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Tissue Involvement (tissue + involvement)
Selected AbstractsAggressive and Neglected Basal Cell CarcinomaDERMATOLOGIC SURGERY, Issue 11 2005Ali Asilian MD Background. Basal cell carcinoma (BCC) is the most common cutaneous malignancy and usually has a benign coarse. Rarely, examples of aggressive and neglected types of this tumor are seen. Objective. To present an interesting and dramatic example of how some people neglect their tumors and how devastating the sequelae can be. Methods. We report a 58-year-old man with an extensive BCC and signs of cranial nerve involvement. Results. The patient had a large, infected ulcer on his scalp. He also had skull bone destruction, osteomyelitis, mastoiditis, cranial nerve paralysis, and radiographic features of the skull base and upper cervical soft tissue involvement. Pathologic studies revealed an infiltrating form of BCC. Conclusions. If left untreated and neglected, as in this case, BCC can become inoperable and complicated. ALI ASILIAN, MD, AND BANAFSHE TAMIZIFAR, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Osteosarcoma near joints: Assessment and implicationsJOURNAL OF SURGICAL ONCOLOGY, Issue 3 2005Gerald M.Y. Quan MBBS Abstract Background The choice of performing surgery when tumors encroach onto joints remains a challenging and controversial issue. Pre-operative assessment by magnetic resonance imaging (MRI) is of critical importance in dictating surgical management and subsequent functional outcome. Methods We examined archival samples from 27 patients with osteosarcoma, adjacent to synovial joints for the incidence and mechanism of osteosarcoma extension into the joint space. Histopathologic findings were correlated with pre-operative MRI findings and choice of operation. Results There was no evidence of penetration across the entire thickness of articular cartilage into the joint cavity in all of the 27 cases. When pre-operative MRI confidently excluded joint involvement by tumor, enabling an intra-articular surgical approach, histopathologic correlation confirmed the absence of joint involvement in all cases. The low incidence of joint involvement was despite the presence of extensive bone and soft tissue involvement in most cases, a tendency for peripheral extension of tumor around the articular margin of the bone, and evidence of joint effusions pre-operatively in more than one-third of cases. Conclusions Joint involvement by osteosarcoma is uncommon, with articular cartilage being a relative barrier to tumor invasion. If pre-operative MRI does not show definite evidence of intra-articular tumor involvement, it is likely to be safe to proceed with intra-articular resection. J. Surg. Oncol. 2005;91:159,166. © 2005 Wiley-Liss, Inc. [source] CD5-Negative, CD10-Negative small B-cell leukemia: Variant of chronic lymphocytic leukemia or a distinct entity?,AMERICAN JOURNAL OF HEMATOLOGY, Issue 4 2002Salwa S. Sheikh Abstract CD5- and CD10-negative chronic lymphocytic leukemias are quite uncommon as compared to the CD5-positive CLL. We reviewed 250 sequential cases of peripheral blood lymphocytosis to characterize cases of small B-cell lymphoproliferative disorders, submitted with a clinical diagnosis of chronic lymphocytic leukemia exhibiting a non-classic immunophenotypic profile. Six cases of CD5-, CD10-negative chronic lymphocytic leukemias and no tissue involvement were identified that revealed high-density surface-membrane immunoglobulin and CD20 expression, with variable expression of CD11c, CD23, and CD25. Most had a profound leukocytosis (mean WBC 180 × 109/L) with proliferation of mature-appearing lymphocytes. Subsequent bone marrow biopsies showed diffuse infiltration by neoplastic cells in all evaluated patients. The clinical course appeared indolent, with follow-up revealing three patients alive (survival time 38,68 months), while two died of unrelated causes and one was lost to follow-up soon after diagnosis. These cases may represent somewhat unusual chronic lymphoproliferative disorders, with morphologic features and immunophenotypic profile not readily classifiable, but which are certainly atypical for classic chronic lymphocytic leukemia. Some of these features are reminiscent of those seen in marginal-zone lymphoma. However, it is most unusual for this known to be tissue-based disease to present primarily as leukemia rather than lymphoma. Am. J. Hematol. 71:306,310, 2002. © 2002 Wiley-Liss, Inc. [source] Laryngeal presentation of systemic apolipoprotein A-I,derived amyloidosis,THE LARYNGOSCOPE, Issue 3 2009Aldert J. C. Hazenberg MD Abstract Objective: To study the clinical and pathological characteristics of two patients with laryngeal apolipoprotein A-I (apoA-I)-derived (AApoAI) amyloidosis with the apolipoprotein A-I variants Leu174Ser and Leu178Pro, respectively. The latter variant has not been associated with amyloid before. Study Design: Descriptive report of two patients who presented with laryngeal amyloid presumed to be of localized AL type, but in who further assessments demonstrated systemic amyloidosis. Methods: The larynx was examined by videolaryngostroboscopy. The voice was analyzed with the GRBAS system, phonation times, and phonetography. Laryngeal biopsies were stained with Congo red and analyzed immunohistochemically. Organ function was assessed and tissue involvement by amyloid further determined by rectal biopsy, abdominal fat tissue aspirate, and serum amyloid P component scintigraphy. Results: The appearance of the laryngeal amyloid was unusual in both patients, occurring as small, irregular floppy proliferations affecting the borders of both vocal folds. Amyloid was stained with antibodies to apoA-I and not with antibodies to immunoglobulin light chains. The 45-year-old woman with the previously described amyloidogenic apoA-I Leu174Ser variant had possible involvement by amyloid in joints, peripheral nerves, and heart. Whereas in the 67-year-old man with apoA-I Leu178Pro there was a clinical suggestion of autonomic and cardiac amyloid and histological corroboration of systemic amyloidosis in abdominal fat. Conclusions: Laryngeal symptoms may be the presenting feature of hereditary systemic AApoAI amyloidosis, and comprehensive investigations including apoA-I genotyping are warranted in patients who present with apparently localized laryngeal amyloidosis. The distinctive appearance of the amyloidotic vocal folds described here may further signal the possibility of hereditary AApoAI type. Laryngoscope, 119:608,615, 2009 [source] Feline immunodeficiency virus status of Australian cats with lymphosarcomaAUSTRALIAN VETERINARY JOURNAL, Issue 8 2001LJ GABOR Objective To determine the FIV status of Australian cats with lymphosarcoma and relate this to patient characteristics, tumour characteristics (tissue involvement, histological grade and immunophenotype), haematological and serum biochemical values and FeLV status of affected cats. Design Prospective study of 101 client-owned cats with naturally-occurring lymphosarcoma. Procedure Western blot analysis, ELISA and immunochromatography were used to detect FIV antibodies in serum from cats with lymphosarcoma. Results On the basis of Western blot analysis (which was considered the most accurate method for determining FIV status), 50/101 (50%) of cats with naturally-occurring lymphosarcoma were positive for FIV antibodies. Of these 50 cats, 35 had tumours of B-cell phenotype, 13 had T-cell tumours and 2 had tumours classified as non-B/non-T. Tumours from eight of these FIV-positive cats contained FeLV gene sequences, including a 9-month-old cat with FeLV antigenaemia. Compared with FIV-negative cats with lymphosarcoma, FIV-positive cats were more likely to be domestic crossbreds (P = 0.004), male (P = 0.048) and have atypical (especially nasal) forms of lymphosarcoma (P = 0.09). Only 39 of 107 (36%) blood or sera tested using ELISA were positive for FIV antibodies (including 5 false-positives). Conclusions The prevalence of FIV infection was considerably higher in our cohort of cats compared with series of lymphosarcoma cases from the Northern hemisphere. A positive FIV status was strongly associated with lymphosarcoma in Australian cats and it is possible that this infection may predispose to the development of lymphoid neoplasia. The presence of FIV infection would have been underestimated if commercial kits alone had been used for serology. [source] Haematological and biochemical findings in cats in Australia with lymphosarcomaAUSTRALIAN VETERINARY JOURNAL, Issue 7 2000LJ GABOR Objective To describe, for the first time, haematological and serum biochemical findings in cases of lymphosarcoma in Australian cats. Design A prospective multi-institutional study. Procedure Of 118 affected cats presented to the authors over a 18-month period, 97 were evaluated haematologically and 87 biochemically. Haematological analysis usually included determination of packed cell volume, haemoglobin concentration, red blood cell and leukocyte counts, differential leukcocyte count, reticulocyte count and examination of buffy-coat smears for neoplastic cells. Serum biochemical analysis was done primarily with a discrete analyser and included a panel of commonly used analytes. Results Nonregenerative anaemia was present in 54% (52/97) of cats. Neutrophilia, present in 65% (59/91) of cats, was commonly associated with lymphocytopaenia, eosinopaenia and monocytosis. Of the 13 cats with a secondary leukaemic manifestation, only five had distinct lymphocytosis. Serum biochemical abnormalities either were nonspecific, such as hypoglycaemia in 37% (32/87) of cats, or related to specific tissue involvement, such as hypoalbuminaemia in 76% (31/41) of cats with alimentary involvement and azotaemia in 60% (15/25) of cats with renal involvement. Conclusion It was shown for the first time that haematological and serum biochemical findings are of limited value in diagnosing lymphosarcoma in Australian cats, except if they are leukaemic. Although clinical pathological changes were common, they were nonspecific or related to specific tissue involvement. Their value in assessing response to therapy needs to be examined further. Patient characteristics such as age, breed and sex also had limited effect on laboratory findings and those observed were of little consequence. Additionally, histological and immunophenotypical variations in tumour type had little effect on laboratory findings. [source] Group A streptococcus bacteraemia: comparison of adults and children in a single medical centreCLINICAL MICROBIOLOGY AND INFECTION, Issue 2 2006O. Megged Abstract Group A streptococcus (GAS) bacteraemia is often associated with soft-tissue infection, with significant morbidity and mortality. Little is known concerning the differences between adults and children with GAS bacteraemia. Records for 98 of 116 cases of GAS bacteraemia (60 adults and 38 children, aged 7 days to 96 years) occurring during a 10-year period (1993,2002) were located and reviewed. GAS bacteraemia comprised 0.6% of all bacteraemias in adults, compared to 3.3% in children (p < 0.001). The rate of adult GAS bacteraemia was two cases/1000 hospitalisations, compared to 13/1000 in children (p < 0.001). Seventy-six (78%) patients had concomitant tissue involvement, with skin or soft-tissue infection being the most common (62%). Fifty-three (88%) of 60 adults and five (13%) of 38 children had underlying conditions (p < 0.001). Twelve patients died, only one of whom was a child. Parameters associated with mortality were older age, lower temperature, hypotension, a need for surgical intervention, toxic shock syndrome, disseminated intravascular coagulation, thrombocytopenia, lymphopenia, hypocalcaemia, renal failure and acidosis (p < 0.05). [source] | ||||||||||