Cancer Races

Saturday, April 5, 2008

Fw: Ultrasound-guided biopsy of greater omentum: An effective method to trace the origin of unclear ascites.

----- Forwarded Message ----
From: HubMed - mesothelioma <rssfwd@rssfwd.com>
To: shell8377@yahoo.com
Sent: Tuesday, March 11, 2008 10:08:51 PM
Subject: Ultrasound-guided biopsy of greater omentum: An effective method to trace the origin of unclear ascites.

[1]Eur J Radiol. 2008 Mar 5;
Que Y, Wang X, Liu Y, Li P, Ou G, Zhao W

OBJECTIVES: Thickened greater omentum is encountered with high frequency in patients with ascites. The purpose of our study was to assess the utility of greater omentum biopsy under the guidance of ultrasound (US) in tracing the origin of unclear ascites and differentiating benign and malignant ascites. MATERIALS AND METHODS: We retrospectively reviewed our institutional database for all records of greater omentum biopsy cases. One hundred and ninety-four patients with unclear ascites and thickened greater omentum were included in the study. The sonograms of greater omentum were evaluated before undergoing the ultrasound-guided biopsy and a biopsy was considered successful if a specific benign or malignant diagnosis was rendered by the pathologist. RESULTS: Successful biopsy was rendered for 182 biopsy procedures (93.8%, 182/194) including tuberculosis (n=114), chronic inflammation (n=3), metastases (n=58), malignant mesothelioma (n=6) and pseudomyxoma peritonei (n=1). Twelve biopsies were non-diagnostic. According to the results of biopsy and follow-up, the sensitivity and specificity of biopsy in distinguishing malignant ascites from benign ascities were respectively 95.6% (65/68) and 92.9% (117/126). The greater omentum of 84 cases of tuberculous peritonitis showed "cerebral fissure" sign and was well seen as an omental cake infiltrated with irregular nodules when involved by carcinomatosis. No "cerebral fissure" sign was observed in peritoneal carcinomatosis. The sensitivity and specificity of this sign in indicating the existence of tuberculous peritonitis were 73.5% (89/121) and 100% (73/73). Moreover, if the specific "cerebral fissure" sign was combined with the biopsy results, the specificity of biopsy in distinguishing malignant ascites from benign ascits increased to 96.8% (122/126). CONCLUSION: Ultrasound-guided biopsy of greater omentum is an important and effective method to diagnose the unclear ascites for patients with thickened omentum if certain techniques could be paid attention to. "Cerebral fissure" sign of greater omentum was a specific sign in indicating the tuberculous peritonitis and could increase the specificity of biopsy in distinguishing malignant ascites from benign ascits if combined with the biopsy results.

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Source: http://www.hubmed.org/display.cgi?uids=18328658
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Thursday, April 3, 2008

Mesothelioma Cancer Info and What you Need to Know

Its transcendently common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).

Unlike lung cancer, there is no association between mesothelioma and smoking Malignancies involving mesothelial cells in these spread cavities are known as malignant mesothelioma, which may be localized or diffuse. Mesothelioma is the word used to describe a cancerous tumor that involves the mesothelial cells of an organ, often the lungs, heart, or abdominal organs.

In this disease, malignant cells develop in the mesothelium, a protective lining that covers transcendently of the spread's internal organs. Greatest malignant mesotheliomas set up complex karyotypes, with extensive aneuploidy and rearrangement of tons chromosomes.

Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma.

If the cancer has length beyond the mesothelium to other parts of the size, symptoms may include pain, trouble swallowing, or swelling of the neck or engage.

Tissue is removed, placed under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. Mesothelioma is diagnosed by pathological examination from a biopsy.

Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and suffering due to ascites (a buildup of fluid in the abdominal cavity). Malignant mesothelioma has also been linked to curing radiation using thorium dioxide and zeolite, a silicate in the soil.

Malignant mesothelioma is often just called simply Mesothelioma and is a form of lung cancer that is quite rare.

Exposure to airborne asbestos particles increases one's risk of developing malignant mesothelioma.

Malignant mesothelioma has a peak incidence 35-45 years after asbestos exposure. Malignant mesothelioma is more humble in men, with a male-to-female ratio of 3:1. Malignant mesothelioma is a rare type of cancer in which malignant cells are found in the sac lining the chest or abdomen. Super people with malignant mesothelioma have on worked on jobs where they breathed asbestos.

It can also occur in children; however, these cases are not thought to be associated with asbestos exposure.

Most people who develop mesothelioma get worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products.

Treatment options for the management of malignant mesothelioma include surgery, chemotherapy, radiation, and multimodality treatment. Surgery in victims with disease confined to the pleural space is reasonable.

Extrapleural pneumonectomy is a more extensive procedure and has a higher mortality rate. Recently, the mortality rate has been lowered to 3.8%. It involves dissection of the parietal pleura; division of the pulmonary vessels; and en bloc resection of the lung, pleura, pericardium, and diaphragm followed by reconstruction. It provides the greatest local control because it removes the entire pleural sac along with the lung parenchyma.

The 2 surgical procedures used are pleurectomy with decortication and extrapleural pneumonectomy.

Surgical resection has been relied upon because radiation and chemotherapy get hold of been ineffective unequivocal treatments. There are now a number of cancer treatment options open to mesothelioma patients. Extrapleural pneumonectomy for selected victims with very early stage disease may expand recurrence-free survival, but the impact it has on overall survival is unknownat this time.