Gastrointestinal Hemorrhage With Gastritis and Pancolitis as the Sole Presentation for Granulomatosis With Polyangiitis Flare.

Granulomatosis with polyangiitis (GPA), previously known as Wegener granulomatosis, is a rare small vessel vasculitis affecting mainly Whites. The prevalence of GPA in the United States is estimated to be 3 of 100,000 individuals. Classically, GPA affects upper airways, lungs, and kidneys, with the upper airways being the most common site.

What should I know before ordering a bone marrow aspiration/biopsy in patients with vitamin B12 deficiency?

Vitamin B12 deficiency is a well recognised cause of macrocytic anaemia and bone marrow failure. Bone marrow aspiration/biopsy is infrequently indicated for the diagnosis in this setting. However, if a bone marrow aspiration/biopsy is performed, it is important to recognise that it may show dysplastic changes mimicking myelodysplastic syndrome (MDS) or acute leukaemia.

Hepatic iron overload, a possible consequence of treatment with imatinib mesylate: a case report.

Imatinib, a tyrosine kinase inhibitor has revolutionized the therapy of Philadelphia chromosome positive chronic myeloid leukemia. Side effects of imatinib include grade 1-4 hepatotoxicity in a subset of patients. We report the case of a 46-year-old male with chronic myeloid leukemia, who developed hepatic hemosiderosis during treatment with imatinib.

A renal mass in a patient with melanoma.

A 61-year-old man presented to the emergency room with significant weight loss. Laboratory analysis revealed elevations in blood urea nitrogen, creatinine, and white blood cell count. Computed tomography imaging showed a large, infiltrative mass in the right renal vein, with metastasis to the brain.

Primary pleuropulmonary synovial sarcoma.

Pleuropulmonary synovial sarcoma (PPSS) is increasingly recognized as a subtype of sarcoma because of the recent identification of a distinctive chromosomal translocation specific to synovial sarcoma. Soft-tissue synovial sarcoma is far more common than PPSS and typically develops in para-articular locations of the extremities, affects young and middle-aged adults, with no difference in distribution between the sexes, and has well-documented radiologic manifestations. Pleuropulmonary synovial sarcoma can arise in the chest wall, heart, mediastinum, pleura, or lung, and it shares patient demographics and several imaging features with its soft-tissue counterpart.

Cancer biology and necrotic changes in metastatic lymph nodes and survival of colon cancer patients.

Background: Identifying factors that can contribute to a better understanding of tumor progression in stage III colon cancer patients continues to be an important task. Necrotic changes in metastatic lymph nodes have not been previously analyzed in English literature.

Methods: The study included 48 consecutive colon and rectosigmoid cancer patients with stage III disease who underwent radical surgery.

Hemopericardium and cardiac tamponade as presenting findings of dexamethasone-induced hypertrophic cardiomyopathy complicated by transmural myocardial infarction.

This is the first report of dexamethasone-induced left ventricular outflow obstruction causing decreased coronary artery perfusion and apical transmural cardiac infarct that resulted in hemopericardium and rapid cardiac tamponade. The differential diagnosis of hemorrhagic pericardial effusion must now include dexamethasone-induced hypertrophic cardiomyopathy.

Methylene blue staining of dysplastic and nondysplastic Barrett's esophagus: an in vivo and ex vivo study.

Background And Study Aims: Methylene blue selectively stains specialized columnar epithelium in Barrett's esophagus with high accuracy. We prospectively evaluated the methylene blue staining properties of dysplastic and nondysplastic Barrett's esophagus and the association of these properties with the risk for dysplasia and cancer.

Patients And Methods: In a ex vivo study, we mapped, photographed, and sampled esophagectomy specimens with high grade dysplasia and/or early adenocarcinoma before and after methylene blue staining.

Methylene blue-directed biopsies improve detection of intestinal metaplasia and dysplasia in Barrett's esophagus.

Background: Endoscopically applied methylene blue selectively stains specialized columnar epithelium in Barrett's esophagus.

Methods: The diagnostic yield and cost of cancer surveillance in patients with Barrett's esophagus using methylene blue-directed biopsies (MBDB) were compared with surveillance using a "jumbo" random biopsy technique in a prospective, sequential, controlled trial. Esophagogastroduodenoscopy was performed with either MBDB or random biopsy in a randomized sequence.

Diffuse stromal Leydig cell hyperplasia: a unique cause of postmenopausal hyperandrogenism and virilization.

A 60-year-old woman presented with diffuse scalp alopecia, hirsutism, and clitorimegaly, and the mean serum testosterone levels were greater than 200 ng/dL. Findings on computed tomography of both adrenal glands were normal. After bilateral oophorectomy, a unique histological picture consisting of diffuse stromal Leydig cell hyperplasia was found.

Lipoinjection in the paralyzed feline vocal fold: study of graft survival.

Six adult domestic strain cats were used to study the long-term histologic outcome of injected autologous fat for augmentation of the paralyzed vocal fold. Each animal had surgically induced left vocal cord paralysis via sectioning of the recurrent laryngeal nerve, followed by injection of 0.1 to 0.

Predictors of invasion in ductal carcinoma in Situ of the breast: The value of a scoring system.

Ductal carcinoma in situ (DCIS) of the breast shows unpredictable association with invasive ductal carcinoma (IDC). Comedo DCIS (CDCIS) is more frequently associated with IDC than noncomedo DCIS (NCDCIS). We studied prognostic variables in 64 cases of DCIS to identify predictors of invasion.

Methylene blue selectively stains intestinal metaplasia in Barrett's esophagus.

Background: Specialized columnar epithelium in Barrett's esophagus resembles gastric intestinal metaplasia, which selectively stains with methylene blue.

Methods: We prospectively evaluated the safety, accuracy, reproducibility, cost, and diagnostic yield of methylene blue-directed biopsy in detecting specialized columnar epithelium and dysplasia in Barrett's esophagus. We performed upper endoscopy with methylene blue-directed biopsy and obtained 236 large cup biopsy specimens (145 stained, 91 unstained) from 14 patients with Barrett's esophagus of any length (Group 1) and 12 control patients.

Topoisomerase I activity in squamous cell carcinoma of the head and neck.

In recent preclinical and clinical trials, topoisomerase I inhibitors have shown great promise as antitumor agents. These agents are most effective against tumors with high topoisomerase I activity. Therefore, determining topoisomerase I activity in advance may predict response to topoisomerase I inhibitors.

Metastatic calcification of the true vocal cords as a cause of hoarseness.

Visceral soft tissue calcification is common in patients with end-stage renal disease. However, metastatic calcification of the true vocal cords has not been described. We present a patient with chronic renal failure and hoarseness in whom an exophytic true vocal cord mass was diagnosed as a metastatic calcification.

The argyrophilic nucleolar organizer regions in ductal carcinoma in situ of the breast. The significance of ploidy and proliferative activity analysis using this silver staining technique.

Background: Two interphase argyrophilic nucleolar organizer region (AgNOR) counts have been correlated with ploidy and proliferative activity in patients with ductal carcinoma in situ (DCIS) of the breast. The first is the mean number of AgNORs (mAgNOR); it reflects ploidy. The second is the percentage of nuclei with greater than or equal to five AgNORs/nucleus (pAgNOR); it correlates with proliferative activity.

Growth stimulation of ovarian and extraovarian mesothelial cells by corpus luteum extract.

Ovarian (OM) and extraovarian (EM) mesothelia represent a common source of gynecologic malignancies with yet unclear pathogenesis. Ovulation triggers a finite wave of DNA synthesis and morphogenesis only in native OM cells, probably through the activation of intraovarian growth factors. To evaluate their growth response to such factors, OM and EM cells were obtained from estrous New Zealand white rabbits by enzymatic dispersion and unit gravity sedimentation.

Photodynamic therapy of human squamous cell carcinoma in vitro and in xenografts in nude mice.

Photodynamic therapy (PDT) of cancer is an experimental tumor therapy which is based on the combined use of a systematically administered photosensitizer to a tumor-bearing host and local illumination of the lesion by a high-intensity visible light source, typically a tunable argon dye laser. Human squamous cell carcinoma (HSCC) is the most frequently encountered malignancy of the head and neck. In this study, responses of HSCC cells to PDT were examined in in vitro and in vivo systems.

Intraabdominal desmoplastic small round cell tumor. Report of a case diagnosed by fine needle aspiration cytology.

In this report, fine needle aspiration (FNA) findings in a case of intraabdominal desmoplastic small round cell tumor (IADSRCT) are presented. Computed tomographic scan-guided FNA performed on a right upper abdominal mass on a 20-year-old man produced a cellular specimen consisting of monomorphic small round cells with scant cytoplasm and ovoid nuclei. FNA cytology and immunocytochemistry suggested the diagnosis of IADSRCT.

[Evaluation of functional reserves of the oxygen transport system in cardiac surgery patients].

The informative value of determination of the restoration rate of spiroergometric parameters was examined in cardiosurgical patients who had undergone exercise testing. All the patients were divided into 3 homogeneous groups: (1) those without disorders; (2) those with moderate restoration; and (3) pronounced restoration. There was a moderate relationship between the restoration rate and the function of the oxygen transport system (OTS) and a high relationship between the rate and exercise tolerance in decompensated metabolic acidosis and left ventricular function.