1/88. CD5 positive breast carcinoma in a patient with untreated chronic lymphocytic leukaemia: molecular studies of chromosome 13q.A 67 year old woman presented with a right breast lump which proved to be a grade 2 invasive ductal carcinoma with axillary lymph node metastasis. She had a five year history of CD5 positive chronic lymphocytic leukaemia, which never required treatment. Immunoperoxidase stains for CD5, using the monoclonal antibody NCL-CD-54C7, showed that there was extensive infiltration of axillary lymph nodes with CD5 positive B lymphocytes. Strong staining for CD5 was also seen in the carcinoma cells within the breast and lymph node metastases. It has recently been suggested that there is a tumour suppresser locus in chronic lymphocytic leukaemia at 13q12.3 near or at the BRCA2 locus. Deletion of regions on chromosome 13q containing the BRCA2 and RB1 genes has also been reported in sporadic breast cancers. These observations suggest that there may be a link between these two diseases acting through chromosome 13, but amplification of several microsatellite repeat markers failed to show any loss of heterozygosity or repeat instability at either these or several other loci on chromosome 13. Examination of additional such cases is needed to perform a more comprehensive study of the significance of positive CD5 staining of breast carcinoma.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/88. Paget's disease of the vulva associated with local adenocarcinoma and previous breast adenocarcinoma: report of two cases.We report two women in whom vulval Paget's disease occurred in association with local adenocarcinoma and previous breast adenocarcinoma. The first patient presented at the age of 83 years with moist erythematous changes over the perineum and an indurated area near the anus. biopsy of the indurated area showed Paget's cells throughout the epidermis and, below, adenocarcinoma infiltrating the dermis. Ten years previously, she had undergone a left mastectomy for infiltrating ductal carcinoma of the breast. The second patient was diagnosed as having Paget's disease at the age of 74 years. A vulval biopsy showed Paget's cells in the epidermis but, in addition, there were changes suggestive of adenocarcinoma of the sweat glands. Her symptoms of vulval itching had started at the age of 45 years and had led to a simple vulvectomy at the age of 57 years. Retrospective review of this vulvectomy specimen showed Paget's disease. She had also previously been treated for infiltrating ductal adenocarcinoma of the breast and adenocarcinoma of the rectum. The management of Paget's disease is difficult because of its high recurrence rate and, as illustrated by our two cases, treatment is difficult if the patients are elderly and in poor general health.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/88. Synchronous primary cancers of the breast and cervix: planning multidisciplinary primary treatment [clinico-pathological conference]Multiple metachronous primary malignancies are becoming increasingly frequent; however, multiple synchronous primary malignancies are still unusual. We report the case of a 61-year-old woman with synchronous stage IIIB ductal carcinoma of the left breast and FIGO stage IB2 squamous cell carcinoma of the cervix. The patient was treated initially every 4 weeks with a 24-h intravenous infusion of paclitaxel (175 mg/m2) followed by a 1-h infusion of carboplatin (area under the curve of 5 mg/ml x min) with concurrent irradiation of the pelvis. Significant toxic reactions including nausea, vomiting, and diarrhea required hospitalization or outpatient intravenous fluids and antiemetics. After four cycles of chemotherapy, the breast cancer was in complete clinical remission, and the patient underwent a modified radical mastectomy with axillary lymph node dissection. Pathologic findings revealed a few microscopic foci of residual infiltrating ductal carcinoma exhibiting a marked treatment effect; none of the 14 axillary lymph nodes removed showed evidence of metastatic tumor. A near-complete pathologic response of the breast cancer and a complete clinical response of the cervical cancer were obtained. Adjuvant chemotherapy for the breast cancer was then initiated, followed by radiation and hormonal therapy.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
4/88. Adenomyxoma of eccrine sweat gland--case report.Although eccrine adenoma is usually situated on the distal portions of the extremities, we present a case localized in the vicinity of a mammary gland near axilla. The clinical diagnosis was of a mammary fibroadenoma with associated apocrine type of adenomere, supported by a myxomatous stromal tissue. The diagnosis was of an eccrine adenomyxoma. We continue with a review of the problems of microscopical differential diagnosis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
5/88. onycholysis as a complication of systemic chemotherapy: report of five cases associated with prolonged weekly paclitaxel therapy and review of the literature.BACKGROUND: onycholysis has been reported in association with the use of several noncytotoxic drugs and with chemotherapy in 135 patients. onycholysis may be precipitated by exposure to ultraviolet radiation. methods: The authors studied 91 patients who received paclitaxel and 187 patients who received doxorubicin. RESULTS: onycholysis occurred in 5 of 21 patients who received > 6 courses of weekly paclitaxel, developing in the summer months in all 5 patients. It did not occur in patients who received fewer weekly paclitaxel courses or those who were treated every 3 weeks. onycholysis did not occur in 187 patients who received doxorubicin. review of the literature revealed that onycholysis is nearly exclusively associated with anthracycline and taxane therapy. CONCLUSIONS: Prolonged weekly paclitaxel, other taxanes, and anthracyclines cause onycholysis in some patients, which may be precipitated by exposure to sunlight. patients receiving these drugs should protect their nails from sunlight.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/88. Cutaneous angiosarcoma in an irradiated breast after breast conservation therapy for cancer: association with chronic breast lymphedema.The authors report a rare case of cutaneous angiosarcoma arising more than 5 years after excision of a 1.5 cm invasive ductal cancer of the breast. All lymph nodes were negative for metastatic breast cancer in this 68-year-old female. The patient had postoperative therapy consisting of 5040 cGy over a 5 week period using a 6 Megavolt linear accelerator. After radiation therapy to the breast and axillae, the patient developed chronic hard, taut edema of the irradiated right breast. tamoxifen was administered for 5 years and then stopped. Three months after the cessation of tamoxifen, cutaneous angiosarcoma was found by skin biopsy. A complete mastectomy removed all tumor with clear margins. There are less than 60 cases of radiation associated breast angiosarcoma found in the literature. The presence of chronic lymphedema in the breast after radiation therapy possibly contributes to the development and is an early warning sign for later development of secondary angiosarcoma. The characteristic purple nodules and discoloration of the irradiated skin is the hallmark to suspect the diagnosis. The authors recommend long-term clinical surveillance for this tumor for all patients who have received breast conservative surgical therapy with concomitant radiation therapy for primary breast cancer.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
7/88. Scintigraphic evolution of a breast cancer with Tc-99m MIBI scintimammography.Early detection and prompt treatment of breast cancer are the main tools to decrease mortality rates. Several diagnostic techniques such as mammography, magnetic resonance imaging, and ultrasound are used, but none of these are conclusive. The authors describe a 56-year-old woman who was suspected of having breast cancer on mammography. Tc-99m MIBI scintimammography showed a small mass with elevated radiotracer uptake located near the pectoral muscle of the patient's left breast. The possible tumor was confirmed with fine-needle aspiration biopsy. After the diagnosis was established, the patient did not allow any treatment. Eighteen months later, a second scintimammography was performed, showing a large mammary tumor with a high radiotracer uptake, a new small lesion located in the left upper quadrant, and axillary lymph node involvement. Chemotherapy treatment was instituted and after treatment, Tc-99m MIBI scintimammography was normal. This case report provides further evidence for Tc-99m MIBI scintimammography for the detection of breast cancer as well as to evaluate the response to chemotherapy.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
8/88. Quantitative hemoglobin tomography with diffuse near-infrared spectroscopy: pilot results in the breast.The authors describe what is, to the best of their knowledge, the first quantitative hemoglobin concentration images of the female breast that were formed with model-based reconstruction of near-infrared intensity-modulated tomographic data. The results in 11 patients, including two with breast tumors with pathologic correlation, are summarized. Hemoglobin concentration appears to correlate with tumor vascularity without the need for exogenous contrast material and thereby has intrinsic diagnostic value.- - - - - - - - - - ranking = 5keywords = near (Clic here for more details about this article) |
9/88. An unusual tumour metastasis to the cervix.INTRODUCTION: The vast majority of tumours in the cervix are either primary carcinomas or direct extension of primary tumours from nearby sites such as the endometrium, myometrium, rectum and bladder. patients usually present with abnormal bleeding, pain and dyspareunia. A smaller number of patients are asymptomatic and their tumours can be diagnosed early by PAP smears. CLINICAL PICTURE: We present an unusual case of an elderly lady with breast cancer that had metastasized to the cervix 4 years after primary treatment of the breast malignancy. Although the appearance of the cervix was "normal looking", it was firm and indurated on palpation. pathology: A definite diagnosis of metastatic infiltration could only be made by colposcopic biopsy. Early PAP smears had shown some abnormal cells suggestive of metastatic lobular carcinoma but were not conclusive of metastasis from breast carcinoma. Subsequent bone scans and CT scans of the abdomen revealed metastatic lesions in the skull, spine, left femoral shaft and liver.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
10/88. Intravascular lymphomatosis presenting within angiolipomas.This report presents a case of intravascular lymphomatosis identified within an angiolipoma. The patient was a 73-year-old woman with a history of lobular carcinoma of the breast who presented with a chest wall nodule near the site of prior mastectomy. Microscopically, the nodule was composed of encapsulated adipose tissue with an associated vascular proliferation. Many of the vascular lumina were expanded by collections of large pleomorphic cells with vesicular nuclei and prominent nucleoli. These atypical cells displayed immunoreactivity for CD45RB (leukocyte common antigen) and the pan-B cell marker CD20 (L26). The patient subsequently developed multiple lesions of the extremities and died soon after developing symptoms referable to the central nervous system. Intravascular lymphomatosis most commonly presents with central nervous system and dermatologic involvement although any organ system may be affected. Intravascular lymphomatosis is an aggressive neoplasm that is generally diagnosed at postmortem examination. This case shows the protean manifestations of intravascular lymphomatosis and highlights the necessity of considering this malignancy in the differential diagnosis when entertaining the diagnosis of vascular invasion by carcinoma. Ann Diagn pathol 5:103-106, 2001. This is a US government work. There are no restrictions on its use.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
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