Barrett’s esophagus and Barrett’s carcinoma

The alarming rise in the incidence of esophageal adenocarcinomas in the Western world has focused interest on so-called Barrett’s esophagus. Barrett’s esophagus is characterized by specialized intestinal epithelium replacing the normal squamous epithelium in the distal esophagus and is considered a consequence of long-lasting and severe gastroesophageal reflux disease. A metaplasia-dysplasia-carcinoma sequence links Barrett’s esophagus with adenocarcinoma of the distal esophagus (Barrett’s cancer). Despite intensive research, many questions concerning the pathogenesis, diagnosis, and treatment of Barrett’s esophagus and associated adenocarcinoma are still unanswered. Based on current data, the malignant progression of Barrett’s esophagus cannot be substantially prevented by medical or surgical therapy for reflux. Although no firm data are available to show that surveillance strategies can reduce overall mortality from Barrett’s cancer, early detection and cure are possible. Management of Barrett’s esophagus and carcinoma is reviewed with reference to the sequence of disease from metaplasia to carcinoma.     

Relationship between Hodgkin’s and non-Hodgkin’s lymphomas

Malignant lymphomas have traditionally been classified as either Hodgkin’s (HL) or non-Hodgkin’s lymphomas (NHL). The tumor cells in NHL have been identified as being derived from T- or B-lymphocytes, but not until recently was it possible to identify the origin of the tumor cells in HL. Differential diagnostic problems may exist with morphological overlaps between HL and NHL but do not reflect an underlying biological relationship. Recent observations indicate that HL and NHL may be more closely related than previously believed. HL and NHL may occur sequentially or simultaneously in one and the same individual and in a few cases a clonal relationship between the lymphomas has been proven. It is thus possible that a biological relationship between the disorders may exist in addition to morphological overlaps, and the purpose with this review is to summarize the different relations between HL and NHL.     

President’s Address

In breast cancer surgery, there has been a major shift toward less invasive local treatment: from extended or radical mastectomy to modified radical mastectomy, from modified radical mastectomy to breast conserving therapy, and from routine axillary lymph node dissection to sentinel lymph node biopsy. Many breast surgeons have experienced an evolutionary progression of surgical management of breast cancer. However, there is an increasing demand for minimally invasive and non-surgical treatment methods for patients with small breast cancer. Radiofrequency (RF) ablation is the most promising among non-surgical ablation techniques in the treatment of breast cancer, although it is still in the investigative stage. Nevertheless, surgery still plays an integral role in the treatment of breast cancer, because local therapy is important for enhancing survival in the presence of systemic therapy. In clinical practice, surgical oncologists must individualize treatments, selecting a surgical or non-surgical procedure that provides the best local control, does not compromise the chances of cure, and achieves the best cosmetic results.     

骨Paget’病

最早由JamesPaget描述本病而得名，又称畸形性骨炎或变形性骨炎，是一种慢性进展的瘤样骨病，至今病因不明，有人认为与病毒感染有关，并具有家族遗传倾向。表现为过量的局部骨组织重吸收和随后过量的骨再生修复，造成病变骨骼增厚、脆弱，可导致病理骨折、骨骼畸形及骨关节退变等。临床多以骨痛就诊。X线表现具有特征性，早期表现为弥漫性的骨吸收，骨皮质为“海绵样”结构所替代，骨髓腔与皮质界限不清，后期成骨增加，表现为骨密度不均匀增高、骨皮质增厚等，可伴有骨骼畸形。     

Kimura’s disease

A 12 year old child developed primary unilateral cervical mass. Routine investigations were inconclusive except cosinophibilia. Excision biopsy revealed the diagonisis as Kimura’s Disease. Retrospective investigations confirmed it. This disease should be suspected when a patient presents with tetrad of painless unilateral cervical lymphodenopathy. Eosinophilia, Hyperimmunoglobulimemia (††/gE) & Positive Candida Specific Antibodies. A flow chart has been drawn to treat this condition after review of literature.Key Words: Kimura’s, Candida specific Antibodies, Eosinophilia     

Cancer screening in France: subjects’ and physicians’ attitudes

Objective Since screening for cancer has been advocated, funded, and promoted in France, it is important to evaluate the attitudes of subjects in the general population and general practitioners (GPs) toward cancer screening strategies. Methods EDIFICE is a nationwide opinion poll that was carried out by telephone among a representative sample of 1,504 subjects living in France and aged between 40 and 75 years and among a representative sample of 600 GPs. The questionnaire administered to subjects queried about previous screening for cancer. Results Ninety-three percent of women stated that they had undergone at least one mammography. Although rated “A” recommendation—strongly recommended—by the US Preventive Services Task Force, screening for colorectal cancer received less attention than prostate cancer screening which is rated “I”—insufficient evidence—(reported screening rates of 25% and 36%, respectively). Six percent of subjects stated that they had undergone lung cancer screening. GPs’ attitudes toward cancer screening showed similar inconsistencies. Conclusions It thus appears that understanding of cancer screening practices in the French general population does not match scientific evidence. To a lesser extent, this also holds for GPs.     

Anticipating Posttraumatic Growth from Cancer: Patients’ and Collaterals’ Experiences

Posttraumatic growth has been demonstrated to occur following the diagnosis and treatment of cancer. Still unknown is whether patients expect such growth, how growth is perceived at early points in time that follow the cancer experience, and whether patient reports of growth are corroborated by others. Participants were 87 patients and 55 collaterals who reported their anticipation of growth pretreatment and their perceived growth at a 9-month follow-up. Patients' expectations for their own growth were significantly higher than collaterals' expectations for theirs. When anticipated growth was compared to later reported growth, patients overanticipated growth across all domains and collaterals underanticipated growth.     

A Snapshot of Patients’ Perceptions of Oncology Providers’ Cultural Competence

In this paper, we describe an anonymous cross-sectional survey with a sample of 100 racially diverse adult oncology patients using a newly developed patient-reported measure of providers’ cultural competence, the Physicians’ Cultural Competence for Patient Satisfaction Scale (PCCPS) [1, 2], which was developed using a US midwestern sample of primary care patients. Our primary aims were to examine the reliability of the PCCPS in a more racially diverse urban oncology clinical setting and to identify salient domains of oncology provider cultural competence based on patient-reported satisfaction with direct clinical encounters. Results suggest that patient-reported satisfaction was significantly associated with one of the four domains measured by the PCCPS, physician’s patient-centered cultural competence (r?=?0.40, p?=?0.01), and female patients were more satisfied (t (91)?=?5.23, p?=?0.02). The PCCPS demonstrated good reliability in an urban diverse cancer patient population. Results help to inform the development of clinical tools that can improve oncology providers’ cultural competency.     

Minor’s Test: Objective Demonstration of Horner’s Syndrome

To highlight the Minor’s test, which is useful in demonstrating anhidrosis of Horner’s syndrome. A 39 year old female presented to us with a slow growing neck swelling which was provisionally diagnosed as a probable case of cervical sympathetic chain (CSC) Schwannoma. Intra operatively, the mass was found arising from the CSC which was sacrificed. Post operatively, Horner’s syndrome was expected, but was difficult to demonstrate clinically. On performing the Minor’s test, the presence of anhidrosis, and thus Horner’s syndrome was confirmed. Minor’s test is a simple objective test to demonstrate Horner’s syndrome, especially because diagnosis from the eye signs can be difficult.     

乳房Paget’s病同发Bowen’s病一例

乳房Ｐａｇｅｔ’ｓ病同发Ｂｏｗｅｎ’ｓ病一例中山市人民医院席亚鸣，孙蓓患者女，５７岁。因左乳头瘙痒、糜烂、渗液、结痂，左腋下肿物４个月，于１９８９年１０月７日入院。体查：双侧乳房对称，左乳头乳晕皮肤潮红、湿润和糜烂，左乳头下可触及一１ｃｍ×ｌ．３Ｃｍ...     

Early-stage hodgkin’s disease

Treatment of Hodgkin’s disease (HD) is strictly dependent on stage. Historically, early-stage HD included the limited stages I, II, and IIIA (according to the Cotswolds modification of the Ann Arbor classsification), whereas advanced HD included stage III with B symptoms and stage IV. It was then observed that early-stage HD with certain clinical risk factors had a significantly worse outcome. As a consequence, several studies defined these patients as suffering from early-stage unfavorable (or intermediate-stage) HD, demanding a more aggressive treatment. The treatment of early-stage HD is changing strikingly. Until recently, extended-field (EF) irradiation has been considered the standard treatment. However, because of the recognition of its high relapse rate and fatal long-term effects, EF radiotherapy is now being abandoned by most study groups. Instead, for favorable early-stage HD, mild chemotherapy for control of occult disease is combined with involved-field (IF) irradiation. In early-stage unfavorable (intermediate) HD, four cycles of chemotherapy plus IF irradiation is accepted as standard treatment.     

Cancer de l’oropharynx

Cancers of the oropharynx are common lesions. Their treatment often includes radiation therapy either exclusively or in combination with chemotherapy or after surgery. The definition of target volumes is made difficult by the complex anatomy of this area. The aim of this work is to clarify the principles of 3D conformal radiation illustrated by a case report.