Lung cancer in the very elderly: incidence, presentation, and diagnostic decision-making. A retrospective analysis at a teaching community hospital.

Background And Objectives: Lung cancer presentation and decision-making in the very elderly patient population, 80 years of age and older, was studied given the projected increase in cancer incidence in the very elderly and yet only limited management guidelines.

Design And Setting: A 10-year experience at the Unity Health System of Rochester, NY, was reviewed using tumor registry data for the entire lung cancer population plus focused medical record review of very elderly patients. A questionnaire survey on the clinical approach to lung cancer in the elderly was distributed to medical staff involved in their care.

Successful management of hemopericardium and cardiac tamponade secondary to occult malignancy and anticoagulation.

In patients presenting with pericarditis or pericardial effusion without known malignancy, the likelihood of finding previously undiagnosed cancer in different publications typically ranges from 4% to 7%. Cardiac tamponade due to malignant pericardial effusion is thus a rare clinical entity and often acutely life threatening. The present report describes an unusual case of large pericardial bleeding causing tamponade in the setting of fondaparinux anticoagulation, heterozygous factor V Leiden mutation and eventual discovery of meta-static adenocarcinoma.

Merkel cell carcinoma after chronic lymphocytic leukemia: case report and literature review.

Increasing evidence supports an association of Merkel cell carcinoma (MCC) with immunodeficiency and neoplasia, and the management and outcome of these patients requires study. This report describes a 72-year-old man with newly diagnosed chronic lymphocytic leukemia (CLL) who developed MCC of his right upper extremity and died of bone marrow metastases at 8 months. In the five previously reported cases of MCC after CLL, a shorter time interval between the diagnosis of CLL and the onset of MCC was associated with a better prognosis.

Early gene activation in chronic leukemic B lymphocytes induced toward a plasma cell phenotype.

Chronic lymphocytic leukemia (CLL) is characterized by the accumulation of lymphocytes that are arrested at an intermediate stage of B lymphocyte development. CLL B lymphocytes transform (mature) to a plasmacytic phenotype with loss of CD19 and CD20 and the appearance of cytoplasmic immunoglobulin when treated in vitro with phorbol esters. We have used array hybridization technology to describe gene expression patterns for untreated and tetradecanoyl phorbol acetate (TPA)-treated CLL B cells at 5, 10, and 20 min following initial TPA exposure.