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)

An autopsy case of malignant mesothelioma with asbestosis caused by asbestos exposure for 17 years is reported. Autopsy revealed that mesothelioma spread extensively in all serosal tissues including pleura, pericardium, diaphragm, peritoneum and tunica vaginalis testis. Histopathologically, most of the tumor showed an epithelial form, but sarcomatous and microcystic patterns were also observed. The tumor cells had abundant glycogen and hyaluronic acid and, immunohistochemically, they were positive for cytokeratin, vimentin and epithelial membrane antigen (EMA). Long, slender microvilli were characteristically observed in these tumor cells. All of these data were compatible with malignant mesothelioma. Procollagen type I (procol.l) immunostaining was performed to reveal the mesenchymal character of mesothelioma. Both epithelial-type cells and sarcomatous-type cells showed positive staining for procol.l, although the latter showed stronger immunoreactivity. Immunostaining for procol.l was found to be one of the useful tools for distinguishing mesothelioma from adenocarcinoma. Using an extraction method for asbestos fibers, asbestos bodies were found in many tissues including lymph nodes, liver, small intestine, spleen, kidney, testis and pleura, in addition to lung parenchyma. Although multiple tumor metastases from an undetermined primary site is not ruled out, 'multifocal tumorigenesis' is suspected from the widespread deposit of asbestos fibers.
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PMID:An autopsy case of malignant mesothelioma associated with asbestosis. 783 80

Abdominal malignant mesothelioma was found in a 17-year-old, spayed female Japanese domestic cat with mast cell leukaemia. The mesothelioma was mainly located at the periphery of the pancreas, spleen and stomach, and showed metastases to the lung, an anterior mediastinal lymph node and lymph ducts in the tracheal mucosa. Micro-circulatory defects caused by the mast cell leukaemia may have been partly responsible for the distant metastases.
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PMID:Malignant mesothelioma with metastases and mast cell leukaemia in a cat. 788 62

Different types of peritoneal mesothelioma (PM) occur in children and adults. All these share certain histopathologic features but differ in other aspects, such as age of occurrence, site and sex predominance, etiology, and biologic behavior. The article describes four patients, two with cystic PM (one of whom had multiple recurrences) and two with malignant PM (one of whom had pleural metastases). These cases illustrate the variable behavior of this tumor in childhood and highlight the difficulties encountered in diagnosis and treatment. Three different groups of mesothelioma are recognized: a classic, asbestos-related, malignant mesothelioma of adults, typically occurring in the pleural cavity; a multicystic mesothelioma, predominantly affecting the pelvic peritoneum of young women and associated with a good prognosis; and mesotheliomas in children, which are not associated with asbestos exposure and have an unpredictable biologic behavior requiring individual treatment strategies. In the patients studied, DNA index measured by flow cytometry showed a difference between the cystic (aneuploid) and malignant (diploid) tumors. The proliferative rate (S phase) of the tumor was low in all four cases.
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PMID:Spectrum of peritoneal mesothelioma in childhood: clinical and histopathologic features, including DNA cytometry. 794 12

Pleural disease provided the first and, for many years, the only indication for thoracoscopy. It remains the most efficient way of obtaining a diagnosis in cases of pleural effusions not diagnosed by thoracentesis and closed-needle biopsy, especially when malignancy is suspected. Thoracoscopy also can provide enough tissue to define cell type. In malignant mesothelioma, it can help assess the resectability of the tumor. In cases of metastatic disease or inoperable malignant mesothelioma, treatment of the effusion by talc poudrage can be combined with a diagnostic procedure. Any case of empyema in which a chest tube does not result in defervescence or complete evacuation of the pleural fluid within 2 to 3 days should be considered for thoracoscopy. In early empyemas, adhesions and loculatons can be addressed, the infected material removed, and the cavity irrigated. If the lung then fully expands, the tubes may be removed when the drainage ceases, precluding the prolonged retention of empyema tubes. Thoracoscopy also has proved useful in the management of benign pleural tumors, hemothorax, and chylothorax.
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PMID:Thoracoscopy for the evaluation and treatment of pleural space disease. 795 79

Malignant mesothelioma remains a frustrating clinical problem with uniformly poor responses to current therapeutic regimens. However, the localized nature of the disease, the potential accessibility of the tumor, and the relative lack of distant metastases make it a particularly attractive candidate for somatic gene therapy. The purpose of this study was to evaluate the ability of an adenoviral vector system to transfer genetic material to human mesothelioma cells in vitro and in vivo. Using a replication-deficient recombinant adenovirus carrying the Escherichia coli lacZ marker gene, we found that human mesothelioma cell lines were susceptible to adenovirus infection. Furthermore, surprisingly effective gene transfer was accomplished within tumor implants of human mesothelioma growing within the peritoneal cavity of immunodeficient mice after intraperitoneal administration of virus. These studies demonstrate that adenoviral vectors hold promise as vehicles to deliver gene therapy in human malignant mesothelioma.
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PMID:Successful adenovirus-mediated gene transfer in an in vivo model of human malignant mesothelioma. 801 Jul 76

It is well known from autopsy series that metastatic tumors of the heart can be found in 1.5% to 21% of patients with malignancies and the incidence of cardiac metastases is showing a gradual increase in recent years. The most common cause of metastatic heart disease is bronchial carcinoma followed by carcinoma of the breast, pleural mesothelioma, malignant melanoma, leukemia and lymphoma, in decreasing order of frequency. However metastatic cancer to the heart is not commonly diagnosed prior to death. Atrial extension has been reported as a common route of local spread in patients with bronchial carcinoma, but cardiac conduction system invasion is infrequent. The purpose of this report is to describe an unusual case of pulmonary adenocarcinoma that presented with cardiac manifestations mimicking atrioventricular (AV) block. This AV block was corrected by pacemaker. Chest radiography and bidimensional echocardiography didn't visualize important lesions. The cardiac findings at autopsy were remarkable not only for the severity of epicardial, myocardial and endocardial involvement, but for the metastatic implants into the His bundle and for the elective and wide infiltration of bifurcating His bundle. On addition histological examination revealed neoplastic emboli in the myocardial lymphatics. No valvular involvement was noted. Technical annotation: histological examination of the conduction system of the heart has been carried out on serial sections with the technique devised by one of the present authors. Bichromic (hematoxylin-eosin) and trichromic (Heidenhain-azan) stainings have been routinely employed.
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PMID:[Cardiac block caused by metastasis of lung adenocarcinoma to the bundle of His]. 849 66

A 43-year-old man was admitted to Nara Medical University Hospital because of right-sided chest pain. Computed tomographic examination revealed a right pleural effusion and diffuse pleural thickening. Malignant mesothelioma was diagnosed from the results of a percutaneous pleural biopsy, and the patient then underwent right pleuro-pneumonectomy. The resected specimen was examined by light and electron microscopy, which revealed scattered sarcoma-like malignant cells with some epithelial differentiation, in abundant extracellular collagen with storiform derangement. Therefore, desmoplastic malignant mesothelioma (mixed type) was diagnosed. This is a rare histological subgroup of malignant mesotheliomas. The patient died 2 months after the operation, due to multiple and rapidly growing metastases. After lung tissue was dissolved, ferruginous (asbestos) bodies were counted, and the results were consistent with occupational exposure to asbestos (413 asbestos bodies per 5 g of lung tissue).
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PMID:[A case of desmoplastic malignant mesothelioma]. 858 23

Immunohistochemistry is a powerful diagnostic adjunct in the differential diagnosis between malignant mesothelioma (especially of the epithelial type) and adenocarcinoma metastatic to the serous membranes. Most of the immunological probes commonly used, however, recognize antigens expressed by the epithelial malignancies and absent from mesothelial cells and mesotheliomas. Probes suitable for the positive identification of mesotheliomas are comparatively scarce and much less commonly used because of their reduced sensitivity and specificity, their unsuitability for staining routinely fixed and embedded tissues, or their lack of commercial availability. We now document that two different polyclonal antisera to calretinin consistently immunostain mesothelial cells and malignant mesotheliomas both in routinely fixed and embedded tissue sections and in cytological preparations of serous effusions. The diagnostic sensitivity of this novel immunocytochemical approach reached 100%, allowing immunostaining of all 44 mesotheliomas investigated, which included five biphasic and three sarcomatoid types. The specificity of calretinin immunoreactivity was checked against 294 adenocarcinomas of different origin (19 serosal metastases and 275 primary tumors potentially able to metastatize to serosal membranes) relevant for the discussion of the differential diagnosis with malignant mesothelioma: only 28 cases showed focal immunoreactivity for calretinin. We conclude that calretinin is a most useful marker for the positive identification of malignant mesotheliomas.
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PMID:Calretinin: a novel immunocytochemical marker for mesothelioma. 876 40

A 50-year-old man presented with a cervical lymph node metastasis of malignant tumor and a radiologically documented well-defined tumorous mass in the middle portion of the mediastinum. Under the presumptive diagnosis of an undifferentiated bronchogenic carcinoma, the patient underwent chemotherapy. However, the tumor did not respond to this treatment and showed further progression. The patient died four weeks after the lymph node biopsy. Autopsy revealed a well-defined cystic tumor in the mediastinum with infiltration of the pericardium. The tumor was not attached to the lungs. By histology and immunohistochemistry, a metastasizing malignant biphasic mesothelioma was diagnosed. The tumor had metastasized to intrapulmonary perivascular and peribronchiolar lymph vessels and hilar lymph nodes. Distant metastases were found in the right and left adrenal gland and in the brain. The strictly mediastinal localization and the cystic growth pattern of the tumor strongly suggest that this mesothelioma developed from a primary benign mesothelial cyst of the pericardium with secondary transformation into a malignant mesothelioma.
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PMID:Malignant mesothelioma arising from a benign mediastinal mesothelial cyst. 879 88

A more modern treatment strategy for diffuse malignant peritoneal mesothelioma may be suggested (figure 3). Clinical suspicion of diffuse malignant mesothelioma (peritoneal carcinomatosis) calls for laparoscopy with evaluation of parietal and visceral peritoneum and multiple biopsies sufficient for definitive histologic diagnosis. Cytologic examination of ascitic fluid is not likely to be of benefit. CT of chest, abdomen, and pelvis is needed for evaluation of visceral involvement and the presence of distant metastases. Contrast enhancement of the gastrointestinal and urinary tract is necessary with the CT. Additional radiologic techniques for detection of distant metastases should be used if there are clinical or laboratory signs of extraperitoneal spread. After histologic diagnosis and extent of tumor spread have been documented, and if no symptoms of intestinal obstruction are present, the patient may be subjected to two to three courses of induction intraperitoneal chemotherapy. This will provide the clinician with important information on tumor response to chemotherapy, minimize tumor accumulation on bowel surfaces, and provide time for surgical conditioning. The time devoted to induction chemotherapy will allow occult distant metastases to be detected. In patients with a response or stable disease, cytoreductive surgery is attempted approximately 2 months after completion of induction chemotherapy. Surgery must be aimed at achieving complete or near-complete cytoreduction through the use of peritonectomy procedures [46,47]. Additional intraperitoneal chemotherapy should be administered intraoperatively and in the early postoperative period (figure 3). This treatment strategy may be the most feasible one according to existing knowledge of the natural history of diffuse malignant peritoneal mesothelioma. Only further phase II clinical trials can reveal the extent to which it is beneficial. Because of the rare occurrence of this disease, the quickest answer would come as a result of cooperative study by several groups experienced in these treatment modalities.
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PMID:Peritoneal mesothelioma: treatment approach based on natural history. 883 86


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