Cases reported "Carcinoma"

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1/9. Refractory arthropathy after intravesical bacillus Calmette-Guerin therapy. Usefulness of isoniazide.

    BACKGROUND: arthritis associated with bacillus Calmette-Guerin immunotherapy usually responds dramatically to nonsteroidal antiinflammatory drug therapy. isoniazid is generally reserved for other complications such as granulomatous hepatitis. CASE-REPORT: A 73-year-old man was admitted for fever, arthritis of the knees and right temporomandibular joint, an inflammatory swelling over the left achilles tendon and bilateral conjunctivitis. The symptoms started in the wake of a course of intravesical bacillus Calmette-Guerin immunotherapy. Laboratory tests showed evidence of severe inflammation. Cultures of blood, urine and joint fluid specimens were negative, as were tests for autoantibodies and serologic tests for organisms known to cause reactive arthritis. Nonsteroidal antiinflammatory therapy was ineffective and glucocorticoid therapy produced only a partial response. All the symptoms resolved under isoniazid therapy in a dosage of 300 mg/day for three months. CONCLUSION: Use of antituberculous agents may be required in some cases of arthritis associated with bacillus Calmette-Guerin immunotherapy, most notably those with severe pyrexia.
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keywords = bacillus
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2/9. Lymphoepithelioma-like carcinoma of the urinary bladder.

    Lymphoepithelioma-like carcinomas (LELCAs) of the urinary bladder are rare. We report 2 such cases presenting with painless gross hematuria. The first case occurred in a 73-year-old man. Bladder sonography revealed a 2 x 3 cm well-defined tumor beneath the bladder mucosa. Radical cystoprostatectomy revealed lymphoepithelioma-like carcinoma with perivesical soft tissue invasion. cisplatin-based chemotherapy was given. Computed tomography scan demonstrated no evidence of recurrence 26 months postoperatively. The second case occurred in a 63-year-old man. cystoscopy revealed a solid tumor at the bladder dome. Transurethral resection of bladder tumor (TUR-BT) demonstrated lymphoepithelioma-like carcinoma with lamina propria invasion. Tumor cells were positive for cytokeratin but negative for leukocyte common antigen. The patient received adjuvant chemotherapy due to suspicious extravesical tumor spread and high-grade tumor characteristics. After tumor recurrence was identified, TUR-BT was performed again and the surgical specimen showed superficial high-grade LELCA. After bacillus Calmette-Guerin instillation, follow-up cystoscopy revealed no recurrence at 10 months postoperatively. Pure LELCA is morphologically different from transitional cell carcinoma and has a more favorable prognosis than high-grade, invasive bladder carcinoma if managed appropriately.
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ranking = 0.14285714285714
keywords = bacillus
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3/9. Percutaneous sequential bacillus Calmette-Guerin and mitomycin C for panurothelial carcinomatosis.

    A 59 year old male presented with a 4 month history of lower urinary tract symptoms. Exhaustive urological investigations revealed papillary tumors and carcinoma in situ extending from the prostatic urethra, throughout the bladder, up both ureters and into the renal pelves. Tumors were resected where possible and then bacillus Calmette-Guerin (BCG) and mitomycin C (MMC) were infused sequentially through bilateral nephrostomy tubes for a total of six BCG and three MMC instillations. Follow up 1 month post treatment demonstrated a complete response which persisted for 2 years. Then there appeared a solitary papillomatous recurrence in the bladder which was successfully resected. Side effects were the occasional fever and BCG induced granulomatous prostatitis which slowly resolved. In conclusion, sequential BCG/MMC instillations were effective treatment for widespread panurothelial carcinomatosis.
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ranking = 0.71428571428571
keywords = bacillus
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4/9. Complications after intravesical instillation of bacillus Calmette-Guerin: rhabdomyolysis and metastatic infection.

    Two cases of adverse reaction to bacillus Calmette-Guerin (BCG) bladder instillations are reported. In both cases transient fevers and systemic symptoms developed following the instillations. After an additional instillation 1 patient had high fevers, severe myalgias and profound weakness followed by rhabdomyolysis and anuric renal failure, which required 3 weeks of hemodialysis before recovery. Extensive evaluation revealed no cause other than the BCG instillations. In the other patient a firm subcutaneous nodule gradually developed on the chest wall, which contained nonviable acid fast bacilli.
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ranking = 0.71428571428571
keywords = bacillus
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5/9. Monitoring intravesical bacillus Calmette-Guerin treatment of superficial bladder carcinoma by serial flow cytometry.

    Simultaneous urinary flow cytometry, cytologic, and cystoscopic examinations were performed at 3-month intervals for a minimum of 1 year on 29 patients receiving intravesical bacillus Calmette-Guerin (BCG) treatment of superficial bladder carcinoma. flow cytometry (FCM) and cytology were concordant in 57 of 103 examinations; both FCM and cytology were positive in 38 instances, and carcinoma was confirmed by biopsy in 35 (92.1%). In 16 instances FCM and cytology were negative, but carcinoma was present on biopsy in 5 (31.3%). Three examinations were suspicious by both techniques. The 46 determinations with discordant FCM and cytology were subdivided into pathologically confirmed recurrences (25 instances) and no evidence of pathologic and/or cystoscopic disease (21 instances). In the 25 instances of recurrences, FCM was positive in 18 (72.0%), suspicious in 3 (12.0%), and negative in 4 (16.0%), while cytology was positive in 3 (12.0%), suspicious in 9 (36.0%), and negative in 13 (52.0%). Most patients had a severe BCG-induced inflammatory response that caused an elevation of the hyperdiploid population, believed secondary to epithelial regeneration and proliferation. In the 21 instances without detectable recurrence, hyperploidy led to a relatively high proportion of positive (15) and suspicious (4) results by FCM, but only eight had distinct aneuploid populations. It is possible that this latter group, at least, is harboring occult carcinoma. Conventional cytology in the nonrecurrent group was positive in 1 (4.8%), suspicious in 7 (33.3%), and negative in 13 (61.9%). In those instances when tumor was confirmed by biopsy, the false-negative rate for FCM was 19.7%; the false-negative rate for cytology was 40.9%. Thus, FCM appears to be more sensitive but less specific than conventional cytology, having a lower false-negative but a higher false-positive rate. Although serial FCM provides an objective quantitative measure of aneuploid stemlines and hyperdiploid populations in bladder irrigation specimens and can be helpful in following intravesical BCG therapy for superficial bladder carcinoma, it should still be used with conventional cytology. The greatest difficulty with FCM at present, as with conventional cytology, is in cases of marked inflammation. The results reported here were obtained under the most stringent conditions and represent the minimum level of accuracy. Potential improvements in the technique, with the addition of immunologic or other markers, hold hope of further increasing the accuracy of FCM.
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ranking = 0.71428571428571
keywords = bacillus
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6/9. tuberculosis of the breast: rare but still extant. review of the literature and report of an additional case.

    tuberculosis of the breast is a rare malady that is usually manifested by a unilateral mass suggestive of carcinoma or sometimes of abscess. mammography also suggests carcinoma in most instances. However, at operation, the discovery of necrotic tissue or abscess may lead to the suspicion of infectious or inflammatory disease rather than neoplasm. The diagnosis of tuberculosis may be established by the demonstration of acid-fast bacilli in excised tissue, by culture studies, or by guinea pig inoculation; however, the diagnosis is usually not suspected. In the past, mastectomy was the usual treatment. Today, successful treatment combines antituberculous drug therapy with the removal of infected breast tissue. The prognosis for complete cure is excellent. One case of secondary tuberculous mastitis has been reported herein. The patient, an Egyptian woman residing in the united states since 1973, was treated in egypt for pulmonary tuberculosis at age 17. She presented in 1982 with a breast mass that mimicked carcinoma on physical examination and mammograms, but excisional biopsy and histologic examination revealed a breast abscess that contained caseous material and a solitary acid-fast bacillus. The patient was cured of her disease after appropriate operation and a course of antituberculous drugs. This has been the only documented case of mammary tuberculosis at our institution. Despite its rarity, tuberculosis of the breast should not be forgotten in this age of world travel.
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ranking = 0.14285714285714
keywords = bacillus
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7/9. Acute polyarthritis after BCG-therapy for bladder carcinoma in a patient with ankylosing spondylitis.

    A case of polyarthritis following intravesical administration of bacillus Calmette-Guerin (BCG) for bladder carcinoma is reported in a patient with long-standing ankylosing spondylitis. Possible links between BCG-therapy and joint manifestations are discussed in the light of data from the literature. patients who develop joint manifestations after BCG-therapy are often HLA B27-positive.
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ranking = 0.14285714285714
keywords = bacillus
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8/9. Reiter's syndrome after intravesical bacillus Calmette-Guerin treatment for superficial bladder carcinoma.

    A 64-year-old woman developed acute Reiter's syndrome 4 weeks after the start of intravesical bacillus Calmette-Guerin immunotherapy for a recurrent superficial bladder carcinoma. The absence of any other cause suggests that the bacillus played an etiopathogenic role in this HLA-B27-positive patient.
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ranking = 0.14285714285714
keywords = bacillus
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9/9. tuberculosis of the nasopharynx following radiotherapy.

    We report the case history of a patient who was treated with radiotherapy for nasopharyngeal carcinoma. During follow-up, she showed signs, symptoms and radiological evidence of disease recurrence and progression. However, repeated biopsies of the posterior nasal space (PNS) failed to demonstrate malignancy. A diagnosis of nasopharyngeal tuberculosis was finally made when tissue from a PNS biopsy stained positive for acid-fast bacillus. The patient responded to antituberculous chemotherapy.
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ranking = 0.14285714285714
keywords = bacillus
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