DOCSLIB.ORG

Retroperitoneal Bronchogenic Cyst: a Rare Incidentaloma Discovered in a Juvenile Hypertensive Patient

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Retroperitoneal Bronchogenic Cyst: a Rare Incidentaloma Discovered in a Juvenile Hypertensive Patient Hypertension Research (2014) 37, 595–597 & 2014 The Japanese Society of Hypertension All rights reserved 0916-9636/14 www.nature.com/hr CORRESPONDENCE Retroperitoneal bronchogenic cyst: a rare incidentaloma discovered in a juvenile hypertensive patient Hypertension Research (2014) 37, 595–597; doi:10.1038/hr.2014.38; published online 6 March 2014 Bronchogenic cysts are incidentally discov- In the laboratory examinations, the blood latent neoplasm. The resected tissue showed ered by radiological examination or during cell count, liver and renal functions, blood a brownish and dark-gray cystic tumor surgical procedures. The symptoms are glucose, and related tumor markers, (Figure 1f). Partly compressed normal adre- usually related to a tracheobronchial pathway including carcinoembryonic antigen ((CEA), nal tissue was attached to the outer surface of obstruction and/or secondary infection or 1.90 ng ml À1 (normal, o5.0)), carbohydrate the tumor (Figure 1g). Microscopically, the hemorrhage. These cysts most commonly antigen 19-9 ((CA19-9), 6.9 Uml À1 (normal, cystic portion was partially lined by ciliated occur in the subcarinal and parahilar areas o40)), and neuron-specific enolase columnar epithelium (Figure 1h) resting on in the mediastinum. However, they have also (8.95 ng ml À1 (normal, o16.3)), were fibrous connective tissue and smooth muscle been found in retroperitoneal locations.1,2 normal, although moderate hypokalemia cells containing mucous glands and hyaline Here, we present an interesting case of (3.8 mmol l À1) was concomitantly detected. (Figure 1i). Pulmonary parenchyma or ter- juvenile hypertension accompanying a left The preoperative basal endocrine data were atomatous components were not found in adrenal incidentaloma, which was patho- as follows: adrenocorticotropin, 27.6 pg ml À1 the tumor. The resected tumor was patholo- logically diagnosed as a bronchogenic cyst (normal, 7.2–63.3); cortisol, 14.0 mgdlÀ1 gically diagnosed as an extra-adrenal retro- post surgery. (normal, 8–25); plasma renin activity, peritoneal bronchogenic cyst. Post surgery, A 27-year-old hypertensive man was 1.5 ng ml À1 h À1 (normal, 0.2–2.7); aldoster- glucocorticoid replacement therapy was not referred to our hospital for examination of one, 10.5 ng dl À1 (normal, 3.6–24); dehydro- required. As shown in Figure 1j, the patient’s a left adrenal tumor that was incidentally epiandrosterone sulfate, 164 mgdlÀ1 (normal, systolic and diastolic blood pressure was discovered by abdominal computed tomo- 138–519); adrenaline, 0.01 ng ml À1 (normal, readily normalized (117/67 mm Hg) after graphy (CT). Hypertension and obesity had o0.1);noradrenaline,0.22ngmlÀ1 the adrenalectomy, and the serum potassium been noted in annual checkups dating back (normal, 0.1–0.5); and dopamine, level gradually normalized (4.3 mmol l À1) 5 years. The patient showed moderate hyper- 0.02 ng ml À1 (normal, o0.03). The urinary within 3 weeks. After one postoperative year, tension (140–149/70 to 86 mm Hg) and obe- catecholamine levels were within normal both the serum cortisol (12.0 mgdlÀ1)and sity (body mass index, 31.3), although he had ranges, including adrenaline (10.7 mgper aldosterone (8.5 ng dl À1) levels were also no Cushingoid features, such as central day, normal, 3–41), noradrenaline (108.8 mg decreased compared with their preoperative obesity and skin lesions. The abdominal CT per day, normal, 31–160), metanephrine levels. showed a 5-cm circumscribed mass measur- (0.13 mg per day, normal, 0.04–0.18), norme- Bronchogenic cysts arise from the foregut ing 50 Hounsfield units (HU) in the left tanephrine (0.19 mg per day, normal, 0.1– as malformations when normal bronchial adrenal region (Figure 1a, upper), and the 0.28) and vanillylmandelic acid (4.1 mg per tubes are developmentally separated. Most right adrenal gland was detected to be day, normal, 1.5–4.3). Note that the urinary bronchogenic cysts occur in the mediastinum normal (Figure 1a, lower). An abdominal excretions of aldosterone (8.9 mgperday, region, and only a few cases have been ultrasound showed a cystic pattern in the left normal, 0–7.5) and cortisol (127 mgperday, reported in the retroperitoneum.1,2 There adrenal region (Figure 1b). On magnetic normal, 26–187) were slightly elevated. An are no gender-related incidence differences, resonance imaging (MRI), the adrenal adrenal scintigram using 131I-adosterol but the age range of onset (i.e., 40–70 years) tumor was detected as an ISO-intensified showed an approximately normal pattern of is older than our patient. Retroperitoneal tumor by T1-weighted images (Figure 1c), bilateral uptake in the adrenal regions; bronchogenic cysts are usually localized in in which no T2-hyperintense signal was with 131I-metaiodobenzylguanidine, the scin- the left adrenal region and the superior observed (Figure 1d). A fat suppression and tigram showed no significant accumulation in body of the pancreas.3 Most bronchogenic spectral attenuated inversion recovery a whole-body scan. cysts are pathologically benign, although (SPAIR) scan of the MRI studies showed Laparoscopic left adrenalectomy was per- malignant forms have been reported due to little inclusion of adipose tissue in the tumor formed based on the size of the adrenal characteristically increased serum levels of (Figure 1e). tumor (54  38 mm2) and considering a tumor markers, including CEA and CA19-9. Correspondence 596 180 5 Lt. Adrenalectomy SBP 4.3 4.5 120 // 3.8 Serum K 4 3.5 60 // DBP Serum K (mEq/l) SBP, DBP (mmHg) SBP, 3 0 // 2.5 0714 30 (days) Admission Discharge Figure 1 The radiological and pathological findings of the left adrenal tumor and the clinical course. (a) The left adrenal mass (indicated by an arrow) and right normal adrenal gland (indicated by an arrowhead) on plain CT. (b) An abdominal ultrasound. (c) A T1-weighted MRI (indicated by an arrow). (d) A T2- weighted MRI (indicated by an arrow). (e) SPAIR-MRI. (f) The gross features of the resected adrenal tumor. (g) The histological findings of the adjacent adrenal tissue, hematoxylin and eosin (H&E) staining  40. (h) The histological findings of the resected tumor, H&E staining  100. (i) The microscopic findings of the resected tumor composed of bronchial-epithelial cells, H&E staining  400. (j) Clinical course. SBP, systolic blood pressure; DBP, diastolic blood pressure; Serum K, serum potassium. A full color version of this figure is available at the Hypertension Research journal online. In the present case, the tumor marker levels and the rate of preoperative discovery of the left adrenalectomy preparation was were within the normal ranges, and the such tumors is only 0.1%.6,7 Likewise, performed with an alpha-blocker (phenoxy- imaging study and pathological workup bronchogenic cysts are often misdiagnosed benzamine), the authors reported that confirmed that the resected adrenal tumor as solid adrenal tumors because of their palpation during surgical exploration of the was benign. rich protein contents.3,8 In the present case, tumor immediately caused tachycardia The incidence of adrenal incidentalomas the CT and MRI results indicated little and hypertension, possibly mediated by has been increasing because of recent inclusion of adipose tissue in the solid a catecholamine release because of an advances in the availability of radiological tumor, while ultrasound was informative expanding mass or hemorrhage.10 Given devices. The CT attenuation value is infor- and differentiated a cystic composition in that hypertension and moderate hypo- mative for differentiating between benign and the adrenal region. kalemia were normalized after surgery in malignant adrenal tumors. A homogeneous The clinical hallmarks used as indicators our case, it is possible that a small amount mass with a smooth border and low HU to determine surgical intervention of of deviation of adrenocortical hormones value (o10 HU) indicates a benign ade- adrenal incidentalomas are the initial size, contained in the tumor and/or those noma, except for lipid-poor adenomas.4 MRI growth rate and imaging characteristics induced by the compressed normal adrenal studies show benign adenomas as clear fat of the adrenal tumor and the endocrine was, at least somewhat, associated with the suppression of the signals by chemical-shift behavior.9 In the present case, the existence of preoperative hypertension. imaging,5 whereas adrenal metastasis is possibility of Cushing’s syndrome, pheo- Collectively, an accumulation of similar hypointense in T1-weighted images but chromocytoma and primary aldo- cases and pathophysiological investigations hyperintense in T2-weighted images. Note steronism was excluded preoperatively by are needed in future studies. The present that radiological examination occasionally endocrine data, including adrenal pressor case further emphasizes the need to consider uncovers various unexpected lesions that hormones and adrenal scintigrams. bronchogenic cysts as a differential diagnosis have originated from extra-adrenal tissues, However, considering the clinical course, for left adrenal incidentaloma with juvenile namely adrenal pseudotumors, which may the existence of the adrenal tumor may hypertension. mislead the diagnosis of tumors. Adrenal have been involved in the complication of 10 pseudotumors, such as gastric diverticulum, hypertension. Doggett et al. have reported a ACKNOWLEDGEMENTS splenic lobulation, renal, pancreatic or similar case of an adrenal bronchogenic cyst We thank Dr Tetsuro Sei and Dr Nanako Ogawa hepatic masses, and periadrenal varices, that was preoperatively considered to be for their constructive discussion regarding are found in B0.7% of incidentalomas, pheochromocytoma. Despite the fact that radiology. Hypertension Research Correspondence 597 Tomohiro Terasaka1,2, Fumio Otsuka2, Dentistry and Pharmaceutical Sciences, washout characteristics on delayed enhanced CT. Kanako Ogura-Ochi1, Kitaku, Okayama, Japan Abdom Imaging 2003; 28: 709–715. 1 1 5 McDermott S, O’Connor OJ, Cronin CG, Blake MA. Tomoko Miyoshi , Kenichi Inagaki , E-mail: [email protected] Radiological evaluation of adrenal incidentalomas: Yasuyuki Kobayashi3, Yasutomo Nasu3 and current methods and future prospects.
Load more

Recommended publications
  • A Case of Mistaken Identity…
    Gastroenterology & Hepatology: Open Access Case Report Open Access A case of mistaken identity… Abstract Volume 5 Issue 8 - 2016 Paragangliomas are rare tumors of the autonomic nervous system, which may origin from Marina Morais,1,2 Marinho de Almeida,1,2 virtually any part of the body containing embryonic neural crest tissue. Catarina Eloy,2,3 Renato Bessa Melo,1,2 Luís A 60year-old old female, with a history of resistant hypertension and constitutional Graça,1 J Costa Maia1 symptoms, was hospitalized for acute renal failure. In the investigation, a CT scan revealed 1General Surgery Department, Portugal a 63x54mm hepatic nodule in the caudate lobe. Intraoperatively, the tumor was closely 2University of Porto Medical School, Portugal attached to segment 1, but not depending directly on the hepatic parenchyma or any other 3Instituto de Patologia e Imunologia Molecular da Universidade adjacent structure, and it was resected. Histology reported a paraganglioma. Postoperative do Porto (IPATIMUP), Portugal period was uneventful. Correspondence: J Costa Maia, Sao Joao Medical Center, A potentially functional PG was mistaken for an incidentaloma, due to its location, General Surgery Department, Portugal, interrelated illnesses and unspecific symptoms. PG may mimic primary liver tumors and Email therefore should be a differential diagnosis for tumors in this location. Received: August 29, 2016 | Published: December 30, 2016 Background and hydrochlorothiazide), was admitted to the Internal Medicine Department due to gastroenteritis and dehydration-associated acute Paragangliomas (PG) are rare tumors of the autonomic nervous renal failure (ARF). She reported weight loss (more than 15%), system. Their origin takes part in the neural crest cells, which produce anorexia, asthenia, polydipsia, polyuria and frequent episodes of 1 neuropeptides and catecholamines.
    [Show full text]
  • Application of an LC–MS/MS Method for the Simultaneous Quantification
    molecules Article Application of an LC–MS/MS Method for the Simultaneous Quantification of Homovanillic Acid and Vanillylmandelic Acid for the Diagnosis and Follow-Up of Neuroblastoma in 357 Patients Narae Hwang 1,† , Eunbin Chong 1,†, Hyeonju Oh 1, Hee Won Cho 2, Ji Won Lee 2 , Ki Woong Sung 2,* and Soo-Youn Lee 1,3,4,* 1 Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; [email protected] (N.H.); [email protected] (E.C.); [email protected] (H.O.) 2 Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; [email protected] (H.W.C.); [email protected] (J.W.L.) 3 Department of Clinical Pharmacology & Therapeutics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea 4 Department of Health Science and Technology, Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University, Seoul 06351, Korea * Correspondence: [email protected] (K.W.S.); [email protected] (S.-Y.L.); Tel.: +82-2-3410-3529 (K.W.S.); Citation: Hwang, N.; Chong, E.; Oh, +82-2-3410-1834 (S.-Y.L.); Fax: +82-2-3410-0043 (K.W.S.); +82-2-3410-2719 (S.Y.L.) H.; Cho, H.W.; Lee, J.W.; Sung, K.W.; † These authors contributed equally to this work. Lee, S.-Y. Application of an LC–MS/MS Method for the Abstract: Homovanillic acid (HVA) and vanillylmandelic acid (VMA) are end-stage metabolites of Simultaneous Quantification of catecholamine and are clinical biomarkers for the diagnosis of neuroblastoma.
    [Show full text]
  • October 2019
    Cleveland Clinic Laboratories Technical Update • October 2019 Cleveland Clinic Laboratories is dedicated to keeping you updated and informed about recent testing changes. This Technical Update is provided on a monthly basis to notify you of any changes to the tests in our catalog. Recently changed tests are bolded, and they could include revisions to methodology, reference range, days performed, or CPT code. Deleted tests and new tests are listed separately. For your convenience, tests are listed alphabetically and order codes are provided. To compare the new information with previous test information, refer to the online Test Directory at clevelandcliniclabs. com. Test information is updated in the online Test Directory on the Effective Date stated in the Technical Update. Please update your database as necessary. For additional detail, contact Client Services at 216.444.5755 or 800.628.6816, or via email at [email protected]. Days Performed/Reported Specimen Requirement Component Change(s) Special Information Test Discontinued Reference Range Name Change Test Update Methodology Order Code New Test Stability Page # CPT Summary of Changes Fee by Test Name 6 Allergen, Ampicilloyl (IgE) 6 Allergen, Cashew Component IgE 2–3, 9 Allergen, Peanut Components IgE 7 Allergen, Tree, Hackberry IgE 7 Allergen, Weed, Careless Weed IgE 8 Allergen, Weed, Yellow Dock (Rumex crispus) IgE 3 ALL NGS Panel Bone Marrow 3 ALL NGS Panel Peripheral Blood 3, 9 Bone Marrow Chromosome Analysis with Reflex SNP Array 3 CA 125 3, 9 Chromosome Analysis, Blood
    [Show full text]
  • Biochemical Procedures As Aids in Diagnosis of Different Forms of Cancer
    A n n a l s o f C l i n i c a l An d L a b o r a t o r y S c i e n c e , Vol. 4, No. 2 Copyright © 1974, Institute for Clinical Science Biochemical Procedures as Aids in Diagnosis of Different Forms of Cancer MORTON K. SCHWARTZ, Ph.D. Memorial Sloan-Kettering Cancer Center, New York, NY 10021 ABSTRACT The application of biochemical analyses as aids in the diagnosis of cancer is discussed with emphasis on the fact that biochemical testing is more useful in following the regression and progression of disease than in early initial diagnosis. The uses of biochemical analyses of metabolic degradation products, lipids, hormones and their receptors, enzymes, including isoenzymes, and trace metals are included. Introduction indicated in table I these include neuro­ Diagnostic procedures in cancer must be blastoma, pheochromocytoma, carcinoid, designed to achieve several purposes. They hepatocellular carcinoma, multiple mye­ must define the disease, describe its extent loma, osteogenic sarcoma and other osteo­ and be useful in following its progression blastic bone tumors. In these diseases, the or regression. For more than 75 years, in­ assay of the listed components is essential vestigators have searched for biochemical for confirmation of the diagnosis and in defects in cancer cells that could be ex­ following the response to therapy. ploited in diagnosis. Despite these long and continuing studies, few biochemical proce­ Serum Enzymes dures have been developed for early diag­ Historically, the biochemical procedure nosis of specific forms of cancer. The most used for the longest time as a diagnostic useful application of biochemical assays aid in cancer is acid phosphatase.
    [Show full text]
  • Treatment of Cancer.Pptx
    5/3/15 Treatment of Cancer – Chemotherapy, Surgery, Radiation Cancer There is a crabgrass illustration – where you and Immunotherapy… find a batch of crabgrass in a beautiful yard… what do you do? • Cut it – Surgery • Burn it – Radiation • Poison it – Chemotherapy The best approach is to know what caused the crabgrass (it is a kind of grass) and treat it specifically – “Personalized Medicine or Molecular/Targeted Therapy” If we only had enough time Effective Therapies – may Aim of Therapy Cure, Control and/or Relieve the symptoms require better diagnosis • Neoadjuvant chemotherapy: Before • Most diagnosis depends on microscopic/ histopathological analysis (remember the surgery or radiation – to shrink tumor making staging?) it more effectively treated or removed • This method does NOT account for the • Adjuvant chemotherapy: treated after heterologous population of cells nor the surgery or radiation – To deal with undetected various mutations of driver/passenger genes, cells, microtumors… specific oncogenes or tumor suppressors. • Some markers are being used but not widely • Palliative chemotherapy: To treat patient and the number of oncologists that and reduce symptoms – improve quality of understand these markers and use them is life, not treat underlying cause or curative questionable except in most advanced cases “Targeted” Cancer Treatment Cancer Targets How does it work? Attack targets which are specific for the cancer cell and are critical for its survival or for its malignant behavior Why is it better than chemotherapy? More specific for cancer cells – chemotherapy hits rapidly growing cells not all cancer cells grow that rapidly some normal cells grow rapidly Possibly more effective From National Cancer Institute, US National Institutes of Health.
    [Show full text]
  • A Systematic Review of Molecular and Biological Tumor Markers in Neuroblastoma
    4 Vol. 10, 4–12, January 1, 2004 Clinical Cancer Research Review A Systematic Review of Molecular and Biological Tumor Markers in Neuroblastoma Richard D. Riley,1 David Heney,2 reviews in the future. In particular, collaboration of cancer David R. Jones,1 Alex J. Sutton,1 research groups is needed to enable bigger sample sizes, Paul C. Lambert,1 Keith R. Abrams,1 standardize methods of analysis and reporting, and facilitate the pooling of individual patient data. Bridget Young,3 Alan J. Wailoo,4 and Susan A. Burchill5 Introduction Departments of 1Health Sciences, 2Medical Education, University of Leicester, Leicester; 3Department of Psychology, University of Hull, Neuroblastoma is a neuroblastic tumor of the primordial Hull; 4School of Health and Related Research, University of neural crest and is the most common extracranial solid tumor of Sheffield, Sheffield; and 5Cancer Research United Kingdom Clinical childhood, comprising between 8 and 10% of all childhood Centre, St. James’s University Hospital, Leeds, United Kingdom cancers. It is an enigmatic tumor demonstrating diverse clinical and biological characteristics and behavior (1). Tumors may regress spontaneously, reflecting induction of apoptosis or dif- Abstract ferentiation, or they may exhibit extremely malignant behavior Purpose: The aim of this study was to conduct a sys- with very low cure rates. The spectrum of clinical behavior tematic review, and where possible meta-analyses, of molec- suggests that genetic, biological, and morphological features ular and biological tumor markers described in neuroblas- may be useful markers to stratify children with this disease for toma, and to establish an evidence-based perspective on the most appropriate management.
    [Show full text]
  • Negative Urinary Fractionated Metanephrines and Elevated
    Metab y & o g lic lo S o y n n i r d Endocrinology & Metabolic c r o o m d n e E Carrillo et al., Endocrinol Metab Synd 2015, 4:1 ISSN: 2161-1017 Syndrome DOI: 10.4172/2161-1017.1000i004 Clinical Image Open Access Negative Urinary Fractionated Metanephrines and Elevated Urinary Vanillylmandelic Acid in a Patient with a Sympathetic Paravesical Paraganglioma Lisseth Fernanda Marín Carrillo1* and Edwin Antonio Wandurraga Sánchez2 1Centro Médico Carlos Ardila Lulle, Carrera 24 # 154-106, Urbanización El Bosque, Torre B Módulo 55 consultorio 806, Floridablanca, Santander, Colombia 2Deparment of Endocrinology and Molecular Oncology, Universidad Autónoma de Bucaramanga UNAB Campus El Bosque, Calle 157 # 14 – 55 Floridablanca, Santander, Colombia *Corresponding author: Lisseth Fernanda Marín Carrillo, Centro Médico Carlos Ardila Lulle, Carrera 24 # 154-106, Urbanización El Bosque. Torre B Módulo 55 consultorio 806, Floridablanca, Santander, Colombia, Tel: +57689303, +573188481025; E-mail: [email protected] Received date: Jan 06, 2015, Accepted date: Jan 07, 2015, Published date: Jan 9, 2015 Copyright: © 2015 Carrillo LFM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Clinical Image hrs). An 18 fluorodeoxiglucose PET/CT study (18 FDG PET/CT) showed an abnormal glucose uptake in the bladder with 16.9 SUVs. No distant metastases were reported. Surgical resection was performed successfully and antihypertensive medication was discontinued. The patient remains asymptomatic and normotensive (unmedicated). Results of genetic testing are pending [1-3].
    [Show full text]
  • Urinary Vanillylmandelic Acid Levels in the Workup of Adrenal Incidentaloma Iass El-Lakkis, M.D.1, Rami Mortada, M.D.2, P
    Kansas Journal of Medicine 2011 Urinary Vanillylmandelic Acid Levels Urinary Vanillylmandelic Acid Levels in the Workup of Adrenal Incidentaloma 1 2 Iass El-Lakkis, M.D. , Rami Mortada, M.D. , 3 1 P. Tyson Blatchford, M.D. , Justin Moore, M.D. 1University of Kansas School of Medicine- Wichita, Department of Internal Medicine, Wichita, Kansas 2University of California-Davis, Division of Endocrinology, Sacramento, California 3South Central Kansas Regional Medical Center, Department of Surgery, Arkansas City, Kansas Introduction Although the majority of patients with the chest was performed and demonstrated pheochromocytoma have hypertension, 5- no evidence of other masses or adenopathy. 15% of patients are normotensive and this The patient denied fevers, flushing, percentage may be higher in patients with palpitations, abdominal pain, or other adrenal “incidentalomas”.1-3 The diagnosis constitutional symptoms. He was a previous of asymptomatic pheochromocytoma is smoker, with roughly a 30 pack-year history. increasing in incidence, most likely due to Physical examination and vital signs widespread use of sectional imaging. 4 The were normal. Laboratory revealed a normal most reliable method for diagnosing random serum cortisol of 7 mcg/dl. A 24- pheochromocytoma or paraganglioma is hour urine collection for catecholamines and measurement of 24-hour urine catechol- metanephrines was within normal limits, amines and metanephrines, with a sensitivity with total metanephrines of 772 mcg/24 and specificity of roughly 98%.5-7 The hours (normal range 224-832 mcg/24 hours) urinary vanillylmandelic acid level though and catecholamines of 55 mcg/24 hours may retain some value in the diagnosis of (normal range 26-121 mcg/24 hours).
    [Show full text]
  • Compositions and Methods for Characterizing, Regulating, Diagnosing and Treating Cancer
    (19) & (11) EP 2 369 014 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.: 28.09.2011 Bulletin 2011/39 C12Q 1/68 (2006.01) A61K 39/395 (2006.01) A61K 38/00 (2006.01) C07K 16/28 (2006.01) (2006.01) (21) Application number: 11152618.2 G01N 33/574 (22) Date of filing: 03.02.2005 (84) Designated Contracting States: (72) Inventors: AT BE BG CH CY CZ DE DK EE ES FI FR GB GR • Clarke, Michael, F. HU IE IS IT LI LT LU MC NL PL PT RO SE SI SK TR Standford, CA 94305 (US) Designated Extension States: •Al-Hajj, Muhammad AL BA HR LV MK YU Eagleville, PA 19403 (US) (30) Priority: 03.02.2004 US 541527 P (74) Representative: King, Hilary Mary Mewburn Ellis LLP (62) Document number(s) of the earlier application(s) in 33 Gutter Lane accordance with Art. 76 EPC: London 05722705.0 / 1 718 767 EC2V 8AS (GB) (71) Applicant: The Regents Of The University Of Remarks: Michigan •This application was filed on 28-01-2011 as a Office Of Technology Transfer divisional application to the application mentioned Ann Arbor, MI 48109-2590 (US) under INID code 62. •Claims filed after the date of filing of the application (Rule 68(4) EPC). (54) Compositions and methods for characterizing, regulating, diagnosing and treating cancer (57) The present invention relates to compositions breast cancer cells and preventing metastasis. The and methods for characterizing, regulating, diagnosing, present invention also provides systems and methods and treating cancer. For example, the present invention for identifying compounds that regulate tumorigenesis.
    [Show full text]
  • Tumor Markers: Issues from an Insurance Perspective
    VOLUME 25, NO. 2 SUMMER ~993 TUMO~ MA~KERS TUMOR MARKERS: ISSUES FROM AN INSURANCE PERSPECTIVE Robert J. Pokorski, MD, FACP Trends in Cancer Mortality later in pancreatic cancer. Human chorionic gonadot- ropin (I-ICG) and serum acid phosphatase were identi- Two important trends in cancer mortality are being fied in the 1930s, followed by the discovery of alkaline reported world-wide. First, changing mortality due to phosphatase, vanillylmandelic acid (VMA), and lactic certain cancers is being observed. In a study of trends dehydrogenase CLDH). But it was not until the isolation in 15 industrialized cotmtries,~ increases in cancer mor-of carcinoembryonic antigen (CEA) in 1965 that tumor tality were reported for lung, breast and prostate can- marker measurements became an important part of cers in most age groups, while a substantial decline in oncology and laboratory medicine.7 stomach cancer mortality was noted. Intestinal cancer mortality varied by age and region of the world. Such Tumor markers may be bound to tissues or circulate patterns should always be interpreted in the context of freely in body fluids. Those that are tissue bound, such other changes that may have been taking place during as estrogen and progesterone receptors in breast cancer, the time of the study. For example, significant improve- can only be obtained via biopsy Circulating tumor ments in the accessibility and quality of health care may markers are found in body fluids such as blood or urine. have occurred over the years, or changes in cancer These are the markers that are commonly used in clini- mortality may be due largely to better statistics2~3 or cal medicine: prostate-specific antigen, carcinoem- earlier diagnosis due to cancer screening.4 bryonic antigen, alpha-fetoprotein, etc.
    [Show full text]
  • New Test Effective
    2/16/2016 NEW TESTS - Please update your EMR catalog with those appropriate to your practice New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type LOINC Reference Range UOM Result Type 5565707 Varicella-Zoster Virus Qualitative by PCR VAR Z QUAL Detail 11483-5 Not Detected Alpha Prompt Code Mnemonic Result Name CPT: 87798 Collection: EDTA plasma, Serum, CSF, Occular Fluid, Vesicle Fluid or Tissue 4195423 VZV Source VZV Source Prompt $225.00 Specimen: 1mL (0.5mL) EDTA Plasma, Serum, CSF, Occular Fluid. Submit Frozen Vesicle Fluid must be placed in Viral Transport Media and submitted frozen. Tissue must be placed in a sterile container and frozen IMMEDIATELY. Stability: RT=Unacceptable, RF=5 days, FZ=3 months. Tissue: Frozen ONLY! Setup: Sun-Sat TAT: 2-4 days after set-up New Test Effective : 04/02/2016 Test Code Test Name Mnemonic Category/Type 5558886 Q-Fever Antibody IgG, Phase I & II with Reflex to Titer Q Fever Ab Group LOINC Result Code Mnemonic Result Name Reference Range UOM Result Type 48720-7 5558881 XQ FV 1 SC Q-Fever Abs, IgG Phase I Screen Negative Alpha CPT: 86638x2 Coxiella burnetii (aka Q-Fever) 48719-9 5558882 XQ FV 2 SC Q-Fever Abs, IgG Phase II Screen Negative Alpha Price $150.80 If either C. Burnetii Abs IgG Phase I and/or Phase II result is indeterminate or positive, then titer(s) will be added. Additional charges apply. If reflexed to Q Fever I Titer 1mL (0.1mL) Serum refrigerated. Spin & separate Possible individual Reflex tests Cpt 86638 serum from cells within 2 hours of collections.
    [Show full text]
  • Test Abbreviations
    TEST ABBREVIATIONS A1A Alpha-1 Antitrypsin CONABO Confirmatory Type A1c Hemoglobin A1c CPK Creatine Phosphokinase AB Antibody Cr Creatinine ABG Arterial Blood Gas CRCL, CrCl Creatinine Clearance ABRH ABO Group and Rh Type CRD Cord Type and DAT ABT Antibody Titer CREAT Creatinine ACA Anti-Cardiolipin Antibodies CRP C-Reactive Protein ACE Angiotensin Converting Enzyme Cu Copper ACID PHOS Acid Phosphatase D Bil Direct Bilirubin ACP Acid Phosphatase DAT Direct Antiglobulin (Coombs) Test ACT Activated Clotting Time DCAS DAT and AB Screen ACTH Adrenocorticotropic Hormone DHEA Dehydroepiandrosterone ADA Adenosine Deaminase DHEAS Dehydroepiandrosterone-Sulfate AFB Acid-Fast Bacillus DIFM Differential AFLM Amniostat Dig Digoxin AFP Alpha Fetoprotein EOS Eosinophils AG Antigen EPO Erythropoietin ALA Aminolevulinic Acid ERA Estrogen Receptor Assay Alb Albumin ESR Erythrocyte Sedimentation Rate Alk Phos Alkaline Phosphatase ETOH Ethanol ALP Alkaline Phosphatase FBS Fasting Blood Sugar (Glucose) ANA Antinuclear Antibody Fe Total Iron Anti-HBc Hepatitis B Core Antibodies FEP Free Erythrocyte Protoporphyrin Anti-HBe Hepatitis Be Virus Antibody FFN Fetal Fibronectin Anti-HBs Hepatitis B Surface Antibody Fol Folate Anti-HCV Hepatitis C Antibody FSH/LH FSH/LH Evaluation APT APT – Stool for Fetal Hemoglobin FT3 Free T3 aPTT Activated Partial Thrombin Time FT4 Free Thyroxine ASN Antibody Screen G2PP 2 Hour Postprandial Glucose ASO Antistreptolysin-O G-6-PD Glucose-6-Phosphate AT III Antithrombin-III Activity Dehydrogenase B12 Vitamin B12 Gamma GT Gamma Glutamyl
    [Show full text]