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)

Splenic fine needle aspiration (FNA) biopsy has been used mainly in Europe to diagnose nonneoplastic systemic diseases. A few reports have described FNA biopsy of the spleen for the diagnosis of lymphoma. There is a definite paucity of North American reports concerning FNA biopsy for metastatic disease involving the spleen; that probably is a reflection of both the relative infrequency of splenic metastases and concern about potential hemorrhagic complications of the procedure. We report a series of 11 FNA biopsies of the spleen in patients with known carcinoma or hematologic malignancies. The FNA biopsies were performed on eight males and three females with a median age of 45 years and a range of 6-77 years. Six patients had a known hematopoietic malignancy at the time of aspiration (five non-Hodgkin's lymphoma, one acute myelogenous leukemia [AML]). The one patient with Hodgkin's disease had an FNA biopsy of the spleen as part of the initial workup; cytologic impression was atypical lymphoid cells with granulomas suggestive of Hodgkin's disease, which was confirmed by splenectomy. Four patients with carcinoma (two testicular, one lung, one ovarian) had FNA biopsies for the evaluation of splenic nodules; FNA biopsy confirmed metastatic carcinoma in three of these patients. In the entire series splenic FNA biopsy documented malignancy in 6 of the 11 patients. The one patient with AML had Aspergillus identified in the splenic aspirate, while granulomatous inflammation with yeast consistent with Candida was seen in a patient with non-Hodgkin's lymphoma. One aspirate demonstrated abscesses without recognizable organisms, and another showed extensive necrosis in a patient with testicular choriocarcinoma. Only one hemorrhagic complication was noted following splenic biopsy. Our experience demonstrates that FNA biopsy of the spleen is a useful and safe procedure in evaluating infectious and neoplastic splenic masses in patients with hematopoietic malignancies and carcinoma.
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PMID:Fine needle aspiration biopsy of the spleen in the evaluation of neoplastic disorders. 846 34

The main goal of our study was to test dynamic CT capability to characterize focal liver lesions. We examined 57 patients: 6 were affected with focal nodular hyperplasia (FNH), 19 with hepatocellular carcinoma (HCC), 1 with a regenerating nodule on cirrhosis; 14 patients had metastases, 3 focal fatty infiltration, 1 a necrotic nodule, 1 a non-Hodgkin's lymphoma, 1 a cysto-adeno-cholangiocarcinoma and 11 hemangiomas. All lesions were identified with US and the diagnosis was confirmed with the gold standard technique--that is, biopsy or surgery, and red blood cell SPECT for hemangiomas. All lesions were studied with a CT multiphase protocol consisting of a single-level dynamic phase followed by an incremental dynamic phase and finally by a delayed phase to study prolonged and delayed enhancement. Single-level dynamic bolus CT requires an injection of 60 ml nonionic contrast agent administered with a power injector into a cubital vein, at a rate of 5 ml/s. Scanning begins 10 seconds after the injection and consists of 6 series of 2 scans each; each scan lasts 2 seconds and is obtained during the same respiratory apnea, with a 5-second interscan pause. In this phase, 12 scans 5 mm thick are obtained, lasting 24 seconds in all, with pauses lasting 25 seconds--in all, 49 seconds. The next phase is the dynamic incremental scanning, to study the whole liver: this phase requires a 50-ml contrast agent injection at a rate of 4 ml/s, followed by 70 ml at a rate of 1 ml/sec, using 5 mm slice thickness and 8 mm scan interval. This results in 16 scans, beginning 20 seconds after the injection, with a scan time of 2 seconds and 4 seconds of interscan delay, 92 seconds in all. In the last phase, scanning begins 5 minutes after the injection, with a maximum delay of 10-15 minutes. Enhancement variations in both the lesions and the surroundings parenchyma, as related to time, were collected together with morphological data. Time density curves were grouped according to histologic classification and red blood cells SPECT findings; the curves were analyzed with the regression analysis. The results were obtained by analyzing a series of equations describing the different densities of the lesion and the surrounding parenchyma at fixed time intervals, integrated with morphological data, and then comparing the groups of lesions with each other. The regression analysis of the density curves and of the morphological data allowed us to correctly differentiate the 4 most frequent types of lesions--that is, hemangioma, HCC, FNH and metastasis--in 89% of the patients.
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PMID:[Dynamic computed tomography in the characterization of focal hepatic lesions]. 861 39

Cytological, immunohistological and electron microscopical observation of 21 percutaneous fine needle punctures of retroperitoneal, pelvic and abdominal lymph nodes after borderline lymphography and computer tomography and 6 punctures of tumours after tomography allowed classification of primary metastases from the small pelvis in 14 patients and characterized tumours in 4 patients, which could not be demarcated by sonography. We distinguished yolk sarcoma metastasis, prostate gland cancer metastasis, three cases of nodular metastases of seminoma cells, and two metastases of melanoma. Malignant cells of Hodgkin's lymphogranuloma and non-Hodgkin's lymphoma were distinguished in seven samples of fine needle puncture. We found malignant cells of adenocarcinoma, T-immunoblastoma, pancreas carcinoma and histiocytosis X in four punctures of tumours. Fine needle puncture processed for electron microscopy with buffered fixation and harvested into Lowicryl K4M resin through centrifugation makes it possible to detect even the minimum of cells present, preserves the structure of cells and enables to correlate cytological findings in semithick sections with correspond ultrastructure in followed series of semithin sections.
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PMID:Malignant cells revealed in fine needle punctures of lymph nodes and tumours by electronmicroscopical methods. 890 20

LL1, a monoclonal antibody (MAb) to HLA Class-II-like antigen (li determinant) on the surface of B-lymphocytes, monocytes and histiocytes, was evaluated as an agent for bone marrow imaging. Six patients with diverse diseases (non-Hodgkin's lymphoma, n = 2; multiple myeloma, n = 1; polycythaemia vera, n = 1; lung cancer, n = 1; breast cancer, n = 1) were given low protein doses (< 1 mg) of 99Tcm (30 mCi) labelled Fab' of LL1. 99Tcm-sulphur colloid (SC) imaging was performed in three patients for comparison. Both planar and single photon emission tomographic images were acquired using Sopha gamma cameras. As early as 2 h post-MAb injection, excellent bone marrow images were achieved in all patients, demonstrating both normal or hyperproliferative marrow, as well as 'cold' bone marrow abnormalities such as radiation defects or cancer metastases. Similar to SC, relatively high uptake of LL1 was found in the liver and spleen. However, the bone marrow-to-liver and -spleen uptake ratios were approximately 19-fold higher (0.75 vs 0.04) and 6-fold higher (1.23 vs 0.22), respectively, with LL1 than with SC. The higher bone marrow uptake allowed clearly superior visualization of the thoracic spine when compared to SC. The mean T1/2 of blood and whole-body clearance were 0.4 and 66 h, respectively. The highest radiation absorbed doses (in cGy mCi-1) were observed in the spleen (0.47 +/- 0.24), kidneys (0.25 +/- 0.09) and liver (0.14 +/- 0.04). The bone marrow dose was only 0.05 +/- 0.02 cGy mCi-1. These results indicate that bone marrow imaging with 99Tcm-LL1 is feasible, and that LL1 may be a suitable alternative to SC because of better visualization of the lower thoracic spine. Potential applications include the improved detection of bone marrow metastases of solid tumours and the assessment of haematological disorders.
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PMID:99Tcm-LL1: a potential new bone marrow imaging agent. 907 70

To arrive at a reasonable estimate of the total need for radiotherapy, the various descriptions of population trends and measures of cancer trends must be studied concurrently. Incidence and mortality are well documented by official statistics. All prognoses are based on these measures, the official population statistics, and the 1989 population prognosis from Statistics Sweden. Incidence, mortality, and prevalence may be considered either individually or together as indirect measures of the need for radiotherapy at different stages for different types of cancer. Incidence, ie, the number of cases of disease onset during a given period, shows the indirect need for curative radiotherapy, eg, for breast cancer, laryngeal cancer, gynecological tumor types, and head and neck cancer. The projected average annual mean increase in total incidence is 1.0%. Mortality may be used as an indirect measure of the need for palliative treatment for recurring cancer, eg, for bone metastases, prostate cancer, lung cancer, or breast cancer. The mean increase is estimated at 0.9% per year. Likewise, prevalence can be an indirect measure of the need for palliative treatment for cancer diseases of a chronic nature, eg, prostate cancer and multiple myeloma. The total mean increase per year has been estimated at 2.0%. The total need for radiotherapy in the future should be viewed against the background of all these descriptive measures. Assessment must also consider numerous other factors that directly influence need. A change in the indications for treatment can quickly increase the need for radiotherapy, eg, the benefits of radiotherapy for noninvasive breast cancer are currently being studied. Even a change in the indications for surgical intervention for small tumors in the breast influence the need for primary curative radiotherapy in this large group of patients. Likewise, a shift in staging the primary diagnosis, eg, in head and neck cancer, and changes in fractionation (hyperfractionation) may substantially influence need. This is addressed further in another section of the report. The largest single group of cancer patients who receive radiotherapy are those with bone metastases (25% of the total). The size of this group, and thereby the potential unsatisfied need, is largely unknown since no statistics show the prevalence of metastases in the population. This group is comprised mainly of patients that were primarily diagnosed with prostate cancer, breast cancer, and lung cancer. Concerning lung cancer, incidence trends probably provide the best measure of changes in the number of bone metastases over time. The annual increase in incidence has been estimated at 1.5%. As for breast cancer and prostate cancer, mortality trends provide more information about trends in the number of bone metastases. Both types of cancer increased by 1.9% per year. Chapter 6 presents the types of cancer for which radiotherapy is usually given. The projected trends show that each of these cancer diagnoses, except lung cancer in men and cervical cancer in women, are expected to increase in number until the year 2010. Prevalence is expected to increase even more, particularly cancer in the rectum, breast, and prostate. Also, the number of cases of non-Hodgkin's lymphoma is expected to nearly double by 2010.
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PMID:Cancer trends in Sweden until 2010. 915 84

We reported a 75-year-old woman with malignant lymphoma who had a metastasis to the right lateral rectus muscle. She was well until two months earlier, when a tumor in the left thigh began to enlarge. Ten days before admission, she noticed medial deviation of the right eyeball. Neurological examination showed the right esotropia with isolated paralysis of the right lateral gaze. She denied double vision. MR imaging demonstrated a swelling of the right lateral rectus muscle. Gallium scanning revealed abnormal accumulation in the right orbit and the left thigh. The tumor in the left thigh was histologically diagnosed as non-Hodgkin's lymphoma, diffuse large cell type. Discrete extraocular muscle metastasis is rare and unreported for malignant lymphoma. Reported cases of breast and thyroid cancers metastatic to the extraocular muscles did not develop diplopia similar to our case. The rapid growth of metastases to the extraocular muscles produces a large visual axes deviation, therefore no diplopia may be elicited.
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PMID:[A case of malignant lymphoma with a metastasis to the lateral rectus muscle]. 936 84

Little is known about the coincidence of hepatitis C virus infection (HCV) and non-Hodgkin's lymphoma, although there is an increased incidence of chronic HCV infection with cryoglobulinemia type II and, interestingly, low-grade non-Hodgkin's lymphoma (NHL) in a few patients. We therefore report on a 74-year-old white male with known chronic hepatitis C virus infection who was admitted to the clinic due to weight loss and pain in the right upper quadrant. Ultrasound examination was performed for suspected hepatocellular carcinoma since a lesion in the left lobe of the liver was seen. X-ray of the lungs showed a few scattered lesions, suggestive of metastases. The ultrasound-guided fine-needle puncture revealed a high-grade malignant B-cell NHL While alpha-fetoprotein was normal, both cryoglobulin type II and the polymerase chain reaction (PCR) for HCV were positive. After six cycles of chemotherapy consisting of CHOP, the patient showed complete remission over three years. Ultimately, he died due to a sudden myeloic blast crisis. In summary, we discuss the possible etiopathologic role of the hepatitis viruses in the occurrence of non-Hodgkin's lymphoma. As we and others showed that HCV infects peripheral mononuclear blood cells (PBML), the infected PBML not only may be a source for reinfection after orthotopic liver transplantation, but also could be the cause for transformation and monoclonal propagation of lymphomatous tissue.
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PMID:Primary hepatic high-grade non-Hodgkin's lymphoma and chronic hepatitis C infection. 939 1

Variants of the CD44 cell-surface adhesion molecule include additional sequences encoded by combinations of exons from the membrane proximal domain (exons 6-14). Preliminary studies suggest that these additional variable membrane proximal sequences may alter the ligand specificity, glycosylation, and biologic function of CD44. In earlier studies, we found that primary extranodal and widely disseminated aggressive non-Hodgkin's lymphomas (NHLs) and normal activated B cells expressed a directly spliced exon 10-containing variant (CD44ex10), whereas normal resting B cells expressed larger exon 10-containing variants (CD44ex10-14 and CD44ex7-14). To obtain additional information regarding the function of exon 10-containing CD44 variants in aggressive NHL, we generated aggressive NHL transfectants that expressed CD44ex10, CD44ex10-14, CD44ex7-14, the standard CD44 isoform (CD44H), or vector alone, and evaluated the local tumorogenicity, aggregation, and metastatic potential of these transfectants. CD44ex10 aggressive NHL transfectants were more likely to cause local tumor formation in nude mice than transfectants expressing the larger exon 10-containing variants, CD44H, or vector alone. In addition, cell suspensions derived from CD44ex10 local tumors exhibited far greater homotypic aggregation than those obtained from other CD44 or vector-only local tumors. In nude mice that received CD44ex10 transfectants, distant metastases were also significantly more likely to develop than in animals that were given either the CD44ex10-14, CD44ex7-14, CD44H, or vector-only transfectants. These data provide the first evidence that the directly spliced exon 10-containing CD44 variant (CD44ex10) has a unique biologic function in aggressive NHL.
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PMID:A directly spliced exon 10-containing CD44 variant promotes the metastasis and homotypic aggregation of aggressive non-Hodgkin's lymphoma. 959 77

Primary non-Hodgkin's lymphoma of the liver is an extremely rare lymphoma subset that often presents with diagnostic difficulties to both clinicians and pathologists. Using MEDLINE search, 90 cases of primary hepatic lymphomas reported in the literature were reviewed. The epidemiology and etiology, clinical presentation, pathologic features, management, and outcome of these patients have been summarized and described. Results of this review show that middle-aged males are most often affected. Abdominal pain or discomfort, weight loss and fever are the most frequent presenting symptoms. Most cases have a solitary or multiple mass lesions in the liver, and are frequently misdiagnosed as having a primary liver tumor or metastatic cancer. Diffuse large cell lymphoma is the most commonly encountered histologic subtype. Surgery, chemotherapy and radiotherapy have been used alone or in combination as treatment but the outcome is generally poor. Although primary hepatic lymphoma is an aggressive disease, it is resectable, and responsive to chemotherapy and radiotherapy. Because of the profound therapeutic implications, it should be considered in the differential diagnosis for patients presenting with mass lesions in the liver or hepatic disease.
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PMID:Primary non-Hodgkin's lymphoma of the liver. 968 27

CD44 is a transmembrane glycoprotein involved in cell-cell and cell-substrate interactions. As a cell surface molecule, CD44 may be shed or released into the circulation by proteolytic enzymatic mechanisms. Therefore, soluble CD44 can be found in cell culture supernatants as well as in plasma. In this study we evaluated the levels of soluble total CD44 (sCD44) in serum samples of patients with breast and colorectal carcinoma as well as non-Hodgkin's lymphoma in order to correlate prognosis with sCD44 expression. Besides, we evaluated other clinical tumour markers routinely used, Cancer Antigen (CA) 15.3 and CA 19.9. We investigated 132 serological samples from breast cancer patients, 48 sera from colorectal tumours, 48 samples from stage IV non-Hodgkin's lymphoma and sera from 80 individuals without evidence of cancer or autoimmune disease. Breast cancer patients were divided into three groups: a) patients with no clinical evidence of positive nodules and no metastatic disease; b) patients with positive nodules; and c) patients with metastasis. sCD44 mean serum levels in these groups were 198+/-54 ng/ml, 221+/-78 ng/ml and 242+/-119 ng/ml, respectively, while the marker CA 15.3 values were 15.6+/-6.6 U/ml, 14.0+/-5.8 U/ml and 211.5+/-358.9 U/ml, respectively. sCD44 levels for colorectal tumour were 243+/-72 ng/ml, while CA 19.9 serum levels were 230+/-270 U/ml. Stage IV non-Hodgkin's lymphoma sCD44 levels were 398+/-160 ng/ml. sCD44, CA 15.3 and CA 19.9 values for healthy individuals without evidence of any cancer pathology were 223+/-58 ng/ml, 16.4+/-6.2 U/ml and 33+/-14 U/ml, respectively. From these results we conclude that sCD44 might be used as a reliable marker for patients with non-Hodgkin's lymphoma. However, sCD44 levels failed to correlate with prognosis, tumour burden or metastasis in breast and colorectal cancer patients. Neither was any correlation found between high CA 15.3 or CA 19.9 levels and soluble CD44 serum level.
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PMID:Evaluation of soluble CD44 in patients with breast and colorectal carcinomas and non-Hodgkin's lymphoma. 1042 14


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