1/17. Metastatic carcinoid to the conducting system-is it a rare or merely unrecognized manifestation of carcinoid cardiopathy?We report a unique case of carcinoid cardiopathy. The patient, a 59-year-old white woman with a known carcinoid tumor of the terminal ileum, presented with complete heart block and subsequently died. Because of her clinical presentation, we examined the conducting system at autopsy. The atrioventricular node was heavily infiltrated by metastatic carcinoid. The tumor was also seen in the surrounding atrial myocardium. No other metastatic lesions were seen in the heart. Carcinoid cardiopathy in the form of right-sided endocardial and valvular thickening has been well documented in the literature, and we found these features in our case as well. To our knowledge, carcinoid has never been documented in the cardiac conducting system until now. We found 2 cases of possible involvement of the conducting system reported in the literature. Unfortunately, the conducting system was not examined postmortem in either of these cases. If conducting system involvement is not unique to the present case, patients with metastatic carcinoid and cardiac problems may require different management. We hope that this case will stimulate further postmortem study of the conducting system in patients with metastatic carcinoid tumor.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
2/17. Midgut carcinoid tumor identified from a metastasis in the uterosacral ligament.Chronic pelvic pain is common in women of reproductive age and accounts for more than 40% of all laparoscopic procedures. In up to 40% of these patients laparoscopic findings are negative. As a result, many gynecologists frequently excise portions of the uterosacral ligaments and biopsy inconspicuous pelvic lesions in an effort to perform uterosacral nerve ablation and also to identify subclinical endometriosis. During diagnostic laparoscopy for chronic intermittent pelvic and abdominal pain, a 37-year-old woman was noted to have an incidental, 5-mm, pink-white nodule in the right uterosacral ligament. Pathologic examination reported features typical of a carcinoid tumor. Further evaluation by computerized tomographic scan and indium-III octreotide scan identified a 1.6-cm lesion in the mesentery. At laparotomy a 2-cm primary mucosal tumor in the terminal ileum and a 2-cm nodule in the adjacent mesentery were present. carcinoid tumor was confirmed in 2 nodules and in 7 of 17 mesenteric lymph nodes. liver and lung metastases were not seen.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
3/17. Jejunoileal alveolar rhabdomyosarcoma. A case report.Intestinal localization of rhabdomyosarcoma is exceptional, this case is the first to be published in the world literature. A 35-year-old patient with abdominal pain, fever, was found to have an infiltrative white-grey tumour, involving 20 cm the jejunoileal wall and also the surrounding mesenterium up to the origin of upper mesenterical vessels and lymph nodes. Histologic examination showed an alveolar type of rhabdomyosarcoma intricated with solid undifferentiated tumoral cells. The presence of multinucleated giant cells and the positivity of protein s 100 reaction was important for differential diagnosis, given the alveolar soft part sarcoma, malignant mesothelioma, malignant melanoma or papillary carcinoma.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
4/17. Hemophagocytic syndrome in ileum-origin B-cell lymphoma.A 56 year-old-man was admitted due to upper abdominal tumor and was diagnosed as having stage IVb diffuse B-cell malignant lymphoma that originally developed in the terminal ileum. The first and the second administrations of CHOP (cyclophosphamide, 750 mg/m(2); adriamycin, 50 mg/m(2); vincristine, 1.4 mg/m(2); and prednisolone, 100 mg/day) therapy were effective; however, the third course of therapy was postponed because of an episode of massive hematochezia. After this episode, lymph nodes began to enlarge and progressive pancytopenia occurred. bone marrow smear showed the proliferation of reactive histiocytic cells which phagocytized red blood cells, white blood cells, and platelets. B-cell lymphoma-associated hemophagocytic syndrome (B-LAHS) was diagnosed. This case is extremely rare because: (1) LAHS occurred in an ileum-origin B-cell lymphoma, and (2) LAHS developed during an interval after chemotherapy.- - - - - - - - - - ranking = 44.843854621952keywords = blood cell, white (Clic here for more details about this article) |
5/17. An unusual case of peripheral T-cell lymphoma with CD56 positivity and angiocentric, angiodestructive morphology arising in the ileum.Natural killer cell and cytotoxic T-cell lymphomas are frequently difficult to distinguish because they share many common features, and yet it is important to make an accurate diagnosis because their prognoses differ. We report an unusual case of a white man with a CD56-positive T-cell lymphoma in the ileum. The histologic pattern was characterized by angioinvasion and angiodestruction. Immunohistochemical staining showed positive reactions to CD3, CD8, CD43, CD45RO, CD56, and T-cell intracellular antigen-1, but negative reactions to CD4, CD5, CD20, CD23, and CD57. Epstein-Barr virus (EBV) was not detected by EBV-latent membrane protein staining and EBV polymerase chain reaction technique. The T-cell receptor gamma chain gene was rearranged. According to the world health organization classification, the absence of EBV excludes the diagnosis of extranodal natural killer/T-cell lymphoma, nasal type. However, the association of EBV with this lymphoma in white patients is not clear. Therefore, absence of EBV alone does not necessarily exclude nasal-type natural killer/T-cell lymphoma, particularly because the histologic pattern in this case is highly characteristic of this tumor.- - - - - - - - - - ranking = 2keywords = white (Clic here for more details about this article) |
6/17. Primary squamous-cell carcinoma of the small bowel. Report of a case.This is the first case report of a primary, pure squamous-cell carcinoma of the small bowel. Small bowel cancer represents only 1 to 2 percent of all gastrointestinal malignancies. Over 35 different histologic types of small bowel tumors have been described. By far, most small bowel epithelial tumors are metastatic. A 65-year-old white female presented with abdominal pain, melena, and hematochezia and was found to have a 5.5-cm, ulcerated, well-differentiated, keratinizing, squamous-cell carcinoma of the terminal ileum.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
7/17. Solitary intestinal fibromatosis: a rare cause of intestinal obstruction in neonate and infant.A 5-month-old white boy infant exhibited remarkable growth retardation and subsequently developed ileal obstruction, which was found to be due to solitary intestinal fibromatosis. This rare lesion has an excellent prognosis if it is completely excised. This is in contrast to cases of congenital fibromatosis with multiple lesions, which carries a poor prognosis.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
8/17. Granulomatous myocarditis with unusual histologic features.A 61-year-old white man was found to have granulomatous myocarditis associated with a carcinoid tumor in the ileum with local lymphatic metastasis, a mixed papillary and follicular carcinoma of the thyroid with regional lymph node metastasis, benign tubular cell adenomas of the kidneys, and chronic pancreatitis.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
9/17. Perforation of the terminal ileum with cytomegalovirus vasculitis and Kaposi's sarcoma in a patient with acquired immunodeficiency syndrome.This case report documents a perforation of the terminal ileum in a 40-year-old white male homosexual with the acquired immunodeficiency syndrome. The perforation occurred at a site that had severe cytomegalovirus infection and was in close proximity to multiple nodules of Kaposi's sarcoma. The ileum showed multiple deep ulcers with large numbers of cytomegalovirus inclusions and vasculitis with infected endothelial cells, small-vessel thrombosis, focal disruption, and hemorrhage. We review the evidence that cytomegalovirus infection--and not Kaposi's sarcoma--was responsible for this perforation and, in light of the new medical therapy for such infections, should be regarded as an important cause of gastrointestinal perforation in patients with the acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
10/17. Endoscopic diagnosis of lymphangioma of the small intestine.In three patients with lymphangioma of the small intestine, the preoperative diagnosis of lymphangioma was made by endoscopy with biopsy and radiology. A typical endoscopic finding was an elevated polypoid tumor, yellowish-white to tan. The surface was smooth, often with white specks, and could be impressed by touching lightly with biopsy forceps. Endoscopic examination revealed satellite lesions not detected radiologically. lymphangioma has heretofore been successfully diagnosed preoperatively by endoscopy in the duodenum. This report of accurate preoperative diagnoses of lymphangioma in the small intestine, other than the duodenum, using endoscopy, may be the first to be documented.- - - - - - - - - - ranking = 2keywords = white (Clic here for more details about this article) |
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