Keeping up with the cancer literature--PDQ ACCESS

Physician Data Query (PDQ) (National Cancer Institute [NCI], Bethesda, MD) and CANCERLIT (NCI, Bethesda, MD) are two online cancer information databases. PDQ summarizes current cancer therapy literature into specific treatment recommendations. CANCERLIT is a bibliographic system similar to MEDLINE (National Library of Medicine [NLM], Bethesda, MD) that provides a comprehensive source of literature citations for the field of cancer. In this report, we discuss linking PDQ and CANCERLIT with PDQ ACCESS (NCI, Bethesda, MD)--a custom software package that makes searching the cancer literature easy for the practicing physician unfamiliar with database searching.     

An emerging role for endothelial nitric oxide synthase in chronic inflammation and cancer

Nitric oxide (NO) is a free radical that is involved in carcinogenesis. Recent literature indicates that endothelial NO synthase (eNOS) can modulate cancer-related events (angiogenesis, apoptosis, cell cycle, invasion, and metastasis). We review the literature linking eNOS to carcinogenesis to encourage future research assessing the role of eNOS in cancer prevention and treatment.     

甲状腺癌肿瘤相关巨噬细胞研究现状

目的肿瘤相关巨噬细胞(tumor-associated macrophage,TAM)是肿瘤微环境中最重要的组成部分,TAM主要为M2表型,与多种肿瘤的不良预后有密切关系。本研究从TAM在甲状腺癌中的募集、分化、发生发展、临床意义和靶向治疗等方面进行综述。方法检索Medline及CNKI期刊全文检索系统,以"肿瘤相关巨噬细胞、甲状腺癌"等为关键词,检索2008-12—2018-01相关文献,共检索到英文文献147条,中文文献51条。纳入标准:肿瘤相关巨噬细胞与甲状腺癌的相关科学研究。剔除标准:(1)研究机制阐述模糊;(2)研究年代久远;(3)重复性文献。符合纳入及排除标准的文献总共46篇。结果甲状腺癌通过释放许多趋化因子/细胞因子来募集并活化肿瘤相关巨噬细胞。甲状腺癌的分化程度越差,分期越晚,其组织中浸润的TAM越多。TAM通过不同的机制促进甲状腺癌的生长及淋巴结转移。此外,TAM还可以作为生物标志物有助于区分甲状腺癌良恶性结节。TAM的靶向治疗可以有效抑制甲状腺癌细胞的生长与分化。结论TAM与甲状腺癌的发生、发展有关,TAM可以作为甲状腺癌诊断、预后的评估指标和治疗的新靶点。期待更多靶向TAM的治疗,以丰富甲状腺癌的治疗手段。     

A primary adenocarcinoma of the appendix, accompanied with 5 ileocolonic fistulae

A primary adenocarcinoma of the appendix is a rare lesion, and this paper reports a case of a primary adenocarcinoma of the appendix, but with the inclusion of 5 fistulae. According to the classification by Uihlein & McDonald, this histology is of the colonic type. The first known case accompanied with a fistula was reported by Haldane (1862) in the English-language literature and by Shiraishi et al. (1954) in Japan. Since then, 21 cases have been found in the Japanese literature. The patient underwent an operation and his prognosis has been considered good. A review of some the relevant literature is discussed with regard to the pathology, diagnosis, and treatment.     

Intra-cranial lesions in a patient with Hodgkin lymphoma

Central nervous system (CNS) lesions in newly diagnosed, advanced Hodgkin's disease (HD) commonly suggest intracranial involvement with HD. However, occasionally this could be the result of a CNS infection. We report a case of concurrent CNS tuberculosis in a patient with stage III E HD the first reported in the English literature. Management of this case and the literature pertaining to infectious complications of HD are reviewed.     

Primary effusion lymphoma: a series of 4 cases and review of the literature with emphasis on cytomorphologic and immunocytochemical differential diagnosis

BACKGROUND: Primary effusion lymphoma (PEL) is a human herpes virus-8 (HHV-8)-associated and very rare type of lymphoma usually confined to the body cavities and commonly observed in human immunodeficiency virus (HIV)-infected patients. A comparison was made between the cytologic and immunocytochemical features of 4 cases of PEL encountered in the authors' department with those reported to date in the literature. METHODS: A comprehensive comparison of the cytologic and immunocytochemical features of the 4 cases with those reported in the literature was conducted. RESULTS: Cytologically, the most consistent features of the 4 cases and those in the literature included large cell size, moderate to abundant cytoplasm, a single nucleus in most cells with occasional bi- or multinucleated giant cells, single to multiple prominent nucleoli, and coarse chromatin. Immunocytochemically, only 2 (50%) of the current cases were of the null-phenotype compared with 93% of cases in the literature; the other 2 cases had a T-cell phenotype. Activation markers were expressed in 50% and 78% of the current cases and the literature cases, respectively. Positivity for HHV-8 was proven in the 4 cases by immunocytochemistry. CONCLUSIONS: Cytomorphologically, PEL exhibits features bridging large cell immunoblastic and anaplastic large cell lymphoma. Although it is usually of null-phenotype, it may occasionally express B-cell or T-cell markers, rendering its distinction difficult from other lymphomatous effusions on a cytologic and immunocytochemical basis alone. Therefore, HHV-8 detection is an essential confirmatory ancillary test in suspected cases of PEL.     

循证医学与肿瘤治疗的疗效评价

建立完善的循证肿瘤学疗效评价方法是肿瘤治疗学发展的必然趋势。循证肿瘤学疗效评价的主要步骤包括;见到病人继而提出需要解决的临床问题。进行全面,准确的文献检索,为问题寻找最佳证据。对相关的文献资料进行客观、综合地评价,然后根据评价结果决定是否应用于临床实践,在临床实践中验证和完善疗效评价结果。     

ALK-positive anaplastic large T-cell lymphoma preceded by Epstein-Barr virus infection complicated by development of an aorto-esophageal fistula

We report an unusual case of aggressive ALK-positive anaplastic large cell lymphoma with widespread mediastinal involvement immediately preceded by an acute Epstein-Barr virus (EBV) infection. Following initiation of chemotherapy and radiological evidence of significant tumor regression, the patient suffered a fatal massive upper gastrointestinal hemorrhage from an aorto-esophageal fistula. The relevant literature relating to EBV in the pathogenesis of ALK-lymphomas and literature relating to aorto-enteric fistula (AEF) in mediastinal lymphoma is reviewed.     

Ameloblastic carcinoma, primary type: case report, immunohistochemical analysis and literature review

Ameloblastic carcinoma (AC) is a rare malignant odontogenic neoplasm with scarce reported cases in the literature and it can be confused with benign ameloblastoma (AM). This study reports a case of AC, and presents a literature review of AC classified into primary type (ACPt) or secondary type (ACSt) by the World Health Organization (WHO). The review addressed 31 cases published in the English literature between the years 2005 and 2011. The majority of cases were ACSt. The mandible was the most common site of occurrence for both AC types. All patients who died of their disease had ACSt. Tumors with plexiform pattern, hyperchromatism, mitosis and necrosis were associated with a higher ratio of histories of recurrence and death by disease, as well as the tumors with clear cells, especially in the ACSt. ACSt appeared to correlate with recurrence and mortality. The histological features may have different prognostic importance depending on the AC type.     

前列腺特异性抗原对中国人群前列腺癌早期检测价值的Meta分析

背景与目的：前列腺特异性抗原（prostate-specific antigen,PSA）是一种前列腺癌标志物,但关于使用PSA作为筛查标准是否合适仍存在争论。评价PSA在中国人群前列腺癌早期检测中的价值,旨在为前列腺癌筛查策略的制定提供依据。方法：对万方数据库、中国医院知识仓库（China Hospital Knowledge Database,CHKD）和PubMed数据库进行文献检索,再根据已发表文献中的参考文献追溯进行手工检索。收集2000年1月—2020年3月有关PSA对中国人群前列腺癌早期检测的文献资料。按确定的纳入标准筛选文献,对纳入的文献进行质量评价。对以PSA>4 ng/mL作为临界点检测前列腺癌的灵敏度、特异度等进行Meta分析。结果：共检索到5 722篇文献,排除重复及不符合标准的5 713篇后,纳入9篇文献。累计研究对象共6 425人,其中前列腺癌患者596例;Meta分析结果显示,以PSA>4 ng/mL作为临界点检测前列腺癌的灵敏度、特异度和集成受试者工作特征（summary receiver operating characteristic,SROC）曲线的曲线下面积（area under curve,AUC）分别为91%（95% CI：89%~93%）、41%（95% CI：27%~56%）和0.91（95% CI：0.88~0.93）。结论：中国人群中以PSA>4 ng/mL作为检测前列腺癌的界值,具有较高的灵敏度,但特异度较低,前列腺癌筛查可在PSA>4 ng/mL的基础上进一步筛选。     

A novel application of plasma and cerebrospinal fluid level of epstein barr virus DNA in the diagnosis of leptomeningeal metastasis from nasopharyngeal carcinoma. A case report

Epstein Barr virus (EBV)-associated nasopharyngeal carcinoma (NPC) is endemic in Southeast Asia, and the plasma level of EBV DNA is a highly sensitive marker of disease recurrence following radiotherapy. Leptomeningeal recurrence from NPC is extremely rare and difficult to diagnose; only 4 cases have been reported in the literature. We report a case of leptomeningeal recurrence in NPC that was diagnosed using imaging and plasma and cerebrospinal fluid EBV DNA assays, followed by a review of the literature.     

Embryonal rhabdomyosarcoma of the middle ear and mastoid

A rare case of embryonal rhabdomyosarcoma of the middle ear and mastoid with facial paralysis is presented with brief review of literature. Embryonal rhabdomyosarcoma of the middle ear and mastoid is very rare. It is highly malignant tumour found in the paediatric age group. Soderserg (1933) reported the first case of embryonal Rhabdomyosarcoma of the middle ear. Stobbe and Drageon (1959) described 15 cases of tumour occuring in the head and neck, out of which two were in the middle ear and the mastoid process. Deutsch and Felder (1974) reviewed the world literature up to 1973 and could collect only 22 cases including 5 of their own. According to Maurer et al (1977) rhabdomyosarcoma originating in the head and neck comprise 36% of all cases of rhabdomyosarcoma. A rare case of Embryonal Rhabdomyosarcoma of the middle ear and mastoid with facial paralysis is being reported with a brief review of literature.     

A Case of Melanoma Concurrent with Progressive Systemic Sclerosis

The association between progressive systemic sclerosis (PSS; scleroderma) and malignancy has been a controversial issue in the literature. The present report describes a rare case of concurrent malignant melanoma and PSS. A literature review suggests a possible connection between these two conditions.     

Primary effusion lymphoma

BACKGROUND

Primary effusion lymphoma (PEL) is a human herpes virus‐8 (HHV‐8)‐associated and very rare type of lymphoma usually confined to the body cavities and commonly observed in human immunodeficiency virus (HIV)‐infected patients. A comparison was made between the cytologic and immunocytochemical features of 4 cases of PEL encountered in the authors' department with those reported to date in the literature.

METHODS

A comprehensive comparison of the cytologic and immunocytochemical features of the 4 cases with those reported in the literature was conducted.

RESULTS

Cytologically, the most consistent features of the 4 cases and those in the literature included large cell size, moderate to abundant cytoplasm, a single nucleus in most cells with occasional bi‐ or multinucleated giant cells, single to multiple prominent nucleoli, and coarse chromatin. Immunocytochemically, only 2 (50%) of the current cases were of the null‐phenotype compared with 93% of cases in the literature; the other 2 cases had a T‐cell phenotype. Activation markers were expressed in 50% and 78% of the current cases and the literature cases, respectively. Positivity for HHV‐8 was proven in the 4 cases by immunocytochemistry.

CONCLUSIONS

Cytomorphologically, PEL exhibits features bridging large cell immunoblastic and anaplastic large cell lymphoma. Although it is usually of null‐phenotype, it may occasionally express B‐cell or T‐cell markers, rendering its distinction difficult from other lymphomatous effusions on a cytologic and immunocytochemical basis alone. Therefore, HHV‐8 detection is an essential confirmatory ancillary test in suspected cases of PEL. Cancer (Cancer Cytopathol) 2007. © 2007 American Cancer Society.     

Management of neurocytomas: case report and review of the literature

The purpose of this report is to review the available literature on the presentation, pathology, and treatment of central nervous system (CNS) neurocytomas. A case report of an extraventricular neurocytoma is presented along with a comprehensive literature search of patients with a diagnosis of CNS neurocytoma. CNS neurocytomas are rare neoplasms, with fewer than 240 cases reported in the literature. The majority of neurocytomas are found in the ventricular system of the brain. Immunohistochemistry is frequently used to help distinguish this tumor from other CNS neoplasms. MIB-1 proliferation index is commonly used in an attempt to predict biologic behavior. Little is known about the management of patients with this tumor, because most reports are from the pathologic literature and contain sparse information regarding clinical management. Neurocytomas are rare CNS tumors with varied biologic behavior. MIB-1 index may help direct adjuvant therapy. An excellent prognosis can be expected if a gross total resection is achieved. Postoperative radiation therapy (RT) may be considered after subtotal resection. Otherwise, RT is an option for medically inoperable or recurrent disease.     

Central Nervous System Metastasis in Patients With Urothelial Carcinoma: Institutional Experience and a Comprehensive Review of the Literature

IntroductionCentral nervous system (CNS) metastasis in patients with urothelial carcinoma (UC) is uncommon and poorly understood. We aimed to explore the clinical behavior and outcomes of this unique patient population.Materials and MethodsWe performed a retrospective analysis of patients with UC and CNS metastasis, treated in our institution (2006-2018), along with an exploratory patient-point meta-analysis of a similar patient population derived from a comprehensive literature review. Data regarding diagnosis, management, and outcomes were extracted. Overall survival, time to CNS metastasis (TTCM), and residual survival (RS) from CNS involvement to death were calculated (Kaplan–Meier method). Cox regression was used for testing key clinicopathologic associations.ResultsWe identified 20 “institutional” and 154 “literature” patients with adequate data granularity for analysis. Median TTCM was 17.7 (institutional cohort) and 10 (literature cohort) months. Most patients who developed CNS metastases had previous non-CNS metastasis (15/20 [75%] and 103/154 [67%], respectively). CNS lesions without previous history of metastasis were identified in 5/20 (25%) and 33/154 (21%) cases and those patients had a shorter TTCM. CNS lesions in the absence of known UC history were also documented in 18/154 (12%) literature cases. Multifocal CNS disease was associated with shorter RS in both cohorts in univariate, but not multivariate, analysis.ConclusionWe observed a variability in disease presentation and course, with a subset of patients showing an early predilection for CNS insult, potentially reflecting a diverse underlying biology. Genomic profiling studies, elucidating the molecular landscape, and driving future treatments should be considered in this setting.     

A case of multiple metastatic low-grade endometrial stromal sarcoma arising from an ovarian endometriotic lesion

The development of endometrial stromal sarcomas (ESSs) in foci of endometriosis is extremely rare, and few cases have been reported in the literature to date, particularly with regard to multiple extrauterine ESS. Here we report a case of endometrial stromal sarcoma with multiple metastasis that arose from an ovarian endometriotic lesion. The literature is also briefly reviewed.     

Carcinoma of the breast with sarcomatous metaplasia

Carcinoma of the breast with sarcomatous metaplasia (CSM) is a rare and interesting tumour with a poorer prognosis than the usual breast malignancies. The mammographic appearances of this lesion have only previously been described once in the literature. A case of CSM is presented with mammographic-pathological correlation and review of the literature.     

Coping With Childhood Cancer

This article presents a conceptual framework for studying the impact of childhood cancer on the psychological and social functioning of the patient and the family. A model based on the literature about coping with stress, especially with respect to cancer, and on two psychosocial theories of human behavior (the attribution theory and the social comparison theory) is used as a starting point. The model (1) describes the problems people experience when confronted with a threatening situation, (2) provides a classification of problems that has a manageable number of categories to which problems can be assigned, and (3) gives insight into some important coping strategies that children and their parents use to lessen the impact of those problems. The problem categories and coping strategies of the model are illustrated mainly from findings described in the literature and from information the authors obtained during interviews with patients and parents.     

A case of primary retroperitoneal undifferentiated endometrial stromal sarcoma after concurrent chemoradiation therapy for cervical cancer

Endometrial stromal sarcoma (ESS) is a relatively rare uterine sarcoma, especially extrauterine ESS. Furthermore, retroperitoneal ESS are extremely rare. Up to now, there are only four cases of primary retroperitoneal ESS reported in the literature. We report one case of primary retroperitoneal undifferentiated endometrial stromal sarcoma after concurrent chemoradiation therapy for cervical cancer with a brief review of the literature.