1/656. p53 gene mutation in 150 dissected lymph nodes in a patient with esophageal cancer.For thoracic esophageal cancer, we perform extended three field lymph node dissection, and have achieved nearly 50% of overall 5-year survival. However, patients sometimes develop lymph node recurrences in spite of having no lymph node metastases found by conventional histopathologic examination. In a patient with esophageal squamous cell carcinoma, we sequenced all the p53 cDNA translated regions (exon 2-10) of primary carcinoma, and confirmed one p53 nonsense mutation in exon 10. Then we extracted genomic dna from 150 surgically dissected lymph nodes from that patient, and performed polymerase chain reaction analysis (PCR-RFLP) to detect the same p53 mutation in the lymph nodes. PCR-RFLP analysis showed the same p53 mutation in six lymph nodes. One node was located along the right recurrent laryngeal nerve, where no positive nodes was identified by conventional histopathologic examination. The p53 mutational diagnosis of metastatic cancer may be useful in detecting minimal residual disease.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/656. A case of advanced esophageal cancer showing a long-term complete response with chemotherapy with nedaplatin alone.We describe a case of advanced esophageal cancer treated successfully by chemotherapy with nedaplatin alone. A 60-year-old male with type 2 advanced esophageal cancer, which was located in the upper part of the esophagus and had invaded adjacent organs, was treated with nedaplatin 150 mg/body (100 mg/m2) given intravenously every 4 weeks from January 6, 1991. He achieved a partial response (PR) and was discharged in March 1991. Subsequently, he received nedaplatin 75 mg/body in an out-patient setting almost every month until August 1992. Toxicities were tolerable and included mild thrombocytopenia and nausea/vomiting. From serial evaluation in October 1993, the esophageal tumor was not observed. After 7 years since initial chemotherapy was administered, he still survives without the disease.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
3/656. Double cancers of the lung and esophagus associated with a sarcoid-like reaction in their regional lymph nodes: report of a case.A case of double cancers of the lung and esophagus associated with a sarcoid-like reaction in their regional lymph nodes is reported. A 73-year-old man with hemosputum was found to have a mass in his right lower lung field on a chest X-ray. Based on a diagnosis of lung cancer, a right middle and lower lobectomy with a dissection of the lymph nodes was performed. Microscopically, a well developed granulomatous reaction was seen in the dissected mediastinal and hilar lymph nodes. Three years after the pulmonary resection, he was admitted to our hospital because of dysphagia. A diagnosis of lower esophageal cancer was made. A lower esophagectomy with a total gastrectomy was performed. A sarcoid-like reaction comprising epithelioid cells and giant cells was seen in the regional lymph nodes. No clinical findings indicative of systemic sarcoidosis were observed. This rare condition may therefore help to improve our overall understanding of the relationship between malignant neoplasms and sarcoid-like reactions in the regional lymph nodes.- - - - - - - - - - ranking = 1.1855394551722keywords = cancer, neoplasm (Clic here for more details about this article) |
4/656. Benign schwannoma of the digestive tract: a clinicopathologic and immunohistochemical study of five cases, including a case of esophageal tumor.We report five cases of schwannomas of the digestive tract. The patients were two men and three women, whose ages ranged from 56 to 74 years. Three cases arose in the stomach, one in the ascending colon, and one in the esophagus; the latter was a hitherto unreported location for this tumor. The schwannomas ranged from 2 to 11 cm in diameter. They were well circumscribed but not encapsulated, with interlacing bundles of spindle cells, nuclear atypia and no mitosis, interspersed with collagenous strands. Inflammatory cells were scattered throughout the tumors and a peripheral cuff of lymphoid aggregates was observed in all cases. Intracellular periodic acid-Schiff (PAS)-positive crystalloids were found in three cases; no skeinoid fibers were seen. A diffuse and intense positivity for vimentin and S-100 protein was detected in all five cases together with a variable and sometimes focal positivity for glial fibrillary acidic protein and neuron-specific enolase. None of the tumors showed expression of CD34 or the smooth muscle antigens tested. The four cases with a sufficient follow-up had a favorable outcome without any recurrence or metastasis. The morphologic and immunohistochemical features of digestive schwannomas were compared with those of other gastrointestinal stromal tumors. Schwannomas have many differences. Digestive schwannomas can be readily recognized on histologic and immunohistochemical examination. They are spindle cell tumors without epithelioid features, with a peripheral cuff of lymphoid tissue. Specific intracellular needle-shaped PAS-positive crystalloids are found in some cases, whereas skeinoid fibers are not. These tumors always express S-100 protein in a diffuse and strong manner, and they express glial fibrillary acidic protein but not express CD34. Digestive schwannomas usually are gastric tumors and have never been reported in the small bowel. They pursue a benign course and are far rarer than gastrointestinal autonomic nerve tumors.- - - - - - - - - - ranking = 1.8575222733999keywords = digestive (Clic here for more details about this article) |
5/656. A novel clinical application for endoscopic mucosal clipping.BACKGROUND: Endoscopic hemoclipping has been shown to be effective in the treatment of gastrointestinal bleeding. Here we describe a novel clinical application for endoscopic application of metal clips. methods: A middle-aged man with inoperable squamous cell cancer of the esophagus underwent per protocol a barium esophagogram to document tumor margins prior to radiation therapy. This study failed to localize the full extent of the tumor. At endoscopy, the tumor margins were clearly visible. To delineate the proximal and distal margins, detachable metallic clips were passed through the accessory channel of a standard endoscope and using a clip fixing device the clips were placed at each level. Subsequently, a chest x-ray was obtained. RESULTS: Placement of mucosal clips facilitated radiotherapy. CONCLUSIONS: Endoscopic mucosal clipping may serve as a useful technique for localizing or marking gastrointestinal lesions, especially for demarcating a precise radiation field when conventional techniques fail.- - - - - - - - - - ranking = 0.16666666666667keywords = cancer (Clic here for more details about this article) |
6/656. Malignant melanoma of the oesophagus: clinicopathological features, lack of p53 expression and steroid receptors and a review of the literature.AIMS: Fortunately, primary malignant melanoma of the oesophagus is a rare entity. The aims of this study were to evaluate the clinicopathological features, p53 over-expression and steroid receptors in oesophageal melanomas and to review the reported cases in the literature. methods: Melanomas reported during a 15-year period (1982-1996) in the Queen Mary Hospital were studied. The clinicopathological features and survival data of patients with oesophageal melanomas were noted. Representative tissue was collected from each tumour and immunohistochemical preparations for HMB-45, p53, oestrogen and progesterone receptors were made. A review of oesophageal melanomas reported in the literature was also performed. RESULTS: Three cases of primary malignant melanoma of the oesophagus were found. They accounted for 3% of melanomas and 0.2% of oesophageal cancers diagnosed. The melanomas were fusiform and large at the time of resection. All three patients died of their malignancy within 9 months of operation. The tumours stained positive for HMB-45 and were negative for p53, oestrogen and progesterone receptors. From previous reports, 154 oesophageal melanomas were documented. The tumours were fusiform, large, often pigmented and located in either the middle or lower oesophagus. Although many oesophageal melanomas presented at early stages (stages I or II), their biological behaviour was aggressive. The 5-year survival rate was 5.7%. CONCLUSIONS: melanoma of the oesophagus is an aggressive tumour. There is no evidence for the p53 gene and female sex hormones having a role in the development or progression of the tumour.- - - - - - - - - - ranking = 0.16666666666667keywords = cancer (Clic here for more details about this article) |
7/656. Giant fibrovascular polyp of the esophagus.Giant fibrovascular polyps (FVP) are the most common intraluminal tumors of the esophagus. The case of a second, nonrecurrent FVP is presented. A thorough review of the literature was conducted to provide an informative discussion on this benign but potentially life-threatening neoplasm.- - - - - - - - - - ranking = 0.018872788505524keywords = neoplasm (Clic here for more details about this article) |
8/656. radiation-induced esophageal carcinoma 30 years after mediastinal irradiation: case report and review of the literature.A 54-year-old man who had been irradiated in 1964 for cervical involvement by Hodgkin's disease was admitted in December 1994 to our clinic with strong complaints of dysphagia. The reason was a moderately differentiated squamous cell carcinoma of the proximal esophagus in the previously irradiated region. The patient had no risk factors (abuse of nicotine or alcohol) for the developement of esophageal carcinoma. A reirradiation was performed, but the disease progressed locally and two weeks after the beginning of the therapy the patient developed two tracheoesophagocutaneous fistulae. The radiation therapy was discontinued and the tumor stenosis was bridged by a tube closing the fistulae. A retrospective dose analysis to evaluate the applied doses will be performed. Furthermore, an overview of 66 cases of the literature with radiation-induced esophageal carcinoma analysed concerning applied dose and latent interval will be given. In conclusion the reported case fits the criteria for radiation-induced malignancies (Chudecki Br J Radiol 1972;45:303-4) known from literature: (1) a history of previous irradiation, (2) a cancer occurring within the irradiated area, (3) gross tissue damage due to an excessive dose of radiation, and (4) a long latent interval between irradiation and development of cancer. Esophageal carcinomas belong to the rare secondary malignancies after the therapeutic use of ionizing radiation. Nevertheless in patients with dysphagia they should be suspected as a differential diagnosis even many years after mediastinal irradiation. The treatment of these tumors is very difficult and is associated with a poor prognosis.- - - - - - - - - - ranking = 0.33333333333333keywords = cancer (Clic here for more details about this article) |
9/656. Anitschkow cells in the human heart.A case of multiple myeloma, who died of congestive heart failure of unknown cause, is presented. Microscopically, Anitschkow cells with caterpillar and owl-eyed nuclei were scattered in the interstitium of the myocardium. To know the pathological significance of their appearance, histological observations of normal, developing and autoimmune disease-bearing heart specimens were made. A few Anitschkow cells were commonly seen in the interstitium of the adult heart with or without autoimmunity, and fetal cardiomyocytes often showed Anitschkow-type nuclear configurations. Moreover, squamous cancer cells metastatic to the myocardium exhibited Anitschkow-type nuclei. No Anitschkow-type nuclei were observed in extracardiac locations. In conclusion, formation of Anitschkow-type nuclear features in the human heart is not necessarily specific to the autoimmune status, but can be regarded as being ubiquitously provoked by the continuous contraction of heart muscle cells.- - - - - - - - - - ranking = 0.16666666666667keywords = cancer (Clic here for more details about this article) |
10/656. Massive pleural effusion and ascites resulting from esophagectomy with extensive lymphadenectomy for cancer of the abdominal esophagus.chylothorax is an uncommon but well recognized complication of esophagectomy. We present the case of a 57 year-old man with squamous cell carcinoma of the abdominal esophagus who underwent subtotal esophagectomy by right thoracotomy. Post-operatively, the volume of pleural effusion from the right chest was increased (1600-2000 ml/day). The effusion was straw colored, not changing to milky after meals. The characteristics and composition of the pleural fluid were similar to those of chyle. We therefore treated this patient using methods for treatment of chylothorax, conservatively, by administration of OK-432 and minocycline/hydrochloride into the pleural cavity from the chest tube with success. We discuss the pathophysiology of this unusual condition and its treatment.- - - - - - - - - - ranking = 0.66666666666667keywords = cancer (Clic here for more details about this article) |
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