1/13. Sternal splitting approach to upper thoracic lesions located anterior to the spinal cord.The sternal splitting approach for upper thoracic lesions located anterior to the spinal cord is described. The sternal splitting approach can be effectively applied to lesions from the T-1 to T-3 levels. The aortic arch prevents procedures below this level. The approach is straight toward the T1-3 vertebral bodies and provides good surgical orientation. The sternal splitting approach was applied to five patients with metastatic spinal tumors at the C7-T3 levels and three patients with ossification of the posterior longitudinal ligament at the T1-3 levels. No postoperative neurological deterioration occurred. Two patients had postoperative hoarseness. The sternal splitting approach to the upper thoracic spine is recommended for hard lesions, extensive lesions requiring radical resection, and lesions requiring postoperative stabilization with spinal instrumentation.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/13. Perineurioma: an uncommon soft tissue neoplasm distinct from localized hypertrophic neuropathy and neurofibroma.Perineurial cells, which normally surround the nerve fascicles within a nerve, can be distinguished from schwann cells by their immunoreactivity for epithelial membrane antigen (EMA) and lack of reactivity for S-100 protein. We report two cases of perineurioma, a tumor composed exclusively of perineurial cells and distinct from other nerve sheath tumors. The first case involved a deep, soft-tissue mass of the neck, and the second involved a tumor located in the infraclavicular subcutaneous tissue. Both tumors were well circumscribed. Histologically, they were hypocellular and composed of spindle cells possessing elongated nuclei and bipolar, wavy, slender, strikingly elongated cytoplasmic processes, disposed in a background of collagen in the form of short bundles and whorls. In the first case, there were frequent calcospherites and remnants of a small nerve at the periphery. The spindle cells stained for EMA but not S-100 protein, chromogranin, neuron-specific enolase or Leu-7. Ultrastructurally, they possessed long cytoplasmic processes with incomplete basal lamina and occasional pinocytotic vesicles. axons were not identified. review of the literature shows that genuine perineuriomas are rare, and most cases reported as such are merely examples of localized hypertrophic neuropathy, a mononeuropathy characterized by fusiform swelling of a nerve, usually in the extremities. The involved segment in localized hypertrophic neuropathy contains distended fascicles composed of whorls of perineurial cells and fibrous tissue entrapping residual axons, probably representing a hyperplastic reaction to nerve damage. The term perineurioma should be reserved for the neoplasm composed only of perineurial cells and presenting as a soft tissue tumor.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
3/13. Cytogenetic characteristics of a malignant rhabdoid tumor arising from the paravertebral region. A case report.The pathological and cytogenetic features of an extrarenal malignant rhabdoid tumor (MRT) arising from the paravertebral region in an infant were investigated. The patient died 4 months after diagnosis, due to aggressive tumor progression. The tumor was composed of medium-sized round cells with cytoplasm containing eosinophilic inclusions, which ultrastructurally were composed of densely packed whorled intermediate filaments. Flow-cytometric analysis of the tumor cells revealed a diploid pattern. Amplification of the N-myc oncogene was not identified. Immunohistologically, the inclusion bodies showed a positive reaction with antiserum against vimentin. The tumor cells were not reactive with antiserum against epithelial membrane antigen, anti-keratin (polyclonal) or cytokeratin (monoclonal, CK1), but did react with 5H10, an antiserum established from human sarcomatous Wilms' tumor. This case is discussed with reference to the literature on extrarenal MRT, placing stress on the histogenesis of this tumor.- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
4/13. Fine needle aspiration cytology of malignant spiradenoma arising in congenital eccrine spiradenoma.The fine needle aspiration (FNA) cytology of malignant eccrine spiradenoma arising in a large benign congenital eccrine spiradenoma is described. The malignant tumor was characterized by cohesive, pleomorphic cells with malignant nuclear features and numerous mitoses. FNA of the adjacent benign eccrine spiradenoma revealed prominent basement membrane deposition with an irregular tubular and nesting growth pattern and bland basaloid cells. To our knowledge, the FNA of malignant eccrine spiradenoma has not been previously described. In this case, FNA cytology was influential in directing patient management.- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
5/13. Osteomyelosclerosis with granulocytic sarcoma of chest wall. Morphological, ultrastructural, immunologic, and cytogenetic study.A case of granulocytic sarcoma presenting as a soft-tissue tumor in the chest wall in a patient with osteomyelosclerosis is reported. The tumor mass was detected by a computed tomographic scan during an investigation of the cause of chest pain in a 58-year-old man. biopsy of the mass showed findings compatible with either a large-cell lymphoma or a granulocytic sarcoma. The latter was confirmed by naphthol-ASD-chloracetate esterase stain and electron microscopic examination. Immunologic study of the tumor mass showed expressions of membrane/cytoplasmic CD 13 and CD 15 antigens. In addition, the tumor cells coexpressed CD 19, although all other T- and B-cell-associated antigens were absent. Cytogenetic study showed translocation t(1;7)(q11;q11) with a net deletion of the entire long arm of chromosome 7 and duplication of the long arm of chromosome 1. Peripheral blood examination showed typical leukoerythroblastosis with teardrop poikilocytosis, large hypogranular platelets, and 0.11 myeloblasts. A bilateral iliac bone marrow biopsy at this time showed osteomyelosclerosis. The patient was treated with hydroxyurea followed by local irradiation, resulting in marked reduction in the size of the tumor and in the pain. He was asymptomatic without any progression in hematologic parameters 10 months after the initial diagnosis.- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
6/13. Cell culture of small round cell tumor originating in the thoracopulmonary region. Evidence for derivation from a primitive pluripotent cell.The authors describe a 14-year-old girl with small round cell tumor originating in the chest wall analyzed by the extensive studies including light and electron microscopic examination, histochemical study, immunochemical study, cytogenetics, and gene analysis. A cell line producing carcinoembryonic antigen (CEA) and neuron-specific enolase (NSE) has been established from pleural effusion of the pulmonary metastatic tumor. cytogenetic analysis disclosed a reciprocal translocation (11;22)(q24;q12). Additionally, immunocytochemical studies demonstrated that CEA, NSE, vimentin, cytokeratin, and epithelial membrane antigens are positive, but desmin and S-100 protein are negative. Although neurofilament was negative in the pulmonary metastatic tumor cells, it became positive in cell line in vitro. These results suggest that this tumor may be derived from the primitive and pluripotential cells, differentiating into mesenchymal, epithelial, and neural features in variable proportions.- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
7/13. Significance of abnormal serum binding of insulin-like growth factor ii in the development of hypoglycemia in patients with non-islet-cell tumors.We reported that serum and tumor from a hypoglycemic patient with a fibrosarcoma contained insulin-like growth factor ii (IGF-II), mostly in a large molecular form designated "big IGF-II." We now describe two additional patients with non-islet-cell tumor with hypoglycemia (NICTH) whose sera contained big IGF-II. Removal of the tumor eliminated most of the big IGF-II from the sera of two patients. Because specific IGF-binding proteins modify the bioactivity of IGFs, the sizes of the endogenous IGF-binding protein complexes were determined after neutral gel filtration through Saphadex G-200. Normally about 75% of IGFs are carried as a ternary complex of 150 kDa consisting of IGF, a growth hormone (GH)-dependent IGF-binding protein, and an acid-labile complexing component. The three patients with NICTH completely lacked the 150-kDa complex. IGF-II was present as a 60-kDa complex with variable contributions of smaller complexes. In the immediate postoperative period, a 110-kDa complex appeared rather than the expected 150-kDa complex. Abnormal IGF-II binding may be important in NICTH because the 150-kDa complexes cross the capillary membrane poorly. The smaller complexes present in our patients' sera would be expected to enter interstitial fluid readily, and a 4- to 5-fold increase in the fraction of IGFs reaching the target cells would result.- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
8/13. Inferior pulmonary ligament lymphadenopathy: demonstration by computed tomography.Inferior pulmonary ligament lymphadenopathy is common in bronchogenic carcinoma and may also occur in lymphoma and potentially in any condition which may cause intrathoracic lymphadenopathy. Despite the apparent frequency with which inferior pulmonary ligament lymphadenopathy occurs, we have been unable to find a description of the computed tomographic findings of this condition. In a patient with lymphoma, we found inferior pulmonary ligament lymphadenopathy by computed tomography as an oval, elongated soft-tissue density arising within the inferior pulmonary ligament and still attached to the mediastinum by a piece of the normal ligament. We believe that this appearance should be sufficient for the correct computed tomographic diagnosis of inferior pulmonary ligament lymphadenopathy.- - - - - - - - - - ranking = 10keywords = ligament (Clic here for more details about this article) |
9/13. Malignant schwannoma: a light microscopic and ultrastructural study.The light microscopic and ultrastructural features of 3 cases of malignant schwannoma were studied and compared with those of other types of soft-tissue sarcoma. The tumor in 1 of these cases originated in an intercostal nerve and was composed of compactly arranged spindle-shaped tumor cells. The other 2 cases showed osteogenic areas in addition to exhibiting prominent nuclear palisading, focal myxoid changes, and a rosette-like arrangement of tumor cells. The tumor in 1 of these latter cases occurred at the site of a preexisting neurofibroma. The Schwann cell origin of these tumors is strongly supported by the ultrastructural findings of basement membranes and conspicuous intercellular junctions in all 3 cases and dense-core granules in 1.- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
10/13. Intrathoracic extraskeletal Ewing's sarcoma: a case report and review of literature.Extraskeletal Ewing's sarcoma (EES) is a rare tumor of soft tissue. As an uncommon clinical entity with histologic features similar to those of other small round-cell tumors, EES occasionally produces difficulty in diagnosis. Hence, diagnosis should be confirmed by histochemical, immunohistochemical and clinical findings. Here, we describe a man aged 29 years who had intrathoracic mass was diagnosed as EES after incisional biopsy of the tumor. The presence of glycogen in the tumor cells was demonstrated by periodic acid-Schiff (PAS) stain but immunoreactivity for cytokeratin, epithelial membrane antigen, leukocyte common antigen, desmin, actin and neuron-specific enolase were absent; vimentin was present. The patient was successfully treated with VIP regimen (etoposide, ifosfamide and cisplatin) followed by local irradiation. He remained alive without recurrence after one year. A review of the literature and recent advances in the treatment of EES are reported.- - - - - - - - - - ranking = 0.056100608459985keywords = membrane (Clic here for more details about this article) |
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