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International Journal of Clinical and... 2015Hepatoid adenocarcinoma (HAC) is the term proposed for a special type of extrahepatic tumors, which is similar to the hepatocellular carcinoma (HCC) both in the... (Review)
Review
Hepatoid adenocarcinoma (HAC) is the term proposed for a special type of extrahepatic tumors, which is similar to the hepatocellular carcinoma (HCC) both in the histopathology and immunohistochemistry. HAC has been observed in the stomach, colon, pancreas, gall bladder, lung and female genital tract, but rarely in the mediastinum. Now we describe a case of a 28-year-old Chinese male with primary mediastinal HAC with lung and liver metastasis. In this patient, HAC was associated with horseshoe kidney and idiopathic nonobstructive azoospermia. It seemed derivation abnormalities during organogenesis in the embryo stage played a significant role in the pathogenesis of HAC, horseshoe kidney and idiopathic nonobstructive azoospermia. Even the pathogenesis was still unknown; it may merit consideration of HAC together with horseshoe kidney and idiopathic nonobstructive azoospermia as a syndrome rather than as a spectrum of coincidental diseases. Furthermore, we found the HAC is a neoplasm with unfavorable outcomes despite aggressive and multi-protocol strategies. The serum alpha fetoprotein (AFP) should be regarded as a useful marker for diagnostic purposes and therapeutic response evaluation of HAC.
Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Azoospermia; Biomarkers, Tumor; Fatal Outcome; Fused Kidney; Humans; Immunohistochemistry; Liver Neoplasms; Lung Neoplasms; Male; Mediastinal Neoplasms
PubMed: 26617920
DOI: No ID Found -
Journal of Medical Primatology Apr 2017Myeloid sarcoma is a rare manifestation of myeloproliferative disorder defined as an extramedullary mass composed of myeloid precursor cells. A 9-month old, female,... (Review)
Review
BACKGROUND
Myeloid sarcoma is a rare manifestation of myeloproliferative disorder defined as an extramedullary mass composed of myeloid precursor cells. A 9-month old, female, common marmoset (Callithrix jacchus) had increased respiratory effort.
METHODS
A complete necropsy with histology and immunohistochemistry was performed.
RESULTS
The thymus was replaced by a firm, gray-tan mass with a faint green tint, filling over 50% of the thoracic cavity. Sheets of granulocytes, lymphoid cells, nucleated erythrocytes, megakaryocytes, and hematopoietic precursors of indeterminate cell lineage replaced the thymus, perithymic connective tissue, mediastinal adipose tissues, epicardium, and much of the myocardium. The cells demonstrated diffuse strong cytoplasmic immunoreactivity for lysozyme, and strong, multifocal membranous immunoreactivity for CD117.
CONCLUSION
We report the first case of a myeloid sarcoma in a common marmoset (C. jacchus), similar to reported human cases of mediastinal myeloid sarcoma, and present a review of myeloproliferative diseases from the veterinary literature.
Topics: Animals; Callithrix; Female; Mediastinal Neoplasms; Monkey Diseases; Sarcoma, Myeloid
PubMed: 28145579
DOI: 10.1111/jmp.12253 -
Diagnostic Cytopathology Apr 2020Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, reliable technique for sampling mediastinal lymph nodes (LNs)....
BACKGROUND
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, reliable technique for sampling mediastinal lymph nodes (LNs). Liquid-based cytology (LBC) is widely used for cervical cancer screening because it provides reliable and feasible results. The present study aimed to evaluate effectiveness of the combination of EBUS-TBNA and LBC in the diagnosis of mediastinal lymphadenopathy.
METHODS
A total of 602 LNs that were retrospectively analyzed were sampled in 442 patients who underwent EBUS-TBNA between January 2014 and December 2016. The histopathological result of TBNA tissue or cell blocks was considered as the gold standard to evaluate diagnostic utility of LBC and conventional smears (CS) for the diagnosis of mediastinal lymphadenopathy.
RESULTS
Of the 602 LNs, 265 were mediastinal LN metastases from lung cancer, four were lymphoma, and 333 were benign. The sensitivity of LBC and CS in the diagnosis of mediastinal LN metastases from lung cancer was 72.8% and 63%, respectively, and the specificity was 98.5% and 97%, respectively. The positive predictive values for LBC and CS were 97.5% and 94.4%, respectively, whereas the negative predictive values were 82.2% and 76.9%, respectively. The accuracy of LBC and CS was 88% and 83.7%, respectively. The diagnostic value of LBC was significantly higher than that of CS (P = .001).
CONCLUSIONS
The combination of EBUS-TBNA and LBC is a highly reliable and feasible procedure that optimizes diagnostic utility for the diagnosis of lung cancer and mediastinal LN staging.
Topics: Adult; Aged; Aged, 80 and over; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Female; Humans; Lung Neoplasms; Lymphadenopathy; Male; Mediastinal Neoplasms; Mediastinum; Middle Aged; Neoplasm Metastasis; Retrospective Studies
PubMed: 31883315
DOI: 10.1002/dc.24374 -
Annals of Surgical Oncology Jan 2022Injury to the artery of Adamkiewicz (AKA) during surgery may lead to spinal cord ischemia and severe neurologic complications. Posterior mediastinal tumors may be...
BACKGROUND
Injury to the artery of Adamkiewicz (AKA) during surgery may lead to spinal cord ischemia and severe neurologic complications. Posterior mediastinal tumors may be adjacent to AKA, but data on preoperative visualization of AKA in children are rare. This study analyzed the importance of identifying the AKA preoperatively by spinal digital subtraction angiography (DSA) in children with posterior mediastinal tumors for therapeutic procedure.
METHODS
Between 2002 and 2021, 36 children with posterior mediastinal tumors were evaluated for surgery at the authors' clinic. In 10 children with left-sided or bilateral tumor located at vertebral levels T8 to L1, spinal DSA was performed during preoperative workup to assess AKA. The patient and tumor characteristics as well as the diagnostic and therapeutic procedures were analyzed.
RESULTS
The median age of the 10 children at examination was 69 months (range, 16-217 months). Three of the children were younger than 2 years. The tumor entities were neuroblastoma, ganglioneuroblastoma, ganglioneuroma, local relapse of a hepatocellular carcinoma, and neurofibroma. The AKA was identified in all cases, and proximity to the tumor was detected in four patients, three of whom had their planned surgery changed to irradiation. No complications occurred during spinal DSA or surgery.
CONCLUSIONS
In posterior mediastinal pediatric tumors, spinal DSA is a safe and reliable method for preoperative visualization of the AKA. It can show proximity to the tumor and guide the local therapy, thereby avoiding critical intra- and postoperative situations.
Topics: Arteries; Child; Humans; Liver Neoplasms; Mediastinal Neoplasms; Mediastinum; Neoplasm Recurrence, Local
PubMed: 34331163
DOI: 10.1245/s10434-021-10381-8 -
Cancer Imaging : the Official... Oct 2007Patients with newly diagnosed non-small cell lung cancer (NSCLC) need accurate tumor staging in order to direct appropriate therapy and establish prognosis; the tumor is... (Review)
Review
Patients with newly diagnosed non-small cell lung cancer (NSCLC) need accurate tumor staging in order to direct appropriate therapy and establish prognosis; the tumor is usually staged using the TNM system. The major imaging modalities currently used for staging this disease are thoracic computed tomography (CT) (including the adrenal glands) and whole body fluorodeoxyglucose (FDG)-positron emission tomography (PET) scanning. CT is generally most useful in evaluating the T stage, i.e. local spread of the neoplasm, whereas PET is most helpful in assessing the N and M stages, i.e. regional and distant tumor spread, respectively. Integrated CT-PET imaging adds information compared to the use of either modality alone. PET findings frequently lead to upstaging the disease and thus prevent unindicated surgeries. Magnetic resonance imaging (MRI) is helpful in evaluating local extent of disease in patients with superior sulcus tumors and possible brachial plexus involvement. Staging accuracy using any of these imaging techniques is imperfect; therefore, pathologic confirmation of positive findings is recommended, whenever possible, before denying a patient potentially curative therapy.
Topics: Adenocarcinoma; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Humans; Lung Neoplasms; Lymphatic Metastasis; Mediastinal Neoplasms; Neoplasm Staging; Pleural Neoplasms; Radiography; Sensitivity and Specificity; Thoracic Wall
PubMed: 17964957
DOI: 10.1102/1470-7330.2007.0026 -
Leukemia & Lymphoma May 2019Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine,...
Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56% with bulky disease, 75% with elevated LDH, 25% with SVC syndrome, and 13% with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93% and 100% respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation.
Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Cyclophosphamide; Disease Management; Doxorubicin; Female; Humans; Lymphoma, B-Cell; Male; Mediastinal Neoplasms; Middle Aged; Neoplasm Staging; Prednisone; Prognosis; Rituximab; Treatment Outcome; Vincristine; Young Adult
PubMed: 30656983
DOI: 10.1080/10428194.2018.1519812 -
Oncology (Williston Park, N.Y.) Jun 2017Primary mediastinal B-cell lymphoma is a distinct clinicopathologic entity that has a predilection for young women. It is clinically and molecularly different from other...
Primary mediastinal B-cell lymphoma is a distinct clinicopathologic entity that has a predilection for young women. It is clinically and molecularly different from other subtypes of diffuse large B-cell lymphoma and has a unique paradigm of management. While the cure rate for patients with primary mediastinal B-cell lymphoma is high, approaches have historically included mediastinal radiation; in moving therapeutics forward, strategies that obviate the need for radiation while maintaining high cure rates are critical. Mediastinal gray zone lymphoma is a closely related disease that is exceedingly rare and more common in men. Over recent years, there has been much progress in elucidating the biology of these lymphomas, and this has paved the way for novel therapies that are currently under investigation in clinical trials.
Topics: Age Factors; Diagnosis, Differential; Disease Management; Female; Hodgkin Disease; Humans; Lymphoma, B-Cell; Male; Mediastinal Neoplasms; Prognosis
PubMed: 28620906
DOI: No ID Found -
Annals of the Royal College of Surgeons... Jul 2020Ganglioneuroma is a rare benign neoplasm. Patients with ganglioneuroma show no symptoms. We describe a rare case of giant ganglioneuroma with scoliosis in a 35-year-old...
Ganglioneuroma is a rare benign neoplasm. Patients with ganglioneuroma show no symptoms. We describe a rare case of giant ganglioneuroma with scoliosis in a 35-year-old woman, who presented to our hospital for haemoptysis. We combined with neurosurgeons to remove the tumour successfully. After 16 months of follow-up, there is no evidence of tumour recurrence.
Topics: Adult; Female; Ganglioneuroma; Hemoptysis; Humans; Magnetic Resonance Imaging; Mediastinal Neoplasms; Neoplasm Invasiveness; Scoliosis; Thoracic Vertebrae; Tomography, X-Ray Computed; Treatment Outcome; Tumor Burden
PubMed: 32233849
DOI: 10.1308/rcsann.2020.0048 -
Thorax Jun 1988Sixty patients with anterior mediastinal neoplasms undergoing computed tomography before surgical exploration were entered in a prospective study to assess the value of...
Sixty patients with anterior mediastinal neoplasms undergoing computed tomography before surgical exploration were entered in a prospective study to assess the value of computed tomography in the preoperative staging of anterior mediastinal tumours. Correct prediction of location, size, and tissue density was obtained in all 60 cases. Correct identification of the nature of the tumours was achieved by computed tomography in 37 of the 54 previously undiagnosed cases. Particular attention was given to the evaluation of the relation of the tumour to adjacent mediastinal structures, to predict the feasibility of radical surgical procedures. Overall sensitivity, specificity, and accuracy in identifying resectability were 46%, 85%, and 64%, with positive and negative predictive indices of 78% and 58%. Capsulated or highly invasive lesions were clearly distinguished, and the presence or absence of infiltration of mediastinal vessels, pericardium, and chest wall was correctly recognised in most cases. It is suggested that the evaluation of anterior mediastinal neoplasms should include computed tomography because of its accuracy in predicting size, location, and tissue density of the neoplasm. Computed tomography may suggest, often with good reliability, the histological type of the tumour and its relation to contiguous mediastinal structures, thus contributing to the choice of the appropriate surgical approach or route for biopsy.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Goiter; Hodgkin Disease; Humans; Male; Mediastinal Neoplasms; Mesonephroma; Middle Aged; Neoplasm Staging; Prospective Studies; Thymoma; Thymus Neoplasms; Tomography, X-Ray Computed
PubMed: 3420555
DOI: 10.1136/thx.43.6.441 -
Journal of Cardiothoracic Surgery Jun 2022Posterior mediastinal paraganglioma (PM-PGL) is a rare disease that is difficult to diagnose. If PM-PGL is misdiagnosed preoperatively, surgeons may encounter severe...
Posterior mediastinal paraganglioma (PM-PGL) is a rare disease that is difficult to diagnose. If PM-PGL is misdiagnosed preoperatively, surgeons may encounter severe tachycardia and hypertension and easy bleeding from the tumor during the operation. Therefore, it is essential to include PGL as a differential diagnosis for mediastinal tumors. We herein describe a 73-year-old Japanese man with a PM-PGL that was diagnosed preoperatively and resected safely by video-assisted thoracic surgery. Preoperative management of hypertension with doxazosin mesylate, soft coagulation of the peritumor area, and careful clipping of feeding arteries were effective for hemostasis. The patient's vital signs were stable during and after the operation.
Topics: Aged; Humans; Hypertension; Male; Mediastinal Neoplasms; Mediastinum; Paraganglioma; Thoracic Surgery, Video-Assisted
PubMed: 35668526
DOI: 10.1186/s13019-022-01892-w