1/154. Fine needle aspiration diagnosis of extraadrenal myelolipoma presenting as a pleural mass. A case report.BACKGROUND: myelolipoma is a benign tumor composed of mature adipose tissue and hematopoietic cells. Although they are commonly found in adrenal glands, extraadrenal myelolipomas (EMLs) are rare but well documented. They have been found in various sites, including mediastinum, liver, stomach, lungs, pelvis, spleen, retroperitoneum, presacral region and mesentery. EMLs must be distinguished from extramedullary hematopoieses, which are also composed of hematopoietic elements but may lack adipose tissue and are associated with anemia and marked bone marrow hyperplasia. CASE: We describe a case of a pleura-based, extraadrenal myelolipoma in a 53-year-old female with unremarkable bone marrow findings that were initially encountered on fluoroscopy-guided fine needle aspiration (FNA). One year later the mass was removed via open thoracotomy. It showed typical EML features histologically. CONCLUSION: EML manifests on aspiration cytology as a cellular specimen with numerous trilineage hematopoietic cells and a variable proportion of mature adipose cells. To our knowledge, FNA cytology of EML has not been found in this location before. Aspiration biopsy offers a simple and reliable method for the diagnosis of EML in the presence of appropriate clinical settings.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
2/154. Subcutaneous seeding after ultrasound-guided placement of intrapleural catheter. An unusual complication of the intracavitary palliative treatment of pleural mesothelioma.Intrapleural catheters are useful in the palliative treatment of malignant effusions. Complications are infrequent and of little importance. We report a case of subcutaneous implantation metastasis along the course of intrapleural catheter, which had been placed under sonographic guidance in a patient with pleural mesothelioma. After drainage of the effusion, cisplatin plus cytarabine was administered via the chest tube, achieving complete remission of the pleural effusion. Subcutaneous metastasis became evident 3 months later and was the only sign of disease progression for 2 months. The seeding of cancer cells was probably caused by a small leakage of fluid around the chest tube that occurred during the placement procedure as a result of the increased intrapleural pressure caused by the large quantity of fluid that had accumulated in the pleural space.- - - - - - - - - - ranking = 22.142814354517keywords = cancer (Clic here for more details about this article) |
3/154. Unilateral absence of lung perfusion on pulmonary scintigraphy secondary to lung cancer with extensive pleural metastases from lung cancer.A man with a 20-year history of smoking who underwent Tc-99m MAA Pulmonary perfusion imaging, which showed virtually absent perfusion of the right lung and fairly normal perfusion of the left lung. Eighteen days after the study, the patient died; at autopsy poorly differentiated carcinoma of the right lung was confirmed, which included extensive thickened pleura and plaques deposits and compression of the right lung; 200 ml of bloody pleural effusion was also found on the right side. The unilateral absence of lung perfusion on Tc-99m MAA pulmonary scintigraphy might reflect the autopsy findings of the right lung and pleura.- - - - - - - - - - ranking = 177.14251483613keywords = cancer (Clic here for more details about this article) |
4/154. Spinal epidural abscess complicating chronic epidural analgesia in 11 cancer patients: clinical findings and magnetic resonance imaging.We reviewed the records of all patients who had received an epidural catheter for management of chronic cancer pain in a 3-year period (1993-1996). patients with nervous system infections were identified, and pertinent clinical, radiological (magnetic resonance imaging), and bacteriological data were analyzed. We identified 11 patients who developed spinal epidural abscess (SEA). All of these had back pain; radicular signs occurred in seven patients and spinal cord compression in two patients. magnetic resonance imaging revealed SEA in all 11 patients. SEA was iso- to hypointense on T1-weighted images and hyperintense on T2-weighted images relative to spinal cord. After gadolinium administration seven lesions showed characteristic rim enhancement while three showed minimal enhancement. No signs of diskitis or osteomyelitis were present, and the abscess was always localized to the posterior epidural space. Cultures were positive in all cases and revealed staphylococcus epidermidis in eight and S. aureus in three. All patients were treated with intravenous antibiotics, and four had an additional decompressive laminectomy. Two patients died within 1 week of diagnosis from overwhelming septicemia despite apparently adequate antibiotic treatment. Within 4 weeks after diagnosis of SEA two patients died from widely metastatic disease, although infection may have contributed. One patient developed septicemia while receiving appropriate antibiotics and underwent emergency laminectomy. The neurological deficits recovered in all patients who survived the acute infectious episode. We conclude that patients with chronic epidural catheters for cancer pain require prompt neurological evaluation and magnetic resonance imaging when SEA is suspected. Early evaluation and treatment may lead to full recovery.- - - - - - - - - - ranking = 132.8568861271keywords = cancer (Clic here for more details about this article) |
5/154. Pleuropulmonary blastoma and ovarian teratoma.We report a patient with pleuropulmonary blastoma who had a benign teratoma as a second primary tumor. The radiology, clinical course, and the biological importance of this rare neoplasm are discussed.- - - - - - - - - - ranking = 123.62097798122keywords = neoplasm (Clic here for more details about this article) |
6/154. The cytomorphology of pleuropulmonary blastoma.Pleuropulmonary blastoma is a rare, primitive primary neoplasm of the thorax in young children. The tumor, which is often but not always associated with cystic lung lesions, may arise in pulmonary parenchyma, the mediastinum, and pleura. Histologically, it is characterized by a biphasic neoplastic population of undifferentiated-appearing small round cells and larger spindle-shaped cells. A proportion of these cancers may also manifest more specific mesenchymal differentiation. In contrast to the pulmonary blastoma of adults, a malignant epithelial component does not occur. We present herein the third known case of a fine needle aspiration biopsy of a pleuropulmonary blastoma in a 5-year-old girl. The smears were moderately cellular and included an admixture of the characteristic small ovoid blastemal elements and scattered spindled mesenchymal tumor cells.- - - - - - - - - - ranking = 145.76379233574keywords = neoplasm, cancer (Clic here for more details about this article) |
7/154. Case of spontaneous regression of metastatic lesions of leiomyosarcoma of the esophagus.A rare case of spontaneous regression of esophageal leiomyosarcoma is reported. A 63-year-old woman underwent esophagectomy and reconstruction at our hospital after diagnosis of leiomyosarcoma. Nineteen months after esophagectomy, a coin lesion was detected in the right lung and right thoracotomy revealed pleural dissemination. The lesion in the right lung was resected and was confirmed histologically as recurrence of leiomyosarcoma. During further surgery, metastatic lesions were found in the spleen and pleura. However, all metastatic lesions were found to decrease without any anti-cancer therapy.- - - - - - - - - - ranking = 23.142814354517keywords = cancer, spleen (Clic here for more details about this article) |
8/154. Malignant mesothelioma in subjects with Marfan's syndrome and ehlers-danlos syndrome: only an apparent association?Malignant mesothelioma is a rare neoplasm which could be favored by an hereditary predisposing factor. So far, malignant mesothelioma have never been described in patients with hereditary diseases of the connective tissue. Here, we report some cases of mesothelioma affecting subjects who were not exposed to inhalation of asbestos. One of these subjects was affected by ehlers-danlos syndrome, whereas in two brothers, mesothelioma was associated with Marfan's syndrome. The observation of the same histologic subtype of mesothelioma in two brothers and the coexistence of two pathologic conditions of mesodermal origin indicate the presence of hereditary factors predisposing to the cancerogenic action of even small amounts of asbestos. Structural alterations of collagen and primary immunodeficiency may represent the host factor inducing development of the neoplasm. We conclude that the association between these rare disorders of the connective tissue and mesothelioma may not be coincidental, but could be the result of the exposition to small amounts of asbestos in predisposed individuals.- - - - - - - - - - ranking = 269.38477031696keywords = neoplasm, cancer (Clic here for more details about this article) |
9/154. smooth muscle tumor of the pleura. A case report and review of the literature.Smooth muscle tumors of the serosal membranes are extremely rare and have received little attention in the literature. To the best of our knowledge, only 1 published series of 5 pleural smooth muscle neoplasms has been published to date. We describe a primary pleural neoplasm with smooth muscle differentiation documented by light microscopy, immunohistochemistry, and electron microscopy. This tumor originated in the parietal pleura in a 32-year-old white man and was diagnosed incidentally by chest radiography; the diagnosis was confirmed by magnetic resonance imaging and biopsy. Four years later, the tumor was noted to have increased in size and disseminated into the chest wall as a separate circumscribed mass located in the pectoral muscle. Both masses were resected and diagnosed as smooth muscle tumors. We conclude that smooth muscle tumor of the pleura is a well-defined entity with a low, but definite malignant potential; therefore, we recommend complete resection and long-term follow-up for all patients.- - - - - - - - - - ranking = 247.24195596244keywords = neoplasm (Clic here for more details about this article) |
10/154. Unusually high incidence of malignant pleural mesothelioma in a town of eastern sicily: an epidemiological and environmental study.In a recent epidemiological study, researchers investigated mortality from malignant pleural neoplasms in italy, and they detected some geographic clusters of cases of this disease. We found a town located in a volcanic area of eastern sicily to be of special interest. The residents, some of whom were diagnosed with pleural mesothelioma, had never had any relevant exposure to asbestos during their professional lives. The results of an environmental survey suggested that a possible cause of asbestos exposure was the stone quarries near the town. The products of the quarries contain fibrous amphiboles, which are used widely in the local building industry. These fibrous amphiboles were identified as intermediate phases between tremolite and actinolite. Samples were collected from buildings in the town, and concentrations of amphibole fibers were evaluated. Fibrous phases were detected in 71% of the samples, and fiber concentrations ranged from a few thousand to more than 4 x 10(4) fibers/mg of material. In addition, we conducted a study on the mineral fiber lung burden in a pleural mesothelioma case. Many mineral fibers that were classified as the same tremolite-actinolite fibrous amphibole found in the quarries and in the building materials were detected in the lung tissue. The results suggest that the inhabitants of the town we studied had been exposed for several decades to asbestos fibers that were present in the material extracted from the local stone quarries. The material was subsequently used in the building industry, and this has caused an increased risk of pleural mesothelioma in the area.- - - - - - - - - - ranking = 123.62097798122keywords = neoplasm (Clic here for more details about this article) |
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