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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our previous study suggested a close relation between a preceding chronic tuberculous pyothorax and the development of non-Hodgkin's lymphoma (NHL) in the pleural cavity. To confirm this further, 37 cases were collected from Japanese hospitals, and their clinical and pathological findings summarized. The age at first admission for lymphoma of patients ranged from 46 to 81 (mean 63) years, the male to female ratio being 5.2:1. All patients were admitted after a 22-55 (mean 33) year history of pyothorax resulting from artificial pneumothorax for the treatment of pulmonary tuberculosis (29 cases) or tuberculous pleuritis (seven cases). The most common presenting symptom was chest pain. The main tumor mass, detected by chest roentgenogram and computed tomographic scans, was situated in the pleura (28 patients), the lung near the pleura (five patients) and the pleura and lung (four patients). The diagnosis of pleural NHL was made by biopsy for 31 of the patients and at autopsy for the other six. Histologically 30 (81%) of the 37 cases were of the diffuse large cell type, and of these the immunoblastic type was the most common (22 cases). Immunological and immunohistologic studies revealed a B-cell nature of the proliferating cells in all but one tumor. Thirty-two patients received chemotherapy and/or radiotherapy. Twenty-seven patients died between one and 144 (median eight) months of diagnosis. Autopsies carried out in 23 cases revealed the disease to have been localized to the thorax in 11 patients. These findings indicated that malignant B-cell lymphoma arose as a monoclonal growth from a pool of proliferating polyclonal B lymphocytes in tissues affected by the chronic tuberculous pyothorax.
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PMID:Non-Hodgkin's lymphoma of the pleural cavity developing from long-standing pyothorax. Summary of clinical and pathological findings in thirty-seven cases. 268 86

Fourteen cases of a mediastinal neoplasm identical to solitary fibrous tumor (so-called fibrous mesothelioma) of the pleura were observed. The lesions presented with cough, chest pain, dyspnea, or as asymptomatic masses detected radiographically. Two patients had associated hypoglycemia. Eleven of the tumors were in the antero-superior mediastinum. One arose on a pedicle from the thymus, and another had entrapped thymic elements. Tumor cells were variably immunoreactive for vimentin and actin, but not for keratin, and lacked ultrastructural evidence of mesothelial or epithelial differentiation. Eight cases had highly cellular mitotically active regions of which six of seven with follow-up behaved aggressively; the exception was the pedunculated tumor. A 13-cm, histologically bland tumor has recurred twice. Aggressive behavior was more common than reported for solitary fibrous tumor of the pleura, but the same criteria (size, cellularity, mitotic activity, presence of pedicle) were of prognostic significance. The occurrence of solitary fibrous tumor in the mediastinum with the suggestion of thymic origin for some cases, combined with the immunohistochemical and ultrastructural findings, support a mesenchymal origin for this tumor. The differential diagnosis includes spindle cell thymoma, hemangiopericytoma, and peripheral nerve tumors.
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PMID:Solitary fibrous tumor of the mediastinum. A report of 14 cases. 273 90

A 61-year-old man was admitted to our hospital with complaints of cough and left back and chest pain. He had suffered from left tuberculous pleurisy at the age of 20 years. Chest X-ray film and CT revealed atelectasis of the left lung, a left hilar mass and an irregular left atrial wall. Depressed P-Ta segment in the inferior limb and anterior chest leads and an abnormal P wave were found on ECG. Transbronchial lung biopsy showed squamous cell carcinoma. After radiation therapy, the patient complained of chest oppression. ECG revealed a normalized P-Ta segment deviation, markedly elevated ST segment in the inferior limb and lateral chest leads and a depressed ST segment in the anterior chest leads. These findings persisted until his death. An obscure appearance of the pericardium and an echogenic intramyocardial mass in the posteroinferior and lateral wall were evident by echocardiography. The patient died due to heart failure. Postmortem needle biopsy showed scattered intramyocardial tumor cell nests with keratinization. CPK, GOT and LDH were within normal limits throughout the course, but CPK-MB was slightly increased. Cardiac metastasis with an ECG appearance similar to that of acute myocardial infarction has been rarely reported. Our present case showed peculiar feature including 1) ECG findings similar to atrial and ventricular myocardial infarction, and 2) an echogenic intramyocardial mass and an ill-defined pericardium on echocardiography. These findings suggested direct invasion of squamous cell carcinoma of the lung to the ventricular myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Report of a case of lung cancer with metastasis to the myocardium which showed electrocardiographic findings similar to acute myocardial infarction and intramyocardial mass on echocardiography]. 274 Jun 46

We reported a case of spontaneous pneumothorax associated with pulmonary metastasis of urinary bladder carcinoma. A 73-year-old male patient complaining of chest pain and dyspnea was admitted, who had undergone transurethral resection of the urinary bladder carcinoma and diagnosis of inactive pulmonary tuberculosis based on the chest X-ray film finding one year previously. On admission, chest X-ray film showed right pneumothorax, and the re-expanded chest X-ray film revealed a cystic lesion in the right upper lung field adjacent to the anterior chest wall, corresponding to the previous pulmonary lesion. Three months later, right thoracotomy was performed because of relapse accompanying by profuse air-leakage. There was a pleural fistula on the surface of the cystic lesion and necrotic tissue in it. Drainage bronchi were involved by surrounding tumorous tissue. Histological examination of the specimen from the cyst wall disclosed metastasis of transitional cell carcinoma of the bladder. The probable mechanism of the spontaneous pneumothorax probable consisted of stenosis of the right B3 bronchus caused by the metastatic tumor produced a check valve mechanism leading to cystic lesion, the rupture of which caused the spontaneous pneumothorax.
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PMID:[A case of spontaneous pneumothorax due to metastasis of urinary bladder carcinoma to the lung]. 274 78

A scarce case of a rupture of thymic carcinoid followed by hemothorax and mediastinal enlargement was reported. And the mechanism of rupture of thymic carcinoid was discussed comparing to 38 thymic carcinoid cases reported in Japan. A 61-year-old male who had been pointed out mediastinal tumor by chance in a chest X-ray developed a sudden onset of chest pain and dyspnea during an aortography in a hospital transferred to our center because the rupture of the tumor was suspected. Emergency median sternotomy revealed a rupture of a solid tumor with a lot of clot which originally located in the anterior mediastinum but perforated into the right pleural space. This may be the first report of the ruptured thymic carcinoid, so far as we know in Japan. Reviewing the reported cases, the tumor of carcinoid is generally large in size and poorly differentiated in histological study. In more than half of the cases, it is reported that intraparenchymal necrosis or hemorrhage is found. Therefore, it is considered that a thymic carcinoid is a tumor which may result in the rupture, and it should be emphasized that the rupture of the thymic carcinoid which require an emergency treatment is one of the severe complications of the tumor.
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PMID:[A case report of ruptured thymic carcinoid]. 280 27

Major changes have recently occurred in the clinical presentation, diagnosis, and management of primary lesions of the mediastinum. New diagnostic techniques and improved therapy have led to more objective preoperative diagnoses as well as better long-term results. These features are clearly demonstrated in a series of 400 consecutive patients with primary lesions of the mediastinum seen at Duke University Medical Center. Of these, 99 (25%) had a primary cystic lesion. The primary tumors included thymic neoplasms (17%), neurogenic tumors (14%), lymphoma (16%), germ cell tumors (11%), and a miscellaneous group. Malignant neoplasms were present in 166 patients (42%). The anterosuperior mediastinum was the most commonly involved site of a primary cyst or neoplasm (54%), followed by the posterior mediastinum (26%) and the middle mediastinum (20%). Symptoms were present in 62% of the patients and included chest pain (30%), dyspnea (16%), fever and chills (20%), and cough (16%). Of the lesions found on routine chest roentgenograms, 83% were benign. In contrast, 57% of the lesions in symptomatic patients were malignant. Prior to 1967, 94% of asymptomatic lesions were benign, but this figure has now decreased to 76%. Fifty percent of symptomatic patients had a malignant neoplasm before 1967 compared with 62% after that year. Newer diagnostic techniques have greatly enhanced the accuracy of the preoperative diagnosis. They include radioisotopic scanning, monoclonal antibodies, hormonal assay, electron microscopy, fine-needle aspiration biopsy, computed tomographic scans, and magnetic resonance imaging. Each has a definite role and is specifically illustrated as being quite important in this series.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. 282 Mar 23

A 26-yr-old male was submitted to bilateral adrenalectomy in 1977 for Cushing's syndrome. Some months later he developed intense skin hyperpigmentation together with increased ACTH levels (149 to 4000 ng/l). The sellar region was always normal in X-ray studies. In April 1985, when the patient complained of chest pain, a chest x-ray showed a polycyclic mass in the upper left lobe of the lung. ACTH ranged from 20,000 to 100,000 ng/l, with no response to CRF or cyproheptadine administration. Urinary 5-OH-indolacetic acid was negative. Thoracotomy was performed in July 1985 with resection of two intrapulmonary masses. Histologic study demonstrated a carcinoid tumor, with positive neuron-specific enolase and ACTH immunochemical stain. ACTH concentration in tumoral tissue was 91 pg/g tissue. After surgery ACTH fell dramatically to 37 ng/l, and has remained at this level since then, associated with resolution of the skin hyperpigmentation.
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PMID:Diagnosis of lung carcinoid with cutaneous hyperpigmentation eight years after bilateral adrenalectomy. 283 Dec 64

Intrathoracic granular cell myoblastoma (GCM) is most commonly a benign neoplasm of Schwann cell origin that occurs in the large airways, the segmental bronchi, and rarely in the mediastinum. The tumor predominantly affects blacks during the fourth decade, and shows no sex predilection. Tracheobronchial GCM most commonly produces cough and chest pain, with focal consolidation or atelectasis shown on chest x-ray films. Extraesophageal mediastinal GCM produces few or no symptoms, and should be included in the differential diagnosis of a posterior mediastinal mass. Computerized tomography is helpful in evaluating the extent of the lesion, defining its relationship to adjacent structures, and planning the therapeutic approach. The diagnosis of tracheobronchial GCM usually can be made by bronchoscopy and/or biopsy. Treatment remains controversial, but most studies suggest surgical or endoscopic resection as the treatment of choice. The prognosis of intrathoracic GCM is good but is dependent upon complete removal.
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PMID:Intrathoracic granular cell myoblastoma. 284 28

Case reports are presented on 2 patients to show the importance of following up apparently false positive results of pregnancy tests. In case 1, a 25-year-old woman was admitted to the hospital with severe breathlessness in September 1987. After she had stopped using oral contraceptives (OCs) in 1985 her periods were irregular and on 4 occasions the results of pregnancy tests bought over the counter were positive. She was twice referred for ultrasound examinations, but the uterus was empty each time. In April 1987, dysfunctional uterine bleeding was diagnosed; she was treated with clomiphene. She then experienced intermittent pleuritic chest pain and breathlessness on exertion. In early September she was admitted with acute breathlessness and chest pain. A further pregnancy test was positive; results of laparoscopy of the pelvis were normal. A radioisotope ventilation-perfusion lung scan showed multiple filling defects in the left lung and no perfusion to the right. A presumptive diagnosis of choriocarcinoma was made with the syndrome of tumor growing in the pulmonary arteries. In case 2, a 32-year-old woman was admitted to the hospital in March 1988 with acute lower abdominal pain. A pregnancy test was positive, and she underwent laparoscopy for suspected ectopic pregnancy. A macroscopic tumor was found on the surface of the right ovary and a right salpingo-oophorectomy was performed. A subsequent histological examination showed choriocarcinoma. The 2 cases reported show the importance of seeking a definitive explanation for a false positive result of a pregnancy test. If the test has been performed correctly and proteinuria and drug interference, for instance, are ruled out, then a raised human chorionic gonadotropin concentration, particularly in young women, is virtually certain. In most cases this will be due to a pregnancy that ends in a 1st trimester abortion, but in a small minority it will be due to the hormone producing a tumor such as choriocarcinoma.
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PMID:Don't ignore a positive pregnancy test. 284 5

We studied a patient with a very small somatostatinoma that arose from the prominence of the orifice of the duct of Santorini. The patient presented clinically with epigastric discomfort, marked loss of weight, diarrhea, exertional dyspnea, and chest pain. He flushed intermittently and had occasional tachycardia and hypertension. Levels of serum serotonin and urinary 5-hydroxyindoleacetic acid were normal. A small ampullary tumor was resected and identified by immunohistochemical staining to be a somatostatinoma. The patient had gained 6.75 kg and was essentially free of symptoms 16 months after surgery.
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PMID:Early somatostatinoma of the papilla of the duct of Santorini. 286 41


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