year of observation. It was concluded that prognosis in SCLC patients is still doubtful, nevertheless, some patients made a complete recovery.
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PMID:Risk of late recurrence and/or second lung cancer after treatment of patients with small cell lung cancer (SCLC). 808 8

When the body's defences are breached by infection, information about such an event is channelled through the lymphatic system to the lymphoid organs in which immune responses occur. The key participants in these responses are lymphocytes, which populate the lymph nodes, spleen, and mucosal lymphoid tissues. Together with other cells, they form an architecture and cell network that enables coordinated function. The lymph nodes, which are usually superficial, are easily accessible and therefore frequently sampled by clinicians. The findings on such samples are invaluable in the diagnosis, staging, treatment and prognosis of disease. From the 28,895 histology specimens submitted to the Histopathology unit in Harare, Zimbabwe in the period January 1988 to June 1990, we have selected and reviewed all lymph node biopsy reports. The commonest diseases in the 2194 lymph node specimens submitted were: (a) non specific hyperplasia (33%); (b) tuberculous lymphadenitis (26.7%); (c) metastases (12.4%); (d) Kaposi's sarcoma (9%); (e) lymphomas (7%). The trends for nodal tuberculosis (including hyporeactive tuberculous lymphadenitis), Kaposi's sarcoma, florid follicular hyperplasia and lymphomas are discussed in the context of the increased incidence of HIV-related lymphoadenopathy.
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PMID:Lymph node pathology in Zimbabwe: a review of 2194 specimens. 810 37

We describe 12 patients with simultaneous bilateral spontaneous pneumothorax (SBSP). They represent 4 percent of patients with spontaneous pneumothorax seen at our hospital from 1971 to 1990. Five of the 12 had no underlying lung disease. In the seven remaining patients, SBSP was secondary to histiocytosis X, lymphangioleiomyomatosis, osteogenic sarcoma with pleural and pulmonary metastases, Hodgkin's disease, mesothelioma, cystic fibrosis, or miliary tuberculosis. Nineteen of the 56 patients with SBSP (34 percent) described in the literature (this series included) had pulmonary disease related to disorders of cells of mesenchymal origin. Emphysema and bullous lung disease were not associated with SBSP. Long-term prognosis was a function of pulmonary status. Four of the patients described herein died during the period reviewed. All suffered from severe underlying disease. In no case was SBSP the main cause of death. With timely treatment, the short-term prognosis is benign even for patients with underlying lung disease. Surgical pleurectomy should be attempted early, especially in SBSP secondary to underlying lung disease.
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PMID:Simultaneous bilateral spontaneous pneumothorax. 816 40

Karl Wittmaack, head of the otology department at Greifswald (1904-1908) and professor of otorhinolaryngology at the universities of Jena (1908-1925) und Hamburg (1926-1946) created a unique histological collection of human and animal temporal bones that is thought to be the largest of its kind in the world. The serial sections of more than 1700 human temporal bones still represent current otological problems--many of which are now rare but are still encountered--such as tuberculosis, lues or diphtheria of the ear. Complications following acute otitis--which were much more frequent and dangerous in the pre-antibiotic era--can be studied in detail. There are numerous cases of labyrinthitis, meningitis, sinus thrombosis, brain abscess etc.--complications which must always be borne in mind to this day. The same is true for tumors like acoustic neurinomas or even malignant tumors, metastases, or manifestations of leukemia. Differences in pneumatization or changes of the bone structure as in otosclerosis have been the subjects of studies dating from Wittmaack's time until very recently. In spite of its topicality, the true value of the collection has only be appreciated by a limited group of persons, which may be due in part to difficulties in orientation within this vast amount of material. Although there are catalogues, it may be difficult to find the appropriate preparations for particular questions. Searching for such specimens often requires rummaging through the whole collection, sometimes resulting in damage or loss of slides or handwritten notes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The Wittmaack temporal bone collection and possibilities for cataloguing with electronic data processing]. 828 75

The various ultrasound (US) findings in 90 patients with abdominal (gastrointestinal, peritoneal, mesenteric and lymph node) tuberculosis (TB) studied in an area of high incidence of TB over a 1 year period were analysed. The lesions encountered were intestinal (n = 31), extraintestinal (n = 39), or a combination (n = 20). The extraintestinal lesions included free and loculated ascites (n = 36), localized ascites ('Club Sandwich sign') (n = 4), adhesions (n = 14), peritoneal thickening (n = 14), peritoneal nodules (n = 3), lymphadenopathy (n = 23) and cold abscesses (n = 10)-of these, the presence of fine fibrinous strands in the ascetic fluid, localized ascites and caseous or calcified lymph nodes were highly suspicious of a diagnosis of TB in appropriate clinical settings. The bowel lesions were characterized by concentric bowel wall thickening (n = 31) with ulceration in six. Bowel thickening, when present in the ileocaecal junction and especially when situated in the subhepatic position, was suggestive of a tuberculous etiology. Complex masses in the abdomen pointed to an advanced stage of the disease. US is a useful imaging modality in patients clinically suspected of having abdominal TB for diagnosis and follow-up, although in a few cases differentiation of it from metastatic disease is difficult. When bowel involvement is suspected, barium studies should be performed.
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PMID:Sonographic findings in gastrointestinal and peritoneal tuberculosis. 829 28

Pleural effusion (PE) has been increasingly diagnosed over the last eight years in the Department of Internal Medicine of the Centre Hospitalier of Kigali, Rwanda. To determine the etiology of PE and to examine its possible association with HIV-1 infection and tuberculosis (TB), the authors performed an etiological work-up, including thoracocentesis and pleural punch biopsy, of all new patients with PE of undetermined etiology referred to the Division of Pulmonary Diseases at the hospital between September 14, 1988, and October 16, 1989. 81 men and 46 women of mean age 34 years were enrolled in the study. Pleural TB was diagnosed in 86% and confirmed histologically and/or bacteriologically in 82%. 82 of the 98 pleural TB patients tested for antibody to HIV-1 were HIV-1-seropositive. Metastatic cancer was responsible for PE in six patients, Kaposi's sarcoma in three, lymphoma in one, anaplastic carcinoma in one, and adenocarcinoma in one. Non-TB pneumonia was documented in five patients and was associated with HIV-1 infection in four. Other causes of PE were congestive heart failure, decompensated cirrhosis, constrictive pericarditis, or undetermined; only one of these latter patients was HIV-seropositive. The authors therefore found TB to be the predominant cause of PE and it is strongly associated with HIV-1 infection. In an African area highly endemic for HIV-1 and Mycobacterium tuberculosis co-infection, PE should therefore be considered a good marker of TB as well as HIV-1 infection.
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PMID:Pleural effusion, tuberculosis and HIV-1 infection in Kigali, Rwanda. 844 20

A man of seventy-one years with gross respiratory failure was suspected of having a cancer of the right upper lobe with metastases to the right pretracheal and intertracheobronchial nodes. A diagnostic mediastinoscopy did not achieve a diagnosis, and a right sub-bronchial node biopsy was performed, using videothoracoscopy and this revealed the presence of tuberculosis without any further delay.
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PMID:[Excision of mediastinal nodes using video-thoracoscopy]. 845 98

Lymph node tuberculosis is the most frequent tuberculous manifestation in the otorhinolaryngological area. In 13 patients with histologically verified tuberculous lymphadenitis cervical sonographic examinations revealed characteristic findings. The sonographic features typical for this disease were multiple, enlarged, conglomerating roundish and oval lymph nodes. These lymph nodes were hypoechoic, exhibited dorsal sound amplification and had sharp margins. With caseation, however, there were blurred borders. In cold abscesses an inhomogeneous texture with inhomogeneous shadows was found. Differential diagnosis included non-specific abscess-forming lymphadenitis, lymph node metastases and malignant lymphoma. A tentative diagnosis of cervical lymph node tuberculosis may be made due to the polymorphous sonographic pattern if history and clinical findings are taken into account. A proper histological and microbiological work-up is still essential for confirmation of the sonographic diagnosis.
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PMID:[Ultrasound diagnosis of cervical lymph node tuberculosis]. 846 83


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