Cases reported "Pleural Effusion"

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1/115. dermatomyositis and peritoneal papillary serous carcinoma.

    We describe an unusual case of peritoneal papillary serous carcinoma (PPSC) arising in a female patient with dermatomyositis (DM). Despite periodic extensive searches for an underlying malignancy, no malignancy had been detected in this patient during the first 2.5 years after the diagnosis of DM. It was only when the patient presented with pleural effusion and ascites that the underlying intra-abdominal malignancy was detected by laparoscopy. Treatment with four cycles of pre-operative chemotherapy (taxol and cisplatin) resulted in tumor regression with amelioration in the muscular manifestation of the DM, but without parallelic amelioration in the skin manifestations of the DM. Explorative laparotomy confirmed the presence of papillary serous carcinoma in the omentum, surface of the left ovary and the retroperitoneal lymph nodes, and established the diagnosis of PPSC. Following two cycles of postoperative chemotherapy, the patient is alive with no evidence of internal malignancy. However, although muscle strength and enzymes have remained normal, no effect on the skin manifestation of DM has been observed. This case illustrates that, alongside the more frequently occurring ovarian carcinoma, PPSC should also be considered in the differential diagnosis of the underlying malignancy that may occur in the female patient with DM.
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ranking = 1
keywords = carcinoma
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2/115. 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.
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ranking = 0.14285714285714
keywords = carcinoma
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3/115. Thoracic blastomycosis and empyema.

    blastomycosis is endemic in river valley areas of the southeastern and midwestern united states. Pulmonary manifestations include chronic cough and pleuritic pain. Radiographic appearance of the infection can mimic bronchogenic lung carcinoma. pleural effusion is rarely associated with this pulmonary infection, and empyema has not been previously reported. We report a case of pulmonary and pleural blastomyces dermatitidis infection presenting as empyema thoracis. diagnosis and treatment were attained with video-assisted thoracoscopic (VATS) pleural and lung biopsy and debridement.
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ranking = 0.14285714285714
keywords = carcinoma
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4/115. Relation between cell composition of pleural effusions in patients with pulmonary carcinomas and their clinical courses.

    1) Cancer cells of the effusions were decreased by chemotherapy, but this did not always indicate a good clinical course. 2) When the clinical condition was fairly good, the percentage of lymphocytes predominated in the pleural effusion. 3) When the clinical conditions became rather critical, there was an increase in the number of macrophage. 4) The cytologic findings were observed prior to the time the clinical symptoms became manifest. 5) The percentage of lymphocytes and macrophages in pleural effusions was not related to the percentage of lymphocytes and monocytes in peripheral blood.
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ranking = 0.57142857142857
keywords = carcinoma
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5/115. Neutrophilia associated with anaplastic carcinoma of the thyroid: production of macrophage colony-stimulating factor (M-CSF) and interleukin-6.

    Cancers associated with marked neutrophilia are relatively rare. We report here two cases of anaplastic thyroid carcinoma associated with neutrophilia. We measured the concentrations of granulocyte colony-stimulating factor (G-CSF), macrophage CSF (M-CSF), granulocyte-macrophage CSF (GM-CSF), interleukin-1alpha (IL-1alpha), IL-1beta, IL-6, and tumor necrosis factor-alpha (TNF-alpha) in sera, pleural effusion, cyst fluid of the thyroid carcinoma region, or culture supernatants of carcinoma cells. Maximum levels of elevated white blood cell counts reached 106.1 x 10(9)/L (neutrophils 103.0 x 10(9)/L) in case 1 and 62.3 x 10(9)/L (neutrophils 57.9 x 10(9)/L) in case 2. Acute-phase reactants were elevated to various degrees, and hypercalcemia was found in both cases. IL-6, G-CSF, and M-CSF seemed to play the principal roles in neutrophilia in case 1, and the elevated levels of IL-6 and M-CSF seemed to mainly contribute to neutrophilia in case 2. Immunohistochemical staining revealed that carcinoma cells themselves produce IL-6 regardless of the types of carcinoma cells. To our knowledge, this is the first report describing the contribution of M-CSF to neutrophilia in patients with thyroid carcinoma.
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ranking = 1.4285714285714
keywords = carcinoma
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6/115. adrenocortical carcinoma in two female children.

    adrenocortical carcinoma is a rare tumor in children. This tumor is more likely to be hormonally active in children than in adults and tends to cause a variety of symptoms, which may mimic other benign endocrinopathies. These tumors are usually diagnosed at advanced stages and portend a dismal prognosis. We describe two cases of adrenocortical carcinoma. One child presented with Cushingoid symptoms secondary to hypercortisolism, including amenorrhea, hirsutism and weight gain. The other child presented with precocious puberty. Both children underwent resection of the tumors. We describe their presenting symptoms, postoperative course, adjuvant therapy and clinical course. Pertinent literature regarding the anatomy of the adrenal gland, pathology of adrenocortical carcinoma, factors influencing outcome, diagnostic modalities and treatment, are discussed.
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ranking = 1
keywords = carcinoma
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7/115. Recurrent ascites and pleural effusions after surgery for early-stage endometrial adenocarcinoma.

    A case of massive postoperative ascites in a woman treated for endometrial cancer is reported. A workup for typical causes of ascites yielded negative results, prompting a more detailed analysis of the patient's condition. hypothyroidism was discovered. After correction of the hypothyroidism, the ascites slowly resolved. Since myxedema is an uncommon cause of ascites, this is usually a diagnosis of exclusion. However, hypothyroidism must be ruled out to prevent unnecessary and possibly inappropriate treatments for ascites.
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ranking = 0.71073553157747
keywords = carcinoma, adenocarcinoma
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8/115. The detrimental role of colloidal volume substitutes in severe ovarian hyperstimulation syndrome: a case report.

    Although, the mechanisms for the development of ovarian hyperstimulation syndrome (OHSS) are still not clear, the symptoms usually correlate with the levels of serum estradiol and ovarian enlargement. We report a case, where the clinical course was unusually prolonged. When menstrual bleeding had already occurred, serum estradiol was less than 10 pg/ml and the ovaries were almost normal in size, the patient developed pleural effusion and a significant alteration in blood-coagulation. This was most likely caused by an over-infusion of hydroxyethyl starch (HES) over 10 days. The pleural effusion contained high levels of HES, reaching 74% of the plasma concentration as measured by a novel method after acidic hydrolysis of HES. carbohydrates as dextran and HES are well known to interact with the blood-coagulation system. Increase capillary permeability, typical of OHSS, leads to loss of colloidal substances into the third space, where HES is slowly degraded and osmotic pressure is high. This might prolong and aggravate the urine of OHSS.
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ranking = 0.32230007068424
keywords = colloid
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9/115. Successful treatment of metastatic hormone-refractory prostate cancer with malignant pericardial tamponade using docetaxel.

    Reports of malignant pericardial effusion due to adenocarcinoma of the prostate are few and describe only patients with hormone-naive disease. We report a case of malignant pleural and pericardial effusions due to metastatic hormone-refractory prostate cancer. Despite presenting with pericardial tamponade, this patient was successfully treated with pericardiocentesis and intrapericardial methylprednisolone and cisplatin, followed by a course of intravenous docetaxel. The patient was alive and free of disease-related symptoms nearly 2 years later. This case suggests that patients with pericardial tamponade due to hormone-refractory prostate cancer do not have a uniformly dismal prognosis and should be considered for aggressive treatment.
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ranking = 0.17768388289437
keywords = carcinoma, adenocarcinoma
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10/115. chromosomes and causation of human cancer and leukemia. X. Banding patterns in cancerous effusions.

    cells from five cancer effusions (two ovarian carcinomas, two lung cancers, and one carcinoma of the breast) were analyzed by G-, C-, and Q-banding techniques. The following observations were made: 1) The origin of some marker chromosomes could be traced accurately by these banding techniques. 2) Several chromosomes, which appeared normal with conventional staining techniques, were found to be re-arranged ones and, hence, abnormal. 3) chromosomes No. 1, No. 3 and No. 11 were the most frequently involved in aberrations, whereas No. 12, No. 13, No. 17-20, and No. 22 Were least frequently involved. Only in one case each was the x chromosome or the y chromosome involved in aberrations. The y chromosome was found to be missing in all cancer cells of one lung cancer. 4) Each effusion had characteristic markers, invariably present in each cell, whether the cells were near diploid, or polyploid. 5) No common markers were observed in the two ovarian carcinomas studied, whereas the two lung cancers had a few common markers.
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ranking = 0.42857142857143
keywords = carcinoma
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