An 11-year-old, spayed female, weighing 10 kg miniature Schnauzer was admitted for abdominal distension, anorexia, pollakiuria, and constipation. A large, homogeneous fat opacity mass was identified in the retroperitoneum and pelvic cavity on the abdominal survey radiography. The mass displaced the descending colon peripherally and ventrally, and the urinary bladder ventrally. On the abdominal ultrasonographic examination, the mass was uniformly hyperechoic with a coarse internal echo texture and had outer hyperechoic capsule, and it showed homogeneously same attenuation (-180 ~ -110 HU) as adjacent fat on the computed tomography. There was no evidence of invasion into the surrounding structures or organs. Cytological findings from fine needle aspirates were numerous sheets and clusters of adipocytes. The dog showed complete resolution of clinical signs after surgical resection of the mass. The mass was confirmed as simple lipoma through histopathological examination.
Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.
Objective: To explore the clinical efficacy and toxic and side effects of recombinant human endostatin (rhendostatin/endostar) combined with chemotherapy in the treatment of advanced gastric cancer. Materials and Methods: A total of 70 patients with advanced gastrointestinal adenocarcioma confirmed by histopathology and/or cytological examination were divided into group A (37 patients) and group B (33 patients). Patients in group A were given intravenous drip of 15 mg endostar added into 500 mL normal saline, once every other day until the cessation of chemotherapy or patients' maximal tolerance to chemotherapy. Patients in group B received chemotherapy alone. Two groups selected the same chemotherapy regimens. FOLFIRI scheme: 90-min intravenous drip of $180mg/m^2$ irinotecan, intravenous drip of $200mg/m^2$ calcium folinate (CF) and $400mg/m^2$ 5-fluorouracil (5-Fu) on d1, and continuous intravenous pumping of 2 $400mg/m^2$ 5-Fu for 46 h. FOLFOX4 scheme: intravenous injection of $85mg/m^2$ oxaliplatin (L-OHP), $200mg/m^2$ calcium folinate (CF) and $400mg/m^2$ 5-FU on d1 for 2 h, and then continuous intravenous pumping of 2 $400mg/m^2$ 5-Fu for 46 h. XELOX scheme: oral administration of 1 $500mg/m^2$ xeloda (or tegafur 50~60 mg) in twice during d1~14 and intravenous drip of $135mg/m^2$ L-OHP on d1 for 2 h. The modified FOLFOX scheme: intravenous injection of $135mg/m^2$ L-OHP on d1 for 2 h, $200mg/m^2$ CF and 1.0 g tegafur during d1~5. Whereas, control Group B received chemotherapy regimens which were same as Group A, but no addition of endostar. Before chemotherapy, patients were given intravenous injection of 8 mg ondansetron, intramuscular injection of 10 mg metoclopramide and 20 mg diphenhydramine for prevention of vomiting, protection of liver and stomach as well as symptomatic supportive treatment. One cycle was 21 d, 4~6 cycles in total. The efficacy was evaluated every 2 cycles. Results: 32 patients in Group A could be evaluated, and the response rate (RR) and disease control rate (DCR) were 59.38% and 78.13%, respectively. 31 patients in Groups could be evaluated, and the RR and DCR were 32.26% and 54.84%, respectively. The differences between 2 groups were significant. The toxic effects include myelosuppression, gastrointestinal reaction, fatigue, cardiotoxicity and peripheral neurotoxicity. Conclusions: Preliminary observations show that endostar (once every other day) combined with chemotherapy is effective in the treatment of advanced gastrointestinal cancer, with low toxic effects, good tolerance, deserving further study.
Purpose: The aim of this study was to evaluate the diagnostic value of FNA-Tg for detecting lymph node metastases in patients with a history of differentiated thyroid cancer (DTC). Materials and Methods: A total of 58 patients with DTC diagnosis and evidence of single or multiple suspicious cervical lymph nodes were assessed. All underwent total or near-total thyroidectomy with (35 cases) or without (23 cases) radioiodine (RAI) ablation, followed by thyroid stimulating hormone (TSH) suppression therapy. A total of 68 lymph nodes were examined by ultrasound-guided fine needle aspiration (US-FNA) for both cytological examination and FNA-Tg measurement. Serum Tg and anti-thyroglobulin antibody (TgAb) levels were also measured. Diagnostic performance including sensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV) of FNAC and FNA-Tg were calculated and compared. The Spearman's rank correlation coefficient was used to estimate the relationship between FNA-Tg and serum TgAb. Results: The FNA-Tg levels were significantly higher with DTC metastatic lymph nodes (median 927.7 ng/mL, interquartile range 602.9 ng/mL) than non-metastatic lymph nodes (median 0.1 ng/mL, interquartile range 0.4 ng/mL) (p<0.01). Considering 1.0 ng/mL as a threshold value for FNA-Tg, the sensitivity, specificity, accuracy, PPV and NPV of FNA-Tg were 95.7%, 95.5%, 95.6%, 97.8% and 91.3%, respectively. The sensitivity and accuracy of the combination of FNAC and FNA-Tg were significantly higher than that of FNAC alone (p<0.05). The diagnostic performance of FNA-Tg was not significantly different between cases with or without RAI ablation, and the serum TgAb levels did not interfere with FNA-Tg measurements. Conclusions: Measurement of FNA-Tg is useful. The combination of FNAC and FNA-Tg is more sensitive and accurate for detecting lymph node metastases in patients with a history of DTC than FNAC alone. Serum TgAbs appear to be irrelevant for measurement of FNA-Tg.
Park, Seungjo;Kwon, Seong-young;Min, Jung-Joon;Choi, Jihye
Journal of Veterinary Clinics
/
v.33
no.1
/
pp.51-57
/
2016
In this study, the features of canine lymphoma on fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were evaluated in three small breed dogs. In case 1, ultrasonography and CT indicated neoplastic involvement of the sternal, right axillary, submandibular, lower cervical, tracheobronchial, mesenteric, and sublumbar lymph nodes; spleen; and liver. However, intense FDG uptake on PET/CT images was detected only for the lymph nodes and spleen. No FDG uptake by the liver was detected for case 1 despite the confirmation of lymphoma by cytology. In case 2, ultrasonography and CT indicated neoplastic involvement of the axillary, mesenteric, and sublumbar lymph nodes and the spleen, while intense FDG uptake on PET/CT images was detected for the axillary and a few mesenteric lymph nodes, and the spleen. FDG uptake was additionally observed from popliteal lymph nodes, however there was no uptake by the sublumbar lymph nodes and some mesenteric lymph nodes. In case 3, neoplastic changes in the splenic, mesenteric, and sublumbar lymph nodes and spleen were suspected on ultrasonography, and lower cervical and popliteal lymph node involvements were additionally detected on PET/CT. Compared to ultrasonography, repeated PET/CT showed increased FDG uptake by the lymph nodes at an earlier stage after chemotherapy in case 3. This study illustrated the features of PET/CT in canine lymphomas and compared those to ultrasonography and CT findings. FDG uptakes were not detected from some lesions which were suspected to be neoplastic involvement in case 1 and 2. We could not clearly explain the reason of this result in the present study because cytological or histological examination was not performed for lesions that showed different results on ultrasonography, CT, and PET/CT. Further studies on the subclassification of canine lymphoma and the sensitivity and specificity of PET/CT for the detection of canine lymphoma are required. PET/CT data can provide useful information for predicting the therapeutic response at an early stage after treatment.
Kim Youn-ju;Jeong A-young;Kim Jae-hoon;Eom Ki-dong;Lee Keun-woo;Oh Tae-ho
Journal of Veterinary Clinics
/
v.21
no.4
/
pp.402-405
/
2004
A 5-year-old Rottweiler neutered female dog was presented with signs of mandibular and popliteal lymphadenopathy, erosion in mucocutaneous junction of muzzle and lips, multiple papules and nodules in right rear limb and neck, and alopecia in right thorax. There was no further clinical sign except anorexia, sporadic fever and ocular hyperemia. She hadn't shown any response to carprofen prescribed by local veterinarian. Hematological abnormalities included mild anemia and severe lymphocytosis. On serum biochemical profile, only elevated AST level was noticed. On cytological examination, there was an evidence of mild bacterial infection which seemed to occur secondarily. Three sites were biopsied that included muzzle, upper lip and right thoracic region. Histopathologically, multifocal confluent pyogranulomatous dermatitis, scattered granulomatous inflammation in subcutis and severe septal panniculitis were observed. Special stainings(Gram, Acid-fast, PAS, Giemsa) were performed to reveal that a dog was negative for any organism. Finally, sterile pyogranuloma/granuloma syndrome (SPGS) was diagnosed. The treatment was initiated with predinsolone and enrofloxacin. The condition was successfully resolved after 4 weeks of treatment. This good response suggests that SPGS may be immune-mediated disease of its pathogenesis and this drug combination may be a viable therapeutic option for dogs suffering from SPGS. Also, this article reports a case of SPGS in Rottweiller for the first time.
A study has been made to correlate morphological and biochemical differentiation in the oocytes of a tubiculous polychaete, Schizobranchia insignis. The pressent paper is concerned with an examination of the cytological changes during oogenesis and annual size distribution of oocytes, The oocytes are released from the ovary into the coelomic sac at the end of the oogonial division and grow to a maximum size (180 $\\mu$ diameter). Oogensis takes place continuously throughout a year, although the breeding season is the period between January and March. When the oocytes reach the largest size class, they remain constant in size thereafter and accumulate in the coelomic sac. The nucleolus, which first appears in the oocytes 5-10$\\mu$ diameter, grows in the early stages of oogenesis, becomes maximum in the oocytes 100-120$\\mu$ diameter, and is constant throughout the rest of the pertiod. The nuclelus initially has a single comartment but becomes bipartite prior to vitello genesis. Three types of yolk including lipid droplets, proteid granules and oval granules oof unknown composition form at different times of oogenesis. The lipid droplets and oval granules appear in the early stage, but mainly in the oocytes larger than 80 $\\mu$ diameter. Proteid yolk and cortical granules appear only in the oocytes larger than 80 $\\mu$ diameter Microvilli are abundant in the oocyte 80 $\\mu$ diameter and embedded in the vitelline membranc. In the oocytes 180 $\\mu$ diameter they have retracted from the vitelline membrane.
A 3-year-old intact female hedgehog (Atelerix albiventris) was presented for evaluation of mandibular swelling. Fine needle aspiration of swollen mandibular was performed and smears were stained with Romanowsky type stain for cytological evaluation. Smears were highly cellular with predominance of variably shaped keratinized or non keratinized squamous cells with low numbers of spindloid to abnormally elongated cells. Cytologic impression was squamous cell carcinoma. The mass was surgically removed for histological examination. Microscopically tortuous and anastomosing delicate to broad pegs and nests of neoplastic squamous epithelial cells were supported by a moderate collagenous and spindloid fibroblast stroma. Tumor cells had moderate anisocytosis and mild anisokaryosis and range from moderately to well keratinized, with areas of intratumoral acantholysis accompanied by mixed stromal lymphoplasmacytic, neutrophilic inflammation. The mitotic index is 2-3 per high-power field. Tumor cells were expanding the subcutis subjacent to the layer of skeletal muscle and incorporating the osseous tissue fragments. The final diagnosis was squamous cell carcinoma. The patient survived three months after surgery without any further medical treatments.
Background: Melanoma antigen genes (MAGE) are expressed in many human malignant cells and are silent in normal tissues other than in testis and in placenta. But MAGE expression in benign lung diseases, such as pulmonary tuberculosis or cases with severe inflammation, needs further evaluation to overcome false-positive findings. We evaluated detection rates of the melanoma antigen genes (MAGE) RT-nested PCR in bronchoscopic washing samples from patients with benign lung disease, as well as in patients with malignancies. Methods: Bronchial washing fluid from 122 patients was used for cytological examination and MAGE gene detection using RT-nested-PCR of common A1-6 mRNA. We compared the results from the RT-nested PCR and the pathologic or bacteriologic diagnosis. We also analyzed the expression rate and false positive rate of MAGE gene. Results: Among 122 subjects, lung cancer was diagnosed in 23 patients and benign lung disease was diagnosed in 99 patients. In patients with lung cancer, the positive rate of MAGE expression was 47.8% (11/23) and in benign lung disease group, the expression rate was 14.1% (14/99). Among benign lung disease group, the expression rate of MAGE gene (25.0%) in patients with pulmonary tuberculosis (11/44) was especially high. Conclusion: MAGE A1-6 RT-nested PCR of bronchial washing fluid can be used as a complementary method in lung cancer, but that test results in a high false positive rate in tuberculosis patients.
An 8-year-old spayed female domestic shorthair cat was presented with a chief complaint of chronic nasal discharge and dyspnea. Physical examination revealed pyohemorrhagic nasal discharge, inspiratory dyspnea and stertor, and an enlarged right mandibular lymph node. Abnormalities of blood works and serum chemistry included mildly increased hematocrit, and globulin concentration. Serologic tests for FeLV and FIV, and a panel of polymerase chain reaction tests for Chlamydophila felis, Feline Calicivirus, Herpesvirus, Bordetella, Mycoplasma felis, and H1N1 influenza was all negative. Only radiographic finding showed increasing soft tissue density in the right nasal cavity and computed tomography disclosed soft tissue/fluid opacification in the right nasal cavity, paranasal sinus, and pharyinx along with slight deviation to the right of the osseous nasal septum. Focal lysis of ventral nasal septum was also suspected in CT scan. Cytological evaluation of fine needle aspirate smears of the enlarged mandibular lymph nodes revealed numerous fungal yeasts having variably thick capsule both extracellularly and intracellularly with low numbers of macrophages. Some yeasts showed narrow based budding, which was a consistent finding with Cryptococcus organisms. Serum protein electrophoresis was a polyclonal consistent with chronic infection and serum was submitted for a fungal serology panel test. In serologic tests Cryptococcus antigen titer was 1 : 32,768. In vitro culture was unsuccessful. Treatment was initiated with administration of fluconazole, clindamycin, and tocopherol. Clinical signs resolved within 3 days after the initial treatment. The cat was discharged and scheduled for periodic evaluation and continued therapy, but was lost to follow-up thereafter.
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