RESUMEN
Although eosinophilic fasciitis (EF) may precede hematologic malignancy or Hodgkin's disease, association with peripheral T-cell lymphoma (PTCL) is extremely rare. Only four cases of EF preceding or concomitant PTCL have been reported in the world literature. We experienced the first Korean case of EF complicated by the later relapse of peripheral T-cell lymphoma. A 63-year-old Korean male has been followed at our outpatient clinic periodically after treatment for stage IV PTCL. He had been in complete remission for seven and a half years when he developed edema of both lower extremities followed by sclerodermatous skin change in both hands with peripheral eosinophilia. Biopsy from the left hand showed fibrous thickening of the fascia with lymphoplasmacytic and eosinophilic infiltrate, consistent with EF. Twenty-five months later, a newly developed lymph node from the left neck showed recurrence of PTCL. EF may occur as a paraneoplastic syndrome associated with the relapse of PTCL. Therefore, in a patient with EF, the possibility of coexisting and/or future occurrence of hematologic neoplasm should be considered.
Asunto(s)
Eosinofilia/complicaciones , Fascitis/complicaciones , Linfoma de Células T Periférico/complicaciones , Eosinofilia/patología , Fascitis/patología , Humanos , Linfoma de Células T Periférico/patología , Masculino , Persona de Mediana Edad , RecurrenciaRESUMEN
Primary intestinal T-cell lymphoma is a rare disease entity, which is approximately 10% to 25% of intestinal lymphomas, and most of the lymphomas occur in the small intestine. We report here a case of a 56-year-old woman who has been suffering from chronic diarrhea and weight loss for 6 months. Abdominal CT scan and small bowel series showed diffuse wall thickening of the small bowel. Gastroscopic examination showed diffuse erythematous lesions on the esophagus and small gastric ulcerations on the antrum of the stomach, and colonoscopic examination also showed multiple punched-out ulcerations and erosions on the entire colon, including the sigmoid colon to the terminal ileum. Diffuse infiltration of CD 3 positive lymphoma cells was found on biopsy. The patient was diagnosed as primary intestinal T-cell lymphoma with diffuse involvement of the entire gastrointestinal tracts from the esophagus to the rectum. Although the patient received systemic combination chemotherapy and achieved partial response initially, the lymphoma relapsed repeatedly.
Asunto(s)
Neoplasias Esofágicas/terapia , Neoplasias Gastrointestinales/terapia , Linfoma de Células T/terapia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patología , Femenino , Neoplasias Gastrointestinales/diagnóstico , Neoplasias Gastrointestinales/patología , Humanos , Linfoma de Células T/diagnóstico , Linfoma de Células T/patología , Persona de Mediana EdadRESUMEN
AIMS: The deregulation of cyclin, cyclin-dependent kinases (CDKs) and their inhibitors could have a crucial role in the development of diverse human cancers. METHODS: In this study, we analysed the expression of cyclin D1, cyclin E, p21WAF1/CIP1 and p27KIP1 in 84 surgically resected gastric cancers by immunohistochemistry with long-term follow-up (median 38 months). We also evaluated the relation between each cell cycle regulator and various clinicopathological findings, including age, sex, histological grade, tumour location, tumour type and stage and lymph-node metastasis. RESULTS: Overexpression of cyclin D1 and E was detected in 21/84 (25%) and 34/84 (40.5%) patients, respectively. Normal gastric epithelium showed consistently positive immunostain for p21WAF1/CIP1 and p27KIP1 in more than 50% of nuclei. Loss of p21WAF1/CIP1 and p27KIP1 expression was noted in 45/84 (53.6%) and 44/84 (52.4%) patients, respectively. Among the various clinicopathological findings, overexpression of cyclin E was associated with lymph-node metastasis (P=0.003) and recurrence (P=0.043). Loss of p21WAF1/CIP1 expression was more frequent in diffuse type cancers (P=0.005) and was correlated with recurrence (P=0.002) and death (P=0.002). Overexpression of cyclin E and loss of p21WAF1/CIP1 expression were significantly correlated with decreased disease-free (P=0.037; P= 0.001) and overall (P=0.031; P=0.001) survival. CONCLUSIONS: These results suggest that immunohistochemical analysis for cell cycle regulators, especially cyclin E and p21WAF1/CIP1, might be a useful prognostic indicator in gastric cancer.
Asunto(s)
Biomarcadores de Tumor/análisis , Ciclina E/análisis , Ciclinas/análisis , Regulación Neoplásica de la Expresión Génica , Neoplasias Gástricas/química , Neoplasias Gástricas/patología , Adulto , Inhibidor p21 de las Quinasas Dependientes de la Ciclina , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunohistoquímica , Metástasis Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Pronóstico , Análisis de SupervivenciaRESUMEN
Pernicious anemia is an autoimmune disease characterized by a gastric mucosal defect which results in an insufficiency of intrinsic factor to facilitate the absorption of the physiologic amount of cobalamin. Increased risk of cancers of the stomach has been reported for patients with pernicious anemia. We report here a case of a 65 year old woman who had been diagnosed as having pernicious anemia 16 months previously, was receiving monthly vitamin B12 injections, and developed early gastric cancer type IIa by routine follow-up gastroscopic examination. This patient underwent endoscopic mucosal resection for an early gastric cancer lesion with a free resection margin.
Asunto(s)
Anemia Perniciosa/complicaciones , Neoplasias Gástricas/etiología , Anciano , Anemia Perniciosa/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugíaRESUMEN
The purpose of this study was to investigate what effect providing the hospice care team with hospice education programs had on the death orientation. The subjects of study were 28 volunteers, 14 nurses, 30 clergies who registered on hospice education programs from Aug. 6th, 1996 to May 20th, 1997. The data were analysed by descriptive analysis, ANOVA, Duncan test, paired t-test. The results of the study can be summarized as follows: 1. The degrees of death orientation were 85.70 in volunteers group, 84.31 in nurses group, and 73.00 in clergies group. So, clergies group has more positive death orientation than others (F = 6.33, p = .000). The degree of death orientation showed significant differences between age groups (F = 5.78, p = .002), and religiosity (t = 3.92, p = .000). There were no significant differences between the degree of death orientation and the others general characteristics of subjects. 2. The mean of death orientation was 80.04 before hospice education programs, but was 75.56 after hospice education programs (t = 3.92, p = .000). In conclusion, the subjects who received the hospice education programs showed the positive change in the degree of the death orientation. Therefore, it has been judged that education programs has been prerequisite in positive death orientation for hospice care. Furthermore, all of the hospice care members those who complete the hospice education program, will be performed efficient hospice care intervention for dying patients and their families.
Asunto(s)
Actitud Frente a la Muerte , Clero/psicología , Conocimientos, Actitudes y Práctica en Salud , Cuidados Paliativos al Final de la Vida/organización & administración , Capacitación en Servicio/organización & administración , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/psicología , Análisis de Varianza , Humanos , Evaluación de Programas y Proyectos de SaludRESUMEN
We report a case of prostate cancer in 34 year old man presenting with generalized lymphadenopathy mimicking malignant lymphoma without any urinary symptoms. Lymph node biopsy revealed metastatic adenocarcinoma and immunohistochemical stain was strongly positive to prostate antigen (PSA). Serum PSA level was also markedly elevated. Transrectal ultrasonogram showed mild enlargement in right lobe of prostate. Needle biopsy finding of prostate also was consistent with adenocarcinoma. Bone scan revealed multiple metastatic lesions including vertebrae, ribs, pelvis, and both femurs. Generalized lymphadenopathy and elevated PSA level was decreased after bilateral orchiectomy.
Asunto(s)
Linfoma/diagnóstico , Neoplasias de la Próstata/diagnóstico , Adulto , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Linfoma/química , Linfoma/cirugía , Masculino , Antígeno Prostático Específico/análisis , Neoplasias de la Próstata/química , Neoplasias de la Próstata/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Neurofibromatosis type 1 (NF1) gene is a tumor suppressor gene, and the NF1 gene product, neurofibromin, can downregulate the N-ras gene. Because the N-ras gene is often mutated in acute myelogenous leukemia (AML), we wondered if the NF1 gene might be mutated in those AML samples not having N-ras mutations. We investigated the mutational status of the N-ras gene and the FLR exon of codons 1371-1423 of the open reading frame of the full-length NF1 cDNA, which has a strong homology with the mammalian ras GTPase-activating protein (GAP), especially for a stretch of three consecutive amino acids (F, L, R), by single-strand conformation polymorphism analysis and direct sequencing in samples from patients with AML. Of 48 AML patients, 10 (21%) had point (missense) mutations of the N-ras gene involving codons 12, 13 and 61. However, mutations in the FLR exon of the NF1 gene were not detected in any of the AML samples. We also examined the difference of clinical response to induction therapy between AML patients with and without N-ras mutation. A significantly lower rate of complete remission was noted in individuals with N-ras gene mutations. These results suggest that mutation of the NF1 gene, at least in the FLR exon, is very rare in AML and the NF1 gene probably is not a functional complement of the N-ras gene mutation. The presence of N-ras gene mutation may be associated with a lower clinical response to antileukemic therapy.