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[PMID]:29224277
[Au] Autor:Wang XY; Xu M; Shi LG; Ding YZ; Cheng Q; Zhao YW
[Ad] Endereço:Department of Pathology, Henan Provincial People's Hospital, Zhengzhou 470003, China.
[Ti] Título:[Clinicopathologic analysis of micronodular thymoma with lymphoid stroma].
[So] Source:Zhonghua Bing Li Xue Za Zhi;46(12):837-840, 2017 Dec 08.
[Is] ISSN:0529-5807
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the clinicopathologic features of micronodular thymoma with lymphoid stroma(MNT). Five cases of MNT diagnosed from January 2007 to December 2016 in Henan Provincial People's Hospital were collected.Hematoxylin-Eosin staining and immunohistochemistry were used to evaluate the histological and immunophenotypic characteristics in 5 MNT cases. Epstein-Barr virus (EBV) status was detected by in situ hybridization for EBV-encoded small RNA (EBER). Polymerase chain reaction was used to detect the rearrangement of immunoglobulin genes. Five cases were MNT, including 3 male and 2 female patients, mean aged 59 years (from 43 to 63 years). All patients had ananterior mediastinal mass, with no myasthenia gravis and autoimmune diseases, and underwent surgical resection.Half to ten years follow-up showed no recurrence.Grossly, the tumors were solid in 4 cases, and cystic and solid in 1 case; the border was clear. Histologically, the tumors presented as a distribution of micronodules separated by abundant lymphoid stroma with prominent germinal centers. The nodules were composed of neoplastic spindle, oval cells containing bland, oval nuclei.Immunohistochemical study showed strong positivity of the tumor cells for CKpan, CK19, CK5/6 and p63. Stains for EMA, CD117, calretinin, TTF1 were negative in the tumor cells.Scattered CD3, CD1a, and TdT positive immature T lymphocytes were noted in and around tumor nodules. Many lymphocytes in the stroma, including germinal centers, were positive for CD20.The bcl-2 was also detected in lymphocytes in the stroma, mantle and marginal zone of lymphoid follicles, and in part of tumor cells. Tumor cells and lymphocytes were negative for EBER. Immunoglobulin genes rearrangement analysis showed that B lymphocytes were polyclonal. MNT is a rare thymoma, which occurs in the elderly and has no obvious symptom. After complete resection, the prognosis is very good. The diagnosis should be based on a combination of clinicopathologic features, and other types of thymoma should be excluded.
[Mh] Termos MeSH primário: Tecido Linfoide/patologia
Timoma/patologia
Neoplasias do Timo/patologia
[Mh] Termos MeSH secundário: Adulto
Linfócitos B/patologia
Feminino
Centro Germinativo/patologia
Herpesvirus Humano 4/isolamento & purificação
Seres Humanos
Imuno-Histoquímica
Imunofenotipagem
Hibridização In Situ
Masculino
Meia-Idade
Proteínas de Neoplasias/análise
Recidiva Local de Neoplasia
Prognóstico
Linfócitos T/patologia
Timoma/química
Timoma/virologia
Neoplasias do Timo/química
Neoplasias do Timo/virologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Neoplasm Proteins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-5807.2017.12.005


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[PMID]:29310389
[Au] Autor:Liao H; Pei W; Liu J; Wang K; Xu T; Chen X
[Ad] Endereço:Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P. R. China.
[Ti] Título:Secondary systemic lupus erythematosus after thymoma resection misdiagnosed as medically unexplained dyspnoea: A case report.
[So] Source:Medicine (Baltimore);96(48):e8944, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Secondary systemic lupus erythematosus (SLE) is an exceedingly rare complication of thymoma resection and is difficult to diagnose because of the insidious and nonspecific clinical manifestations. A case of SLE that occurs secondary to thymoma resection is described in this report. PATIENT CONCERNS: A 43-year-old male came to our hospital with the sole symptom of dyspnea after thymoma resection initially. However, other atypical lesions of SLE occurred over time. DIAGNOSES: Antinuclear antibody spectrum test showed positive results and the diagnosis of SLE was obtained. INTERVENTIONS: Initially the patient was treated for medically unexplained dyspnea (MUD) without much improvement. Following the diagnosis, the methylprednisolone pulse therapy and therapies of immunoglobulin and cyclophosphamide were adopted for the treatment. OUTCOMES: Finally, the patient's symptoms faded rapidly and favorable prognosis has been maintained till now. LESSONS: This case highlights the importance of a serious and comprehensive analysis before we give the diagnosis of MUD. Additionally, ignorance of secondary SLE after thymoma resection should be prevented to avoid a delayed diagnosis and treatment.
[Mh] Termos MeSH primário: Dispneia/diagnóstico
Dispneia/etiologia
Lúpus Eritematoso Sistêmico/diagnóstico
Lúpus Eritematoso Sistêmico/etiologia
Timoma/cirurgia
Neoplasias do Timo/cirurgia
[Mh] Termos MeSH secundário: Adulto
Erros de Diagnóstico
Dispneia/tratamento farmacológico
Seres Humanos
Lúpus Eritematoso Sistêmico/tratamento farmacológico
Masculino
Timoma/diagnóstico por imagem
Timoma/patologia
Neoplasias do Timo/diagnóstico por imagem
Neoplasias do Timo/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008944


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[PMID]:27771373
[Au] Autor:Kiuchi S; Tomaru U; Ishizu A; Imagawa M; Kiuchi T; Iwasaki S; Suzuki A; Otsuka N; Deguchi T; Shimizu T; Marukawa K; Matsuno Y; Kasahara M
[Ad] Endereço:Department of Pathology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.
[Ti] Título:Expression of cathepsins V and S in thymic epithelial tumors.
[So] Source:Hum Pathol;60:66-74, 2017 02.
[Is] ISSN:1532-8392
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cathepsins are a group of proteolytic enzymes of the endosomal/lysosomal pathway involved in the thymic development of T cells restricted by major histocompatibility complex class II molecules. In the normal thymus, cathepsin V (CTV) and cathepsin S (CTS) are expressed in cortical and medullary epithelial cells, respectively. To investigate whether cathepsins could serve as a diagnostic marker, we performed immunohistochemical analysis for CTV and CTS in 77 cases of thymic epithelial tumors. Almost all cases (59/60) of thymoma expressed CTV, whereas 28 of 60 cases of thymoma expressed CTS. Notably, CTS was expressed in most cases of type A and type AB thymomas, but not in type B thymoma. The expression of cathepsins in type AB thymoma showed a clear correlation with histologic features; CTV was found predominantly in the type B component, and CTS was frequently expressed in the type A component. In thymic carcinoma, CTV was expressed in less than half cases (7/17), and the ratio of CTS-positive cases was equivalent to that of thymoma (8/17). Cases of CTV-negative thymic carcinoma tended to have a higher incidence of recurrence than did CTV-positive cases. Although further studies with a larger number of cases are required to confirm the utility of cathepsin immunostaining, CTV and CTS appear to serve as auxiliary diagnostic and/or prognostic markers in thymic epithelial tumors.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/análise
Catepsinas/análise
Cisteína Endopeptidases/análise
Neoplasias Epiteliais e Glandulares/enzimologia
Timoma/enzimologia
Neoplasias do Timo/enzimologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Biópsia
Diagnóstico Diferencial
Feminino
Seres Humanos
Imuno-Histoquímica
Masculino
Meia-Idade
Estadiamento de Neoplasias
Neoplasias Epiteliais e Glandulares/patologia
Neoplasias Epiteliais e Glandulares/cirurgia
Valor Preditivo dos Testes
Timoma/patologia
Timoma/cirurgia
Neoplasias do Timo/patologia
Neoplasias do Timo/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers, Tumor); EC 3.4.- (Cathepsins); EC 3.4.22.- (Cysteine Endopeptidases); EC 3.4.22.27 (cathepsin S); EC 3.4.22.43 (CTSL2 protein, human)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180114
[Lr] Data última revisão:
180114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29245252
[Au] Autor:Gui X; Zhu X; Guo L; Tan G; Liu Y; Tan Y; Chen Q; Song Y; Lin S
[Ad] Endereço:aDepartment of Oncology, The First Affiliated Hospital of Jinan UniversitybDepartment of Traditional Chinese Medicine, The First Affiliated Hospital of Jinan UniversitycDepartment of Central Laboratory, The First Affiliated Hospital of Jinan UniversitydDepartment of Clinical Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.
[Ti] Título:Graft-versus-host disease-like erythroderma: a sign of recurrent thymoma: A case report.
[So] Source:Medicine (Baltimore);96(49):e8877, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Thymomas are associated with numerous autoimmune disorders, such as myasthenia gravis (MG), pure red cell aplasia (PRCA), and systemic lupus erythematosus (SLE). However, graft-versus-host disease (GVHD)-like erythroderma is a relatively uncommon paraneoplastic disorder associated with thymomas and signifies a poor prognosis. PATIENT CONCERNS: A 35-year-old woman with medical history significant for stage IVa type AB thymoma presented with patchy erythema over face, trunk, and extremities that failed to respond to topical steroids. DIAGNOSIS: A contrast-enhanced computerized tomography (CECT) scan of the chest demonstrated tumors in the right mediastinum and right pleura. Percutaneous right mediastinal pleural biopsy confirmed recurrent thymoma (WHO type B3, Masaoka stage IVb). Histopathologic examination of her skin lesions revealed GVHD-like erythroderma. INTERVENTIONS: The patient received chemotherapy and local thoracic radiotherapy, as well as corticosteroids. OUTCOMES: The eruptions gradually subsided with hyperpigmentation; however the patient eventually died of multiple organ failure. LESSONS: GVHD-like erythroderma is an uncommon paraneoplastic disorder associated with thymomas. Though its pathogenesis still needs further research, prompt diagnosis and appropriate treatment can improve survival rate in patients.
[Mh] Termos MeSH primário: Dermatite Esfoliativa/patologia
Doença Enxerto-Hospedeiro/patologia
Recidiva Local de Neoplasia/diagnóstico por imagem
Recidiva Local de Neoplasia/patologia
Timoma/diagnóstico por imagem
Timoma/patologia
Neoplasias do Timo/diagnóstico por imagem
Neoplasias do Timo/patologia
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Adulto
Meios de Contraste
Diagnóstico Diferencial
Evolução Fatal
Feminino
Seres Humanos
Estadiamento de Neoplasias
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171225
[Lr] Data última revisão:
171225
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008877


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[PMID]:28458302
[Au] Autor:Nakada T; Akiba T; Yabe M; Tanaka K; Nakano M; Suzuki M; Morikawa T
[Ad] Endereço:Department of Surgery, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.
[Ti] Título:Clinicopathological Features of Thymoma with Ring Calcification: Case Reports.
[So] Source:Ann Thorac Cardiovasc Surg;23(5):256-261, 2017 Oct 20.
[Is] ISSN:2186-1005
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Thymomas with ring calcifications are very rare and quaint style. Herein, we presented our three cases of thymomas with ring calcifications and reviewed totally 10 cases including 7 cases of previous English literatures. The median age was 53 years. Myasthenia gravis was a complication in 40%. The median maximal diameter was 50 mm. They were diagnosed as pathological type B or had type B component. Based on World Health Organization (WHO) classification, 20%, 60%, and 20% cases were stage I, stage II, and stage III, respectively. Seven ring calcifications were within tumors (inner type) and two cases were outside tumors (outer type). The other had a thymoma arising in the calcic wall of a calcified thymic cyst (miscellaneous type). Four other anterior mediastinal tumors with ring calcification had been reported. We need pathological examinations for a definitive diagnosis. Surgeons should plan surgery because of the possibility of invasive thymomas, or other malignant tumors.
[Mh] Termos MeSH primário: Calcinose/patologia
Cisto Mediastínico/patologia
Timoma/patologia
Neoplasias da Glândula Tireoide/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biópsia
Calcinose/diagnóstico por imagem
Calcinose/cirurgia
Criança
Feminino
Seres Humanos
Masculino
Cisto Mediastínico/diagnóstico por imagem
Cisto Mediastínico/cirurgia
Meia-Idade
Estadiamento de Neoplasias
Timectomia
Timoma/diagnóstico por imagem
Timoma/cirurgia
Neoplasias da Glândula Tireoide/diagnóstico por imagem
Neoplasias da Glândula Tireoide/cirurgia
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Carga Tumoral
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171212
[Lr] Data última revisão:
171212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.5761/atcs.cr.16-00247


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[PMID]:28969896
[Au] Autor:Zhai Y; Hui Z; Ji W; Wang X; Liang J; Mao Y; Luo Y; Zou S; Lv J; Zhou Z; Chen D; Zhang H; Xiao Z; Wang L; Feng Q
[Ad] Endereço:Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
[Ti] Título:A Single-Center Analysis of the Treatment and Prognosis of Patients With Thymic Carcinoma.
[So] Source:Ann Thorac Surg;104(5):1718-1724, 2017 Nov.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The low incidence of thymic carcinoma has precluded the development of randomized clinical trials, and present knowledge is based on small retrospective studies. We performed this single-center retrospective analysis to evaluate the clinical characteristics, treatments, and prognosis in patients with pathologically confirmed thymic carcinoma. METHODS: Data regarding clinicopathologic characteristics, treatment protocols, toxicities, and survival were collected from 135 patients who attended our institution between January 1980 and January 2010. Survival was assessed using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the log-rank test and Cox proportional hazards model. RESULTS: The 135 patients (88 men) were with a median age of 48 years, and 123 patients were diagnosed with Masaoka stage III to IV disease. R0 resection was performed in 35 patients. Treatment comprised radiotherapy in 121 patients and chemotherapy in 60. The median follow-up time was 12.5 years. At 5 and 10 years, local-regional relapse free survivals were 81.4% and 54.4%, overall survivals were 42.2% and 15.4%, progression-free survivals were 29.7% and 8.0%, and distant metastasis-free survivals were 35.9% and 25.6%, respectively. R0 resection was the only independent prognosticator of overall survival, progression-free survival, and distant metastasis-free survival in univariate and multivariate analyses. CONCLUSIONS: Thymic carcinoma was frequently diagnosed at Masaoka stage III to IV with a poor prognosis. Surgical resection is still the predominant treatment. Radiotherapy may increase local-regional relapse free survival with mild toxicities in advanced-stage patients.
[Mh] Termos MeSH primário: Timectomia/métodos
Timoma/mortalidade
Timoma/cirurgia
Neoplasias do Timo/mortalidade
Neoplasias do Timo/cirurgia
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Idoso
China
Bases de Dados Factuais
Intervalo Livre de Doença
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Análise Multivariada
Invasividade Neoplásica/patologia
Estadiamento de Neoplasias
Prognóstico
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Medição de Risco
Análise de Sobrevida
Timectomia/efeitos adversos
Timoma/patologia
Neoplasias do Timo/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE


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[PMID]:28968686
[Au] Autor:Saito M; Fujiwara Y; Asao T; Honda T; Shimada Y; Kanai Y; Tsuta K; Kono K; Watanabe S; Ohe Y; Kohno T
[Ad] Endereço:Division of Genome Biology, National Cancer Center Research Institute, Tokyo 104-0045, Japan.
[Ti] Título:The genomic and epigenomic landscape in thymic carcinoma.
[So] Source:Carcinogenesis;38(11):1084-1091, 2017 Oct 26.
[Is] ISSN:1460-2180
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Thymic carcinoma (TC) is a rare cancer whose genomic features have been examined in only a limited number of patients of European descent. Here, we characterized both genomic and epigenomic aberrations by whole exome sequencing, RNA sequencing, methylation array and copy number analyses in TCs from Asian patients and compared them with those in TCs from USA/European patients. Samples analyzed were 10 pairs of snap-frozen surgical specimens of cancerous and non-cancerous thymic tissue. All 10 cases were Japanese patients treated at the National Cancer Center Hospital, Japan, between 1994 and 2010. Mutational signature analysis indicated that the accumulation of age-related mutations drive TC development. We identified recurrent somatic mutations in TET2, CYLD, SETD2, TP53, FBXW7, HRAS and RB1, and no mutations in GTF2I, supporting the hypothesis that TC and thymoma are distinguishable by their genetic profiles. TCs with TET2 mutations had more hypermethylated genes than those without, and hyper-methylation was associated with downregulation of gene expression. Focal genome copy number gains, associated with elevated gene expression, were observed at the KIT (which is known to drive thymic carcinogenesis) and AHNAK2 gene loci. Taken together, the results suggest that the molecular processes leading to TC depend on the accumulation of genetic and epigenetic aberrations. In addition, epigenetic dysregulation as a result of the TET2 mutation was observed in a subset of TCs.
[Mh] Termos MeSH primário: Epigênese Genética/genética
Genoma/genética
Timoma/genética
Neoplasias do Timo/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Grupo com Ancestrais do Continente Asiático/genética
Variações do Número de Cópias de DNA/genética
Análise Mutacional de DNA/métodos
Epigenômica/métodos
Exoma/genética
Feminino
Expressão Gênica/genética
Genômica/métodos
Seres Humanos
Masculino
Meia-Idade
Mutação/genética
Transcriptoma/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1093/carcin/bgx094


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[PMID]:28935345
[Au] Autor:Kneuertz PJ; Kamel MK; Stiles BM; Lee BE; Rahouma M; Nasar A; Altorki NK; Port JL
[Ad] Endereço:Department of Cardiothoracic Surgery, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, New York.
[Ti] Título:Robotic Thymectomy Is Feasible for Large Thymomas: A Propensity-Matched Comparison.
[So] Source:Ann Thorac Surg;104(5):1673-1678, 2017 Nov.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Robotic-assisted thymectomy (RAT) is increasingly performed for resection of thymomas. Its application for large tumors remains controversial. In this study, we evaluated the safety and feasibility of RAT for large thymomas in comparison with transsternal thymectomy (ST). METHODS: A single institution database was reviewed for patients who underwent RAT for thymoma of 4 cm or larger between 2004 and 2016. Propensity scores were applied to match RAT with ST patients, based on age, sex, tumor size, and Masaoka stage. Perioperative outcomes were compared. RESULTS: Twenty patients (15 women and 5 men, median age 59 years) underwent RAT for a large thymoma (median size 6.0 cm). A right-sided approach was used in 14 patients (70%). A control group of 34 ST patients (median size 6.7 cm) had similar Masaoka staging (p = 0.64). Combined resection of adjacent structures, including pericardium, lung, and phrenic nerve, were frequently performed in both groups (50% RAT versus 47% ST, p = 0.83). RAT patients had lower blood loss (25 mL versus 150 mL, p = 0.001), were more frequently managed with a single chest tube (85% versus 56%, p = 0.027), and had a shorter median length of stay (3 days versus 4 days, p = 0.034). There were no perioperative deaths and no major vascular injuries. Three RAT patients (15%) were converted to open approach. Overall complication rates were similar between RAT and ST patients (15% versus 24%, p = 0.45). No difference was seen in R0 resection rates (90% versus 85%, p = 0.62). CONCLUSIONS: RAT can be performed safely and effectively in a radical fashion for large thymomas. Future studies are necessary to determine long-term oncologic outcomes.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Robóticos/métodos
Esternotomia/métodos
Timectomia/métodos
Timoma/cirurgia
Neoplasias do Timo/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Biópsia por Agulha
Estudos de Coortes
Estudos de Viabilidade
Feminino
Seguimentos
Seres Humanos
Imuno-Histoquímica
Masculino
Meia-Idade
Duração da Cirurgia
Complicações Pós-Operatórias/fisiopatologia
Pontuação de Propensão
Estudos Retrospectivos
Medição de Risco
Procedimentos Cirúrgicos Robóticos/efeitos adversos
Esternotomia/efeitos adversos
Taxa de Sobrevida
Timectomia/efeitos adversos
Timoma/diagnóstico por imagem
Timoma/patologia
Neoplasias do Timo/diagnóstico por imagem
Neoplasias do Timo/patologia
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170923
[St] Status:MEDLINE


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[PMID]:28871993
[Au] Autor:Vogel J; Lin L; Litzky LA; Berman AT; Simone CB
[Ad] Endereço:Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: jennifer.vogel@uphs.upenn.edu.
[Ti] Título:Predicted Rate of Secondary Malignancies Following Adjuvant Proton Versus Photon Radiation Therapy for Thymoma.
[So] Source:Int J Radiat Oncol Biol Phys;99(2):427-433, 2017 Oct 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Thymic malignancies are the most common tumors of the anterior mediastinum. The benefit of adjuvant radiation therapy for stage II disease remains controversial, and patients treated with adjuvant radiation therapy are at risk of late complications, including radiation-induced secondary malignant neoplasms (SMNs), that may reduce the overall benefit of treatment. We assess the risk of predicted SMNs following adjuvant proton radiation therapy compared with photon radiation therapy after resection of stage II thymic malignancies to determine whether proton therapy improves the risk-benefit ratio. METHODS AND MATERIALS: Ten consecutive patients treated with double-scattered proton beam radiation therapy (DS-PBT) were prospectively enrolled in an institutional review board-approved proton registry study. All patients were treated with DS-PBT. Intensity modulated radiation therapy (IMRT) plans for comparison were generated. SMN risk was calculated based on organ equivalent dose. RESULTS: Patients had a median age of 65 years (range, 25-77 years), and 60% were men. All patients had stage II disease, and many had close or positive margins (60%). The median dose was 50.4 Gy (range, 50.4-54.0 Gy) in 1.8-Gy relative biological effectiveness daily fractions. No differences in target coverage were seen with DS-PBT compared with IMRT plans. Significant reductions were seen in mean and volumetric lung, heart, and esophageal doses with DS-PBT compared with IMRT plans (all P≤.01). Significant reductions in SMNs in the lung, breast, esophagus, skin, and stomach were seen with DS-PBT compared with IMRT. For patients with thymoma diagnosed at the median national age, 5 excess secondary malignancies per 100 patients would be avoided by treating them with protons instead of photons. CONCLUSIONS: Treatment with proton therapy can achieve comparable target coverage but significantly reduced doses to critical normal structures, which can lead to fewer predicted SMNs compared with IMRT. By decreasing expected late complications, proton therapy may improve the therapeutic ratio of adjuvant radiation therapy for patients with stage II thymic malignancies.
[Mh] Termos MeSH primário: Neoplasias Induzidas por Radiação
Segunda Neoplasia Primária/etiologia
Timoma/radioterapia
Neoplasias do Timo/radioterapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias da Mama/etiologia
Neoplasias Esofágicas/etiologia
Feminino
Tomografia Computadorizada Quadridimensional
Seres Humanos
Neoplasias Pulmonares/etiologia
Masculino
Meia-Idade
Órgãos em Risco
Fótons/uso terapêutico
Terapia com Prótons/métodos
Dosagem Radioterapêutica
Planejamento da Radioterapia Assistida por Computador/métodos
Radioterapia Adjuvante/efeitos adversos
Radioterapia de Intensidade Modulada/efeitos adversos
Radioterapia de Intensidade Modulada/métodos
Neoplasias Cutâneas/etiologia
Neoplasias Gástricas/etiologia
Timoma/diagnóstico por imagem
Timoma/patologia
Neoplasias do Timo/diagnóstico por imagem
Neoplasias do Timo/patologia
Neoplasias da Glândula Tireoide/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE


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[PMID]:28791840
[Au] Autor:Jiang Y; Dai X; Duan L; Zhou Y
[Ad] Endereço:Department of Rheumatology and Clinical Immunology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
[Ti] Título:The coexistence of autoimmune rheumatic diseases and thymomas.
[So] Source:Adv Clin Exp Med;26(2):237-243, 2017 Mar-Apr.
[Is] ISSN:1899-5276
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Autoimmune rheumatic diseases (ARDs), involving immune disturbances resulting from auto-inflammatory mechanisms, are a group of diseases characterized by autoimmunity and autoimmunemediated organ damage. Thymoma, whose mechanism is also associated with immune abnormalities, is the most common neoplasm of the anterior mediastinum. But thymoma with ARDs is relatively less frequent. The clinical characteristics of the coexistence of ARDs and thymomas are still not very clear. And the therapeutic strategy for ARDs combined with thymomas varies, with an uncertain outcome. OBJECTIVES: The aim of this study was to investigate the clinical characteristics of the coexistence of ARDs and thymomas in order to speculate whether a thymectomy is effective for ARDs combined with thymomas, and to seek the proper therapeutic strategy for treating ARDs combined with thymomas. MATERIAL AND METHODS: We presented 2 cases of the coexistence of ARDs and thymomas. Then, we summarized 20 cases (including our 2 cases) in which the ARD was diagnosed concurrently with, or prior to, the thymoma. RESULTS: Pure red cell aplastic anemia (PRCA) might be associated with an ARD and a thymoma, and a thymectomy may lead to the appearance, exacerbation, or remission of ARDs. CONCLUSIONS: Searching for a thymoma is necessitated if a patient with ARDs experiences PRCA and the effects of thymectomy in ARDs combined with thymomas may be associated with the onset sequence of ARDs and thymomas.
[Mh] Termos MeSH primário: Doenças Autoimunes/complicações
Doenças Reumáticas/complicações
Timoma/complicações
Neoplasias do Timo/complicações
[Mh] Termos MeSH secundário: Doenças Autoimunes/diagnóstico
Doenças Autoimunes/terapia
Feminino
Seres Humanos
Meia-Idade
Literatura de Revisão como Assunto
Doenças Reumáticas/diagnóstico
Doenças Reumáticas/terapia
Timectomia/métodos
Timoma/diagnóstico
Timoma/cirurgia
Neoplasias do Timo/diagnóstico
Neoplasias do Timo/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE
[do] DOI:10.17219/acem/61004



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