scholarly journals Nonbacterial Thrombotic Endocarditis and Widespread Skin Necrosis in Newly Diagnosed Lung Adenocarcinoma

2020 ◽  
Vol 13 (1) ◽  
pp. 239-244 ◽  
Author(s):  
Katerina Zakka ◽  
Patrick Zakka ◽  
Amir Davarpanah ◽  
Nikoloz Koshkelashvili ◽  
Mehmet A. Bilen ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Lung Adenocarcinoma ◽  
Ct Scan ◽  
Metastatic Disease ◽  
Skin Lesions ◽  
Primary Adenocarcinoma ◽  
Neoplastic Disease ◽  
Lung Field ◽  
Nonbacterial Thrombotic Endocarditis ◽  
Hands And Feet

Nonbacterial thrombotic endocarditis (NBTE) is a rare entity most commonly diagnosed postmortem with rates in autopsy series ranging from 0.9 to 1.6%. A 63-year-old female with past medical history of hypertension and mitral valve prolapse presented to the hospital with shortness of breath, headache, and necrotic skin lesions on her hands and feet. Computed tomography (CT) scan of her chest demonstrated a pulmonary embolus in the right lower lung segmental artery and right upper lobe lobar to segmental pulmonary artery, a mass-like consolidation in the left upper lung field impeding the hilum. CT scan of the abdomen demonstrated metastatic disease in liver and bone and bilateral femoral deep vein thrombosis. Transesophageal echocardiography revealed severe mitral regurgitation with two small mobile plaques on the mitral valve and two immobile plaques on the descending aorta. Magnetic resonance imaging of the brain was consistent with subacute infarcts and metastatic disease. Bronchoscopy was performed and pathology revealed primary adenocarcinoma of the lung. She was treated with anticoagulation and systemic chemotherapy. The patient and family elected to proceed with hospice due to her clinical decline, poor performance status, and poor prognosis after a prolonged hospital stay. Underlying malignancy is detected in approximately 40–85% of patients with NBTE. Lung cancer is the most frequently associated malignancy followed by pancreatic, stomach, breast, and ovarian cancer. Widespread necrotic skin lesions as presenting symptoms of primary lung adenocarcinoma are rare. In the present case, the diagnosis of necrotic skin lesions and NBTE preceded that of the neoplastic disease. Necrotic skin lesions and NBTE can be the first manifestations of an occult malignancy causing extensive multi-organ infarcts. NBTE can present with such extensive skin lesions as a first presenting sign of malignancy. To the best of our knowledge, this is the first case to present with such extensive skin lesions as the first presenting symptom of lung adenocarcinoma.

Metastatic choriocarcinoma with multiple neoplastic intracranial microaneurysms

2008 ◽  
Vol 108 (5) ◽  
pp. 1014-1017 ◽  
Author(s):  
In Bok Chang ◽  
Byung Moon Cho ◽  
Se Hyuck Park ◽  
Dae Young Yoon ◽  
Sae Moon Oh
Keyword(s):  
Ct Scan ◽  
Cerebral Arteries ◽  
Lung Field ◽  
Necrotizing Vasculitis ◽  
Cerebral Angiogram ◽  
Lower Lung Field ◽  
Metastatic Lesions ◽  
Middle Cerebral Arteries ◽  
Lower Lung ◽  
Chest Ct Scan

✓The authors report on a case of a metastatic choriocarcinoma that mimicked systemic necrotizing vasculitis on a cerebral angiogram. A 35-year-old woman presented with right hemiplegia and a drowsy mental state. A computed tomography (CT) scan revealed an intracerebral hemorrhage in the left frontal region. A cerebral angiogram showed multiple microaneurysms arising from the bilateral anterior cerebral arteries and middle cerebral arteries, and the renal angiogram showed multiple microaneurysms arising from the left distal renal artery. A chest CT scan revealed multiple metastatic lesions in the left lower lung field. The hematoma and microaneurysms were surgically removed. Choriocarcinoma was diagnosed after histological examination. Despite receiving postoperative chemotherapy, the patient died 1 month after the operation.

Osseous Metastatic Disease to the Hands and Feet

Orthopedics ◽  
2019 ◽  
Vol 42 (2) ◽  
pp. e197-e201 ◽  
Author(s):  
Jad M. El Abiad ◽  
Keith Aziz ◽  
Adam S. Levin ◽  
Edward M. McCarthy ◽  
Carol D. Morris
Keyword(s):  
Metastatic Disease ◽  
Hands And Feet

scholarly journals Lung Involvement Found on Chest CT Scan in a Pre-Symptomatic Person with SARS-CoV-2 Infection: A Case Report

2020 ◽  
Vol 5 (2) ◽  
pp. 56 ◽  
Author(s):  
Ali Asadollahi-Amin ◽  
Mehrdad Hasibi ◽  
Fatemeh Ghadimi ◽  
Hosnieh Rezaei ◽  
SeyedAhmad SeyedAlinaghi
Keyword(s):  
Ct Scan ◽  
Stable Condition ◽  
Lung Field ◽  
The Novel ◽  
Lung Involvement ◽  
Compassionate Use ◽  
Unrelated Condition ◽  
Novel Coronavirus ◽  
Care Worker ◽  
Chest Ct Scan

The novel coronavirus SARS-CoV-2 infection is spreading worldwide, and there are many reports of acute respiratory distress syndrome caused by this infection. However, asymptomatic lung involvement has not been reported. We hereby present the case of a 44-year-old health-care worker, who was found to be infected with the SARS-CoV-2 virus after a CT-scan performed for an unrelated condition revealed a lesion in the lung field compatible with COVID-19 infection. His condition deteriorated initially, but eventually improved with supportive treatment and the compassionate use of antivirals and antimalarials and is now in a stable condition.

scholarly journals Mechanical Mitral Valve Thrombosis in a Patient With Prior Nonbacterial Thrombotic Endocarditis

2020 ◽  
Vol 2 (4) ◽  
pp. 539-543
Author(s):  
Kalyan R. Chitturi ◽  
Miguel A. Castro ◽  
Eric Salazar ◽  
Michael Deavers ◽  
Su Min Chang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Thrombosis ◽  
Nonbacterial Thrombotic Endocarditis

scholarly journals Transcatheter Mitral Valve Replacement Guided by Echocardiographic–CT Scan Fusion

2020 ◽  
Vol 13 (11) ◽  
pp. 1376-1378 ◽  
Author(s):  
Augustin Coisne ◽  
François Pontana ◽  
Thomas Modine ◽  
Arnaud Sudre ◽  
Patrizio Lancellotti ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Ct Scan ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Transcatheter Mitral Valve Replacement

Cutaneous Metastases in Patients with Rectal Cancer: A Report of Six Cases

2008 ◽  
Vol 74 (2) ◽  
pp. 138-140 ◽  
Author(s):  
Leo M. Gazoni ◽  
Traci L. Hedrick ◽  
Philip W. Smith ◽  
Charles M. Friel ◽  
Brian R. Swenson ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cause Of Death ◽  
Metastatic Disease ◽  
Retrospective Review ◽  
Skin Lesions ◽  
Rectal Tumor ◽  
Cutaneous Metastases ◽  
History Of ◽  
Disseminated Disease ◽  
Visceral Malignancy

Cutaneous metastases from rectal cancer are rare manifestations of disseminated disease and uniformly represent dismal survival. A retrospective review of six patients with rectal cancer metastatic to the dermis was performed. The diagnosis of rectal cancer was made concurrently with the diagnosis of the dermal metastases in all six patients. A 100 per cent histopathologic concordance existed between the tissue of the dermal metastases and primary rectal tumor. The progression of systemic metastatic disease was the cause of death in 83.3 per cent of patients (5/6). No patient survived more than 7 months from the time of diagnosis. Recognition of suspicious skin lesions as possible harbingers of undiagnosed visceral malignancy is important in managing patients both with and without a history of previous cancer.

Incidence of Ct scan-detected pulmonary embolism in patients with oncogene-addicted, advanced lung adenocarcinoma

2015 ◽  
Vol 136 (5) ◽  
pp. 924-927 ◽  
Author(s):  
Melina Verso ◽  
Rita Chiari ◽  
Stefano Mosca ◽  
Laura Franco ◽  
Matthias Fischer ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Lung Adenocarcinoma ◽  
Ct Scan

scholarly journals Perioperative Cerebral Ischaemia in Cardiac Surgery and BIS

2005 ◽  
Vol 33 (4) ◽  
pp. 514-517 ◽  
Author(s):  
J. Villacorta ◽  
F. Kerbaul ◽  
F. Collart ◽  
C. Guidon ◽  
M. Bonnet ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Ct Scan ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Bispectral Index ◽  
Cerebral Ischaemia ◽  
Air Embolism ◽  
Aortic Cross Clamp ◽  
Bispectral Index Monitoring

A 46-year-old woman was monitored by bispectral index monitoring (BIS) during redo aortic and mitral valve replacement. On release of the aortic cross clamp there was a sudden, severe, unexplained, and sustained fall in the BIS value. Postoperatively, a CT scan was consistent with multiple ischaemic lesions. The lesions were presumed to be due to air embolism. This case suggests that a sudden unexplained and persistent fall in BIS may indicate cerebral ischaemia.

Circulating tumor cells (CTC), [18F]fluorodeoxyglucose positron emission tomography, and computed tomography (PET/CT) for treatment monitoring in patients with metastatic breast cancer (MBC)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e12007-e12007
Author(s):  
D. Tamkus ◽  
S. R. Chandana ◽  
K. Berger ◽  
T. Aung
Keyword(s):  
Ct Scan ◽  
Metastatic Disease ◽  
Response To Therapy ◽  
Predictive Values ◽  
Positive Correlation ◽  
Time Points ◽  
Female Patients ◽  
18F Fluorodeoxyglucose ◽  
Pet Ct

e12007 Background: Use of [18F]-fluorodeoxyglucose PET /CT and/or CTC is being investigated to follow up response to treatment in patients with MBC. It is not clear if these tests can be a surrogate for one another. Methods: We retrospectively analyzed a database of female patients with MBC undergoing chemotherapy or hormonal therapy. Most of these patients received at least 2 lines of therapy. Standard CT scan tumor measurements were used to assess response to therapy. CTC were defined either low (0–5) or high (>5). Maximum standard uptake values (max SUV) on PET scan were defined either low (<3) or high (>3). Correlation between the max SUV and CTC counts was statistically analyzed. Sensitivity, specificity, positive and negative predictive values were calculated from 2 x 2 table. Results: A total of 9 female patients with MBC were identified (mean age of 52 years). The receptor status of these patients includes 67 % positive for ER and 33 % positive for HER-2/neu. Median follow up was 9.8 months. There were 59 time points (> or = 4 weeks apart) when either PET/CT or CTC were performed. The results of PET/CT scans were compared with CTC at 38 events. The sensitivity of CTC to detect metastatic disease shown on PET/CT was 32% and specificity of 100%. The positive and negative predictive values were 100% and 32% respectively. There was a positive correlation between the max SUV and CTC count (p = 0.001). However in three patients, despite of progression of disease per PET/CT, CTC were undetectable at three different time points. Interestingly, two out of these three patients were triple negative. Disease progression was confirmed by biopsy in two of these patients. Conclusions: Our data suggest positive correlation between PET/CT scan and CTC. However, CTC had poor sensitivity and negative predictive value to detect progressive metastatic disease. Normal CTC values have to be interpreted cautiously in patients with MBC. We are now planning to investigate the utility of these tests, prospectively, in a large cohort of MBC patients. No significant financial relationships to disclose.

Assessing the use of routine abdominal CT in staging evaluation of patients with primary breast cancer.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 3-3
Author(s):  
Stuart-Allison Moffat Staley
Keyword(s):  
Breast Cancer ◽  
Ct Scan ◽  
Metastatic Disease ◽  
Predictive Value ◽  
Primary Breast Cancer ◽  
Chest Ct ◽  
Disease Spread ◽  
Newly Diagnosed ◽  
Abdominal Ct ◽  
Axillary Nodes

3 Background: The purpose of this study was to determine the utility of routine abdominal CT in the staging evaluation of women with newly diagnosed primary breast cancer given no detectable disease beyond the ipsilateral axillary nodes on chest CT. Methods: The chest and abdominal CT scans from 440 patients over a 10-year period were reviewed. The presence of definite or possible metastatic disease in the axillary nodes, chest wall, internal mammary nodes, mediastinal nodes, lungs, liver and adrenals were recorded for each patient. Cross tabulation bivariate analysis as well as a chi-square test were performed to characterize the relationship between detection of disease in the chest and disease in the abdomen. Results: Of the 440 patients reviewed, the following were found to have detectable metastatic disease by CT scan: axillary nodes 258 of 440 (56.46%), chest wall 40 of 440 (9.10%), internalmammary nodes 8 of 440 (1.82%), mediastinal nodes 29 of 440 (6.59%), lung 25 of 440 (5.68%), liver 12 of 437 (2.73%), and adrenals 8 of 440 (1.82%). In total, 81 patients had disease detectable in the chest beyond the ipsilateral axillary nodes, and only 12 patients had detectable disease spread in the abdomen. Of the 359 patients who had a negative chest CT, only 1 patient had detectable or possible metastatic disease spread on abdominal CT, resulting in a 99.70% negative predictive value (p < 0.001). Conclusions: The routine use of abdominal CT in women with newly diagnosed primary breast cancer and no detectable disease beyond the ipsilateral axillary nodes on staging chest CT scan has little value with a 99.70% negative predictive value. We recommend that if a negative CT scan of the patient’s chest yields no detectable disease beyond the axillary nodes, then further CT imaging of the abdomen is of no additional benefit to the patient. [Table: see text]

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