scholarly journals Her2+ and b-HCG Producing Undifferentiated Gastric Adenocarcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Sahar Eivaz-Mohammadi ◽  
Fernando Gonzalez-Ibarra ◽  
Waheed Abdul ◽  
Omer Tarar ◽  
Khurram Malik ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Stage Iv ◽  
Stomach Body ◽  
Ct Angiogram ◽  
Lytic Lesions ◽  
Night Sweats ◽  
History Of ◽  
Stomach Fundus ◽  
Poorly Differentiated ◽  
Lesser Curvature

A 25-year-old Hispanic female with a history of anemia, schizoaffective disorder, and psychosis was admitted for anemia associated with fatigue, weakness, shortness of breath, night sweats, weight loss, and abdominal and lower back pain for the past two months. On routine management, she was found to have a positive serum b-HCG of 80.4 (0–5 mIU/mL) but the patient denied any sexual activity in her life. During her admission, U/S of the pelvis was noncontributory. CT angiogram of the chest was significant for prominent mediastinal and hilar lymph nodes, diffusely thickened stomach suggesting gastric malignancy with multiple hypoenhancing lesions in the liver and diffuse lytic lesions in the spine and sacrum suspicious for metastatic disease. The MRI of the abdomen confirmed the CT angiogram findings. After these findings, EGD was performed which showed lesions in the antrum, body of the stomach, fundus, and cardia on the lesser curvature of the stomach body correlating with carcinoma. The biopsy was positive for Her2, b-HCG producing poorly differentiated gastric adenocarcinoma. Patient underwent one successful round of chemotherapy with Taxotene, Cisplatin, and 5-FU for Stage IV gastric adenocarcinoma.

scholarly journals COMPARISON OF BAYESIAN AND FREQUENTIST SURVIVAL ANALYSIS METHODS IN MODELLING OF PROSTATE CANCER SURVIVORSHIP IN OYO STATE, NIGERIA

2020 ◽  
Author(s):  
ROLAND ABI ◽  
A.F. Fagbamigbe ◽  
A.M Akinwande
Keyword(s):  
Prostate Cancer ◽  
Survival Analysis ◽  
Bayesian Approach ◽  
Prostate Gland ◽  
Stage Iv ◽  
Distribution Models ◽  
Aft Model ◽  
History Of ◽  
Poorly Differentiated ◽  
The Bayesian Approach

Background: Survival analysis is a statistical method for modeling the probability that a subset of a given population will survive past a certain time. In the context of cancer, this probability would represent a recurrence of tumor, or remission (i.e. being disease-free). This study seeks to compare the traditional frequentist approach and the Bayesian approach to survival analysis in estimating, and the predictors of prostate cancer (CaP) survivorship. Prostate cancer starts when healthy cells in the prostate gland change and grow out of place, forming a mass called a tumor. Method: A retrospective analytical study design was employed, through the extraction of case files of patients diagnosed and treated for CaP from January 2010 to December 2017 at UCH, Ibadan. The extracted data were further divided into two cohorts (2010 - 2014) and (2015 - 2017). A proforma was used for extraction which includes the following sections; socio-demographic, clinical/pathological characteristics, date of diagnosis, date last seen, and treatment received. Descriptive statistics were used to describe these characteristics. The survival probability was determined by the KM survival method. Cox proportional hazard (CPH), Weibull AFT, and Bayesian Weibull AFT (using normal prior distribution) models were used to determine predictors of survivorship. Results: The average age of the patients was 72 years, with a peak incidence of CaP among those aged 70 79 years. Most patients 87.3% were diagnosed at stage IV, with many having metastasis to the spine. Among the patients, 33.6% received chemotherapy and surgery. Patients from Northcentral had the highest median survival (MS) time in the (2015 - 2017) cohort. The overall MS time for the (2010 - 2014) cohort was 2.9 months, and 3.3 months for the (2015 - 2017) cohort while the overall MS time for the study was 3.2 months. Patients treated with chemotherapy and surgery in both cohorts experienced delayed remission. The Weibull AFT model found that patients with a moderately differentiated Gleason experienced a 50% increase in time (TR = 0.5; 95%CI: 0.3 0.9) to remission. Patients, with a poorly differentiated Gleason, experienced a 70% decrease in time (aTR = 1.7; 95%CI: 1.0 - 2.7) to remission. The Bayesian AFT model also found delay in time to remission for patients with moderately differentiated Gleason (TR = 0.6; 95%CrI: 0.3 0.9), and those treated with Chemotherapy and Surgery (aTR = 3.3; 95%CrI: 2.6 4.4). The Bayesian model showed that age, south-south, north-central, no family history of CaP, moderately and poorly differentiated Gleason and treatment with Chemotherapy, Radiotherapy, and Surgery, Chemotherapy, and Surgery to significantly delay time to remission. Conclusion: This study found that in considering predictors of survivorship a host of factors should be considered, particularly age, location, marital status, occupation, stage, method of diagnosis, Gleason group, site, and treatment received. In terms of approaches to survival analysis, greater emphasis should be given to the Bayesian approach, as observed in this study, the Bayesian approach extracted more significant predictors of survivorship than the CPH and Weibull AFT models and besides, it is more suitable for studies with fewer observations.

HER2 OVEREXPRESSION IN ENDOSCOPIC BIOPSY SAMPLE OF GASTRIC ADENOCARCINOMA BY IMMUNOHISTOCHEMISTRY

2012 ◽  
pp. 109-118
Author(s):  
Viet Nho Le ◽  
Van Huy Tran ◽  
Cong Thuan Dang ◽  
Van To Ta
Keyword(s):  
Gastric Adenocarcinoma ◽  
Undifferentiated Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Endoscopic Biopsy ◽  
Her2 Overexpression ◽  
Tubular Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Well Differentiated

Background and aim: HER2 overexpression by immunohistochemistry is a prognostic maker in gastric cancer and helps to select candidates benefitted from targeted therapy with trastuzumab. This study is aimed at the assessing HER2 overexpression and its relationship with endoscopic and histopathological findings of gastric adenocarcinoma. Objectives and methods: Biopsy samples from 92 gastric cancer patients were examined for HER2 status by immunohistochemical staining. Results: 6.5% of tumors were cardia tumors and 93.5% were non-cardia tumors. Using the Lauren classification, 51.1% were intestinal type and 48.9% were diffuse type. Using WHO classification, 54.3% were tubular adenocarcinoma, 7.6% were mucinous adenocarcinoma, 15.2% were signet-ring cell carcinoma, and 22.8% were undifferentiated carcinoma. 32.6% were well-differentiated, 15.2% were moderately-differentiated, and 52.2% were poorly-differentiated carcinoma. HER2 was positive in 20.7% of gastric carcinomas, 50% cardia tumors and 18.6% non-cardia tumors. HER2 positivity among polypoid, fungating, ulcerated, and infiltrative types were 38.5%, 29.7%, 9.1% and 0%, respectively. HER2 overexpression in intestinal type was higher than that in diffuse type (31.9% vs. 8.9%, p = 0.009). HER2 overexpression in tubular adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, and undifferentiated carcinoma was 28.0%, 14.3%, 7.1% and 14.3%, respectively. HER2 overexpressions were different between differentiation degrees: 30% of well-differentiated tumors, 35.7% moderately-differentiated tumors, and 10.4% of poorly-differentiated tumors (p = 0.037). Conclusions: HER2 overexpression was found in 20.7% of endoscopic biopsy sample of gastric adenocarcinoma and was associated with endoscopic gross characteristic, Lauren histologic type and differentiation degree.

scholarly journals Gastric adenocarcinoma at stage IV with complete remission after neoadjuvant therapy concurrent with adenosquamous carcinoma of the ampulla of Vater: a case report and literature review

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuo Li ◽  
Mengqing Sun ◽  
Yingxin Wei ◽  
Yunlu Feng ◽  
Xiaoyan Chang ◽  
...  
Keyword(s):  
Complete Remission ◽  
Neoadjuvant Therapy ◽  
Gastric Adenocarcinoma ◽  
Adenosquamous Carcinoma ◽  
Stage Iv ◽  
Ampulla Of Vater ◽  
Regional Lymph Node Dissection ◽  
Contrast Enhanced Ct ◽  
Supraclavicular Lymph Nodes ◽  
Ampullary Tumor

Abstract Background Adenosquamous carcinoma (ASC) of the ampulla of Vater (AmV) is exceedingly rare with more aggressive behavior and worse prognosis than adenocarcinoma. The finding of ASC at the AmV in combination to the gastric adenocarcinoma has never been reported in the literature before. Case presentation An old lady was diagnosed as gastric adenocarcinoma at stage IV with enlargement of supraclavicular lymph nodes by gastroscopy and histopathological evaluation 3 years ago. Afterwards, the patient achieved complete remission after regular chemotherapy. However, the patient manifested yellow sclera and skin, choluria and clay colored stool 3 months ago. Preoperative contrast-enhanced CT, ERCP, MRCP, and PET/CT revealed the presence of an ampullary tumor. The patient then underwent laparoscopic radical gastrectomy and pancreaticoduodenectomy with regional lymph node dissection. Postoperative cytological analyses confirmed the diagnosis of gastric ulcer with complete response to neoadjuvant therapy and ASC at the AmV. The patient’s postoperative outcome was uneventful. Conclusion Drawing firm conclusions about the diagnosis of ampullary ASC is difficult because of the difficulty in acquiring both adenocarcinoma and SCC components by fine needle biopsy. The rarity of ASC of the AmV coexistent with gastric carcinoma makes it difficult to elucidate their clinicopathological characteristics, therapeutic strategies and overall prognosis. Surgical resection still remains the main treatment method.

scholarly journals Concomitant autoimmunity may be a predictor of more severe stages of endometriosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vanni Valeria Stella ◽  
Villanacci Roberta ◽  
Salmeri Noemi ◽  
Papaleo Enrico ◽  
Delprato Diana ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Adaptive Immune System ◽  
Stage Iv ◽  
Multivariate Logistic Regression Model ◽  
Medical Patients ◽  
Laparoscopic Procedures ◽  
Logistic Analysis ◽  
Increased Risk ◽  
History Of

AbstractPathogenesis of endometriosis is still unclear and a role of both innate and adaptive immune system has been postulated. Some recent findings have revealed an increased risk to have concomitant autoimmune disease in women with endometriosis, but no study so far has investigated whether this association could affect endometriosis severity and stage. We retrospectively reviewed medical patients’ notes of women with a confirmed diagnosis of endometriosis who referred to our endometriosis outpatient clinic between January 2015 and December 2019. Cases (endometriosis and an autoimmune disease) were matched in a 1:3 ratio by age and study period with controls (endometriosis without history of autoimmunity). At univariate logistic analysis, concomitant autoimmunity (OR 2.63, 95% CI 1.64–4.21, p < 0.001) and the number of laparoscopic procedures performed (OR 2.81, 95% CI 1.45–5.43, p = 0.002) emerged as factors significantly associated with the likelihood of stage IV endometriosis. In the multivariate logistic regression model, concomitant autoimmunity remained a significant predictor of stage IV endometriosis (OR 2.54, 95% CI 1.57–4.10, p = 0.004), whereas the association between the number of laparoscopic procedures performed and stage IV endometriosis was found to be of borderline-significance (OR 2.70, 95% 1.37–5.30, p = 0.050). Our findings suggest that endometriosis is more severe in patients who are also affected by autoimmune disturbances after controlling for relevant confounders.

IJV thrombophlebitis: be wary of the occult

2021 ◽  
Vol 14 (3) ◽  
pp. e238813
Author(s):  
Pamela Oshinyemi ◽  
Charlotte Lee ◽  
Antony Gough-Palmer ◽  
Iain McKay-Davies
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Palliative Chemotherapy ◽  
Jugular Vein ◽  
Thrombus Formation ◽  
Locally Advanced ◽  
Patients With Cancer ◽  
Occult Malignancy ◽  
Night Sweats ◽  
History Of ◽  
Nose And Throat

A 43-year-old woman was referred to the Ear, Nose and Throat Department with a 3-day history of left-sided neck pain and swelling associated with fevers and night sweats. She also reported a cough, oral thrush and a dental extraction more than a month previously. A CT scan of the neck with contrast revealed left internal jugular vein (IJV) thrombophlebitis and the patient was initially managed for suspected Lemierre’s syndrome. Subsequent investigations revealed a locally advanced metastatic colorectal adenocarcinoma as the cause of her thrombosis, which was deemed inoperable. The patient was referred to oncology and commenced on palliative chemotherapy.The incidence of thrombophlebitis in patients with cancer is high. Although the IJV is a relatively uncommon site of thrombus formation, IJV thrombophlebitis is associated with significant morbidity and mortality. As it may be the first manifestation of an occult malignancy, a neoplastic cause should always be considered.

scholarly journals Network pharmacology dissection of multiscale mechanisms of herbal medicines in stage IV gastric adenocarcinoma treatment

Medicine ◽  
2016 ◽  
Vol 95 (35) ◽  
pp. e4389 ◽  
Author(s):  
Li Gao ◽  
Jian Hao ◽  
Yang-Yang Niu ◽  
Miao Tian ◽  
Xue Yang ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Herbal Medicines ◽  
Stage Iv ◽  
Network Pharmacology

Man with bilateral inguinal lymphadenopathy

2018 ◽  
Vol 35 (8) ◽  
pp. 522.1-522
Author(s):  
Charlotte Delcourt ◽  
Jean Cyr Yombi ◽  
Halil Yildiz
Keyword(s):  
Lymph Node ◽  
Physical Examination ◽  
Sexual Intercourse ◽  
Vital Signs ◽  
List Type ◽  
Cat Scratch Disease ◽  
Night Sweats ◽  
History Of ◽  
Inguinal Lymphadenopathy ◽  
Lymph Node Tuberculosis

Clinical introductionA 37-year-old man with history of lymph node tuberculosis presented with bilateral inguinal swelling with night sweats but no fever for 2 weeks. He had a cat but he had no history of scratches. He had an extraconjugal sexual intercourse a few weeks before. Physical examination revealed 5 cm tender, erythematous and painful bilateral inguinal adenopathy (figure 1A) and a small ulceration at the base of the penis (figure 1B). Vital signs were normal.Figure 1(A) Inguinal lymphadenopathy. (B) Ulceration at the base of the penis.QuestionWhat is the most likely diagnosis?ToxoplasmosisTuberculosisCat-scratch diseaseLymphogranuloma venereumSyphilis

scholarly journals Clinical Value of Energy Spectrum Curves of Dual-energy CT in Evaluating Pathological Grading of Gastric Adenocarcinoma

2019 ◽  
Author(s):  
Zhihua Lu ◽  
Suying Wu ◽  
Jianwei Chen ◽  
Chuan Yan ◽  
Yueming Li
Keyword(s):  
Gastric Cancer ◽  
Energy Spectrum ◽  
Gastric Adenocarcinoma ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Clinical Value ◽  
Pathological Differentiation ◽  
Dual Source ◽  
Venous Phase ◽  
Poorly Differentiated

Abstract Backgroud: Accurate diagnosis of cancer staging and pathological differentiation are critical for the formulation of individualized treatment and prognosis of gastric cancer. It is vital to explore non-invasive preoperative imaging techniques to evaluate the pathological differentiation degree of gastric cancer tissues, and provide better diagnostic basis and decision-making reference for treatment. The purpose of this study was to explore the clinical value of energy spectrum curves of dual-source dual-energy CT in the quantitative evaluation of different pathological grades of gastric adenocarcinoma. Methods: A total of 62 patients with 1 well, 25 moderately and 36 poorly differentiated gastric adenocarcinomas pathologically confirmed by surgery were collected, and they underwent dual-source dual-energy CT plain scanning and enhanced scanning before operation. Dual-Energy software was used to measure the slope of the energy spectrum curves (λ) in arterial and venous phases after image reconstruction. Patients were divided into two groups according to the pathological results, including well and moderately differentiated gastric adenocarcinoma group and poorly differentiated gastric adenocarcinoma group. Data of each group were analyzed by independent sample t-test. The receiver operating characteristic curve was plotted to evaluate the diagnostic efficiency of the corresponding parameters. Results: There were significant differences in λ values of 40-50keV, 40-60keV, 40-80keV, 40-90keV, 40-100keV, 40-120keV, 40-130keV, 40-140keV and 40-150keV energy ranges in venous phase between the well and moderately differentiated group and poorly differentiated group (P<0.05), but no significant differences in λ values of different energy ranges in arterial phase between the two groups (P>0.05). And the area under curve in 40-120keV energy range was the largest in venous phase. K40-120keV =2.69 was selected as the diagnostic threshold with the maximum Youden index, the sensitivity and specificity were 61.1% and 76%, respectively. Conclusion: The energy spectrum curve of dual-energy CT had certain diagnostic value in the quantitative evaluation of pathological grading of gastric adenocarcinoma.

Brain Abscess Caused by Bordetella hinzii

2021 ◽  
pp. 10.1212/CPJ.0000000000001122
Author(s):  
Nehali Mahesh Mehta ◽  
Josiah Gerdts ◽  
Monica Fung ◽  
Elan Guterman
Keyword(s):  
Follicular Lymphoma ◽  
Brain Abscess ◽  
Chronic Sinusitis ◽  
Stage Iv ◽  
History Of

A 60 year-old well-travelled botanist with a history of chronic sinusitis and treated stage IV follicular lymphoma presented to an outside facility with two weeks of progressive headache and nausea.

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