Cases reported "Arteritis"

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1/8. Paraneoplastic vasculitis associated with esophageal carcinoma.

    We report a case of esophageal carcinoma associated with paraneoplastic vasculitis. A 69-year-old man suffered from low-grade fever and numbness of the lower limbs for 3 months before esophageal and gastric carcinomas were detected. Concurrent infection or collagen disease was ruled out following clinical and laboratory examinations. In April 1996, the gastric carcinoma was completely removed by endoscopic mucosal resection, but the symptoms remained. Three weeks later esophagectomy was performed for esophageal carcinoma after which time the fever and numbness disappeared. The esophageal carcinoma was a well-differentiated squamous cell carcinoma invading into the submucosal layer. Twenty-two lymph node metastases were found in 68 resected lymph nodes. Latent thyroid cancer was found. Histologically, vasculitis was detected in the esophagus, stomach and serratus anterior muscle. The distribution and degree of vasculitis were most pronounced in the esophagus. The concurrent onset and spontaneous resolution of fever and numbness after the removal of the esophageal carcinoma suggested a paraneoplastic origin. The majority of patients with malignant neoplasm-associated vasculitis had hematologic neoplasms. Cases of esophageal carcinoma associated with paraneoplastic vasculitis are extremely rare.
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ranking = 1
keywords = cancer
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2/8. Intrahepatic cholangitis and arteritis after transcatheter arterial embolization in a patient with tumor-like lesion-associated autoimmune hepatitis.

    Autoimmune hepatitis is a chronic liver disease characterized by immune-mediated, progressive hepatocellular damage, although the target autoantigen remains speculative. Intrahepatic biliary lesions are not a feature of this disease. We describe herein a female patient, 57 years, with autoimmune hepatitis who developed hepatic regenerative mass after acute exacerbation of hepatitis. This hepatic regenerative mass was clinically diagnosed as hepatocellular carcinoma and was surgically resected after transcatheter arterial embolization therapy. Widespread nonsuppurative destructive granulomatous cholangitis as well as necrotizing, granulomatous arteritis of the intrahepatic small arteries were found in the surgically resected hepatic regenerative mass. The bile duct lesions were histologically and immunohistochemically very similar to the granulomatous cholangitis of primary biliary cirrhosis. We would like to propose that these unusual lesions in the intrahepatic bile ducts and intrahepatic arteries represent a reaction of this patient to an anti-cancer drug included in chemoembolization. No such cases have been reported so far.
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ranking = 1
keywords = cancer
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3/8. arteritis and brachial plexus neuropathy as delayed complications of radiation therapy.

    radiation-induced arteritis of large vessels and brachial plexus neuropathy are uncommon delayed complications of local radiation therapy. We describe a 66-year-old woman with right arm discomfort, weakness, and acrocyanosis that developed 21 years after local radiation for breast adenocarcinoma. Arteriography revealed arteritis, with ulcerated plaque formation at the subclavian-axillary artery junction, consistent with radiation-induced disease, and diffuse irregularity of the axillary artery. electromyography showed a chronic brachial plexopathy. The patient's acrocyanosis, thought to be due to digital embolization from her vascular disease, improved with antiplatelet therapy. The concurrent combination of radiation-induced arteritis and brachial plexopathy is uncommon but should be considered in patients presenting with upper extremity pain or weakness after radiation therapy.
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ranking = 26164.179490694
keywords = radiation-induced
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4/8. radiation arteritis following treatment for Wilms' tumor: an unusual case of weight loss.

    Wilms' tumor is the most common pediatric primary renal cancer and is highly responsive to surgery and chemotherapy. The role of radiotherapy has evolved in the last three decades from the use of stepwise incremental doses in all patients to the current concept of added radiotherapy in advanced cases or in those with unfavorable pathology. To the authors' knowledge, this is the first case of a young woman with prior history of Wilms' tumor and significant weight loss due to radiation arteritis involving the abdominal vasculature. A 31-year-old woman presented with a history of weight loss and severe malnutrition. An angiogram revealed that the aorta was occluded below the renal artery. The celiac artery and the superior mesenteric artery were occluded at the origin, and large intercostal collaterals reconstituted the pelvic circulation. She was initially treated with total parenteral nutrition (TPN) and underwent an infrarenal aortic bypass surgery. Histopathology of the aorta revealed intimal fibrocalcific thickening and changes consistent with radiation-induced arteritis. Later, she was readmitted with progressive hepatic insufficiency. Despite intensive medical therapy, she died of multi-organ failure.
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ranking = 13083.089745347
keywords = radiation-induced, cancer
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5/8. Carotid stenting for symptomatic radiation-induced arteritis complicated by recurrent aneurysm formation.

    We describe a 56-year-old male who underwent successful carotid stenting (CS) with adjuvant distal protection in response to symptomatic radiation-induced carotid disease. During the CS procedure, it was incidentally noted that the lesion yield pressure was surprisingly low (2 atm). The patient returned with local symptoms from common carotid aneurysmal dilation at the proximal edge of the stent that was successfully treated with a stent graft. A second aneurysm developed proximal to the stent graft and, based on intravascular ultrasound mapping, he ultimately underwent venous bypass covered by a free-muscle graft. We believe the low lesion yield pressure in this case reflected loss of vessel integrity and it may be prudent to avoid oversizing the stent in such patients.
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ranking = 65410.448726734
keywords = radiation-induced
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6/8. aortitis due to metastatic gas gangrene.

    clostridium septicum bacteremia and its association with hematologic malignancy and colorectal cancer have been well recognized. Panwalker, in a recent review, discussed clostridial sepsis and other unusual infections associated with colorectal tumors, including streptococcal bovis and bacteroides. He reports the coexistence of colorectal cancer and metastatic clostridium septicum infections at multiple sites. We describe a case in which a patient with an occult cecal carcinoma develops clostridium septicum sepsis and thoracic aortitis secondary to metastatic gas gangrene. This dramatic and unusual complication has not previously been documented. The necessity of colonic evaluation with Clostridium septicum bacteremia is discussed.
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ranking = 2
keywords = cancer
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7/8. breast arteritis in polymyalgia rheumatica.

    A 79-year-old woman with the clinical presentation of polymyalgia rheumatica (PMR) also had breast cancer. Histopathologic evidence of arteritis was found in mastectomy tissue and in a temporal artery, neither of which had produced symptoms before surgery. Previously reported cases are reviewed in the context that breast vasculitis may be more common than in generally recognized in patients with PMR.
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ranking = 1
keywords = cancer
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8/8. vasculitis carcinomatosa occurring in association with adenocarcinoma of the stomach.

    Invasion of vascular walls by cancer cells is a well-known phenomenon in lymphoid malignancies. However, its occurrence in epithelial tumors is less well known. This report documents the occurrence of such invasion of vascular walls by an adenocarcinoma of the stomach in a 68-year-old woman. This rare event differs histopathologically from inflammatory vasculitis associated with malignant disease, lymphangitis carcinomatosa, and carcinomatous arteriopathy. In inflammatory vasculitis associated with malignant disease, the main histopathologic feature is fibrinoid necrosis and ordinary pan arteritis-like vasculitis. In lymphangitis carcinomatosa, the main feature is plugging of vascular lumina by tumor cells, a finding not encountered in our case, while in carcinomatosa arteriopathy, the main event is an obliterative fibrointimal hyperplasia, apparently resulting from arterial tumor emboli. In none of these three conditions has direct invasion of vascular walls by tumor cells been previously reported.
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ranking = 1
keywords = cancer
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