Maturation of Pulmonary Metastases of Wilms' Tumor after Therapy: A Case Report

A case is reported of Wilms' tumor associated with multiple pulmonary metastases histologically showing maturation of the tumor cells at 9 years after the resection of the primary tumor and intensive therapy. A huge tumor of a 22-month-old patient's right kidney was resected. The tumor was diagnosed as Wilms' tumor of mesenchymal type (stage 1), which consisted of predominantly immature mesenchymal tissue including rhabdomyoblasts, smooth muscle and fibrous tissue, and few blastemal and epithelial components. Intensive preoperative and postoperative chemotherapy with actinomycin D and vincristine and postoperative irradiation therapy totaling 16 Gy were carried out. The patient was regularly followed up uneventfully until 9 years after the surgery. On routine chest x ray at the age of 10 years 11 months, multiple pulmonary nodules were found. The excised nodules from the bilateral lungs disclosed similar histology, exclusively composed of dense collagen bundles and fibrocytes intermingled with mature striated muscle bundles. No immature tumor components were detected. The possible effect of intensive therapy in this maturation was stressed, although spontaneous benign differentiation of tumor cells cannot be excluded.     

Primary malignant lymphoma of the rectum with distant metastasis to the stomach: Report of a case

Primary extranodal malignant lymphoma frequently occurs in the gastrointestinal tract; however, it is rarely encountered in the rectum. We report herein the case of an 85-year-old man who underwent abdominoperineal resection for primary malignant lymphoma of the rectum, and 1 year later, developed hematemesis caused by gastric metastasis. To our knowledge this is the first case report of such distant metastasis developing from malignant lymphoma of the rectum.     

Giant splenic metastasis due to lung adenocarcinoma

Lung cancer is the most prevalent malignancy in western countries and most of the patients present at advanced stages, but single splenic metastasis is exceptional instead. We report on a case of a seventy-three-year old male presenting with non-hemoptoic productive cough, constitutional syndrome and pain in the left lower quadrant. Physical examination and complementary radiological and hystologycal procedures revealed the presence of an adenocarcinoma of the left lung with probable splenic metastasis. The patient underwent splenectomy, which confirmed the diagnose of splenic metastasis of lung adenocarcinoma and, secondly, lung resection was performed. Topics about lung cancer metastasis are discussed.     

小鼠肝癌细胞H22对淋巴内皮细胞flt-4、c-fos、PCNA表达的影响

目的：初步探讨有自发淋巴转移特性的肝癌细胞对淋巴内皮细胞增殖的影响。方法：弗氏不完全佐剂诱导Balb／c小鼠腹腔良性淋巴管瘤，分离瘤体消化法体外培养淋巴内皮细胞；H22细胞接种Balb／c小鼠腹腔，收集腹水制成H22条件培养液，观察其对淋巴内皮细胞生长和表达flt-4、c-fos、PCNA的影响。结果：小鼠淋巴管瘤来源的淋巴内皮细胞可成单层贴壁培养，在内皮细胞完全培养液和H22条件培养液作用下可增殖达到或接近铺满状态，并阳性表达flt-4、c-fos、PCNA，普通培养液不能支持细胞生长，flt-4等染色为阴性：结论：淋巴内皮细胞增殖可能是癌细胞淋巴路转移的必要条件。     

肺癌侵犯中央肺动脉继发肺低灌注的CT与DSA对照研究

目的　探讨肺癌侵犯中央肺动脉继发肺低灌注的CT特征及其诊断价值。方法　对2 0例手术及病理证实的肺癌侵犯中央肺动脉 (cancerousinvasionofcentralpulmonaryarteriesinlungcancer,CICPA)患者术前肺血管DSA及增强螺旋CT(含高分辨率CT ,即HRCT)征象行前瞻性对照研究。根据DSA和CT胸膜下末梢肺动脉分布和数量变化 ,即肺血管征、肺毛细血管充盈度和肺实质强化后密度及时间 密度曲线变化 (即肺实质征 ) ,行两者间的盲法对照 ,统计学分析CT与DSA征象及其一致性 ,评估CT对CICPA继发肺低灌注的诊断价值。结果　 2 0例手术病理证实的CICPA病例中 ,共3 0支肺叶动脉受累 ,DSA显示 90 % (2 7/3 0 )出现肺叶低灌注征象 ,CT诊断肺低灌注敏感度为 78%(2 1/2 7) ,特异度 10 0 % (3 /3 ) ,准确度 80 % (2 4/3 0 )。肺低灌注与CPA狭窄程度无明显相关性 (rs=0 40 ,P =0 0 73 )。CT与DSA的肺血管征一致性较好 (Kappa =0 69,P <0 0 0 1) ,而肺实质征一致性稍差 (Kappa =0 3 7,P =0 0 11)。结论　肺低灌注是肺癌侵犯中央肺动脉的常见表现 ,CT对其定性诊断具有重要价值 ,而定量判断有一定限度     

直肠癌肠系膜静脉血CK20 mRNA的检测及其临床意义

目的　检测直肠癌肠系膜静脉血细胞角蛋白 2 0 (CK2 0 )mRNA ,并探讨其临床意义。方法　以RT -PCR方法检测 4 2例直肠癌术中肠系膜静脉血CK2 0mRNA。结果　 4 2例中 2 2例CK2 0mRNA阳性 ,阳性率 5 2 .4 %。随着病理分期的进展 ,肠系膜静脉血CK2 0mRNA阳性率升高 :DukesC +D期CK2 0mRNA阳性率高于DukesA +B期(P <0 .0 1)。随访发现 ,肠系膜静脉血阳性者远处转移率增高 (18.2 % )。结论　肠系膜静脉血CK2 0mRNA的检测可提高直肠癌临床分期的准确性 ;CK2 0mRNA阳性者 ,远处转移的可能性大。     

肝癌术后监测血清AFP的临床意义(附70例报告)

为探讨肝癌术后监测血清甲胎蛋白(AFP)的临床意义，回顾性分析1996年2月至2002年3月间肝癌根治切除术后定期监测发现血清AFP阳性的70例患者AFP升高与肿瘤残留、复发或转移的关系。肝癌术后血清AFP升高可见于肝癌的残留或早期转移、肝癌的复发或转移、肝癌的再发以及晚期肝硬变4种情况。对肝癌患者术后定期作AFP检查，有助于检出AFP阳性肝癌患者的肿瘤残留及亚临床期复发转移，不仅适用于术前AFP阳性，而且适用于术前AFP阴性的肝癌患者。肝癌患者术后AFP下降，但不能降至正常，可能与晚期肝硬变肝脏内干细胞-卵圆形细胞代偿性增生有关。     

Lymph node metastases in the neck and parotid gland from an unknown primary melanoma

A lymph node metastasis in the neck or parotid region from an unknown primary melanoma is an uncommon occurrence. Out of a total of 300 patients with head and neck melanoma treated at the Netherlands Cancer Institute between 1976 and 1992, 17 (5.7%) presented in this way. The most common site for metastatic lymph nodes (18 nodes in 17 patients) was level V (n= 7), followed by the parotid region (n= 4), level II (n= 4), level III (n= 2), and level IV (n= 7). Two patients had local excision of the neck node metastasis only, while the remaining 15 patients underwent more extensive surgical treatment. The 5-year disease-specific survival rate in this group was 48%, with a median survival of 36 months, which is more or less similar to the prognosis of stage II melanoma of the head and neck with a known, surgically treated primary tumour. No relation was found between disease-free interval and sex, the number of positive lymph nodes or the duration of symptoms.     

94例脑转移瘤CT诊断与临床分析

总结94例脑转移瘤的CT诊断与临床资料。临床多以颅内压增高及脑组织损坏为主要征象。原发肿瘤部位按例数依次为肺癌、乳腺癌、鼻咽癌、甲状腺癌、胃癌和前列腺癌。原发肿瘤的症状常较隐匿,60％的病人首先发现脑转移瘤,然后才追查到原发肿瘤。当发现脑内多发或单发肿瘤时,应排除转移瘤。CT是诊断脑转移瘤的可靠方法,能准确地判断肿瘤的部位、大小、数目以及水肿范围与并发改变等情况。