ABSTRACT
The case of hypercalcemia secondary to metastasis to a benign parathyroid adenoma is reported. The patient had documented lung adenocarcinoma with multiple bone metastases and a mass in the lower anterior neck for at least 5 months before hypercalcemia and hypophosphatemia resistant to treatment developed. Autopsy revealed widespread metastatic disease including metastatic tumor invading a benign parathyroid adenoma. The analysis of four cases of metastatic cancer spread to a benign parathyroid adenoma reported previously revealed that two of them also had hypercalcemia during a late stage of the disease. There are data that the incidence of metastases to parathyroid gland might be as high as 11.9%, and the incidence of parathyroid adenomas in patients with cancer is significantly higher than in controls. The metastases to benign parathyroid adenomas might be another mechanism of hypercalcemia of malignancy.
Subject(s)
Adenocarcinoma/secondary , Adenoma/secondary , Head and Neck Neoplasms/secondary , Hypercalcemia/etiology , Lung Neoplasms/secondary , Parathyroid Neoplasms/secondary , Adenoma/complications , Aged , Female , Humans , Parathyroid Neoplasms/complicationsABSTRACT
The role of CT in the diagnosis of intrathoracic Kaposi's sarcoma (KS) was evaluated retrospectively in 24 patients, in the absence of coexistent opportunistic infections. In all cases the diagnosis of KS was initially established by histologic evaluation of extrathoracic disease: 15 patients had verified parenchymal KS and nine patients endobronchial KS. (Chest roentgenograms were analyzed separately for each group: in 14 patients serial films were available for review. The predominant radiographic findings was the presence of nonspecific, bilateral, perihilar infiltrates in 22 of 24 cases (92 percent). Corresponding CT scans documented the presence of abnormal hilar densities characteristically extending into the adjacent pulmonary parenchyma along distinctly perivascular and peribronchial pathways. Discrete, poorly marginated nodules were identified radiographically in ten cases (42 percent); these proved to be randomly distributed throughout the parenchyma on CT. Radiographic evidence of mediastinal adenopathy was distinctly unusual, seen in only two cases (8 percent). While CT typically demonstrated shotty adenopathy, significantly enlarged nodes (greater than 1 cm) were rarely identified. We concluded that CT is more specific than routine roentgenograms for identifying pulmonary KS. While not pathognomonic, peribronchial and perivascular disease is sufficiently characteristic to obviate more invasive diagnostic procedures, especially in patients with established KS.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Lung Neoplasms/diagnostic imaging , Sarcoma, Kaposi/diagnostic imaging , Adult , Humans , Lung Neoplasms/etiology , Male , Middle Aged , Mycobacterium avium-intracellulare Infection/diagnostic imaging , Pneumonia, Pneumocystis/diagnostic imaging , Retrospective Studies , Sarcoma, Kaposi/etiology , Tomography, X-Ray ComputedABSTRACT
A 33-yr-old white woman treated for alcoholic hepatitis developed acute pancreatitis during her hospital stay. At autopsy, two major pathological processes were found: alcoholic cirrhosis and chronic pancreatitis. In both, there was evidence of an acute episode, i.e., acute alcoholic hepatitis and acute hemorrhagic pancreatitis superimposed on the chronic alcoholic lesions. The sequence of events would indicate that the acute pancreatic pathology was precipitated by supranormal ecbolic stimulation of the acinar segment of the "pancreon" units, triggered as a result of a high protein and fat diet.
Subject(s)
Hepatitis, Alcoholic/complications , Pancreatitis/etiology , Acute Disease , Adult , Chronic Disease , Female , Hepatitis, Alcoholic/pathology , Humans , Liver Cirrhosis, Alcoholic/pathology , Pancreatitis/pathologyABSTRACT
A case is presented of cystosarcoma phyllodes of the breast metastatic to the pancreas. Solitary metastasis to the pancreas has not been reported. The lesion was excised in toto with a good result. Clinical and pathological features of cystosarcoma phyllodes are discussed.
Subject(s)
Breast Neoplasms/pathology , Pancreatic Neoplasms/pathology , Phyllodes Tumor/pathology , Female , Humans , Middle Aged , Neoplasm MetastasisABSTRACT
Effects of irradiation on the pancreas was studied in 6 dogs receiving a dose equivalent to the biologic effect of 4000 R/6 weeks (with a nominal stnadard dose of 1175 rets) given to patients with Hodgkins disease. After control secretory, histologic and pancreatographic studies, 6 Thomas fistula dogs were subjected to 2400 R tumor dose over two weeks. There was a biphasic response to secretin alone or secretin with cholecystokininpancreozymin. An initial hypersecretion occurred at 2 weeks --volume was increased, but bicarbonate and enzyme output remained unchanged. Thereafter there was a progressive reduction in volume, bicarbonate and enzyme outputs ( greater than 90% after 3 months). Histology showed early ductal reduplication but with progressive fibrosis, features compatible with chronic pancreatitis. Pancreatic insufficiency may contribute to post-irradiation gastrointestinal symptomatology. Close field irradiation of the pancreas results in actual destruction of the parenchyma.
Subject(s)
Pancreas/radiation effects , Pancreatic Diseases/etiology , Radiation Injuries, Experimental/etiology , Animals , Bicarbonates/analysis , Cholecystokinin/pharmacology , Disease Models, Animal , Dogs , Female , Male , Pancreas/drug effects , Pancreas/metabolism , Pancreatic Juice/analysis , Radiation Dosage , Secretin/pharmacologyABSTRACT
A case of pulmonary fungus ball produced by Cladosporium cladosporioides is reported. The fungus occupied a cavity in the upper lobe of right lung. Invasion of the cavitary wall or adjacent pulmonary tissue by the fungus was not observed.
