RESUMO
Sarcomatoid carcinoma arising from intrahepatic cholangiocyte, an extremely rare primary liver cancer, has highly invasive and metastatic potential. The pathogenesis of this tumor is unclear, although histogenetic mechanisms, such as transdifferentiation/dedifferentiation (epithelial-mesenchymal transition or metaplastic transformation), biphasic differentiation (combination and collision), and redifferentiation, might be suggested to explain the simultaneous co-existence of carcinoma and sarcoma components in the same tumor. Immunohistochemical staining might be necessary to differentiate whether sarcomatous component is originated from hepatocyte or cholangiocyte. We report a case of sarcomatoid intrahepatic cholangiocarcinoma in a 58 year-old man presenting as an incidentally detected liver mass on regular health examination, which was diagnosed by an application of immunohistochemical methods after surgical resection, with a review of the literature based on 9 cases reported in Korea.
Assuntos
Colangiocarcinoma , Hepatócitos , Coreia (Geográfico) , Neoplasias Hepáticas , Fígado , SarcomaRESUMO
No abstract available.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Doença Aguda , Biópsia , Evolução Fatal , Imunofluorescência , Glomerulonefrite/complicações , Imunossupressores/uso terapêutico , Poliangiite Microscópica/complicações , Pancreatite/diagnóstico , Resultado do TratamentoRESUMO
Secondary involvement of the gallbladder by systemic lymphoma is exceedingly rare and relapsed diffuse large B cell lymphoma of the gallbladder has not been reported. A 78-year-old man was admitted to the hospital due to epigastric pain and jaundice. His past medical history was remarkable for diagnosis with diffuse large B-cell lymphoma of the ileum 5 years ago. He underwent right hemicolectomy and three cycles of adjuvant chemotherapy and had complete remission. Abdominal computed tomography showed choledocholithiasis and focal thickening at fundus of the gallbladder. The patient underwent open cholecystectomy. Pathologic examination revealed diffuse large B-cell lymphoma. We report a case of solitary, relapsed diffuse large B-cell lymphoma of the gallbladder with literature review.
Assuntos
Idoso , Humanos , Linfócitos B , Quimioterapia Adjuvante , Colecistectomia , Coledocolitíase , Diagnóstico , Vesícula Biliar , Íleo , Icterícia , Linfoma , Linfoma de Células B , Linfoma não Hodgkin , RecidivaRESUMO
Rothia muciliaginosa (R. mucilaginosa) is a facultative, Gram-positive coccus that is considered to be part of the normal flora of the mouth and respiratory tract. There are sporadic reports of the organism causing endocarditis in patients with heart valve abnormalities, as well as meningitis, septicemia, and pneumonia associated with intravenous drug abuse. However, it is an unusual pathogen in cases of peritoneal dialysis (PD)-associated peritonitis. Although R. mucilaginosa is generally susceptible to penicillin, ampicillin, cefotaxime, imipenem, rifampicin, and glycopeptides, there are no guidelines for the treatment of PD-associated peritonitis. Herein, we report a case of PD-associated peritonitis due to R. mucilaginosa that was resolved with intraperitoneal antibiotic treatment.
Assuntos
Humanos , Ampicilina , Cefotaxima , Endocardite , Glicopeptídeos , Valvas Cardíacas , Imipenem , Meningite , Boca , Penicilinas , Diálise Peritoneal , Diálise Peritoneal Ambulatorial Contínua , Peritonite , Pneumonia , Sistema Respiratório , Rifampina , Sepse , Abuso de Substâncias por Via IntravenosaRESUMO
Concurrence of primary gastric adenocarcinoma and lymphoma have been described very rarely in the literature; its incidence is estimated at 0.08%. To our knowledge, there are no reports about a collision tumor comprising early gastric cancer and diffuse large B-cell lymphoma from the same lesion. The term "collision tumor" refers to the coexistence of two or more histologically distinct tumors within the same mass with no histologic admixture. A 76-year-old man complained of a 5-month-history of dyspepsia, and underwent esophagogastroduodenoscopy. Endoscopic findings showed a nodular, round, flat mass lesion in the upper body, therefore we performed endoscopic submucosal dissection (ESD). Pathologic findings revealed a well-differentiated adenocarcinoma accompanied by diffuse large B-cell lymphoma without evidence of Helicobacter pylori infection. Conventional CT and PET-CT scans revealed metastatic lymph nodes in the parotid gland, submandibular gland, maxillary gland and the inguinal regions. The pathogenesis of a collision tumor comprising two different cancers is not well understood. In addition, there are no established treatment guidelines in this series. In the current case, the patient underwent ESD for the removal of adenocarcinoma concomitantly with chemotherapy for the management of metastatic lymphoma.
Assuntos
Idoso , Humanos , Adenocarcinoma , Linfócitos B , Tratamento Farmacológico , Dispepsia , Endoscopia do Sistema Digestório , Helicobacter pylori , Incidência , Linfonodos , Linfoma , Linfoma de Células B , Linfoma Difuso de Grandes Células B , Glândula Parótida , Neoplasias Gástricas , Glândula SubmandibularRESUMO
Diabetic ketoacidosis (DKA) is a complex medical disorder characterized by abnormalities in electrolyte, acid-base, and volume status. Metabolic acidosis in mild and moderate DKA is corrected with insulin therapy. Bicarbonate therapy may be indicated in cases of severe metabolic acidosis, however the use of bicarbonate in severe DKA is controversial due to a lack of prospective randomized studies. Renal replacement therapy can be used for correction of systemic acidemia. Continuous renal replacement therapy (CRRT) is used in patients who are too hemodynamically unstable to tolerate conventional hemodialysis, but has also been used in treatment of patients with severe DKA. CRRT has never been used previously in DKA patients with refractory metabolic acidosis in Korea. Here, we describe the successful treatment of a DKA patient with refractory metabolic acidosis with CRRT.
Assuntos
Humanos , Acidose , Cetoacidose Diabética , Hemodiafiltração , Insulina , Coreia (Geográfico) , Estudos Prospectivos , Diálise Renal , Terapia de Substituição RenalRESUMO
BACKGROUND: Malignant cells exhibit increased glycolytic metabolism, and in many cases increased glucose transporter gene expression. The authors hypothesized that GLUT1 glucose transporter expression is increased in gallbladder carcinoma, and the degree of expression might have prognostic significance. METHODS: To evaluate a possible prognostic factor, we studied the expression of GLUT1 glucose transporter by an immunohistochemical method in 56 gallbladder carcinomas from patients and we compared these results with established prognostic factors. RESULTS: Of the 56 cases, 34 (60.7%) were positive for GLUT1. The expression of GLUT1 was not associated with patient age, sex and histologic type. Whereas the expression of GLUT1 was significantly correlated with depth of tumor invasion and lymph node and distant metastases. CONCLUSIONS: GLUT1 glucose transporter expression is strongly associated with poor prognostic factors of the gallbladder carcinoma and the assessment of the extent of GLUT1 immunostaining identifies patient with poorer prognosis.
Assuntos
Humanos , Vesícula Biliar , Expressão Gênica , Proteínas Facilitadoras de Transporte de Glucose , Glucose , Linfonodos , Metabolismo , Metástase Neoplásica , PrognósticoRESUMO
BACKGROUND: The treatment plan for breast cancer depends on the axillary lymph-node status. Because of improved screening methods, the number and the proportion of node-negative patients are increasing, leading to a need to search for a reliable prognostic marker. Assessment of prognostic markers, is of major concern for the application of adjuvant treatment regimens, independenent of the axillary lymph-node status. METHODS: The study samples consisting of 96 primary breast cancer tissues were analyzed immunohistochemically for the presence of p53 protein in a paraffin-embedded material. The reaction to monoclonal mouse anti-human p53 protein (DAKO-p53, DO-7) (DAKO, Denmark) produced our experimental data. RESULTS: Nuclear accumulation of the p53 protein suspected to be an independent marker of dedifferentiation, regardless of the lymph-node status. In our study the p53 positivity was 56.25% (54/96), and statistically p53 positivity was not affected by menopausal status, lymph-node metastasis, tumor size, age, presence of the estrogen receptor and the progesterone receptor, and pathologic grading. CONCLUSION: We weren't able to prove statistically that overexpression of p53 is an independent prognostic factor in breast cancer. With more cases of breast cancer involving the monoclonal antibody, a study of the correlation of overall survival and disease-free survival with lymph-node metastasis, pathologic grade, and p53 overexpression is necessary to decide on an early breast-cander treatment modality by using a prognostic marker such as p53.
Assuntos
Animais , Humanos , Camundongos , Neoplasias da Mama , Mama , Intervalo Livre de Doença , Estrogênios , Imuno-Histoquímica , Programas de Rastreamento , Metástase Neoplásica , Receptores de ProgesteronaRESUMO
Liver transplantation is an accepted and successful mode of treatment for pediatric end-stage liver disease. Living related liver transplatation(LRLT) in child has certain potential advantages, such as short cold ischemic time, accurate graft size and vessel diameter match based on elective preoperative preparations. Recently, introduction of microvasular surgery technique to hepatic artery reconstruction has been used, but still remained the possibility of hepatic artery thrombosis. Herein, We report a LRLT case, which showed hepatic artery stenosis postoperatively, successfully dilated by ballon angioplasty technique.