Sample records for solitary extramedullary plasmacytomas

  1. A Review for Solitary Plasmacytoma of Bone and Extramedullary Plasmacytoma

    Sevil Kilciksiz


    Full Text Available Solitary plasmacytoma (SP is characterized by a mass of neoplastic monoclonal plasma cells in either bone (SBP or soft tissue without evidence of systemic disease attributing to myeloma. Biopsy confirmation of a monoclonal plasma cell infiltration from a single site is required for diagnosis. The common presentation of SBP is in the axial skeleton, whereas the extramedullary plasmacytoma (EMP is usually seen in the head and neck. The ratio of SP seen at males to females is 2 : 1 and the median age of patients is 55 years. The incidence rate of SP in black race is approximately 30% higher than the white race. Incidence rate increases exponentially by advancing age. SBP has a significant higher risk for progression to myeloma, and the choice of treatment is radiotherapy (RT that is applied with curative intent at min. 4000 cGy. By only RT application, long-term disease-free survival (DFS is possible for approximately 30% of patients with SBP and 65% of patients with EMP.

  2. Solitary extramedullary plasmacytoma in retroperitoneum: A case report and review of the literature

    Wei Hong; Xin-Min Yu; Ming-Qiang Jiang; Bo Chen; Xin-Bao Wang; Li-Tao Yang; Yi-Ping Zhang


    Extramedullary plasmacytoma (EPM) is a plasma cell tumor arising outside of the bone marrow. Solitary EMP is an uncommon neoplasm and rarely occurs in the retroperitoneum and lacks distinctive clinical manifestations. We report a 26-year-old man with a solitary EMP in the retroperitoneum and discuss its clinical features, diagnosis and treatment.

  3. Nasal septum extramedullary plasmacytoma

    Belić Branislav


    Full Text Available Introduction. Plasmacytomas are malignant tumors characterized by abnormal monoclonal proliferation of plasma cells. They originate in either bone - solitary osseous plasmacytoma, or in soft tissue - extramedullary plasmacytoma (EMP. EMP represents less than 1% of all head and neck malignancies. Case report. We presented a case of EMP of the nasal septum in a 44-year-old male who had progressive difficulty in breathing through the nose and frequent heavy epistaxis on the right side. Nasal endoscopy showed dark red, soft, polypoid tumor in the last third of the right nasal cavity arising from the nasal septum. The biopsy showed that it was plasmacytoma. Bence Jones protein in the urine, serum electrophoresis, bone marrow biopsy, skeletal survey and other screening tests failed to detect multiple myeloma. This confirmed the diagnosis of EMP. The mass was completely removed via an endoscopic approach, and then, 4 week later, radiotherapy was conducted with a radiation dose of 50 Gray. No recurrence was noted in a 3-year follow- up period. Conclusion. EMP of the nasal cavity, being rare and having long natural history, represents a diagnostic and therapeutic challenge for any ear, nose and throat surgeon. Depending on the resectability of the lesion, a combined therapy is the accepted treatment.

  4. Solitary extramedullary plasmacytomas of thyroid in Hashimoto's thyroiditis: Mimicking benign cystic nodule on ultrasonography

    Kwon, Yohan; Kim, Soo Jin; Hur, Joon Ho; Park, Sung Hee; Lee, Sun Jin; Lee, Tae Jin [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of)


    Solitary extramedullary plasmacytoma (SEP) of the thyroid is uncommon and mostly occur in patients with a Hashimoto's thyroiditis (82%). We present a case on SEP of thyroid in Hashimoto's thyroiditis, which mimics growing benign cystic masses on serial ultrasonography.

  5. Extramedullary Plasmacytoma of Maxillary Antrum

    Aniece Chowdhary, Des Raj Bhagat, Shazia Hamid, Rajni Malhotra, S S. Bhau


    Full Text Available Extramedullary plasmacytoma (EMP represents approximately 3% of all plasma cell neoplasms.With anidea to heighlight its diagnosis,treatment modalties, we report a case of extramedullary plasmacytoma in a52 years old male patient.

  6. Solitary extramedullary plasmacytoma of the duodenum and pancreas: A case report and review of the literature

    Ignjatović Mile


    Full Text Available Introduction. The extramedullary plasmacytomas (EMPs are rare tumors of plasma cell disorders which are rarely found in the duodenum. We presented a case of solitary EMPs involving the duodenum and pancreas successfully treated by surgical resection after failure of chemotherapy. Case report. A 55-year-old female with previously diagnosed solitary EMP of the duodenum was admitted to our institution after failure of three cycles of vincristine, adriablastine, dexamethasone (VAD chemotherapy regimen with an upper gastrointestinal obstruction. On admission computed tomography of the abdomen showed tumor in the region of the second part of duodenum and uncinate process of the pancreas with a complete duodenal obstruction. Intraoperatively a tumor formation was in the region of the second duodenal part, originated from the wall of duodenum with the total diameter of 7 x 5 cm, covering the entire circumference of duodenal wall leaded to a narrowing of duodenal lumen to the thigh gap with an upper gastrointestinal obstruction. Infiltration in the head of the pancreas and uncinate process were also found. The Whipple’s procedure was performed but postoperative course was complicated by rapidly refilling chylous ascites which was resolved 4 days after the surgery. Conclusion. Each patient with gastrointestinal EMPs should be considered separately and in timely manner, thus adequate treatment could provide local disease control.

  7. Testicular extramedullary plasmacytoma

    M Samet


    Full Text Available Extramedullary plasmacytomas are plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck. Extramedullary plasmacytomas account for approximately 3 percent of plasma cell malignancies. The diagnosis of an extramedullary plasmacytoma depends upon the demonstration of a monoclonal plasma cell tumor at an extramedullary site with no evidence of multiple myeloma based upon bone marrow examination and roentgenographic studies, absence of an M-protein in serum and/ or urine, and no related organ or tissue impairment. These tumors are highly responsive to local radiation therapy and rarely progress or recur. A 77 year old man referred for gradual enlargement of scrotum in April, 2004. He had no fever, weight loss or loss of appetite during the period. No tenderness, warmth or erythem of scrotum was observed on physical examination. No lymphadenopathy was detected. Later he had temporary relief because of antibiotic therapy . 7 months later, he referred again following the aggravation of his symptom. Ultrasonography of his scrotum was done and enlargement in the left testis was reported. Lab data including CBC,diff,ESR,AFP were normal but βHCG titer was reported higher than normal . He underwent radical orchiectomy and the specimen was sent for pathological study. Spermatocytic seminoma and plasmacytoma were suspected, but plasmacytoma was reported after the IHC . In order to rule out multiple myeloma, whole body bone scanning with sestamibi and urine Bence Jones protein were examined, all of which were negative. In bone marrow aspiration, the cellularity was normal and no pathologic lesion was reported. Considering clinical and paraclinical evidences, the diagnosis was extramedullary plasmacytoma.

  8. Soft Tissue Extramedullary Plasmacytoma

    Fernando Ruiz Santiago


    Full Text Available We present the uncommon case of a subcutaneous fascia-based extramedullary plasmacytoma in the leg, which was confirmed by the pathology report and followed up until its remission. We report the differential diagnosis with other more common soft tissue masses. Imaging findings are nonspecific but are important to determine the tumour extension and to plan the biopsy.

  9. Solitary extramedullary plasmacytoma of thoracic epidural space presenting with dorsal compressive myelopathy: A case report and review of literature

    Amandeep Kumar


    Full Text Available Plasma Cell neoplasms result from monoclonal proliferation of plasma cells. Solitary extramedullary plasmacytomas (SEMPs are rare and constitute 5% of all plasma cell disorders. SEMPs most commonly involve upper aerodigestive tract. Isolated spinal epidural space involvement by SEMPs is extremely rare and to best of our knowledge only 7 such cases have been reported previously in available English literature. We hereby present a rare case of thoracic epidural SEMP in a 32-year-old female who presented with thoracic compressive myelopathy and discuss the pertinent literature.

  10. Imaging of a Case of Extramedullary Solitary Plasmacytoma of the Trachea

    M. Garelli


    Full Text Available We describe a case of extramedullary tracheal plasmacytoma that was incidentally discovered in a 73-year-old man on a PET scan performed for assessing the extent of colon cancer. CT scan showed the tumor; multiplanar reformation coupled with virtual bronchoscopy allowed proper treatment planning. The tracheal tumor was resected during rigid bronchoscopy. Relevant investigations excluded multiple myeloma. Follow-up CT showed persistent thickening of the tracheal wall, but there has been no recurrence after one-year followup.

  11. Extramedullary Plasmacytoma of Soft Tissues and Gingiva

    Amrit Kaur Kaler


    Full Text Available Extramedullary plasmacytoma (EMP is a rare plasma cell neoplasm of soft tissue without bone marrow involvement or other systemic characteristics of multiple myeloma. It accounts for 3% of all plasma cell tumors. Multiple extramedullary plasmacytoma is defined when there is more than one extramedullary tumor of clonal plasma cells and such presentation has not been described earlier. We report such rare case of multiple extramedullary plasmacytoma involving multiple soft tissues in chest, abdomen, mandible, maxilla, and gingiva.

  12. Extramedullary Plasmacytoma of the Tonsil

    Kevin C. Huoh


    Full Text Available Plasma cell tumors are a diverse group of neoplasms characterized by monoclonal proliferation of plasma cells. Extramedullary plasmacytoma (EMP is a rare form of localized plasma cell tumor that arises most often in the head and neck region. We present an unusual case of EMP of the palatine tonsil from a tertiary care university hospital. We discuss the histopathologic and radiologic evaluation as well as treatment of EMP.

  13. Multi-Institutional Analysis of Solitary Extramedullary Plasmacytoma of the Head and Neck Treated With Curative Radiotherapy

    Sasaki, Ryohei, E-mail: [Division of Radiation Oncology, Kobe University Graduate School of Medicine (Japan); Yasuda, Koichi [Department of Radiology, Hokkaido University School of Medicine (Japan); Abe, Eisuke [Division of Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University (Japan); Uchida, Nobue [Department of Radiation Oncology, Shimane University Faculty of Medicine (Japan); Kawashima, Mitsuhiko [Radiation Oncology Division, National Cancer Center Hospital East (Japan); Uno, Takashi [Department of Radiology, Graduate School of Medicine, Chiba University (Japan); Fujiwara, Masayuki [Department of Radiology, Hyogo College of Medicine (Japan); Shioyama, Yoshiyuki [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University (Japan); Kagami, Yoshikazu [Radiation Oncology Division, National Cancer Center Hospital (Japan); Shibamoto, Yuta [Department of Radiology, Nagoya City University Graduate School of Medical Sciences (Japan); Nakata, Kensei [Department of Radiology, Sapporo Medical University (Japan); Takada, Yoshie [Department of Radiology, Osaka City University Graduate School of Medicine (Japan); Kawabe, Tetsuya; Uehara, Kazuyuki [Division of Radiation Oncology, Kobe University Graduate School of Medicine (Japan); Nibu, Kenichi [Division of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine (Japan); Yamada, Syogo [Department of Radiation Oncology, Tohoku University School of Medicine (Japan)


    Purpose: The purpose of this study was to elucidate the efficacy and optimal method of radiotherapy in the management of solitary extramedullary plasmacytoma occurring in the head and neck regions (EMPHN). Methods and Materials: Sixty-seven patients (43 male and 24 female) diagnosed with EMPHN between 1983 and 2008 at 23 Japanese institutions were reviewed. The median patient age was 64 years (range, 12-83). The median dose administered was 50 Gy (range, 30-64 Gy). Survival data were calculated by the Kaplan-Meier method. Results: The median follow-up duration was 63 months. Major tumor sites were nasal or paranasal cavities in 36 (54%) patients, oropharynx or nasopharynx in 16 (23%) patients, orbita in 6 (9%) patients, and larynx in 3 (5%) patients. The 5- and 10-year local control rates were 95% and 87%, whereas the 5- and 10-year disease-free survival rates were 56% and 54%, respectively. There were 5 (7.5%), 12 (18%), and 8 (12%) patients who experienced local failure, distant metastasis, and progression to multiple myeloma, respectively. In total, 18 patients died, including 10 (15%) patients who died due to complications from EMPHN. The 5- and 10-year overall survival (OS) rates were 73% and 56%, respectively. Radiotherapy combined with surgery was identified as the lone significant prognostic factor for OS (p = 0.04), whereas age, gender, radiation dose, tumor size, and chemotherapy were not predictive. No patient experienced any severe acute morbidity. Conclusions: Radiotherapy was quite effective and safe for patients with EMPHN. Radiotherapy combined with surgery produced a better outcome according to survival rates. These findings require confirmation by further studies with larger numbers of patients with EMPHN.

  14. Synchronous infiltrating ductal carcinoma and primary extramedullary plasmacytoma of the breast

    Liu Yan-Xue


    Full Text Available Abstract Background Extramedullary plasmacytomas are seldom solitary and usually progress to diffuse myelomatosis. Plasmacytomas of the breast are rare, especially when not associated multiple myeloma. Synchronous infiltrating ductal carcinoma and primary extramedullary plasmacytoma of the breast have not previously reported. Case presentation A 27-years-old woman with an untreated upper outer quadrant breast mass for 1-year was referred to our cancer hospital for surgical evaluation of increasing breast pain. Postoperatively, microscopic examination revealed an infiltrating ductal carcinoma complicated by an extramedullary plasmacytoma divided by fibrous tissue in one section. Following surgery, the patient received chemotherapy for the carcinoma and radiotherapy for the plasmacytoma. Conclusion In this case, careful histopathology examination was essential to make the correct diagnosis and therapy for these synchronous lesions. The patient finished chemotherapy and radiotherapy without significant adverse effects.

  15. A Case Report of Tracheal Extramedullary Plasmacytoma

    Kun Wang; Yunchao Huang; Anning Chen


    @@ Introduction Extramedullary plasmacytoma (EMP) is an uncommon tumor that often develops outside the bone and arises from clonal proliferation of atypical plasma cells before EMP is diagnosed. Multiple myeloma(MM) must be excluded by performing laboratory tests such as serum protein electrophoresis, bone marrow biopsy and skeletal imaging ex-aminations. A bone marrow biopsy should show no evidence of mul-tiple myeloma, and less than 3% of plasma cells. Monoclonal bands of serum protein and Bence-Jones protein in the urine can sometimes be detected. EMP can involve any extraosseous organs, but it pre-dominantly affects the head and neck areas. Any extra-osseous organ may also be involved[1,2]. Tracheal involvement is a rare finding. Only a few cases of primary tracheal extramedullary plasmcytoma have been reported[2-4], Here we present a rare case of truly localized tra-cheal extram edullary plasmacytoma without evidence of myelomaelsewhere.

  16. Radiation therapy for the solitary plasmacytoma

    Esengül Koçak


    Full Text Available Plasma-cell neoplasms are classically categorized into four groups as: multiple myeloma (MM, plasma-cell leukemias, solitary plasmacytomas (SP of the bone (SPB, and extramedullary plasmacytomas (EMP. These tumors may be described as localized or diffuse in presentation. Localized plasma-cell neoplasms are rare, and include SP of the skeletal system, accounting for 2-5% of all plasma-cell neoplasms, and EMP of soft tissue, accounting for approximately 3% of all such neoplasms. SP is defined as a solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. There appears to be a continuum in which SP often progresses to MM. The main treatment modality for SP is radiation therapy (RT. However, there are no conclusive data in the literature on the optimal RT dose for SP. This review describes the interrelationship of plasma-cell neoplasms, and attempts to determine the minimal RT dose required to obtain local control.

  17. Morphology and immunoreactivity of canine and feline extramedullary plasmacytomas.

    Mikiewicz, M; Otrocka-Domagała, I; Paździor-Czapula, K; Gesek, M


    The aim of the study was the evaluation of morphology and immunophenotype of canine (19 cases) and feline (7 cases) extramedullary plasmacytomas. Tumours, located in skin, oral cavity and spleen were surgically excised, fixed and processed for histopathology and immunohistochemistry (CD79α, CD18, proliferating cell nuclear antigen, metallothionein). Histologically, tumours were classified into mature, cleaved, asynchronous, polymorphous blastic, hyalin, or monomorphous blastic type. All evaluated tumours showed cytoplasmic expression of CD79α antigen. The expression of CD18 was observed in canine cutaneous and splenic tumours. In canine tumours expression of metallothionein was low to moderate, while in feline plasmacytomas - absent or low. In canine tumours, the mitotic index and proliferating cell nuclear antigen index were positively correlated with the expression of metallothionein. In feline tumours no correlation between mitotic index, proliferating cell nuclear antigen and metallothionein was found. This is the first study describing expression of metallothionein in canine and feline extramedullary plasmacytoma.

  18. Imaging features of solitary extramedullary plasmacytoma of liver%肝脏孤立性髓外浆细胞瘤的影像学特征

    李晓明; 陈伟; 蔡萍; 阎晓初; 王健


    ,色黄,质地坚硬,边界清晰,有包膜,与肝右静脉、下腔静脉前壁邻近.病理学检查:肿瘤细胞较小,核呈圆形、卵圆形,偏位,可见核分裂象,瘤细胞弥漫成束状分布.免疫组织化学染色检测:血管内皮标记CD34、多发性骨髓瘤基因MUM1、波形蛋白、浆细胞标记物38和138、λ轻链蛋白表达均为阳性,细胞增殖活性标记Ki-67阳性细胞指数为10%.术后血常规和血生化检测:患者无贫血、高钙血症、肾功能异常,血清或尿液中无单克隆免疫球蛋白.术后患者行骨髓穿刺、免疫球蛋白测定、全身骨扫描结果均正常.综合术后检查最终诊断为右半肝SEP.患者术后9d恢复良好出院.术后1个月彩色多普勒超声检查结果示右半肝术后改变,术后6个月未见明显复发征象.结论 肝脏SEP多发生于右半肝,其影像学主要表现为边界清楚,回声、密度或信号均匀,邻近包膜无明显外凸,周围血管无明显受侵犯,呈受压移位改变,强化方式为快进快出.%Objective To summarize the imaging features of ultrasound, computed tomography (CT) and gadolinium-ethoxybenzyl-diethylenetriamine pentoacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) of solitary extramedullary plasmacytoma (SEP) of liver, and investigate the key points of identification and diagnosis.Methods The clinical data of 1 patient with SEP of the liver who was admitted to the Southwest Hospital of the Third Military Medical University at 7 May, 2015 were retrospectively analyzed.The patient received contrast-enhanced ultrasound (CEUS) , plain and enhanced scan of CT and Gd-EOB-DTPA enhanced MRI.The patient underwent treatment after preoperative examinations.Pathological examination and immunohistochemical staining were done after operation.The patient was followed up by outpatient examination of color Doppler ultrasonography till 12 November, 2015.The location, size, shape, echo, density or signal, enhancement

  19. Extramedullary plasmacytoma extensively affecting the sella turcica and paranasal sinuses.

    Oishi, T; Kasai, H; Sakurai, Y; Kawamoto, K


    We report a 62-year-old Japanese male who complained of double vision and showed clear boundary mass extending to the clivus, intrasella, suprasella, ethmoidal sinus and sphenoid sinus on neuroimaging. The tumor mass was partially resected via transsphenoidal approach and was diagnosed as the extramedullary plasmacytoma by IgA immunostaining and electron microscopy. Making diagnosis from the imaging findings was difficult in this rare case, but immunohistological and electron microscopic examinations were useful for pathological diagnosis.

  20. The solitary sellar plasmacytoma: a diagnostic challenge

    Soejbjerg, Anne; Dyve, Suzan; Baerentzen, Steen


    UNLABELLED: Solitary sellar plasmacytomas are exceedingly rare and difficult to distinguish from other pituitary tumors. We report a case of a 62-year-old woman presenting with blurred vision of the right eye and tenderness of the right temporal region, which was interpreted as temporal arteritis...

  1. Plasmacytoma of the Nasolacrimal Duct Simulating Dacryocystitis: An Uncommon Presentation for Extramedullary Relapse of Multiple Myeloma

    Sevgi Kalayoglu-Besisik


    Full Text Available The most common site for localized forms of plasma cell neoplasms (extramedullary plasmacytoma; EMP is the upper respiratory tract, including the oropharynx, nasal cavities, sinuses and larynx. A 50-year-old woman with a history of myeloma in complete remission after autologous stem cell transplantation complained of two weeks of epiphora of the left eye with subsequent diplopia, bloody nasal discharge and progressive swelling around the nasolacrimal sac. A solitary mass in the left sinonasal area, extending to the nasolacrimal duct (NLD was detected on MRI, whose histopathological examination was consistent with plasmacytoma. Further clinical investigation ruled out multiple myeloma (MM. The patient underwent debulking surgery and adjuvant chemotherapy followed by local radiotherapy in an attempt to achieve complete response. Despite being a rare entity, EMP of the NLD should be considered in the differential diagnosis of epiphora and dacryocystitis. To our knowledge, this is the first case of a plasmacytoma of the NLD presenting as isolated extramedullary relapse of MM. The follow-up in EMPs should include appropriate imaging studies, a systemic workup to rule out MM.

  2. Triple manifestation of extramedullary plasmacytoma in the upper airway: an unusual clinical entity.

    Morariu, I


    OBJECTIVE: We report an extremely rare case of extramedullary plasmacytoma. METHOD: Case report and review of the English-literature concerning extramedullary plasmacytoma and multiple myeloma. RESULT: We present an unusual case of multiple extramedullary plasmacytomas, which, over a protracted course of 30 years, presented on different occasions at three separate sites in the head and neck. The patient was managed surgically on all occasions, and was disease-free at the time of writing. CONCLUSION: Following review of the literature, we believe this to be the only case with this extremely unusual presentation. This case is noteworthy, not only because of the rarity of extramedullary plasmacytoma, but also because it highlights a number of important clinical issues. The diagnosis and management of extramedullary plasmacytoma require close cooperation between multiple disciplines.

  3. Extramedullary Plasmacytoma Mimicking Pancreatic Cancer: An Unusual Presentation

    Daniela Sciancalepore


    Full Text Available Multiple myeloma is a plasma cell tumor that homes to and expands in the bone marrow and that, despite the new available drugs, remains incurable. Extramedullary plasmacytoma is a not frequent manifestation during the natural history of multiple myeloma and is frequently associated with plasma cell bone marrow infiltration. The most common locations for an EMP include the gastrointestinal tract, pleura, testis, skin, peritoneum, liver, endocrine glands, and lymph nodes. Primary involvement of the gallbladder fossa is exceedingly rare. In this report, we describe a patient with multiple myeloma who achieved a clinical and serological remission after autologous transplant but progressed rapidly at extramedullary site mimicking a second cancer (i.e., pancreatic or biliary cancer. In this case, the extramedullary localization was refractory to standard therapy, differently from bone marrow localization, but responded to lymphoma-like therapy. In this patient (i the particular site of developing plasmacytoma is the gallbladder fossa, (ii the timing of onset of this neoplasm is immediately after autologous transplant, and (iii its disjunction from primary myeloma is that it appears in clinical and serological remission phase which may be confounding during the diagnostic approach simulating a different tumor (solid tumor.

  4. Extramedullary plasmacytoma in a captive collared peccary (Pecari tajacu

    Roberio G. Olinda


    Full Text Available Abstract: An extramedullary plasmacytoma case in a captive collared peccary (Pecari tajacu is reported. The animal, a female aging three years old, had a medical history of diffusely distributed skin and mucocutaneous junction lesions, associated with swollen lymph nodes. Clinical examination and complementary exams (complete blood count, biochemical analysis, skin scraping to search mites and fungal culture were performed. Thirty days after examination, the animal died. At necropsy, multiple consistent nodules, aseptic pustules and swollen lymph nodes were found. On histological exams of the skin and oral mucosa, we observed a large number of round cells forming masses organized in nests, sheets, and cords of cells in a well-vascularized fibrovascular tissue. Neoplastic plasma cells infiltrated between the fibers and the lamina propria of smooth muscle. Spaces among the cell masses were filled with some eosinophil and fluid. Most of the cells were well differentiated, presenting a perinuclear clear zone. In some points, the cells were pleomorphic. The plasma cells presented eccentric, basophilic and spherical nuclei, showing a dense to organized chromatin with distinct nucleoli. Binucleate cells were observed, but multinucleated giant cells were rare. Oral mucosa and lymph nodes tested by immunohistochemical analyses were positive for Mb-1, with a multifocal distribution. In regard to Bcl-2, the neoplastic cells were intermittent weakly positive. So, an extramedullary plasmacytoma was diagnosed in the collared peccary considering the location, the histopathological and immunohistochemical findings.

  5. Bortezomib in treatment of extramedullary plasmacytoma of the pancreas

    Ju-Ying Wei; Hong-Yan Tong; Wei-Fang Zhu; Hui Liu; Feng-Juan Zhang; Wen-Juan Yu; Jie Jin


    BACKGROUND: Extramedullary pancreatic plasmacy-toma treated with bortezomib is rarely reported. METHODS: We admitted a 53-year-old woman with an asymptomatic mass above the left clavicle for over three months, then an asymptomatic swelling of the pancreas was found. A biopsy on the mass and a ifne needle aspiration of the pancreas were performed. The diagnosis of extramedullary plasmacytoma (EMP) was made. The patient was initially treated with combination chemotherapy consisting of vincristine, doxorubicin and dexamethasone (VAD regimen). She progressed to painless jaundice during the chemotherapy. Then she was treated with bortezomib and hyper-dose dexamethasone. As a result, she had a near complete remission. RESULTS: The data demonstrated that the diagnosis was EMP of the pancreas. The patient responded very well to bortezomib, while failing to respond to the traditional chemotherapy regimen of VAD. CONCLUSION: EMP of the pancreas is rare. This case gives evidence for an excellent response of EMP of the pancreas to bortezomib.


    Harshita V. Sabhahit


    Full Text Available BACKGROUND Plasmacytomas are rare plasma cell tumours occurring consequent to monoclonal proliferation of plasma cells. They are divided into Solitary bone plasmacytoma, Extramedullary plasmacytoma (EMP and Multiple myeloma. EMPs are commonly housed in the head and neck region with a predilection to the mucosa associated lymphoid tissue in the aerodigestive tract. The nasal cavity, paranasal sinuses, and nasopharynx are the most common sites. OBJECTIVE We describe our experience with this tumour owing to its clinical rarity and a different way of presentation. METHODS After complete surgical excision of a nasal mass presenting in a young male with features masquerading that of Juvenile Nasopharyngeal Angiofibroma, a diagnosis of plasma cell tumour was made on histopathological analysis which was confirmed using immunohistochemistry. Serum electrophoresis, urine Bence Jones proteins, complete skeletal survey were done to rule out any progression into multiple myeloma. Radiation therapy was given with 45 Gy in 25 fractions at 1.8 Gy per day, 5 days a week. RESULTS Followup after 2 years showed no recurrence locally as well as in regional nodes. CONCLUSION Given to the rarity of the tumour, undefined manner of presentation and a predominant prevalence in the head and neck region, every otolaryngologist should keep EMP in mind while considering sinonasal masses. A multidisciplinary approach with a combination of surgery and radiotherapy is found to benefit the patient significantly. A long term watch out for progression to MM is mandatory to commence early treatment and thus prolonged disease-free survival from the same.

  7. Extramedullary Plasmacytoma of the Frontal Sinus: Case Report and Turkish Literature Review

    Ayşegül Verim


    Full Text Available Solitary extramedullary plasmacytomas (EMPs are nonepithelial neoplasms of plasma cell origin categorized among non- Hodgkin lymphomas, without the bone marrow involvement and systemic spread seen in multiple myeloma. They are uncommon tumors comprising 3% of all plasma cell neoplasias. Although they usually occur in the upper respiratory tract, only 1 case of EMP localized to the frontal sinus has been reported in the English literature. We present in this report a rare case of EMP originated from the left frontal sinus leading to left eyeball proptosis and movement restriction. A survey of sinonasal EMPs in the Turkish literature is reported, as well. Paranasal computerized tomography and magnetic resonance imaging of a 69-year-old female who presented with left eyeball proptosis and left-sided headache revealed a solid mass in the left frontal sinus. Histopathological analysis of the completely excised mass supported the diagnosis of plasmacytoma. The definitive diagnosis of solitary EMP was confirmed with further investigations at hematology and oncology clinics. The patient was treated with surgery followed by local radiotherapy to the head and neck region, and she was disease-free at her 1-year follow-up. Treatment of sinonasal EMP is surgery alone or surgery combined with radiotherapy. Long-term follow-up is a requisite for systemic control because of the disease’s high potential to transform into multiple myeloma.

  8. Extramedullary plasmacytoma of maxilla with cervical nodal metastasis associated with sinonasal aspergillosis

    Virender Suhag


    Full Text Available Extramedullary plasmacytoma (EMP is defined as neoplastic proliferation of plasma cells in the soft tissue. It represents approximately 3% of all plasma cell neoplasms. EMP of the head and neck are very uncommon tumors, representing approximately 0.4% of all head and neck malignancies; amongst them, plasmacytoma of the maxilla is extremely rare. We present a rare case of EMP which had metastasized to multiple cervical lymph nodes and was associated with aspergillosis. The possibility of extramedullary plasmacytoma should be considered when an elderly patient presents with symptoms of recurrent rhinosinusitis not responding to conservative management and imaging shows a destructive soft tissue mass.

  9. The solitary sellar plasmacytoma: a diagnostic challenge

    Anne Soejbjerg


    Full Text Available Solitary sellar plasmacytomas are exceedingly rare and difficult to distinguish from other pituitary tumors. We report a case of a 62-year-old woman presenting with blurred vision of the right eye and tenderness of the right temporal region, which was interpreted as temporal arteritis. MRI revealed a pituitary mass lesion (20mm×14mm×17mm without compression of the optic chiasm and her pituitary function was normal. Pituitary surgery was undertaken due to growth of the lesion, and histopathological examination showed a highly cellular neoplasm composed of mature monoclonal plasma cells. Subsequent examinations revealed no evidence of extrasellar myeloma. The patient received pituitary irradiation and has remained well and free of symptoms apart from iatrogenic central diabetes insipidus. Until now, only eight cases of solitary sellar plasmacytoma have been reported. Most frequent symptoms stem from compression of the cranial nerves in the cavernous sinus (III, IV, V, whereas the anterior pituitary function is mostly intact.

  10. Solitary plasmacytoma of spine with amyloidosis

    Cui-yun SUN


    Full Text Available Objective To report the diagnosis and treatment of one case of solitary plasmacytoma of spine with amyloidosis and investigate the clinicopathological features combined with literatures. Methods and Results The patient was a 46-year-old woman. She suffered from weakness of both lower limbs, unsteady gait and numbness of toes for 20 d. MRI examination revealed an irregular mass behind the spinal cord at T5-7 level and T6-7 vertebral body accessory. The enhanced MRI showed obvious heterogeneous enhancement. The border was clear and spinal dura mater was compressed to shift forward. During operation, T5-7 processus spinosus and vertebral laminae were eroded, and the cortex of bone showed "moth-eaten" erosion. The intraspinal and extradural lesion had rich blood supply, loose bone structure and intact spinal dura mater. Histologically, tumor cells were composed of intensive small cells, and focal plasmacytoid cells were seen. Flake pink staining substance was among them. Artificial cracks were common and multinuclear giant tumor cells were scatteredly distributed. Immunohistochemical analysis showed the cytoplasm of tumor cells were diffusely positive for CD138, CD38 and vimentin (Vim,scatteredly positive for leukocyte common antigen (LCA, and negative for immune globulin κ light chain(IgGκ and λ light chain (IgGλ, CD99, S-100 protein (S-100, pan cytokeratin (PCK, epithelial membrane antigen (EMA, HMB45 and CD34. The Ki-67 labeling index was 1.25%. Congo red staining showed the pink staining substance was brownish red. Hybridization in situ examination showed the DNA content of IgGκ was more than that of IgGλ. The final pathological diagnosis was solitary plasmacytoma of spine with amyloidosis. The patient was treated with postoperative chemotherapy, and there was no recurrence or metastasis during 18-month follow-up period. Conclusions Solitary plasmacytoma of spine with amyloidosis is a rare tumor. The imaging features can offer a few

  11. Solitary plasmacytoma of the rib: A rare case

    Rikki Singal


    Full Text Available Localized solitary plasmacytoma of the bone is a rare disease and is characterized by only one or two isolated bone lesions with no evidence of disease dissemination. We report a case of solitary plasmacytoma of the rib in a 43-year-old female. The patient underwent complete en-bloc resection of the chest wall including rib, muscle, and parietal pleura. Patient is asymptomatic without any recurrence after two and half years of follow up.

  12. Solitary Plasmacytoma of the Chest Wall

    Servet Kayhan


    Full Text Available A previously healthy 55-year-old man with right sided lateral chest pain admitted to clinic. It was found a solid and painful mass at the right 4th rib in physical examination. Chest X-ray and thoracic computarized tomography showed an opacity measured 60x33 mm within the right chest wall destructing the 4th rib. Needle aspiration was performed from tumor and cytologic examination showed atypic plasma cell infiltration. The patient was scheduled for a chest wall resection and reconstructive surgery. Examination of a permanent section showed that the chest wall tumor was solitary plasmacytoma. There was no evidence of multiple myeloma recurrence after two years from the operation.

  13. Extramedullary plasmacytoma in the posterior triangle of neck: A rare entity

    Mahesh Kumar Mittal


    Full Text Available Extramedullary plasmacytoma (EMP is a rare plasma cell neoplasm of soft tissue without involvement of bone marrow or other systemic characteristics of multiple myeloma. It accounts for only 4% of all plasma cell tumors. We have reported herein a rare case of EMP involving soft tissues of the neck.

  14. Solitary Plasmacytoma of the Cecum and the Ascending Colon: Surgical Resection as a Treatment Modality

    Dalgic, Tahsin; Bostanci, Erdal Birol; Cakir, Tebessum; Ozer, Ilter; Ulas, Murat; Aydog, Gulden; Akoglu, Musa


    Colonic solitary plasmacytoma is a rare disease, with few reports occurring in the literature. Solitary plasmacytoma is defined as a plasma cell tumour with no evidence of bone marrow infiltration. Plasmacytoma can present as a solitary tumour in bone or in other parts of the body. The gastrointestinal tract is rarely the site of the disease. We report on the case of a 51-year-old man presenting with a colonic symptomatic mass with unclear biopsy results. A resected specimen showed a solitary plasmacytoma. Surgical resection was an adequate treatment modality in this case. Endoscopic resection, radiotherapy, and chemotherapy are also preferred treatments in selected gastrointestinal plasmacytoma cases. PMID:25954564

  15. Solitary Plasmacytoma of the Cecum and the Ascending Colon: Surgical Resection as a Treatment Modality

    Tahsin Dalgic


    Full Text Available Colonic solitary plasmacytoma is a rare disease, with few reports occurring in the literature. Solitary plasmacytoma is defined as a plasma cell tumour with no evidence of bone marrow infiltration. Plasmacytoma can present as a solitary tumour in bone or in other parts of the body. The gastrointestinal tract is rarely the site of the disease. We report on the case of a 51-year-old man presenting with a colonic symptomatic mass with unclear biopsy results. A resected specimen showed a solitary plasmacytoma. Surgical resection was an adequate treatment modality in this case. Endoscopic resection, radiotherapy, and chemotherapy are also preferred treatments in selected gastrointestinal plasmacytoma cases.

  16. Solitary Bone Plasmacytoma Progressing into Retroperitoneal Plasma Cell Myeloma with No Related End Organ or Tissue Impairment: A Case Report and Review of the Literature

    Gargi Tikku


    Full Text Available Solitary bone plasmacytomas and plasma cell myeloma are clonal proliferations of plasma cells. Many patients with solitary bone plasmacytomas develop plasma cell myeloma on follow-up. We present a case of a 70-year-old man who presented with fracture and a lytic lesion in the subtrochanteric region of the left femur and was assigned a diagnosis of solitary bone plasmacytoma. He received local curative radiotherapy. However, 4 months later his serum M protein and β2-microglobulin levels increased to 2.31 g/dL and 5.965 mg/L, respectively. He complained of abdominal fullness and constipation. Ultrasound and non-contrast CT imaging revealed multiple retroperitoneal masses. Colonoscopic examination was normal. Biopsy of the a retroperitoneal mass confirmed it to be a plasmacytoma. Repeat hemogram, blood urea, serum creatinine, skeletal survey, and bone marrow examination revealed no abnormalities. This is an unusual presentation of plasma cell myeloma, which manifested as multiple huge extramedullary retroperitoneal masses and arose from a solitary bone plasmacytoma, without related end organ or tissue impairment and bone marrow plasmacytosis. The patient succumbed to his disease 8 months after the appearance of the retroperitoneal masses. This case highlights the importance of close monitoring of patients diagnosed with solitary bone plasmacytoma with increased serum M protein and serum β2-microglobulin levels, so that early therapy can be instituted to prevent conversion to plasma cell myeloma.

  17. Extramedullary plasmacytoma of the pancreas as an uncommon cause of obstructive jaundice: a case report

    Leake Pierre-Anthony


    Full Text Available Abstract Introduction Though uncommon, extramedullary plasmacytoma of the pancreas should be considered in the differential diagnosis of obstructive jaundice and pancreatic neoplasms. This report highlights a case of obstructive jaundice in a 46-year-old West Indian man that resulted from an extramedullary plasmacytoma. Case presentation A 46-year-old West Indian man presented to our hospital with evidence of a significant upper gastrointestinal bleed. He gave a recent history of jaundice, constitutional symptoms and back pain. Ultrasonography revealed a mass in the head of the pancreas with resultant common bile duct dilatation. The patient required urgent surgical intervention for ongoing bleeding at which time a biopsy of the pancreas was taken. Histological analysis revealed a plasmacytoma of the pancreas. A blood film showing rouleaux formation and a skeletal survey demonstrating multiple lytic lesions confirmed multiple myeloma. Before further evaluation or treatment was carried out, the patient defaulted from follow-up and died from his illness seven months later. Conclusion This case represents an example of multiple myeloma with visceral involvement, brought to clinical attention through involvement of the pancreas. The report serves to reaffirm knowledge of the various presentations, the optimal diagnostic tools and the current proposed treatment strategies for extramedullary plasmacytomas of the pancreas.

  18. Solitary osteosclerotic plasmacytoma: association with demyelinating polyneuropathy and amyloid deposition

    Voss, S.D.; Hall, F.M. [Dept. of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Murphey, M.D. [Dept. of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC (United States); Dept. of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD (United States); Department of Radiology, University of Maryland School of Medicine, Baltimore, Maryland (United States)


    A 51-year-old man presented with a 1-year history of polyneuropathy necessitating the use of a wheelchair. Initial diagnosis was idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) and associated monoclonal gammopathy. Investigations for multiple myeloma, including bone marrow aspiration and biopsy, were negative. What was initially felt to be an incidental osteosclerotic focus noted on the radiographic bone survey was eventually shown to be a solitary osteosclereotic plasmacytoma with associated amyloid. This dramatically altered treatment. This case emphasizes the importance of including osteosclerotic plasmacytoma in the differential diagnosis of a focal sclerotic bone lesion in the clinical setting of polyneuropathy. These lesions are less likely to progress to multiple myeloma than lytic plasma cell neoplasms, and the presence of polyneuropathy often results in earlier diagnosis and treatment with enhanced prospect of cure. The finding of amyloid deposition within the osteosclerotic lesion may be of prognostic importance. (orig.)

  19. Primary Pulmonary Plasmacytoma with Diffuse Alveolar Consolidation: A Case Report

    Zohreh Mohammad Taheri


    Full Text Available Solitary extramedullary plasmacytomas are plasma cell tumors that tend to develop in mucosa-associated lymphoid tissues including the sinonasal or nasopharyngeal regions. Primary plasmacytoma of the lung is exceedingly rare and often presents as a solitary mass or nodule in mid-lung or hilar areas and diagnosed after resection. Herein, we report a case of primary pulmonary plasmacytoma that presented with diffuse alveolar consolidation and diagnosed by transbronchial lung biopsy.

  20. Radiotherapy for solitary plasmacytoma and multiple myeloma; Strahlentherapie bei solitaerem Plasmozytom und multiplem Myelom

    Schmaus, M.C. [Universitaetsklinikum Heidelberg, Klinik fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Neuhof, D. [MVZ Strahlentherapie und Nuklearmedizin Weinheim, Weinheim (Germany)


    Solitary plasmacytoma and multiple myeloma require a differentiated radiotherapy. The irradiation for plasmacytoma with an adequate total dose (medullary 40-50 Gy or extramedullary 50-60 Gy) leads to a high degree of local control with a low rate of side effects. In cases of multiple myeloma radiotherapy will achieve effective palliation, both in terms of recalcification as well as reduction of neurological symptoms and analgesia. In terms of analgesia the rule is the higher the single dose fraction the faster the reduction of pain. As part of a conditioning treatment prior to stem cell transplantation radiotherapy contributes to the establishment of a graft versus myeloma effect (GVM). (orig.) [German] Das solitaere Plasmozytom und das multiple Myelom fordern eine differenzierte Strahlenbehandlung. Bei Plasmozytomen fuehrt eine Bestrahlung mit ausreichender Gesamtdosis (medullaer 40-50 Gy oder extramedullaer 50-60 Gy) zu einer hohen Lokalkontrolle mit einer geringen Rate an Nebenwirkungen. Beim multiplen Myelom kann die Strahlentherapie eine effektive Palliation sowohl hinsichtlich Rekalzifikation als auch Reduktion neurologischer Symptomatik und Analgesie erzielen. Hinsichtlich der Analgesie gilt: Je hoeher die Einzeldosis, desto schneller der Wirkeintritt. Im Rahmen einer Konditionierungstherapie vor Stammzelltransplantation traegt die Strahlentherapie zur Etablierung eines Graft-versus-Myelom-Effekts (GvM) bei. (orig.)

  1. Relapse of Multiple Myeloma Presenting as Extramedullary Plasmacytomas in Multiple Organs

    Murat Köse


    Full Text Available Multiple myeloma is a neoplastic plasma cell disorder. It is characterized by collections of abnormal plasma cells accumulating in the bone marrow, where they interfere with the production of normal blood cells. It usually presents as a multisystemic involvement, whose symptoms and signs vary greatly. Some patients have slowly progressive disease while others have aggressive clinical behavior by extramedullary involvement. In addition to renal failure, anemia, hypercalcemia, lytic bone lesions, and immunodeficiency, it also affects multiple organ system, such as pancreas, adrenal glands, kidney, skin, lung, liver, spleen, lymph nodes, and bone. To raise awareness of the variable presentations of this disease, we report a 53-year-old male patient, with multiple myeloma in his first remission who relapsed with extramedullary plasmacytomas (EMPs involving multiple organs, such as pancreas, adrenal glands, kidney, skin, lung, liver, spleen, and lymph nodes.

  2. Extramedullary Plasmacytoma Diagnosed in an HIV-Positive Patient by an Unusual Clinical Presentation

    de Camargo Moraes, Paulo; Thomaz, Luiz Alexandre; Montalli, Victor Angelo Martins; Junqueira, José Luiz Cintra; Ribeiro, Camila Maria Beder


    The aim of this paper is to describe a case report of EMP in an HIV-positive patient. A 44-year-old, dark-skinned HIV-infected woman was referred to the Oral Diseases Treatment Center with a swelling at palate and left gingival fornix in the maxilla. Biopsy was taken and the oral lesion was diagnosed as EMP with well-differentiated plasma cells and restriction of the lambda light-chain. Skeletal survey was performed and no radiograph alterations were observed, thus supporting the diagnosis of EMP. Patient was referred to treatment and after two months of chemo and radiotherapy, an expanding lesion was observed in L5/S1 patient's vertebrae. Biopsy of the spinal lesion was consistent with lymphoma with plasmocitary differentiation, supporting the diagnosis of multiple myeloma (MM). Regarding the medical history, the final diagnostic was an oral extramedullary plasmacytoma with rapid progression into multiple myeloma. It is crucial to emphasize the relevance of HIV infection as a risk factor for both aggressive clinical behavior and unusual clinical presentation of extramedullary plasmacytoma cases. PMID:27980867

  3. Clinicopathological Analysis of a Primary and Solitary Brain Plasmacytoma: Case Report with an Encephalocoele


    @@ A primary and solitary plasmacytoma with an encephalocoele is an extremely rare tumor[1]. The origin of plasmacytoma cells has not been clarified, but a number of studies have suggested the possibility that it originates from the meninges and reticular cells of the Virchow-Robin space.

  4. Retro-peritoneal plasmacytoma: A case report and review of literature

    Sharma Lalit


    Full Text Available Solitary Extramedullary Plasmacytoma (EMP is an uncommon neoplasm. When diagnosed, head and neck region is its most likely location. Rarely, it may occur in the retro-peritoneum. We report a 44year old man with solitary extramedullary plasmacytoma in the retro peritoneum (RPEMP. The patient did not show response to three cycles of VAD chemotherapy. Thereafter Surgical excision of the mass was performed successfully. This is probably the first case report from Indian subcontinent.




    Full Text Available Plasma cell neoplasm’s constitute a group of disorders characterized by monoclonal proliferation of plasma cells and presence of monoclonal immunoglobulin in the serum. We report a case of solitary bone plasmacytoma of maxilla, a variant of PCNs. Because solitary bone plasmacytoma are quite rare in the oral cavity, they are often not commonly included i n the differential diagnosis of lesions occurring in the maxillary palatal region. The definitive diagnosis requires computed tomography scan, histopathological examination and immunoelectrophoresis.

  6. Extramedullary Plasmacytoma of the Larynx: A Case Report of Subglottic Localization

    Jaqueline Ramírez-Anguiano


    Full Text Available Extramedullary plasmacytoma (EMP is a rare neoplasm of plasma cells, described in soft tissue outside the bone marrow. EMP of the larynx represents 0.04 to 0.45% of malignant tumors of the larynx. A male of 57 years old presented with hoarseness, dyspnea, and biphasic stridor of 2 months. The indirect laryngoscopy (IL revealed severe edema of the posterior commissure and a polypoid mass in the right posterior lateral subglottic wall. A biopsy of the subglottic mass was performed by a direct laryngoscopy (DL. The histopathologic diagnosis was EMP CD138+, therefore radiotherapy was given at 54 Gy in 30 sessions. The patient had an adequate postoperative clinical course and a new biopsy was performed having tumor-free margins. All laryngeal lesions should be biopsied prior to treatment to determine an accurate diagnosis to guide a proper management of the condition. Radiation therapy to the EMP is considered the treatment of choice, having local control rates of 80% to 100%. The subglottis is the least accessible area of view and the least frequent location of a laryngeal mass, nevertheless the otolaryngologist should always do a complete and systematic exam of the larynx when a tumor is suspected, to detect diagnoses such as a subglottic plasmacytoma.

  7. Clinical analysis of 40 multiple myeloma patients with extramedullary plasmacytoma of the head.

    Sun, Wan-Jun; Zhang, Jia-Jia; An, Na; Shen, Men; Huang, Zhong-Xia; Li, Xin


    Objectives To investigate the clinical characteristics, survival and prognosis of patients with multiple myeloma (MM) and head extramedullary plasmacytoma (EMP). Methods Forty MM patients were enrolled in the study (18 men, 22 women; median age, 55 years). Results Median overall survival (OS) and progression-free survival (PFS) were 24 (5-78) months and 17 (2-36) months, respectively. The 2-, 3- and 5-year OS rates were 51%, 20% and 7%, respectively. The 2-year PFS was 15%. Median OS and PFS in patients administered velcade were 26 (18-50) and 22.5 (5-78) months, compared with 20 (10-30) and 13.5 (2-36) months in patients without velcade, respectively. Median OS was 23.5 (5-50) months in patients with EMP at MM diagnosis ( n = 25) and 36 (22-78) months in patients with head EMP diagnosed during the disease course ( n = 15). Sixteen MM patients had EMP invasion of the head only and 24 had invasion at multiple sites. Median OS was 25 (22-78) months in patients with EMP of the head only and 22 (5-78) months in patients with EMP invasion at multiple sites. Conclusion MM patients with head EMP show a more aggressive disease course and shorter OS and PFS. The prognosis of these patients is poor, especially in patients with head EMP at MM diagnosis, though combined chemotherapy and radiotherapy may prolong survival.

  8. Extramedullary plasmacytoma of thyroid - a mimicker of medullary carcinoma at fine needle aspiration cytology: A case report

    Vidya Bhat


    Full Text Available A rare case of extra medullary plasmacytoma (EMP of thyroid gland in a 60 year old male, occurring against a background of Hashimoto′s thyroiditis is reported. The fine needle aspiration cytology (FNAC initially done as an outpatient procedure, showed atypical epithelial cells on a background of amyloid. Considering these findings we gave a diagnosis of medullary carcinoma. Histology of the total thyroidectomy specimen showed an extensive infiltration of neoplastic plasma cells against a background of Hashimoto′s thyroiditis, with a bizarre Hurthle cell change. Immunohistochemistry on the histology sections confirmed the diagnosis of solitary plasmacytoma of thyroid against a background of Hashimoto′s thyroiditis.

  9. Refractory plasmablastic type myeloma with multiple extramedullary plasmacytomas and massive myelomatous effusion: remarkable response with a combination of thalidomide and dexamethasone.

    Nakazato, Tomonori; Suzuki, Kazuhito; Mihara, Ai; Sanada, Yukinari; Kakimoto, Tsunayuki


    A 74-year-old man with multiple myeloma was refractory to melphalan/prednisolone (MP), high-dose dexamethasone and VAD chemotherapy. He had the following poor prognostic factors: 1) multiple extramedullary plasmacytomas, 2) massive myelomatous effusion, 3) increasing immature myeloma cells with plasmablastic morphology, and 4) predominance of MPC1-CD49e-CD45+ phenotype immature myeloma cells. Combination therapy with thalidomide and dexamethasone resulted in a rapid response and a partial remission despite his multiple poor prognostic factors. The present case suggests that combination therapy with thalidomide and dexamethasone is still an alternative treatment regimen for resistant extramedullary plasmacytoma with a plasmablastic morphology.

  10. Bladder extramedullary plasmacytoma and synchronous bladder urothelial transitional cell carcinoma: A case report and review of the literature

    Karan Wadhwa


    Full Text Available Karan Wadhwa, Raj Singh, Lemke Z SolomonDepartment of Urology, Queen Alexandra Hospital, Portsmouth, UKAbstract: A 69-year-old man presented with sudden onset of macroscopic hematuria. While an ultrasound of the bladder revealed a posterior bladder mass, subsequent flexible cystoscopy demonstrated only an area of irregular urothelium. Initial general anesthetic cytoscopy and biopsy revealed conventional G2/3 T1 TCC. Histology of a further formal resection of this irregular area revealed carcinoma-in-situ and population of atypical cells with enlarged nuclei, prominent nucleoli, and varying quantities of cytoplasm showing plasma cell features. The immunohistochemistry was consistent with a plasmacytoma. There must be a high index of suspicion when ultrasound demonstrates a mass not detected by flexible cystoscopy, and biopsies/resection are advised to exclude extramedullary plasmacytoma (EMP as the cause. EMP of the urinary bladder is a rare entity with only 21 cases reported in the literature. In this report we describe a further case of EMP of the bladder associated with synchronous transitional cell carcinoma (TCC of the urothelium. We also highlight the important histopathological findings and review the current literature to report the outcomes of existing approaches to management of this rare form of bladder cancer. We believe this to be the first case reported in which a patient presented concurrently with bladder EMP and urothelial TCC. EMPs are highly radiosensitive tumors and in the case of head/neck disease, survival at 10 years is in the order of 65% following radical radiotherapy. Given the paucity of reported cases of primary bladder EMP, the optimal treatment regime remains unclear. In keeping with other anatomical sites current treatment is based to the assumed benefit of radical radiotherapy and prognosis appears to be better in those with no evidence of systemic disease.Keywords: bladder cancer, extramedullary plasmacytoma

  11. Cytological diagnosis of solitary plasmacytoma of the skull: A rare case report

    Mohamad Banyameen Iqbal


    Full Text Available Solitary plasmacytoma (SPC of the skull (SPS is rare, and only a few cases have been reported in the literature so far. Plasmacytoma of the skull has a wide spectrum of pathology, including a quite benign, SPC, and an extremely malignant, multiple myeloma at the two ends of the spectrum. SPC of bone including SPS is characterized by a radiologically solitary bone lesion, neoplastic plasma cells in the biopsy specimen, fewer than 5% plasma cells in bone marrow, <2.0 g/dl monoclonal protein in the serum when present and negative urine test for Bence Jones protein (monoclonal light chain. For diagnosing, a comprehensive examination and analysis, which includes radiological examination, immunoglobulin, biochemistry, test for Bence Jones protein in the urine and bone marrow is needed.

  12. Contribution of Surgery in Solitary Plasmacytoma of Spine; A Case Report

    Babak Mirzashahi


    Full Text Available Solitary plasmacytoma of bone is a rare malignant tumor mostly involving the axial skeleton. The tumor occurs in middle- aged or elderly people (mean age: 55 years and has a high risk of progression to multiple myeloma. Radiotherapy is the preferred treatment for this disease. We report a case of recurrent solitary plasmacytoma of the fourth lumbar vertebra in a 35-year-old male. The patient suffered from intractable pain due to a pathologic fracture and instability. We performed two-stage posterior and anterior surgical procedures on him. Our method was useful for immediate pain relief and early return to activity, spinal decompression and biomechanical stabilization of the involved vertebra. Afterward, the patient underwent radiotherapy as the adjuvant therapy. The patient is asymptomatic without any recurrenceafter a one-year follow up. We recommend surgery as an appropriate option for patients with intractable pain as a result of pathologic fracture, vertebral instability, neurological compromise, failure of radiotherapy or a combination of these disorders.

  13. POEMS syndrome associated with plasmacytoma of the clivus: "Time discovers the truth"

    J Thomas


    Full Text Available Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS syndrome is characterized by the presence of a monoclonal plasma cell disorder, peripheral neuropathy, and one or more of the following features: Osteosclerotic myeloma, Castleman′s disease (angiofollicular lymph node hyperplasia, increased levels of serum vascular endothelial growth factor (VEGF, organomegaly, endocrinopathy, edema, typical skin changes, and papilledema. [1] Solitary plasmacytomas most frequently occur in the bone but can also be found in soft tissues (extramedullary plasmacytoma. [2] We report a case that showed a rare association of POEMS syndrome with a plasmacytoma of the clivus.

  14. Solitary bone plasmacytoma: An interesting case report with unusual clinico-cytological features.

    Saksena, Annapurna; Mahajan, Nidhi; Agarwal, Shipra; Jain, Shyama


    Solitary bone plasmacytoma (SBP) is a rare entity characterized by localized proliferation of monoclonal plasma cells primarily occurring in the axial skeleton without systemic involvement. Involvement of the distal extremity is unusual. In the absence of typical clinical presentation, diagnosis may not be suspected clinico-radiologically; hence, fine-needle aspiration cytology may help in early and definitive diagnosis, hastening meticulous diagnostic workup and appropriate management of these patients. Intracytoplasmic crystalline inclusions (CI) have been reported in multiple myeloma and lymphoproliferative disorders. The present case highlights unusual clinico-cytological features of SBP with primary involvement of humerus, progression to tibia, and presence of extracellular and intracytoplasmic CI in plasma cells, a morphologic finding not reported in SBP earlier.

  15. [Plasmacytomas of the head and neck].

    Marzetti, E; Marzetti, A; Palma, O; Pezzuto, R W


    Neoplastic proliferation of plasma cells results in a population of immunologically homogeneous cells that can produce diffuse (multiple myeloma) or localized (extramedullary plasmacytomas and solitary plasmacytoma of bone) disease. In otorhinolaryngologic literature these neoplasms are rarely described and their nosological arrangement is often confused. The presence of a plasma cell neoplasm can be a surprise and sometimes a diagnostic challenge to the head and neck surgeon. Proper management of such lesions needs to be individualized according to their expected biologic behaviour. The recent observation of a case of maxillary sinus plasmacytoma suggested the Authors to carefully review the literature, drawing their attention mainly on the current histogenetic hypotheses and their consequences in therapeutic strategy. The correct diagnostic procedure is also explained, highlighting the difficulties due to both the protean nature of the disease and the still existing nosological confusion. The possibility of a plasma cell tumour should be never forgotten in presence of an head and neck neoplasm. Because these neoplasms may signal the presence of multiple mieloma, full evaluation is required to exclude disseminated disease. In light of recent histogenetic acquisitions it is suggested that extramedullary plasmacytomas can be classified among the so-called "mucosa-associated" lymphomas. Possible following differences in therapeutic approach and long-term follow-up are also indicated, stressing the role of surgery in managing these disorders. Surgical excision of extramedullary plasmacytomas followed by complementary radiotherapy on the site of tumour is proposed as the best treatment for these kind of neoplasms. This is in opposition with "classical" statement considering radiotherapy the only treatment for this kind of disorders.

  16. 18F-FDG PET/CT for Early Postradiotherapy Assessment in Solitary Bone Plasmacytomas.

    Alongi, Pierpaolo; Zanoni, Lucia; Incerti, Elena; Fallanca, Federico; Mapelli, Paola; Papathanasiou, Nikolaos; Gianolli, Luigi; Picchio, Maria; Bomanji, Jamshed


    The purpose of this study was to evaluate the performance and possible prognostic value of early (18)F-FDG PET/CT (FDG PET/CT) assessment after radiotherapy (RT) in patients with solitary bone plasmacytoma (SBP). Twenty-one patients affected by SBP who underwent FDG PET/CT scan for early restaging (≤6 months) postradiotherapy assessment were selected from the PET databases of University College London Hospital of London and San Raffaele Hospital of Milan. Patients with no abnormal uptake were classified as having no pathologic uptake (NPU). A SUV(max) cutoff value of 4 was chosen to discriminate minimal residual uptake (MRU; SUV(max) ≤ 4) from pathologic uptake (PU, SUV(max) >4). Progression-free survival (PFS) rate was estimated using Kaplan-Meier curves and Cox regression analysis. In 10 of 21 patients restaged by FDG PET/CT, further previous baseline scan was available also at staging, and results showed positive findings at the level of all biopsy-proven disease areas.Considering MRU as PU, FDG PET/CT showed a sensitivity and specificity of 86% and 29%, respectively. Using SUV(max) >4 as the cutoff, sensitivity and specificity were 86% and 93%, respectively. Kaplan-Meier curves revealed a significant difference in PFS probability between patients classified as positive on FDG PET/CT using a cutoff of SUV(max) >4 (PU) and those classified as negative (NPU + MRU) (log-rank, Mantel-Cox, P = 0.009; χ(2) = 6.85). Cox regression analysis of PFS using SUV(max) >4 as cutoff revealed an interesting relation in prediction of progression (HR, 9.458). (18)F-FDG PET/CT for early restaging after RT in patients with SBP should be considered carefully in view of the lack of specificity of a low SUV(max) value. The good correlation between a high SUV(max) value and follow-up suggests a possible prognostic role for FDG PET/CT in disease progression at early restaging after RT.

  17. Testicular plasmacytoma: a case report and review of the literature

    WANG Yi-min; LI Fang-yin; LUO Jin-dan; LI Jun; XIE Li-ping; YANG Guo-sheng


    @@ Testicular plasmacytoma is rarely reported. The diagnosis is mainly based on pathological examination. Orchiectomy, combined with chemotherapy and radiotherapy, is currently the main treatment strategy for testicular plasmacytoma. The prognosis of extramedullary plasmacytoma involving the testis is much better than multiple myeloma involving the testis.Herein we present a case of a 62-year-old man who was diagnosed with testicular plasmacytoma.

  18. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)


    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation.

  19. A secondary extramedullary, localized, non-secreting plasmacytoma of the right plica ventricularis diagnosed by computed tomography; Computertomographische Diagnostik eines sekundaer extramedullaer lokalisierten, nichtsezernierenden Plasmozytoms der rechten Plica ventricularis

    Scherer, G. [Universitaetsklinik Heidelberg (Germany). Abt. Radiodiagnostik; Roeren, T. [Universitaetsklinik Heidelberg (Germany). Abt. Radiodiagnostik; Schlenk, R. [Medizinische Universitaetsklinik Heidelberg (Germany). Abt. Medizinische Poliklinik; Kauffmann, G.W. [Universitaetsklinik Heidelberg (Germany). Abt. Radiodiagnostik


    The authors report the case of a 62-year-old male patient with an extramedullary non-secreting plasmacytoma of the right plica ventricularis. Although his skeletal lesions remained stable, the patient developed hoarseness. This was interpreted as mycotic laryngitis and computed tomography showed a tumor of the right plica ventricularis. Differential diagnosis included neoplasms of the larynx, thyroid gland or a lymphoma. After biopsy, however, histology revealed the rare diagnosis of a secondary extramedullary non-secreting plasmacytoma. (orig.) [Deutsch] Kasuistische Mitteilung ueber einen 62jaehrigen maennlichen Patienten mit einem sekundaer extramedullaer lokalisierten, nichtsezernierenden Plasmozytombefall des rechten Taschenbandes. Bei stationaerem, ossaeren Befund entwickelte der Patient eine klinisch manifeste Heiserkeit. Diese wurde als Folge einer Soorlaryngitis interpretiert und daraufhin wurde der Patient primaer antimykotisch therapiert. Bei therapierefraktaerer Persistenz der Heiserkeit wurde laryngoskopiert und eine CT veranlasst. Diagnostiziert wurde schliesslich ein Tumor der rechten Plica ventricularis. Differentialdiagnostisch standen eine Neoplasie des Larynx, der Schilddruese und eine Lymphommanifestation zur Disposition. Erst die histologische Analyse des Feinnadelpunktates sicherte die seltene Diagnose eines sekundaer extramedullaer lokalisierten, nichtsezernierenden Plasmozytoms. (orig.)

  20. Successful treatment of a primary gastric plasmacytoma mimicking intractable gastric ulcer by using high-dose dexamethasone therapy: a case report.

    Kang, Da-yeong; Kim, Gee-Bum; Choi, Byung-Seok; Seo, Jun-won; Lim, Hyun-Jong; Hong, Ran; Park, Sang-Gon


    Extramedullary plasmacytoma is a plasma cell neoplasm that presents as a solitary lesion in soft tissue. Most extramedullary plasmacytomas involve the nasopharynx or upper respiratory tract. Primary plasmacytoma of the stomach is extremely rare. A 78-year-old Korean woman presented with epigastric pain for 3 months. She had a history of an intractable gastric ulcer despite repeated endoscopic biopsies and appropriate medical therapy for the ulcer. She underwent another endoscopy and a biopsy was performed for multiple large and deep specimens. Ultimately, primary gastric plasmacytoma was confirmed. However, she and her attendant refused standard local radiotherapy or surgical resection. She came to our emergency room 3 months later with hematemesis due to a large gastric ulcer, despite management with medication for over 3 months at a local clinic. We again recommended local radiation or surgical resection. However, as she was willing to undergo only medical therapy, she was prescribed high-dose dexamethasone. Surprisingly, her ulcer completely regressed and remission was maintained for over 1 year. We report successful treatment of a rare primary gastric plasmacytoma mimicking intractable ulcer by using high-dose dexamethasone. To the best of our knowledge, this is the first reported case successfully treated with only high-dose dexamethasone.

  1. Plasmacytoma of tonsil diagnosed by fine-needle aspiration cytology

    Bhat Ramachandra


    Full Text Available Extramedullary plasmacytoma of tonsil is rare. Even though biopsy is necessary for final diagnosis, fine-needle aspiration cytology (FNAC can provide useful information in the management of such cases. We report a case of plasmacytoma of tonsil diagnosed by FNAC in a 43-year-old man who presented with a swelling in the right tonsillar area. FNAC smears revealed sheets of plasma cells at various stages of maturation. Subsequent histopathological and immunohistochemical studies confirmed the diagnosis of plasmacytoma. This case is reported for the rarity of site for extramedullary plasmacytoma and to highlight the usefulness of FNAC in lesions of tonsil.

  2. Mesenteric plasmacytoma: An unusual cause of an abdominal mass

    protein electrophoresis demonstrated a monoclonal band (gamma- .... The disease is staged according to the Wiltshaw classification[4] as follows: I – limited ... Wiltshaw E. The natural history of extramedullary plasmacytoma and its relation to.

  3. Pancreatic plasmacytomas in a patient with multiple myeloma: CT and ultrasound findings.

    Olson, M C; Kalbhen, C L; Posniak, H V


    Extramedullary plasmacytomas are an unusual manifestation of multiple myeloma. They occur most frequently in tissues or organs rich in reticulo-endothelial cells. Pancreatic plasmacytomas are rare, with only a few case reports in the literature. We present the ultrasound (US) and computed tomographic (CT) findings of two pancreatic plasmacytomas in a patient with multiple myeloma.

  4. Clinical pathologic observation of the solitary plasmacytoma of bone%6例骨的孤立性浆细胞瘤临床病理观察

    阳桂丽; 钟先荣; 胡碧清


    目的 探讨骨的孤立性浆细胞瘤的临床病理特征及诊断方法.方法 收集和复习本院1996年1月至2009年12月病理确诊为骨的孤立性浆细胞瘤6例临床资料,通过对其临床特征、影像学表现、血尿检测、病理常规HE染色及免疫组化染色等进行分析,并复习相关文献.结果 6例骨的孤立性浆细胞瘤均为单一区域骨骼破坏,好发于红髓丰富的部位,分别为肋骨2例、颅骨2例、胸椎1例、股骨干1例;男性比女性常见,男女之比为2∶1.临床表现为单骨部位疼痛,无贫血、高钙血症和肾功能损害,尿Bence-Jones蛋白阴性;免疫组化表达CD38和/或CD138,单克隆表达轻链球蛋白Kappa 2例、Lambda 4例.结论 骨的孤立性浆细胞瘤较为罕见,确诊需综合多方面情况,且首先应排除骨多发性骨髓瘤.%Objective To investigate the clinical pathologic feature and the diagnosis method about the solitary plasmacytoma of bone. Methods We collected and reviewed the clinical information of 6 cases of the final pathologic diagnosis solitary plasmacyoma of bone who were treated in our hospital from January, 1966 to December, 2009 , through the clinical feature, imageologic appearance, the detection of blood and urine, pathologic routine HE staining and immunohistochemical staining to analyze, and reviewed pertinent literature. Results All the 6 cases with the solitary plasmacytoma of bone were skeletal destruction of single region,especially frequent in the location of abundance splenic pulp,2 lesions involved the costal bone,2 leisons cranium,l leison thoracic vertebra and 1 leison involved shaft of femur,respectively,and more common in male than that in female(the ratio of male to female was 2 : 1). The clinical situations were the pain of single bone location, no anaemia, hypercalcinemia and the damage of renal function, negative urine Bence-Jones proteins. Immunohistochemical expressions were CD38 and(or)CD138 ,and monoclonal

  5. Use of Endoscopic Ultrasound in Diagnosing Plasmacytoma of the Pancreas

    Milos Miljkovic


    Full Text Available Context An extramedullary plasmacytoma is a discrete collection of monoclonal plasmocytes arising in tissues other than the bone. Gastrointestinal involvement has been reported in approximately 10% of cases and usually involves the liver; however, there have been a number of cases involving the pancreas. Discussion Although helical CT can be used to diagnose pancreatic plasmacytomas based on a typical radiological appearance, there are a number of pitfalls with CT including similar radiologic appearances of other pancreatic tumors, malignant seeding induced by CT biopsy, and creation of multiple secondary plasmacytomas precipitated by CT biopsy. Tissue diagnosis is critical to management in pancreatic lesions as the decision to pursue surgery (pancreatic adenocarcinoma versus chemotherapy (lymphoma or radiation (extramedullary plasmacytoma is dependent on a correct tissue diagnosis. Tissue diagnosis can change morbidity and mortality with respect to specific treatment of pancreatic lesions in the milieu of pancreatic tumor variance. In the confirmed tissue diagnosis of pancreatic plasmacytoma, radiation and chemotherapy can be preferentially chosen over high risk surgery. EUS-FNA has a lower risk of malignant seeding, complications, and a high sensitivity in the diagnosis of pancreatic plasmacytomas, especially with an increased number of passes and bedside cytopathologists. Conclusion It is important for physicians to have a high index of suspicion for diagnosing pancreatic plasmacytomas in the appropriate clinical setting (i.e., a previously diagnosed multiple myeloma, extramedullary plasmacytoma or any other plasma cell neoplasm. EUS-FNA is now an indispensable imaging modality to achieve the diagnosis of pancreatic extramedullary plasmacytomas with an inherently lower rate of complications, and should be the first choice for tissue evaluation.

  6. In vivo dosimetric study for a jaw-solitary-bony plasmacytomas-electron-beam-therapy;Estudo dosimetrico in vivo para terapia com eletrons em caso de plasmocitoma osseo solitario em mandibula

    Biazotto, Bruna [Universidade Estadual de Campinas (HC/FCM/UNICAMP), SP (Brazil). Fac. de Ciencias Medicas. Hospital de Clinicas; Ferreira, Valeria A.; Ferrari, Vilma [Universidade Estadual de Campinas (HC/UNICAMP), SP (Brazil). Hospital de Clinicas. Servico de Radioterapia


    Some superficial tumors are treated with high energy electron beams. The dose distribution is rather complex, due to the beam crossing different electronic densities' materials. In the present work, the dose distribution in a jaw's-solitary-bony-plasmacytomas-treatment has been studied, to which 15 MeV electron beam was, initially, prescribed. Using lithium fluoride thermoluminescent dosimeters, the dose was evaluated on skin surface, behind the jaw, and, also, behind a lead shield designed to oral cavity protection. It was determined that the dose transmitted through the shield was 16% of the prescription dose, equivalent to 32 cGy, and, according to the medical staff, the treatment was modified to the 12 MeV-energy, resulting in a reduction to 8 cGy. It was assessed the influence of electron backscattering, resulting in a increase of the bolus thickness around the lead. (author)

  7. Solitary plasmacytoma of bone: a clinicopathologic, immunohistochemical and immunoglobulin gene rearrangement study%骨孤立性浆细胞瘤的临床病理分析

    左卓; 刘卫平; 唐源; 毕成峰; 王晓卿; 张文燕; 杨群培; 邹立群


    目的 探讨骨孤立性浆细胞瘤(SPB)的临床病理特征,了解免疫表型在SPB的病理诊断和鉴别诊断中的意义和作用.方法 收集1990-2008年21例SPB的临床病理资料并进行回顾性分析,应用免疫组织化学(EnVision或EliVision法)检测17种抗原的表达情况,并用半套式PCR技术,以免疫球蛋白重链通用型引物,以及BIOMED-2系统引物IgK和IgL进行免疫球蛋白基因重排检测.结果 21例SPB患者年龄36~72岁,中位年龄50岁.主要病变部位为中轴骨骼(14例,66.7%),其次为四肢骨骼(7例,33.3%).5例有血清Ig升高,其中3例为IgA型,2例为IgG型.临床表现与肿瘤部位有关,有局部疼痛、脊神经压迫征和病理性骨折等.所有病例均表现为局部孤立性占位病变伴骨质破坏.组织学分级:21例中Ⅰ、Ⅱ和Ⅲ级者分别为12例(57.1%)、5例(23.8%)和4例(19.0%).免疫表型:所有病例之瘤细胞均表达两种及以上浆细胞抗原,如CD138、CD38和浆细胞抗体;均不表达CD19和CD20,CD79a表达率为23.8%(5/21).CD56、CD27和CD44v6的表达率分别为57.1%(12/21)、15.0%(3/20)和23.8%(5/21).21例SPB中12例(57.1%)检出IgH基因克隆性重排.12例(57.1%)有随访,7例死亡,5例存活;其中3例发展为多发性骨髓瘤并已死亡.结论 SPB以骨的孤立性占位伴疼痛为其临床特征,诊断需排除多发性骨髓瘤髓外浸润之可能.免疫表型及Ig基因重排检测在该肿瘤的诊断中起重要作用.%Objective To investigate clinicopathologic features of solitary plasmacytoma of bone(SPB) and the role of immuno-phenotype and immunoglobulin gene rearrangement detection in the diagnosis and differential diagnosis of SPB.Methods A total of 21 cases of SPB were selected during a period from 1990 to 2008.A retrospective clinicopathologic study and immunohistochemistry (EnVision or EliVision methods) of 17 antigens were performed.In addition, universal IgH (FR3A/LJH/VLJH) primers and BIOMED-2 PCR multiplex tubes were

  8. A rare case of primary gastric plasmacytoma: An unforeseen surprise

    Krishnamoorthy Navin


    Full Text Available Primary plasmacytoma of the gastrointestinal tract is a rare entity. We report a case of a primary gastric plasmacytoma in a 57-year-old man who presented with upper-gastrointestinal bleeding. Endoscopy showed a nodular gastric mass with central umblication. Histological examination of the gastrectomy specimen revealed a monoclonal lambda-chain extramedullary plasmacytoma. Further staging was found to be negative for multiple myeloma. As other more common pathologic processes at this site may also be endowed with numerous plasma cells, awareness of this entity and distinction using immunohistochemistry are extremely crucial. Because systemic disease ultimately develops in many patients with localized plasmacytoma, such patients should be followed closely for the appearance of clinical, biochemical, and roentgenologic evidence of multiple myeloma.

  9. Intramuscular plasmacytoma

    Surov, Alexey [Martin-Luther-University of Halle-Wittenberg, Department of Radiology, Halle (Saale) (Germany); Tcherkes, Anatolij [Martin-Luther-University of Halle-Wittenberg, Department of Hematology/Oncology, Halle (Saale) (Germany); Meier, Frieder [Martin-Luther-University of Halle-Wittenberg, Department of Pathology, Halle (Saale) (Germany)


    In multiple myeloma, secondary infiltration of adjacent muscles from bone lesions is common. However, plasmacytoma directly arising within the skeletal musculature is rare. Imaging findings of this rare entity have been described only sporadically. The purpose of this study was to identify the clinical signs and radiological features of intramuscular plasmacytoma (IP). Eleven patients with IP were retrospectively identified in the pathological and radiological databases of our institution. Computed tomography (CT) was performed in nine patients and magnetic resonance imaging (MRI) in four cases. IP presented clinically with local pain in four patients. In one case with involvement of the rectus lateralis muscle of the eye, the patient showed a painless bulbus proptosis. In another patient, IP manifested as a massive bilateral forearm swelling with compartment syndrome. In four patients, IP was identified incidentally on computed tomography during staging examination. On imaging, two patterns of IP were found: intramuscular mass (n = 5) or diffuse muscle infiltration (n = 6). On CT with contrast, IP showed a moderate enhancement. With MRI on T1-weighted images, IP was isointense in comparison to the unaffected musculature, whereas on T2-weighted images, IP showed high signal intensity. After intravenous administration of contrast medium, a slight-to-moderate inhomogeneous enhancement was seen in all cases. IP should be considered in the differential diagnosis of muscle tumors. It manifests with two radiological patterns, either as intramuscular mass or as diffuse muscle infiltration. (orig.)

  10. Detection of Extramedullary Multiple Myeloma in Liver by FDG-PET/CT

    Kim, Daeweung; Kim, Woo Hyoung; Kim, Myoung Hyoun; Choi, Keum Ha; Kim, Chang Guhn [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)


    We present the case of a 42-year-old man with a painful mass lesion in the right shoulder that was detected by contrast-enhanced computed tomography (CT) and {sup 18}F-fluoro-2-deoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/CT. Excisional biopsy revealed infiltration of plasma cells with anaplastic features, consistent with solitary plasmacytoma (PC). Serum analysis showed elevation of serum free lambda light chain levels (27.78 mg/l), with an abnormally high kappa:lambda ratio (2.33) and high total proteins (10.4 g/dl). Serum protein electrophoresis revealed an M spike in the gamma-globulin region (56.1 %=5.8 g/dl). Subsequently, {sup 18}F-FDG PET/CT revealed another hypermetabolic mass in the right lobe of the liver. CT-guided biopsy of the liver lesion revealed plasma cell myeloma, consistent with multiple myeloma. Multiple myeloma presenting as nodular liver masses is very rare in clinical practice. In a retrospective review of more than 2,000 patients, Talamo et al. reported only nine cases where there was nodular involvement of the liver by multiple myeloma. The organ most commonly involved was the liver, followed by pancreas, stomach, peritoneum with malignant ascites, colon, rectum, duodenum and ileum. Therefore, the literature published thus far has been limited to a few reports and case series. Among these reports, some had demonstrated the PET or PET/CT findings of nodular liver involvement of multiple myeloma. About 10 % of the solitary myelomas appeared as extramedullary PC or solitary PC of bone. In spite of the advances in therapy, the treatment of multiple myeloma is still palliative. However, solitary PC could be cured by resection or radiation therapy. Thus, differentiation between PC and multiple myeloma is essential in making a decision for the appropriate therapeutic regimen. {sup 18}F-FDG PET/CT has the unique ability to detect and characterize malignant lesions in one single examination. Schirrmeister et al. reported that

  11. 脊柱孤立性浆细胞瘤的临床病理分析%Solitary plasmacytoma of spine:a clinical, radiologic and pathologic study of 13 cases

    何妙侠; 朱明华; 张亚明; 傅青格; 吴丽莉


    Objective To study the clinical, radiologic and pathologic features of solitary plasmacytorna of spine. Methods The clinical, radiologic and pathologic features, as well as treatment and fallow-up data, of 13 solitary plasmacytoma of spine cases were retrieved and analyzed. Immunohistochemical study using EnVision method for LCA, CD19, CD20, CD79a, CD3, CD7, PC,MUM1, CD138, IgG, IgM, kappa, lambda and Ki-67 was carried out. Results All the tumours were primarily located in the vertebrae (including 9 cases in thoracic vertebrae and 4 cases in lumbar vertebrae).years). The commonest symptom was pain in the surrounding regions. The degree of neurologic disturbance mostly depended on the extent of vertebral destruction and structural instability of the spine. Radiologic examination showed mainly osteolytic lesions in vertebrae. Magnetic resonance imaging demonstrated the presence of heterogeneous intensity inside the involved vertebrae (low in T1 weighted and high in T2 weighted images). Histologic examination showed diffuse infiltration by malignant cells. In welldifferentiated plasmacytomas, the tumor cells resembled normal plasma cells.In poorly differentiated examples, the cellular morphology mimicked that of the centroblasts. The interstitial stroma was scanty and contained plenty of vessels, sometimes with formation of blood lakes. Amyloid deposition was present in some of the cases.Immunohistochemical study showed that the tumor cells were positive for CD79a and negative for CD20. Light chain restriction was detected in all the 13 cases studied. Plasma cell marker PC was expressed in all cases, while IgG was positive in 5 cases, IgM in 1 case, MUM1 in 10 cases and CD138 in 8 cases. Ki-67 index varied from 10% to 50%. All cases were operated, with adjuvant chemotherapy and radiotherapy given. Conclusions Correlation of clinical, radiologic and pathologic features is important in diagnosis of solitary plasmacytoma of spine. The possibility of multiple myeloma

  12. 颈椎孤立性浆细胞瘤的外科干预及放疗结果分析%Surgical intervention and radiotherapy outcome of solitary plasmacytoma of cervical spine

    黄稳定; 冯大鹏; 肖建如; 黄权; 郑伟; 吴志鹏; 周振华; 杨兴海; 谢宁


    目的 探讨颈椎孤立性浆细胞瘤的临床特点、治疗方法及结果.方法 回顾性分析我科1995年1月至2007年12月收治的23例颈椎孤立性浆细胞瘤患者的临床资料,其中男性16例,女性7例,年龄32~76岁,平均56岁.23例患者除2例仅行单纯放疗外,余21例均行手术治疗.依据脊柱肿瘤WBB分期,采取全椎体切除6例,附件切除4例,矢状切除3例,全椎节切除8例,手术病例采用前路、后路或前后联合入路.脊柱重建方式采取自体髂骨植骨和颈前路钛板、钛网骨水泥内固定或前后联合植骨融合内固定,术后均行辅助放疗.结果 23例患者获得随访,随访时间24.0~143.0个月,平均64.7个月.患者术后颈部疼痛症状明显好转,神经压迫症状消失或得到不同程度的改善,术后3个月患者神经功能Frankel分级平均有1~2个级别的改善.内固定位置及颈椎稳定性良好,无脊柱失稳现象,植骨融合率100%.随访期内有6例局部复发,且进展为多发性骨髓瘤(MM),死亡3例.2例未手术者分别于确诊后1年及1.5年进展为MM,转血液科进一步化疗.15例患者术后辅助放疗后一般情况良好,随访期内复查M蛋白、骨髓穿刺等检查均未见明显异常,单光子发射计算机断层扫描或PET-CT检查未发现其他部位骨骼有新发病灶.结论 颈椎孤立性浆细胞瘤临床较为少见,对于骨质破坏明显、椎节不稳或神经功能障碍者,首选手术治疗;术后辅助放疗能明显降低局部复发率及进展为MM的可能性,进展为MM者应根据相应化疗方案进行化疗,预后相对较差.%Objective To study the clinical features, treatment methods and outcome of solitary plasmacytoma of cervical spine. Methods From January 1995 to December 2007, the data of 23 cases with solitary plasmacytoma of cervical spine was analyzed. There were 16 males and 7 females ( mean age 56 years, range: 32-76 years). Two cases underwent radiotherapy alone and 21

  13. Primary plasmacytoma of the cervix in a 21-year-old female patient.

    Schor, Ana Paula T; Moraes, Marcelo P T; Bisson, Frank W; Bisson, Marcelo A M; Luiz, Orlando M R; Bacchi, Carlos E


    Extramedullary (extraosseous) plasmacytomas are localized, plasma cell neoplasms that arise in tissues other than bone and bone marrow, and constitute about 4% of all plasma cell neoplasms. Extramedullary (extraosseous) plasmacytomas rarely affects the female lower genital tract; only 6 cases of primary cervix plasmacytomas have been reported to date. Here we describe the case of an otherwise healthy 21-year-old woman who presented for a routine examination with no symptoms. A Pap smear showed an intense inflammatory process with some atypical cells. This was confirmed by microscopic examination of a biopsy, which revealed a metaplastic process of the cervix with a massive infiltration of plasma cells with mild atypia. The atypical plasma cells showed cytoplasmic lambda immunoglobulin light chain restriction with the absence of kappa light chains, indicative of monoclonality. The patient was extensively screened for systemic disease, including bone marrow biopsy, but the disease was restricted to the cervix.

  14. Periportal Extramedullary Hematopoiesis

    Ha, Dong Ho [Dong-A University, Busan (Korea, Republic of)


    In a bone marrow failure patient, a soft tissue mass lesion in the periportal area is a rare presentation. We present the sonographic and dynamic CT findings of a histologically confirmed case of hepatic periportal extramedullary hematopoiesis.

  15. Plasmacytoma presenting as missing rib on chest film: a case report and review of the literature.

    Caffery, Terrell; Foy, Matthew


    A 33-year-old man presented to the emergency department (ED) with chief complaint of chest pain, persisting for approximately one year. Chest X-ray revealed he was missing the right posterior fifth rib. Physical examination showed no surgical scars, and he reported no history of chest trauma. A CT of his chest demonstrated a mass involving the posterior aspect of the right fifth rib, and subsequent biopsy revealed plasma cells. Laboratory results indicated the tumor was a solitary plasmacytoma of the rib. He was referred to oncology and treated with radiation therapy. This case report illustrates an unusual presentation of a solitary plasmacytoma of the rib.

  16. Extramedullary Cardiac Multiple Myeloma-A Case Report and Contemporary Review of the Literature.

    Coakley, Maria; Yeneneh, Beeletsega; Rosenthal, Allison; Fonseca, Rafael; Mookadam, Farouk


    Multiple myeloma (MM) is characterized by a clonal proliferation of plasma cells. Although the bone marrow is the usual site of involvement, extramedullary plasmacytomas (EMPs) also occur, affecting any tissue. Cardiac and pericardial involvement, although described, have been rare occurrences. We present the case of a 61-year-old female patient 47 days after autologous stem cell transplant for MM who developed cardiac tamponade owing to extramedullary recurrence of myeloma, pulmonary embolism, and takotsubo cardiomyopathy. We performed a review of the published studies of all cases of MM presenting at diagnosis or relapse with cardiac or pericardial involvement in the past 25 years. Including our patient, 34 patients with plasmacytoma involving cardiac or pericardial structures were identified from the literature search. Approximately equal numbers of patients were male and female (42% and 57%, respectively). The mean age was 62 years. Primary plasmacytomas accounted for 12% of the cases. A history of MM, EMP, or monoclonal gammopathy of uncertain significance was noted in two thirds of the cases (66.6%). Treatment included chemotherapy and/or high-dose corticosteroids in 81.1% of cases and 27% underwent radiation therapy. The reporting of all cases to date has focused on unusual findings, rather than treatment approaches or new therapeutic strategies that might benefit patients. We suggest the formation of a database of all cases of cardiac and pericardial EMPs, with a focus on predictive disease variables, standardized staging, outcomes, and survival, to ensure that patients are optimally treated in the modern era.

  17. Fractura mandibular patológica por plasmocitoma intraóseo Pathological mandibular fracture due to intraosseous plasmacytoma

    D. Antunes Freitas


    Full Text Available Los tumores de células plasmáticas se subclasifican en: Plasmocitomas solitarios de hueso, mieloma múltiple y plasmocitoma extramedular. El 80 % de estos últimos afecta la región de la cabeza y cuello surgiendo en el tejido blando del conducto respiratorio alto y, raras veces, en la cavidad bucal. La búsqueda de una enfermedad sistémica es importante es aquellos casos en los que se haga dicho diagnóstico. Se presenta el caso de un paciente, varón de 73 años de edad, residente en la localidad rural de Gran Mogol, en Minas Gerais (Brasil, La tomografía computarizada mostró hipodensidad y reabsorción osteolítica irregular en la base de la cresta alveolar mandibular izquierda. La lesión de medición 38,0×19,0×15,0 mm. En la TC se ve claramente la presencia de fractura patológica del lado izquierdo. La aspiración con aguja se realizó, donde se obtuvo sangre. Se realizó la biopsia incisional. El diagnóstico presuntivo fue ameloblastoma. La muestra de biopsia fue enviada para análisis anatomohistopatológica. La microscopía mostró células tumorales compuesto por células monomórficas, con núcleos ovalados, grandes periféricos, y excéntricos, nucléolos prominentes y citoplasma basófilo, rodeado por estroma escaso y la infiltración de hueso esponjoso. La prueba de orina se destinó específicamente a la proteína de Bence-Jones, que fue negativo. Las radiografías de cráneo y tórax fueron realizados y no mostró cambios. Luego completó un diagnóstico de Plasmocitoma solitario en la mandíbula. El paciente está sometido a radioterapia en el Servicio de Oncología de la Santa Casa de Misericordia. El paciente tuvo mucositis severa y cambios en el color facial como resultado de la radioterapia.Plasma cell tumors are subclassified into: Solitary plasmacytoma of bone, multiple myeloma and extramedullary plasmacytoma. 80% of the latter affects the region of the head and neck soft tissue arising in the upper respiratory

  18. MRI features of epidural extramedullary hematopoiesis

    Alorainy, Ibrahim A. E-mail:; Al-Asmi, Abdullah R.; Carpio, Raquel del


    A case of {beta}-thalassemia intermedia with spinal cord compression due to extramedullary hematopoiesis, which was successfully treated by blood transfusion, is presented. Emphasis was made on the MRI appearance of extramedullary hematopoiesis on different pulse sequences. The theories that aimed to explain the involvement of the epidural space by extramedullary hematopoiesis are discussed.

  19. Primary intradural extramedullary hydatid cyst.

    Kahilogullari, Gokmen; Tuna, Hakan; Aydin, Zafer; Colpan, Efkan; Egemen, Nihat


    Spinal hydatid cysts account for 1% of all cases of hydatid disease; primary intradural hydatid cysts are uncommon. We present a case of pathologically confirmed intradural spinal cyst hydatid in an otherwise healthy patient who showed no other evidence of systemic hydatid cyst disease. The patient presented with back pain, paraparesis, and weakness. An intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be a hydatid cyst by histopathologic examination after surgical removal. To our knowledge, this is the 25th case of hydatid cyst at an intradural extramedullary location reported in the literature.

  20. MRI findings of extramedullary haemopoiesis

    Chourmouzi, D.; Pistevou-Gompaki, K.; Plataniotis, G.; Skaragas, G.; Papadopoulos, L.; Drevelegas, A. [Dept. of Diagnostic Radiology and Radiation Oncology, AHEPA University Hospital, Thessaloniki (Greece)


    Extramedullary haemopoiesis (EH) is a compensatory process associated with chronic haemolytic anaemia. It is rare, however, for such an abnormality to cause spinal cord compression. We present two patients with known beta-thalassaemia intermedia who developed spinal cord compression due to masses of extramedullary haematopoietic tissue in the epidural space of the thoracic spine. The EH masses were diagnosed by MRI as an isointense epidural lesion on both T1- and T2-weighted images, compressing severely the spinal cord. After administration of a paramagnetic agent, an intermediate enhancement of the masses was evident. All the vertebral bodies had low to intermediate signal intensity as a result of displacement of fatty marrow by haematopoietic marrow. Expansion of thoracic ribs with bilateral paravertebral masses were characteristic. A small dose of radiotherapy was given and marked improvement in neurological symptoms was evident. An MRI examination established shrinkage of the mass and decompression of spinal cord. The role of MRI in diagnosis of EH masses is essential and radiation therapy is a very effective treatment for this rare complication. (orig.)

  1. A Solitary Plasmocytoma Case Causing Horner Syndrome

    Mustafa Vayvada


    Full Text Available Solitary plasmacytoma is a rare plasma cell tumour, when seen in the chest wall, it is important to diagnose since the treatment scheme and prognosis will vary, compared to primary malignant tumours of the chest wall. A 60-year-old male presented to our clinic with left shoulder pain radiating to the left axilla. Horner%u2019s syndrome symptoms were present, in further examination a chest wall mass located in the left upper lung lobe region was detected. Histopathologic diagnosis was solitary plasmocytoma via video-assisted thoracoscopy. The primary tumor of the rib malignancy causing Horner%u2019s syndrome is discussed with reference to the relevant literature.

  2. CASE REPORT Extramedullary haematopoiesis causing spinal cord ...

    Extramedullary haematopoiesis (EMH) is a rare cause of spinal cord compression. ... 6-week history of progressive muscle weakness, back pain, paraesthesia and spasm in ... The patient also underwent magnetic resonance imaging (MRI).

  3. Intradural extramedullary tuberculoma mimicking en plaque meningioma

    Ozek Erdinc


    Full Text Available In this paper we report an 18 year old woman with an intradural extramedullary tuberculoma mimicking en plaque meningioma located in the thoracic region. The patient was operated via thoracic laminoplasty and tumor was totally resected. On the follow-up examination the magnetic resonance imaging demonstrated the total excision of the tumor. Here we describe a case of intradural extramedullary tuberculoma of the spinal cord as a complication of tuberculosis meningitis in a previously healthy young female.

  4. Mass-like extramedullary hematopoiesis: imaging features

    Ginzel, Andrew W. [Synergy Radiology Associates, Houston, TX (United States); Kransdorf, Mark J.; Peterson, Jeffrey J.; Garner, Hillary W. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Murphey, Mark D. [American Institute for Radiologic Pathology, Silver Spring, MD (United States)


    To report the imaging appearances of mass-like extramedullary hematopoiesis (EMH), to identify those features that are sufficiently characteristic to allow a confident diagnosis, and to recognize the clinical conditions associated with EMH and the relative incidence of mass-like disease. We retrospectively identified 44 patients with EMH; 12 of which (27%) had focal mass-like lesions and formed the study group. The study group consisted of 6 male and 6 female subjects with a mean age of 58 years (range 13-80 years). All 12 patients underwent CT imaging and 3 of the 12 patients had undergone additional MR imaging. The imaging characteristics of the extramedullary hematopoiesis lesions in the study group were analyzed and recorded. The patient's clinical presentation, including any condition associated with extramedullary hematopoiesis, was also recorded. Ten of the 12 (83%) patients had one or more masses located along the axial skeleton. Of the 10 patients with axial masses, 9 (90%) had multiple masses and 7 (70%) demonstrated internal fat. Eight patients (80%) had paraspinal masses and 4 patients (40%) had presacral masses. Seven patients (70%) had splenomegaly. Eleven of the 12 patients had a clinical history available for review. A predisposing condition for extramedullary hematopoiesis was present in 10 patients and included various anemias (5 cases; 45%), myelofibrosis/myelodysplastic syndrome (4 cases; 36%), and marrow proliferative disorder (1 case; 9%). One patient had no known predisposing condition. Mass-like extramedullary hematopoiesis most commonly presents as multiple, fat-containing lesions localized to the axial skeleton. When these imaging features are identified, extramedullary hematopoiesis should be strongly considered, particularly when occurring in the setting of a predisposing medical condition. (orig.)

  5. Extramedullary paraspinal hematopoiesis in hereditary spherocytosis

    Gogia P


    Full Text Available Hereditary spherocytosis (HS is a common inherited hemolytic anemia due to red cell membrane defects. Extramedullary hematopoiesis is a compensatory response to insufficient bone marrow blood cell production. The preferred sites of extramedullary hematopoietic involvement are the spleen, liver and lymph nodes; but in HS, the posterior paravertebral mediastinum is also commonly involved. We report a case of a 50-year-old male who presented to us in respiratory distress and with bilateral paravertebral posterior mediastinal masses, which on trucut biopsy were found to be extra-hematopoietic masses; and the patient was found to have hereditary spherocytosis.

  6. Extramedullary Waldenström macroglobulinemia.

    Banwait, Ranjit; Aljawai, Yosra; Cappuccio, Joseph; McDiarmid, Serena; Morgan, Elizabeth A; Leblebjian, Houry; Roccaro, Aldo M; Laubach, Jacob; Castillo, Jorge J; Paba-Prada, Claudia; Treon, Steven; Redd, Robert; Weller, Edie; Ghobrial, Irene M


    Disease assessment in Waldenstrom Macroglobulinemia (WM) is dependent on the percent involvement of B-cell neoplasm in the bone marrow and IgM paraprotein in the serum. A subset of patients also demonstrates extramedullary involvement, which is infrequently examined. The role of extramedullary involvement in the diagnosis and prognosis of WM is poorly understood. The purpose of this study is to report the characteristics of WM patients with extramedullary disease (EMD). Nine hundred and eight-five patients with WM were evaluated at one academic center and the presence of EMD was assessed in these patients. Forty-three (4.4%) patients were identified to have EMD. Nine (21%) patients presented with involvement at WM diagnosis, while 34 (79%) developed EMD post-therapy for WM. Most frequent EMD sites involved were pulmonary (30%), soft tissue (21%), cerebrospinal fluid (23%), renal (8%), and bone (9%). The median overall survival at 10 years was 79% (95% CI: 57-90%). This is the first study to describe the clinical characteristics, response and overall survival in patients with extramedullary WM. Further studies to define the molecular characteristics of this entity and mechanisms of its development are warranted.

  7. A case of plasmacytoma of scalp in pediatric thalassemia human immunodeficiency virus positive child

    Swapan Kumar Mallick


    Full Text Available A 9-year-old female child, known case of beta thalassemia major and human immunodeficiency virus seropositive, presented with two slowly growing masses in the temporoparietal region of the skull on both sides. Irregular bony erosion at left parietal area with underlying scalp hematoma with similar change at the right side to a lesser degree were found. Fine needle aspiration cytology from masses showed abundant plasmacytoid cells some of which are binucleated along with free erythroblasts. Cytological features were suggestive of plasmacytoma. Serum protein electrophoresis showed no M-band. Urine was negative for Bence-Jones protein. Bone marrow biopsy showed no plasma cell neoplasm. Diagnosed as first reported case of primary multiple solitary plasmacyomas affecting bilateral temporoparietal bones in a pediatric patient, the child was treated with external beam radiation therapy to scalp lesions showing excellent results and on further follow-up showed no evidence of progressive disease.

  8. Extramedullary paraspinal hematopoiesis in thalassemia: CT and MRI evaluation

    Tsitouridis, J.; Stamos, S.; Hassapopoulou, E.; Tsitouridis, K.; Nikolopoulos, P


    We present a comparative CT and MRI study of the paraspinal extramedullary hematopoiesis in 32 thalassemic patients. The patients were classified into four groups according to the MRI and CT imaging findings. Active recent extramedullary paraspinal hematopoietic masses show soft tissue behavior in both CT and MRI. Older inactive masses reveal iron deposition or fatty replacement. Combined imaging findings of paraspinal extramedullary hematopoiesis revealed the phase of its evolution and the correct diagnosis.

  9. MRI of perineural extramedullary granulocytic sarcoma

    Graham, A. [Rehabilitation Medicine, Hunters Moor Neurological Rehabilitation Centre, Newcastle-Upon-Tyne (United Kingdom); Hodgson, T. [Neuroradiology Dept., Royal Hallamshire Hospital, Sheffield (United Kingdom); Jacubowski, J. [Neurosurgical Dept., Royal Hallamshire Hospital, Sheffield (United Kingdom); Norfolk, D. [Haematology Department, Leeds General Infirmary, Leeds LS1 3EX (United Kingdom); Smith, C. [Pathology Dept., Royal Hallamshire Hospital, Sheffield (United Kingdom)


    Granulocytic sarcoma is an extramedullary solid tumour consisting of myelogenous leukaemic blast cells, usually seen in acute myeloid leukaemia and less commonly in patients with chronic myeloid leukaemia or myeloproliferative disorders. Blast cells have a predilection for periosteal and perineural regions and rarely precede evidence of systemic disease. We present two patients, aleukaemic on peripheral blood counts, both at presentation and during subsequent treatment. We present the MRI features of this rare but important condition. (orig.)

  10. MR imaging of intradural extramedullary tumors

    Li, M.H.; Holtaas, S.; Larsson, E.M. (Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology)


    Thirty-one consecutive intradual extramedullary spinal tumors examined with MR at 0.3 T were reviewed. In 13 of the patients myelography had been performed. There were 11 patients with meningeoma, 14 with neuroma, one ependymoma, 3 metastases, and 2 lipomas. All tumours were surgically removed and verified by histology. The intradural extramedullary location of the tumors was accurately assessed by MR imaging in all patients and by myelography in 10 of 13. The MR diagnoses were in accordance with the histologic findings in 74% of cases. Compression of the spinal cord of cauda equina with widening of the subarachnoid space above and below the mass or outward displacement of epidural fat was characteristic of the intradural extramedullary tumors. The signal intensity of meningeoma as well as neuroma was slightly lower or equal to that of the cord on T1-weighted images, and equal to or higher than cord signal on T2-weighted images. Neuroma had a lower signal intensity on T1-weighted images and a higher signal intensity on T2-weighted images than meningeoma. Meningeoma appeared more homogeneous than neuroma and had a broad base towards the dura. (orig.).

  11. Insertional hypermutation in mineral oil-induced plasmacytomas.

    Knittel, Gero; Metzner, Mirjam; Beck-Engeser, Gabriele; Kan, Ada; Ahrends, Tomasz; Eilat, Dan; Huppi, Konrad; Wabl, Matthias


    Unless stimulated by a chronic inflammatory agent, such as mineral oil, plasma cell tumors are rare in young BALB/c mice. This raises the questions: What do inflammatory tissues provide to promote mutagenesis? And what is the nature of mutagenesis? We determined that mineral oil-induced plasmacytomas produce large amounts of endogenous retroelements--ecotropic and polytropic murine leukemia virus and intracisternal A particles. Therefore, plasmacytoma formation might occur, in part, by de novo insertion of these retroelements, induced or helped by the inflammation. We recovered up to ten de novo insertions in a single plasmacytoma, mostly in genes with common retroviral integration sites. Additional integrations accompany tumor evolution from a solid tumor through several generations in cell culture. The high frequency of de novo integrations into cancer genes suggests that endogenous retroelements are coresponsible for plasmacytoma formation and progression in BALB/c mice.

  12. Intracranial Extramedullary Hematopoiesis in Beta-Thalassemia

    Karki, Bivek; Xu, Yi Kai; Wu, Yuan Kui [Nan fang Hospital, Southern Medical University, Guangzhou (China); Tamrakar, Karuna [Zhujiang Hospital, Southern Medical University, Guangzhou (China)


    Extramedullary hematopoiesis (EMH) represents tumor-like proliferation of hemopoietic tissue which complicates chronic hemoglobinopathy. Intracranial EMH is an extremely rare occurrence. Magnetic resonance imaging (MRI) offers a precise diagnosis. It is essential to distinguish EMH from other extradural central nervous system tumors, because treatment and prognosis are totally different. Herein, we report the imaging findings of beta-thalassemia in a 13-year-old boy complaining of weakness of left side of the body and gait disturbance; CT and MRI revealed an extradural mass in the right temporoparietal region.

  13. File list: His.Bld.10.AllAg.Plasmacytoma [Chip-atlas[Archive

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  14. File list: His.Bld.05.AllAg.Plasmacytoma [Chip-atlas[Archive

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  15. File list: His.Bld.20.AllAg.Plasmacytoma [Chip-atlas[Archive

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  17. File list: ALL.Bld.20.AllAg.Plasmacytoma [Chip-atlas[Archive

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  1. CT of disseminated plasmacytoma - in an AIDS patient

    Leder, D.S.; Nazarian, L.N.; Burke, M. [Thomas Jefferson Univ., Philadelphia, PA (United States)


    It is well known that acquired immunodeficiency syndrome (AIDS) is associated with increased risk of neoplasms, particularly Kaposi sarcoma and non-Hodgkin lymphoma. There have been several recent reports in the literature describing plasma cell tumors in AIDS patients. We report the imaging findings in a case of widely disseminated plasmacytoma in a patient with known AIDS. 7 refs., 3 figs.

  2. Intracranial involvement in plasmacytomas and multiple myeloma: a pictorial essay

    Cerase, Alfonso; Gennari, Paola; Monti, Lucia; Venturi, Carlo [Azienda Ospedaliera Universitaria Senese, Unit of Diagnostic and Therapeutic Neuroradiology, and InterDepartmental Center of Nuclear Magnetic Resonance, Policlinico ' Santa Maria alle Scotte' , Siena (Italy); Tarantino, Annachiara; Muccio, Carmine Franco [Azienda Ospedaliera ' G. Rummo' , Unit of Neuroradiology, Department of Neurosciences, Benevento (Italy); Gozzetti, Alessandro [University of Siena, Unit of Hematology and Transplants, Policlinico ' Santa Maria alle Scotte' , Siena (Italy); Di Blasi, Arturo [Azienda Ospedaliera ' G. Rummo' , Unit of Pathology, Department of Oncology, Benevento (Italy)


    The purpose of this pictorial essay is to increase awareness of the clinical presentation, neuroradiological findings, treatment options, and neuroradiological follow-up of plasmacytomas and multiple myeloma with intracranial growth. This pictorial essay reviews the clinical features and neuroradiological findings in seven patients (four women, three men; age range at diagnosis 62-82 years) followed in two institutions. Six patients, one with IgG-{kappa} plasmacytoma, and five with IgG-{kappa}(n=3), IgG-{lambda}(n=1), and nonsecretory (n=1) multiple myeloma, had been seen over a period of 9 years in one institution, and the other patient with IgG-{kappa} plasmacytoma had been seen over a period of 3.5 years in the other. Intracranial involvement is rare, most frequently resulting from osseous lesions in the cranial vault, skull base, nose, or paranasal sinuses. Primary dural or leptomeningeal involvement is rarer. Some typical findings of a dural and/or osseous plasmacytoma include iso- to hyperdensity on CT scan, T1 equal to high signal intensity and T2 markedly hypointense signal on MRI, and high vascularity possibly documented on intraarterial digital subtraction angiography. However, the neuroradiological findings generally lack specificity, since they are generally no different from those of meningioma, metastasis, lymphoma, dural sarcoma, plasma cell granuloma, infectious meningitis, and leptomeningeal carcinomatosis. The spectrum of clinical and neuroradiological evaluation shows that intracranial involvement from plasmacytoma and multiple myeloma must be taken into account in the differential diagnosis of cranial osseous and meningeal disease. (orig.)

  3. Bumblebees and solitary bees

    Henriksen, Casper Christian I

    Summary: The effects of farming system, flower resources and semi-natural habitats on bumblebees and solitary bees in intensively cultivated landscapes in Denmark were investigated in two sets of studies, in 2011 and 2012. The pan trap colour preferences of bumblebees and solitary bees were also...... assessed. In 2011, bumblebees and solitary bees were trapped in road verges bordering 14 organic (organic sites) and 14 conventional (conventional sites) winter wheat fields. The quantity and quality of local flower resources in the road verge and adjacent field headland were estimated as overall density...... use as a proxy at four different scales (250, 500, 750 and 1000 m). In 2012, the effect of a four-fold larger area of organic arable fields in simple, homogeneous landscapes on bumblebees and solitary bees was investigated in eight circular landscapes (radius 1000 m). Bumblebees and solitary bees were...

  4. Extramedullary Hematopoiesis: An Unusual Finding in Subdural Hematomas

    Rong Li


    Full Text Available We present a case of a 59-year-old man who was found to have clusters of hyperchromatic, small, round nucleated cells within a subdural hematoma removed after a skull fracture. Immunohistochemistry study confirmed that the cells were hematopoietic components predominantly composed of normoblasts. In this paper, we describe the clinical and pathological findings. A brief review of published information on extramedullary hematopoiesis in subdural hematoma and the mechanisms of pathogenesis are also discussed. While extramedullary hematopoiesis is seen anecdotally by neuropathologists in chronic subdural hematomas, only a few cases are documented in the literature. Furthermore, extramedullary hematopoiesis in subdural hematoma can pose a diagnostic challenge for general pathologists who encounter subdural hematoma evacuations seldom in their surgical pathology practices.

  5. Successful surgical resection of solitary plasmacytoma of the liver mimicking hepatocellular carcinoma. A case report.

    Mirarchi, Mariateresa; De Raffele, Emilio; Bacci, Francesco; Cuicchi, Dajana; Lecce, Ferdinando; Cola, Bruno

    Il plasmocitoma extramidollare solitario (SEMP) del fegato è una neoplasia estremamente rara. Viene riferito il caso di un’anziana donna affetta da un voluminoso SEMP con caratteristiche simili a quelle di un carcinoma epatocellulare (HCC). Si tratta di una donna di 89 anni giunta alla nostra osservazione con un dolore addominale piuttosto severo, di recente insorgenza, ed una voluminosa massa situata nell’ipocondrio destro. I dati di laboratorio all’ingresso non evidenziavano alterazioni della funzionalità epatica; i valori di alfa-fetoproteinemia erano nella norma; non erano presenti markers di un’infezione da virus dell’epatite B e C. Una tomografia assiale computerizzata (TC) multifasica documentava la presenza di una voluminosa neoplasia dell’emifegato sinistro, ipodensa alle immagini senza mezzo di contrasto, disomogeneamente iperdensa in fase arteriosa, e con “washout” nelle fasi portale e di equilibrio. Una tomografia ad emissione di positroni con 18F-FDG (18FFDG PET)-TC evidenziava una marcata captazione del radiocomposto da parte della neoplasia, in assenza peraltro di metastasi a distanza. Le caratteristiche cliniche e radiologiche della lesione erano interpretate come compatibili con una diagnosi di HCC scarsamente differenziato con aree di necrosi intralesionale verosimilmente in evoluzione verso la rottura spontanea. La valutazione clinica complessiva ci faceva reputare accettabile il rischio chirurgico e la paziente veniva sottoposta ad un’epatectomia sinistra con resezione parziale dell’emidiaframma destro. Il decorso postoperatorio era sostanzialmente regolare e la paziente veniva dimessa in 12° giornata postoperatoria. L’esame istologico definitivo deponeva per un plasmocitoma extramidollare. L’analisi immunoistochimica dimostrava che le cellule tumorali esprimevano CD45, CD38, IRF4, HTPD52, catene leggere kappa ma non catene leggere lambda; l’indice di proliferazione Mib-1 era del 50%. La successiva valutazione clinica permetteva di escludere qualsiasi manifestazione di mieloma multiplo; si giungeva pertanto alla diagnosi di plasmocitoma extramidollare localizzato esclusivamente al fegato. Stando ai dati della letteratura scientifica, si tratta del primo caso di SEMP del fegato sottoposto con successo ad una resezione epatica curativa. La paziente è vivente ed in buone condizioni cliniche a distanza di 5 anni dall’intervento chirurgico, in assenza di recidive locoregionali e di manifestazioni di mieloma multiplo.

  6. Primary plasmacytoma of the thyroid gland: a case report of a rare neoplasia Plasmocitoma da glândula tireoide: relato de caso de uma rara neoplasia

    Eduardo Cambruzzi


    Full Text Available Extramedullary plasmacytoma comprises 3%-5% of all plasma cell neoplasms, and approximately 80% of the cases occur in the upper respiratory tract. Primary thyroid plasmacytomas (PTP are rare tumors. The authors report a case of PTP in a male patient with dyspnea and dysphagia. Physical examination and computerized tomography (CT scan revealed a solid tumor affecting the thyroid gland, measuring 12 cm in its greatest dimension. Surgical biopsy was performed. Microscopy revealed a hypercellular malignant neoplasm composed of round plasmacytoid cells arranged in solid nests, which showed a positive immunoexpression for CD138, epithelial membrane antigen (AME, kappa light chains and multiple myeloma oncogene 1 (MUM1. The diagnosis of PTP was accordingly established.O plasmocitoma extramedular constitui 3%-5% de todas as neoplasias de plasmócitos e aproximadamente 80% dos casos ocorrem no trato respiratório superior. Plasmocitomas primários da tireoide (TPP são tumores raros. Os autores relatam um caso de TPP em um paciente masculino referindo dispneia e disfagia. O exame físico e a tomografia computadorizada revelaram tumor sólido comprometendo a glândula tireoide, medindo 12 cm na maior dimensão, o qual foi submetido à biópsia cirúrgica. À microscopia, foi identificada neoplasia maligna hipercelular constituída por células redondas/plasmocitoides dispostas em ninhos sólidos, as quais exibiam imunoexpressão positiva para CD138, antígeno da membrana epitelial (AME, cadeias leves kappa e oncogene mieloma múltiplo 1 (MUM1. O diagnóstico de TPP foi, então, estabelecido.

  7. Non-exposed variant of bisphosphonate-related osteonecrosis of the jaw (BRONJ with a plasmacytoma: A rare case report

    Arvind Muthukrishnan


    Full Text Available Bisphoshonate-related osteonecrosis of the jaw (BRONJ is an avascular osteo-chemonecrosis of the jaw which results after administration of the group of drugs called as bisphosphonates. Bisphosphonates are given to prevent bone resorption in osteolytic diseases such as Paget′s, osteoporosis, osteogenic carcinoma, and other carcinomas where there could be metastasis and bone resorption. Incidence of BRONJ is reported to be high in western literature and is found to be more after intravenous route compared to oral route of administration. There are various clinical stages of BRONJ as per the American Association of Oral and Maxillofacial Surgeons (AAOMS. Here, we present a rare case of a 60-year-old lady who presented with a complaint of a painless swelling in the alveolus and gingiva in the left maxillary posterior region. This patient was on intravenous Zolendronate for more than 4 years. Thorough examination with detailed investigations revealed BRONJ along with a coexisting second primary tumor, plasmacytoma. Metastasis to distant site is a common feature of malignancy. A metastatic lesion usually occurs within 6 months to 1 year after treatment of a primary lesion. Any fresh neoplasm beyond 1 or 2 years after detection of a primary can be regarded as a second primary tumor. Solitary bone plasmacytoma is a localized form of plasma cell tumor. Diagnosis is based on the presence of the following: Malignant proliferation of plasma cells in biopsy, absence of osteolytic bone lesion, absence of Bence Jones proteins, low concentration of monoclonal proteins, elevated IgG and gamma globulin levels.

  8. [Spondylodiscitis after embolization of an extramedullary intraspinal arteriovenous fistula].

    Baudrillard, J C; Toubas, O; Lerais, J M; Auquier, F; Gatfosse, M; Bernard, M H


    The authors report a case of spondylitis Th11-Th12 occurred 1 month after embolization of an intraspinal extramedullary arteriovenous fistulae; this fistulae was fed by 11th left intercostal artery. The infecting organism isolated from the affected intervertebral disc was streptococcus sanguis a common agent of dental abscess.

  9. Presacral extramedullary haematopoiesis with involvement of the sciatic nerve

    Ruiz Carazo, E.; Ortega Herrera, R.; Rull, J.P. [Department of Radiology, University Hospital, Granada (Spain); Muros de Fuentes, T. [Department of Endocrinology, University Hospital, Granada (Spain); Marcos Munoz, C. [Department of Pathology, University Hospital, Granada (Spain)


    We present the case of a 60-year-old woman with no known blood disease who developed an extramedullary haematopoiesis of presacral localization that affected the right sciatic nerve. The diagnosis was made with imaging studies and CT-guided fine-needle aspiration. (orig.) With 4 figs., 12 refs.

  10. Solitary Tibial Osteolytic Lesion

    Emilios E. Pakos


    Full Text Available We report an unusual case of solitary osteolytic tibial metastasis from a primary endometrial cancer in a 62-year-old woman. The primary cancer was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy combined with postoperative external beam radiotherapy, while the tibial metastasis was treated with an above knee amputation. The rarity of the case lies on the fact that metastases distally to the elbow and knee are uncommon and endometrial cancer rarely gives distal bone metastases and particularly solitary to the extremities.

  11. Extramedullary Myeloid Cell Tumour Presenting As Leukaemia Cutis

    Thappa Devinder Mohan


    Full Text Available We herewith report a case of extramedullary myeloid cell tumour presenting as leukaemia cutis for its rarity. It occurred in a 50 year old male patient who presented to us with a 40 days history of painless raised solid skin swellings over the trunk. Histopathological examination of the skin biopsy and bone marrow biopsy showed features suggestive of non-Hodgkin’s lymphoma. Immunophenotyping on skin biopsy specimens and bone marrow biopsy found tumour cells expressing CD43 and Tdt but were negative for CD3 and CD20. These features were consistent with extramedullary myeloid cell tumour involving skin and subcutis (cutaneous manifestation of acute myeloid leukaemia.

  12. Extramedullary intradural spinal tumors; Extramedullaere intradurale spinale Tumoren

    Papanagiotou, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)


    The category of extramedullary intradural tumors includes a variety of lesions ranging from meningiomas originating from meningeal cells and nerve sheath tumors (neurofibromas, schwannomas) to less common primary tumors, such as lipomas, ependymomas, hemangiopericytomas, epidermoid cysts and dermoid cysts. Extramedullary metastases can occur as transcoelomic metastases in tumors of the central nervous system (CNS) or metastasization from other tumors. Magnetic resonance imaging (MRI) is the method of choice for localization and characterization of these lesions before treatment. (orig.) [German] Die Kategorie der extramedullaeren intraduralen Tumoren enthaelt Laesionen, die von den Nervenhuellen (Schwannome und Neurofibrome) oder von den meningealen Zellen ausgehen (Meningeome). Ependymome, Lipome, Haemangioperizytome, Epidermoidzysten und Dermoidzysten entsprechen selteneren primaeren Tumoren. Extramedullaere Metastasen koennen als Abtropfmetastasen bei ZNS-Tumoren oder als Metastasierung anderer Karzinomerkrankungen auftreten. Die Magnetresonanztomographie (MRT) ist die Methode der Wahl zur Abklaerung einer intraduralen Raumforderung. (orig.)

  13. Spinal Cord Compression Secondary to Extramedullary Hematopoiesis in Thalassemia

    Mohammad Hadi Bagheri; Jalal Jalal Shokouhi; Farrokh Habibzadeh; Aliakbar Ameri


    Backgroud/Objective: Extramedullary hematopoiesis (EMH) is a physiological response to chronic anemia and may rarely cause spinal cord compression. Herein, we describe 9 thalassemic patients presenting with signs and symptoms of cord compression either due to epidural mass or spinal canal stenosis secondary to bone widening. Since this emergency condition can be readily diagnosed by MRI and has medical rather than surgical treatment, i.e., blood transfusion and/or low dose radiation therapy, ...

  14. Premature epiphyseal fusion and extramedullary hematopoiesis in thalassemia

    Colavita, N.; Orazi, C.; Danza, S.M.; Falappa, P.G.; Fabbri, R.


    The main skeletal abnormalities in ..beta..-thalassemia are widening of medullary spaces, rarefaction of bone trabeculae, thinning of cortical bone, and perpendicular periosteal spiculation. Premature epiphyseal fusion (PEF) and extramedullary hematopoiesis (EH) are found, though more rarely. The incidence of PEF and EH in 64 patients affected by ..beta..-thalassemia is reported. The different incidence of such complications in thalassemia major and intermedia is reported, and a possible correlation with transfusion regimen is also considered.

  15. Solitary midbrain metastasis.

    Ongerboer de Visser, B W; Moffie, D


    The available clinical and pathological data of 5 cases with solitary midbrain metastasis including 2 of the present study are reviewed. Progressive dementia occurred in one case and mild dementia in another who also developed ocular symptoms. Ocular symptoms with sensory and coordination disturbances were seen in one, and only ocular symptoms in another case. Right-sided hemiplegia of 5 years duration occurred in the remaining case. Survival in tegmentum lesions is short.

  16. Solitary intraosseous neurofibroma of mandible.

    Vivek N


    Full Text Available Solitary intraosseous neurofibroma is a rare benign non-odontogenic tumor. Although neurofibromas occur predominantly as a feature of neurofibromatosis affecting the soft tissue, a few cases of solitary intraosseous neurofibromas of the jaw have been reported. We herewith report a case of solitary intraosseous neurofibroma of mandible in a middle-aged woman with a discussion on its clinical, radiological, and histopathological presentation along with review of cases.

  17. Plasmacytoma with amyloidosis masquerding as tuberculosis on cytology

    Sharma Neelam


    Full Text Available Amyloid material on lymph node cytology smears can mimic caseous necrosis. We report one such case where a 50-year-old lady presented with a nasal mass and cervical lymphadenopathy. Fine needle aspiration cytology smears of the cervical lymph node were interpreted as tuberculous lymphadenitis based on the presence of an occasional epithelioid cell and caseous material. The patient did not respond to antituberculous therapy and was revaluated. Repeat aspiration from the lymph node showed numerous plasma cells and myeloma cells in addition to the amorphous material which was confirmed to be amyloid on staining with congo red. A diagnosis of plasmacytoma with amyloidosis was rendered. Imprint smears from nasal mass, detailed hematology workup and subsequent histology confirmed the diagnosis.

  18. Unilateral hemilaminectomy for patients with intradural extramedullary tumors

    Cai-xing SUN; Xu-li MENG; Shang-nao XIE; Yang YU; Hong-jian YANG; Bin WU


    A modified hemilaminectomy was introduced in an attempt to explore the operative techniques and the values of the limited approach to spinal cord tumors.Forty-five consecutive patients with intradural extramedullary lesions,who underwent modified hemilaminectomy,were studied retrospectively.The intraspinal tumors were removed via the limited bone window with a 3.3-cm mean length (range:2.0-6.5 cm) and a 1.2-cm mean width (range:0.6-1.5 cm),in which the inner parts of the medial and lateral laminae were mostly undercut for wider view.Spinal lesions were cervical in 21 cases,thoracic in 12 cases,lumbar in 10 cases,and multiple in 2 cases.Forty-three cases were completely excised via hemilaminectomy alone.Two subjects with dumbbell neurinoma underwent two-stage tumor removal via anterolateral cervical approach following hemilaminectomy.With respect to neurological status,the percentage of good Frankel scale (D+E grade) was markedly improved from 22.2% on admission to 93.3% at follow-up.At the median 26-month follow-up evaluation by magnetic resonance imaging (MRI),none of the subjects showed spinal deformity or instability.By preserving musculoligamentous attachments and posterior bony elements as much as possible,the modified approach is minimally invasive and may be routinely used to remove intradural and extramedullary tumors,especially in patients with meningiomas and neurinomas.

  19. Myelomatous ascites as an initial manifestation of extramedullary involvement of multiple myeloma

    Choi, Seo Youn; Lee, Hae Kyung; Yi, Boem Ha; Lee, Min Hee; Kim, Hee Kyung; Park, Seong Kyu [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)


    Multiple myeloma is a common hematological malignancy. Aggressive myeloma invades the organs outside the bone marrow, lymph, or reticuloendothelial systems. Among the extramedullary involvements of multiple myeloma, myelomatous ascites are extremely rare and are associated with a poor prognosis. We describe a case of myelomatous ascites as an initial manifestation of extramedullary involvement of multiple myeloma in 39-year-old patient. The patient was treated with high-dose chemotherapy, but extensive extramedullary involvement progressed, and the patient expired approximately five months after the initial detection of ascites.

  20. Skeletal Plasmacytoma: Progression of disease and impact of local treatment; an analysis of SEER database

    Scully Sean P


    Full Text Available Abstract Background Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of developing myeloma and determine the prognostic factors affecting the progression of disease. Methods Patients with plasmacytoma diagnosed between 1973 and 2005 were identified in the SEER database(1164 patients. Patient demographics and clinical characteristics, treatment(s, cause of death, and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze prognostic factors. Results The five year survival among patients initially diagnosed with plasmacytoma that later progressed to multiple myeloma and those initially diagnosed with multiple myeloma were almost identical (25% and 23%; respectively. Five year survival for patients with plasmacytoma that did not progress to multiple myeloma was significantly better (72%. Age > 60 years was the only factor that correlated with progression of disease (p = 0.027. Discussion Plasmacytoma consists of two cohorts of patients with different overall survival; those patients that do not progress to systemic disease and those that develop myeloma. Age > 60 years is associated with disease progression. Identifying patients with systemic disease early in the treatment will permit aggressive and novel treatment strategies to be implemented.

  1. Solitary eyelid schwannoma

    Renu M Magdum


    Full Text Available Schwannomas are rare benign tumors arising from Schwann cells of peripheral nerves that form the neural sheath. While there have been reports of such tumors in the orbit, solitary schwannomas arising from the eyelids are very rare. There are reports of schwannomas being erroneously diagnosed as chalazion, inclusion cysts or even eyelid malignancy. We are reporting a case of a 20-year-old female who presented with a painless, non-tender, slow-growing mass in the upper eyelid of the right eye. The external appearance of the mass was suggestive of an implantation cyst of the eyelid and it could be completely excised as it had a well-defined capsule. Histopathological examination showed characteristic hypercellular and hypocellular areas with fusiform nuclei that tended to form palisades. The purpose of reporting this case of schwannoma in a young female is to recommend the inclusion of this entity as a differential diagnosis of well-defined lid tumors.

  2. Solitary Polypoid Laryngeal Xanthoma

    Francisco Vera-Sempere


    Full Text Available We report the case of a 51-year-old male smoker with diabetes mellitus and hyperlipidaemia and a long history of human immunodeficiency virus (HIV/hepatitis C virus (HCV infection treated with various antiretroviral regimes, who was referred to the otolaryngology department with progressive dysphonia. Fibre-optic laryngoscopy showed a solitary, yellowish-white pedunculated polyp on the anterior third of the left cord, with no other abnormality. Pathological analysis revealed a polypoid laryngeal xanthoma that was immunoreactive against CD68, perilipin, and adipophilin. This unusual laryngeal lesion in the clinical context of our patient suggests a possible role of antiretroviral treatment in the pathogenesis of these xanthomas.

  3. Solitary fibrous tumor

    Manlio Mencoboni


    Full Text Available Solitary fibrous tumor (SFT is a rare mesenchymal neoplasm which may be found everywhere in the body. It is now distinguished into two forms, pleural and extrapleural, which morphologically resemble each other. Abdomi­nal localizations are quite rare, with 10 cases only reported in bladder; rarely they can be source of paraneoplastic syndromes (i.e., hypoglycemia secondary to insulin-like growth factor. In April 2006 a 74-year-old white male presented with chills, diaphoresis and acute abdominal pain with hematuria. At admission in emergency he underwent an abdominal X-ray (no pathological findings and an ultrasound examination of the kidneys and urinary tract, which revealed a pelvic hyperechogenic neoformation measuring approximately 10¥8¥7 cm, compressing the bladder. Blood chemistry at admission revealed only a mild neutrophilic leucocytosis (WBC 16600, N 80%, L 11%, elevated fibrinogen and ESR, and hypoglycemia (38 mg/dL. Macro­scopic hematuria was evident, while urinocolture was negative. Contrast enhanced CT scan of the abdomen and pelvic region revealed a large round neoformation dislocating the bladder, with an evident contrast-enhanced periphery and a central necrotic area. Continuous infusion of glucose 5% solution was necessary in order to maintain blood glucose levels above 50 mg/dL. The patient underwent complete surgical resection of an ovoidal mass coated by adipose tissue, with well delimited margins; histological findings were consistent with solitary fibrous tumor (SFT. Hypoglycemia resolved completely with removal of the growth. In this case report we describe a SFT growing in the bladder, a quite rare localization, which presented a unique hypoglycemia. In contrast to the majority of cases reported in the literature, the behavior of this SFT was not aggressive, and, since the patient is still alive, surgical resection was considered conclusive.

  4. Adrenal extramedullary hematopoiesis associated with β-thalassemia major

    Bijan Keikhaei


    Full Text Available The presence of apparently normal hematopoietic tissue outside of bone marrow cavity is defined as extramedullary hema - topoiesis (EMH. EMH is a rare complication in thalassemia major (TM and adrenal gland as well. This report describes a case of adrenal EMH in a 26-year-old man with β-TM. He has been transfused with regular blood transfusion since 9 months. During the routine physical examination he was incidentally found to have a hypoechoic mass at his abdominal ultrasonography. Abdominal computed tomography scan revealed a right well-defined suprarenal mass 7.7¥7.3¥5.8 cm in size. The diagnosis of EMH was confirmed with ultrasonographic-guided fine needle biopsy. Treatment options which include intensified regular blood transfusion and hydroxyurea have been started.

  5. Spinal cord compression due to epidural extramedullary haematopoiesis in thalassaemia: MRI

    Aydingoez, Ue.; Oto, A.; Cila, A. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)


    Spinal epidural extramedullary haematopoiesis is very rare in thalassaemia. A 27-year-old man with thalassaemia intermedia presented with symptoms and signs of spinal cord compression. MRI showed a thoracic spinal epidural mass, representing extramedullary haematopoietic tissue, compressing the spinal cord. Following radiotherapy, serial MRI revealed regression of the epidural mass and gradual resolution of spinal cord oedema. (orig.) With 3 figs., 6 refs.

  6. Solitary spinal dural syphilis granuloma mimicking a spinal meningioma.

    Zhou, Heng-Jun; Zhan, Ren-Ya; Chen, Man-Tao; Cao, Fei; Zheng, Xiu-Jue


    Dural granuloma is extremely rare. To our knowledge, there has no case reported solitary spinal dural syphilis granuloma worldwide so far. Here we report our findings in a 49-year-old woman, who presented with 10-year progressive left lower-limb numbness and two weeks of right lower-limb numbness. Magnetic resonance imaging (MRI) suggested a homogeneous enhanced spindle-shaped lesion, 2.9 × 1.5 cm in size, occupying the spinal intradural extramedullary space, at the level of Thoracic (T)-2/3, which mimicked the appearance of spinal meningioma. The Treponema pallidum particle agglutination (TPPA) test titer of 1:8, and the venereal diseases research laboratory of cerebral spinal fluid (VDRL-CSF) was reactive, so confirmed neurosyphilis was considered. After formal anti-syphilis treatment, posterior laminectomy surgery was performed, and the lesion was completely separated and extirpated. Final histopathologic diagnosis of the lesion was confirmed as chronic granulomatous inflammation, combined with the neurosyphilis history, spinal dural syphilis granuloma was finally diagnosed. Postoperatively, the patient recovered without any further treatment.

  7. Pulmonary Extramedullary Hematopoiesis in a Patient with Chronic Asthma Resembling Lung Cancer: A Case Report

    Massood Hosseinzadeh


    Full Text Available Background. Extramedullary hematopoiesis is most often seen in reticuloendothelial organs specially spleen, liver, or lymph nodes, and it is rarely seen in lung parenchyma. Almost all reported cases of pulmonary extramedullary hematopoiesis occurred following myeloproliferative disorders specially myelofibrosis. Other less common underlying causes are thalassemia syndromes and other hemoglobinopathies. There was not any reported case of pulmonary extramedullary hematopoiesis in asthmatic patients in the medical literature. Case. Here we reported a 65-year-old lady who was a known case of bronchial asthma with recent developed right lower lobe lung mass. Chest X-ray and CT studies showed an infiltrating mass resembling malignancy. Fine needle aspiration cytology of mass revealed pulmonary extramedullary hematopoiesis. The patient followed for 10 months with serial physical examination and laboratory evaluations which were unremarkable. Conclusion. Extramedullary hematopoiesis of lung parenchyma can be mistaken for lung cancer radiologically. Although previous reported cases occurred with myelofibrosis or hemoglobinopathies, we are reporting the first case of asthma-associated extramedullary hematopoiesis.

  8. Clinical Features of Intradural Extramedullary Spinal Cord Metastases 
in Primary Lung Cancer

    Yan XU


    Full Text Available Background and objective Intradural extramedullary spinal cord metastases in lung cancer is rare, and it leads to severe neurological damage. The aim of this study is to identify the clinical features of intradural extramedullary spinal cord metastases in primary lung cancer patients. Methods The 8 cases of lung cancer with intradural extramedullary metastases, who were hospitalized in Peking Union Medical College Hospital (PUMCH during May 2013 to May 2016, were enrolled in the retrospective study. Medical charts of the 8 patients were reviewed systematically. Results Intradural extramedullary spinal cord metastases was diagnosed in 7 cases with non-small cell lung cancer (NSCLC and 1 case with small cell lung cancer (SCLC. Cauda equina syndrome was the most common clinical manifestation. Malignant cells in cerebrospinal fluid were positive in all the 5 cases (100% who underwent lumbar puncture. Contrast-enhanced magnetic resonance imaging (MRI of spine manifested as diffuse abnormal enhancement of pial lining of spinal cordin 3 cases, intradural extramedullary nodules in 4 cases, and both of them in 1 case. Neurological symptoms were improved or stable in 4 cases who underwent targeted therapy and/or radiotherapy. The median overall survival was 5.8 months. Conclusion Intradural extramedullary spinal cord metastases can be diagnosed with caution according to its neurological symptoms and contrast-enhanced MRI presentation.Targeted therapy and/or radiotherapy may be effective for symptoms control.

  9. An intracranial extramedullary hematopoiesis in a 34-year-old man with beta thalassemia: a case report

    Tabesh Homayoun


    Full Text Available Abstract Introduction Extramedullary hematopoiesis occurs in approximately 15% of cases of thalassemia. Intracranial deposits of extramedullary hematopoiesis are an extremely rare compensatory process in intermediate and severe thalassemia. Case presentation We present an unusual case of an intracranial extramedullary hematopoiesis with a choroid plexus origin in a 34-year-old Caucasian man with beta thalassemia intermedia, who presented with the complaints of chronic headache and rapid progressive visual loss. Conclusion An intracranial extramedullary hematopoiesis, although extremely rare, should be considered as a potential ancillary diagnosis in any thalassemic patient and therefore appropriate studies should be performed to investigate the probable intracranial ectopic marrow before any surgical intervention.

  10. Progression of cutaneous plasmacytoma to plasma cell leukemia in a dog.

    Rout, Emily D; Shank, Alba Maria M; Waite, Angharad H K; Siegel, Andrea; Avery, Anne C; Avery, Paul R


    A 5-year-old male neutered Bernese Mountain Dog was presented for cutaneous plasmacytoma, which was treated by surgical excision. Four months later, the dog developed multiple skin masses, hyphema, pericardial and mild bicavitary effusions, myocardial masses, and marked plasmacytosis in the peripheral blood. Circulating plasma cells expressed CD34 and MHC class II by flow cytometry. Immunocytochemistry demonstrated that these cells were strongly positive for multiple myeloma oncogene 1/interferon regulatory factor 4 (MUM-1) and weakly to moderately positive for Pax5. The dog was hypoglobulinemic but had a monoclonal IgA gammopathy detected by serum immunofixation electrophoresis. The PCR analysis of antigen receptor gene rearrangements (PARR) by fragment analysis using GeneScan methodology revealed that plasmacytoid cells in the original cutaneous plasmacytoma and peripheral blood had an identical immunoglobulin heavy chain gene (IgH) rearrangement, indicating that both populations were derived from the same neoplastic clone. Canine cutaneous plasmacytoma rarely progresses to a malignant form and plasma cell leukemia is rarely diagnosed in the dog. This report describes a case of cutaneous plasmacytoma progressing to plasma cell leukemia with a rapid and aggressive clinical course. This report also highlights the utility of flow cytometry, immunocytochemistry, immunofixation electrophoresis, and PARR by fragment analysis using GeneScan methodology in the diagnosis of this hematopoietic neoplasm.

  11. Plasmacytoma of the ovary: additional role of 18F-FDG PET/CT.

    Santhosh, Sampath; Mittal, Bhagwant Rai; Raveendran, Ainharan; Jain, Vanita; Nijhawan, Raje; Kumar, Ritesh; Bhattacharya, Anish; Sharma, Suresh C


    We report a case of ovarian plasmacytomas where 18F-FDG PET/CT helped in staging by demonstrating increased FDG uptake limited to the ovary, and hence, surgical treatment was carried out as the disease was localized to the ovary.

  12. Plasmacytoma with aberrant expression of myeloid markers, T-cell markers, and cytokeratin

    Shin, J S; Stopyra, G A; Warhol, M J;


    variations in immunophenotype occur. We describe a case of a plasmacytoma from a patient who presented with sudden onset of pain and a lytic lesion of the left proximal humerus. Hematoxylin and eosin-stained sections showed a lymphoproliferative lesion composed of large lymphoid cells, some with plasmacytoid...

  13. Primary cerebellar extramedullary myeloid cell tumor mimicking oligodendroglioma.

    Ho, D M; Wong, T T; Guo, W Y; Chang, K P; Yen, S H


    Extramedullary myeloid cell tumors (EMCTs) are tumors consisting of immature cells of the myeloid series that occur outside the bone marrow. Most of them are associated with acute myelogenous leukemia or other myeloproliferative disorders, and a small number occur as primary lesions, i.e., are not associated with hematological disorders. Occurrence inside the cranium is rare, and there has been only one case of primary EMCT involving the cerebellum reported in the literature. The case we report here is a blastic EMCT occurring in the cerebellum of a 3-year-old boy who had no signs of leukemia or any hematological disorder throughout the entire course. The cerebellar tumor was at first misdiagnosed as an "oligodendroglioma" because of the uniformity and "fried egg" artifact of the tumor cells. The tumor disappeared during chemotherapy consisting of 12 treatments. However, it recurred and metastasized to the cerebrospinal fluid (CSF) shortly after the therapy was completed. A diagnosis of EMCT was suspected because of the presence of immature myeloid cells in the CSF, and was confirmed by anti-myeloperoxidase and anti-lysozyme immunoreactivity of the cerebellar tumor. The patient succumbed 1 year and 3 months after the first presentation of the disease.

  14. A perisinusoidal niche for extramedullary haematopoiesis in the spleen

    Acar, Melih; Murphy, Malea M.; Richardson, James; Zhao, Zhiyu; Morrison, Sean J.


    Haematopoietic stresses mobilize haematopoietic stem cells (HSCs) from the bone marrow to the spleen and induce extramedullary haematopoiesis (EMH). However, the cellular nature of the EMH niche is unknown. Here, we assessed the sources of the key niche factors, SCF and CXCL12, in the mouse spleen after EMH induction by myeloablation, blood loss, or pregnancy. In each case, Scf was expressed by endothelial cells and Tcf21+ stromal cells, primarily around sinusoids in the red pulp, while Cxcl12 was expressed by a subset of Tcf21+ stromal cells. EMH induction markedly expanded the Scf-expressing endothelial cells and stromal cells by inducing proliferation. Most splenic HSCs were adjacent to Tcf21+ stromal cells in red pulp. Conditional deletion of Scf from spleen endothelial cells or Scf or Cxcl12 from Tcf21+ stromal cells severely reduced spleen EMH and reduced blood cell counts without affecting bone marrow haematopoiesis. Endothelial cells and Tcf21+ stromal cells thus create a perisinusoidal EMH niche in the spleen, which is necessary for the physiological response to diverse haematopoietic stresses. PMID:26570997

  15. A perisinusoidal niche for extramedullary haematopoiesis in the spleen.

    Inra, Christopher N; Zhou, Bo O; Acar, Melih; Murphy, Malea M; Richardson, James; Zhao, Zhiyu; Morrison, Sean J


    Haematopoietic stresses mobilize haematopoietic stem cells (HSCs) from the bone marrow to the spleen and induce extramedullary haematopoiesis (EMH). However, the cellular nature of the EMH niche is unknown. Here we assessed the sources of the key niche factors, SCF (also known as KITL) and CXCL12, in the mouse spleen after EMH induction by myeloablation, blood loss, or pregnancy. In each case, Scf was expressed by endothelial cells and Tcf21(+) stromal cells, primarily around sinusoids in the red pulp, while Cxcl12 was expressed by a subset of Tcf21(+) stromal cells. EMH induction markedly expanded the Scf-expressing endothelial cells and stromal cells by inducing proliferation. Most splenic HSCs were adjacent to Tcf21(+) stromal cells in red pulp. Conditional deletion of Scf from spleen endothelial cells, or of Scf or Cxcl12 from Tcf21+ stromal cells, severely reduced spleen EMH and reduced blood cell counts without affecting bone marrow haematopoiesis. Endothelial cells and Tcf21(+) stromal cells thus create a perisinusoidal EMH niche in the spleen, which is necessary for the physiological response to diverse haematopoietic stresses.

  16. Diplopia and variable ptosis as the sole initial findings in a case of orbital plasmacytoma and multiple myeloma.

    Galea, Martin; McMillan, Nigel; Weir, Clifford


    Plasmacytomas are monoclonal plasma cell tumors. They represent 3% of all orbital tumors. We present an unusual case of orbital plasmacytoma and advanced multiple myeloma where the sole presenting symptoms were those of diplopia and ptosis. Clinical examination revealed right hypertropia and variable left upper lid ptosis but no proptosis. The visual acuity and the rest of the ocular examination were normal in both eyes. An MRI scan of the brain and orbits revealed a frontal bone lesion consistent with a plasmacytoma. A bone marrow biopsy showed a light chain multiple myeloma with free lambda light chains. Although the literature reports diplopia and ptosis as being clinical features of orbital plasmacytomas, to our knowledge this is the first reported case where these symptoms were the only presenting features, despite widespread disease.

  17. Solitary mastocytoma in an adult

    Jain V


    Full Text Available A 24-year old female developed late onset solitary mastocytoma on the left forearm. She complained of intense pruritus off and on which was not associated with flushing of face and blister formation over the nodule. Darier′s sign was positive. Excisional biopsy was done and histopathology confirmed the diagnosis.

  18. Solitary waves and homoclinic orbits

    Balmforth, N.J.


    The notion that fluid motion often organizes itself into coherent structures has increasingly permeated modern fluid dynamics. Such localized objects appear in laminar flows and persist in turbulent states; from the water on windows on rainy days, to the circulations in planetary atmospheres. This review concerns solitary waves in fluids. More specifically, it centres around the mathematical description of solitary waves in a single spatial dimension. Moreover, it concentrates on strongly dissipative dynamics, rather than integrable systems like the KdV equation. One-dimensional solitary waves, or pulses and fronts as they are also called, are the simplest kinds of coherent structure (at least from a geometrical point of view). Nevertheless, their dynamics can be rich and complicated. In some circumstances this leads to the formation of spatio-temporal chaos in the systems giving birth to the solitary waves, and understanding that phenomenon is one of the major goals in the theory outlined in this review. Unfortunately, such a goal is far from achieved to date, and the author assess its current status and incompleteness.


    Giorgina Specchia


    Full Text Available

    In acute promyelocytic leukemia (APL, extramedullary disease (EMD is particularly rare and shows special clinical and biological features. It is estimated that about 3–5% of APL patients will suffer extramedullary relapse. The most common site of EMD in APL is the CNS.  At present, there are still many issues of EMD in APL needing further clarification, including pathogenesis, risk factors, prognosis and treatment. A better understanding of the biological mechanisms underlying EMD is important to be able to devise more effective CNS prophylaxis and induction-consolidation therapeutic strategies

  20. Extramedullary Involvement of Mast Cell Leukemia Detected by 18F-FDG PET/CT.

    Fu, Zhanli; Zhang, Jin; Liu, Meng; Li, Ziao; Li, Qian


    Mast cell leukemia (MCL) is a very rare subtype of systemic mastocytosis, characterized by the leukemic expansion of immature mast cells. We present a case of MCL with extramedullary involvement of cervical lymph node and lung demonstrated by the initial F-FDG PET/CT scan. After a transient complete remission by induction chemotherapy and allogeneic hematopoietic stem cell transplantation, the follow-up PET/CT showed extensive extramedullary relapse involving multiple lymph nodes and small bowel. F-FDG PET/CT may be a useful tool to comprehensively stage and follow-up MCL.


    Francesco Albano


    Full Text Available In acute promyelocytic leukemia (APL, extramedullary disease (EMD is particularly rare and shows special clinical and biological features. It is estimated that about 3–5% of APL patients will suffer extramedullary relapse. The most common site of EMD in APL is the CNS.  At present, there are still many issues of EMD in APL needing further clarification, including pathogenesis, risk factors, prognosis and treatment. A better understanding of the biological mechanisms underlying EMD is important to be able to devise more effective CNS prophylaxis and induction-consolidation therapeutic strategies

  2. Functional Characterization of the Plasmacytoma Variant Translocation 1 Gene (PVT1) in Diabetic Nephropathy

    M Lucrecia Alvarez; Johanna K. DiStefano


    We previously observed association between variants in the plasmacytoma variant translocation 1 gene (PVT1) and end-stage renal disease (ESRD) attributed to both type 1 and type 2 diabetes, and demonstrated PVT1 expression in a variety of renal cell types. While these findings suggest a role for PVT1 in the development of ESRD, potential mechanisms for involvement remain unknown. The goal of this study was to identify possible molecular mechanisms by which PVT1 may contribute to the developme...

  3. Intradural extramedullary spinal cord tumors: a retrospective study at tertiary referral hospital

    Govind Mangal


    Full Text Available Introduction: Intradural extramedullary (IDEM spinal cord tumours account two thirds of all intraspinal tumours. The objective of this study was to determine short- and long-term outcomes of surgical patients with IDEM spinal cord tumours, and to see clinical features that could be helpful in management of patients with these lesions (operated by single senior surgeononly.

  4. Imaging of spinal cord compression due to thoracic extramedullary haematopoiesis in myelofibrosis

    Guermazi, A.; Miaux, Y.; Chiras, J. [Department of Neuroradiology `Charcot`, Salpetriere Hospital, Paris (France)


    We describe a case of spinal cord compression secondary to extramedullary haematopoiesis in a patient with primary myelofibrosis. We show that MRI should be the procedure of choice for patients suspected of this condition. Furthermore, it could be of value for assessing the extent of cord compression, planning radiotherapy and for follow-up. (orig.). With 2 figs.

  5. Extramedullary Manifestation in Multiple Myeloma Bears High Incidence of Poor Cytogenetic Aberration and Novel Agents Resistance

    Xiaoyan Qu


    Full Text Available Extramedullary disease (EMD in multiple myeloma (MM patients is an uncommon event and more attention was directed toward the feature of these patients. Cytogenetic aberration is an important characteristic of MM and is associated with patients’ outcome. In this study, we aimed to compare the cytogenetic abnormality of patients with and without extramedullary manifestation, and to analyze the clinical outcomes of novel agents in EMD patients. We retrospectively investigated data from 41 MM patients. Our analyses showed del(17p13 in 31% of EMD versus 13% of medullary disease (P=0.03 and amp(1q21 in 55% versus 32% (P=0.019. No differences were shown in del(13q14 and t(4;14. 24/27 patients with EMD at diagnosis responded to the novel agents-containing regimens. However, when relapsed, 70% of patients did not benefit from the sequential use of novel agents as salvage therapy. In 14 patients who developed EMD at relapse phase, only 2 patients responded to novel agents therapy. Median overall survival of patients with extramedullary manifestations was 30 months, in comparison to 104 months for patients without EMD (P=0.002. Patients with extramedullary manifestation bore high incidence of poor cytogenetic aberration and novel agents resistance.

  6. Intramedullary versus extramedullary fixation in the management of subtrochanteric femur fractures: a meta-analysis

    Liu PC


    Full Text Available Pengcheng Liu,1,2,* Xing Wu,1,* Hui Shi,1,2 Run Liu,1 Hexi Shu,1 JinPeng Gong,1 Yong Yang,1 Qi Sun,1 Jiezhou Wu,1,2 Xiaoyang Nie,1 Ming Cai1 1Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, Shanghai, 2First Clinical Medical College, Nanjing Medical University, Nanjing, People’s Republic of China *These authors contributed equally to this work Background: Intramedullary and extramedullary fixation methods are used in the management of subtrochanteric femur fractures. However, whether intramedullary or extramedullary fixation is the primary treatment for subtrochanteric femur fractures in adults remains debatable.Level of evidence: Meta-analyses of prospective studies, level I.Materials and methods: The Cochrane library, Embase, Google Scholar, and PubMed databases were searched separately for all relevant studies published before January 1, 2015. No language restriction was applied. Prospective randomized controlled trials that compared intramedullary or extramedullary internal fixation to repair subtrochanteric femur fractures in adults were included. We determined intraoperative data, postoperative complications, fracture fixation complications, wound infection, hospital stay days, and final outcome measures to assess the relative effects of different internal fixation methods for the treatment of subtrochanteric femur fractures in adults.Results: Six studies were included in our meta-analysis. The relative risks (RRs of revision rate was 83% lower (RR, 0.17, 95% confidence interval [CI], 0.05 to 0.60; P=0.006, fixation failure rate was 64% lower (RR, 0.36, 95% CI, 0.12 to 1.08; P=0.07, non-union rate was 77% lower (RR, 0.23, 95% CI, 0.07 to 0.81; P=0.02 in the intramedullary group compared with the extramedullary group. No significant differences were found between the intramedullary group and extramedullary group for intraoperative data, postoperative complications, wound infection

  7. Solitary angiokeratoma of the tongue.

    Sion-Vardy, Netta; Manor, Esther; Puterman, Max; Bodner, Lipa


    Angiokeratoma is a rare cutaneous lesion. It can be either a generalized systemic form, presenting as multiple asymptomatic papules on the skin, associated with metabolic diseases or a solitary cutaneous form. Oral cavity involvement is more common in the systemic form, as a part of a more generalized cutaneous disease, but very rare in the localized form of angiokeratoma. A 45-year-old female presented with a painless lesion on the tongue of one months duration, which bled occasionally. On clinical examination, a lesion of approximately 5 mm in diameter was observed on the left surface of the tongue. The lesion was purple in color with a granulomatous appearance. There were no other changes in the oral mucosa. On dermatologic examination, no angiokeratomas were found, anywhere on the skin. The lesion was excised under local anesthesia. The histologic diagnosis was angiokeratoma. A case of a solitary angiokeratoma of the tongue is reported. We report here the third intra-oral case and the second case in the tongue with solitary angiokeratoma.

  8. Multi-component optical solitary waves

    Kivshar, Y. S.; Sukhorukov, A. A.; Ostrovskaya, E. A.


    We discuss several novel types of multi-component (temporal and spatial) envelope solitary waves that appear in fiber and waveguide nonlinear optics. In particular, we describe multi-channel solitary waves in bit-parallel-wavelength fiber transmission systems for highperformance computer networks......, multi-color parametric spatial solitary waves due to cascaded nonlinearities of quadratic materials, and quasiperiodic envelope solitons due to quasi-phase-matching in Fibonacci optical superlattices. (C) 2000 Elsevier Science B.V. All rights reserved....

  9. Kidney and Pancreatic Extramedullary Relapse in Adult Acute Lymphoblastic Leukemia: A Case Report and Review of the Literature

    Leslie Skeith


    Full Text Available Extramedullary relapse of acute lymphoblastic leukemia (ALL is rare and has been primarily reported in pediatric patients or hematopoietic stem cell transplant recipients. We report a case of a 62-year-old woman who presented with relapsed ALL involving her kidneys, pancreas, and bone marrow 2 years after completing chemotherapy with a standard ALL protocol. Unfortunately, her extramedullary disease progressed despite treatment. To the best of our knowledge, this is the first reported case of extramedullary relapse of B-cell ALL to the kidneys and pancreas occurring in an adult patient who had not previously undergone a hematopoietic stem cell transplant. A literature review of kidney and pancreatic extramedullary relapse in ALL is also included.

  10. [Solitary plasmocytoma of the mandible].

    Laurent, F; Chausse, J M; Toccanier, M F; Kuffer, R


    The authors present a case of solitary bony plasmocytoma of the mandibule, with local amyloid deposition. Diagnosis was made at extemporaneous pathological examination, then confirmed by the examination of the fixed surgical sample. Immunoenzymologically the proliferation proved to be monoclonal, with secretion of kappa light chain. The patient was treated by surgical curettage and homologous cancelous bone filling, followed by 5,500 rads of electrontherapy. He was then regularly controlled during 8 years and remained free from local recurrence. All investigations in search of dissemination (Kahler disease) remained negative.

  11. Solitary Fibrous Tumor of the Stomach

    Hussain, Qulsoom; Shafique, Khurram; Hurairah, Abu; Grossman, Evan B.


    Solitary fibrous tumor is a rare mesenchymal neoplasm that usually originates from the pleura, but has been reported in other extrapleural locations. We report a rare case of a solitary fibrous tumor of the stomach, which was successfully treated with endoscopic mucosal resection. PMID:28286800

  12. Solitary intraosseous neurofibroma of the tibia

    Huang, Guo-Shu; Chang, Wei-Chou; Juan, Chun-Jung; Chen, Cheng-Yu. [National Defense Medical Center, Department of Radiology, Tri-Service General Hospital, Neihu 114, Taipei (Taiwan); Lee, Chian-Her [National Defense Medical Center, Department of Orthopedic Surgery, Tri-Service General Hospital, Neihu 114, Taipei (Taiwan); Lee, Herng-Sheng [National Defense Medical Center, Department of Pathology, Tri-Service General Hospital, Neihu 114, Taipei (Taiwan)


    A solitary intraosseous neurofibroma is rare and mostly occurs in the mandible. We report a case of a solitary intraosseous neurofibroma of the tibia. The radiographic findings were nonspecific and showed an eccentrically located, osteolytic lesion with a thin sclerotic border in the diaphysis of the left proximal tibia. The entity of intraosseous neurofibroma is briefly reviewed. (orig.)

  13. Solitary Waves in Relativistic Electromagnetic Plasma

    XIE Bai-Song; HUA Cun-Cai


    Solitary waves in relativistic electromagnetic plasmas are obtained numerically. The longitudinal momentum of electrons has been taken into account in the problem. It is found that in the moving frame with electromagnetic field propagating the solitary waves can exist in both cases, where the vector potential frequency is larger or smaller than the plasma characteristic frequency.

  14. Intramedullary versus extramedullary alignment of the tibial component in the Triathlon knee

    Synnott Keith


    Full Text Available Abstract Background Long term survivorship in total knee arthroplasty is significantly dependant on prosthesis alignment. Our aim was determine which alignment guide was more accurate in positioning of the tibial component in total knee arthroplasty. We also aimed to assess whether there was any difference in short term patient outcome. Method A comparison of intramedullary versus extramedullary alignment jig was performed. Radiological alignment of tibial components and patient outcomes of 103 Triathlon total knee arthroplasties were analysed. Results Use of the intramedullary was found to be significantly more accurate in determining coronal alignment (p = 0.02 while use of the extramedullary jig was found to give more accurate results in sagittal alignment (p = 0.04. There was no significant difference in WOMAC or SF-36 at six months. Conclusion Use of an intramedullary jig is preferable for positioning of the tibial component using this knee system.

  15. Intramedullary versus extramedullary alignment of the tibial component in the Triathlon knee

    Cashman, James P


    Abstract Background Long term survivorship in total knee arthroplasty is significantly dependant on prosthesis alignment. Our aim was determine which alignment guide was more accurate in positioning of the tibial component in total knee arthroplasty. We also aimed to assess whether there was any difference in short term patient outcome. Method A comparison of intramedullary versus extramedullary alignment jig was performed. Radiological alignment of tibial components and patient outcomes of 103 Triathlon total knee arthroplasties were analysed. Results Use of the intramedullary was found to be significantly more accurate in determining coronal alignment (p = 0.02) while use of the extramedullary jig was found to give more accurate results in sagittal alignment (p = 0.04). There was no significant difference in WOMAC or SF-36 at six months. Conclusion Use of an intramedullary jig is preferable for positioning of the tibial component using this knee system.

  16. Extramedullary hemopoiesis with undiagnosed, early myelofibrosis causing spastic compressive myelopathy: Case report and review

    Dewan Udita


    Full Text Available Extramedullary hemopoiesis (EMH is a common compensatory phenomenon associated with chronic hemolytic anemia. Abnormal hemopoietic tissue usually develops in sites responsible for fetal hemopoiesis, such as spleen, liver and kidney; however, other regions such as the spine may also become involved. In this study, a patient presenting with spastic paraparesis due to EMH in the dorsal spine is described. A 62-year-old man presented with paraparesis. Magnetic resonance imaging revealed a large lesion involving the T2-L2 vertebral levels with a large extradural component causing thecal sac compression. Laminectomy with excision of mass was carried out. The histopathology revealed EMH. The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis. This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

  17. Mixed capillary-cavernous extramedullary intradural hemangioma of the spinal cord mimicking meningioma: Case report.

    Alobaid, Abdullah; Bennardo, Michael Ross; Cenic, Aleksa; Lach, Boleslaw


    Hemangiomas are customarily described as low-grade vascular tumors most often located in the head and neck, but on rare occasions occurring in the intradural space of the spine. The different subtypes of hemangiomas can be distinguished histologically as capillary, cavernous, or mixed types. We describe a rare case of a mixed capillary-cavernous extramedullary intradural hemangioma of the thoracic spinal cord, mimicking meningioma radiologically.

  18. Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera

    Ito, Shuhei; Hosogane, Naobumi; Nagoshi, Narihito; Yagi, Mitsuru; Iwanami, Akio; Watanabe, Kota; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Ishii, Ken


    Extramedullary hematopoiesis (EMH) occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH. PMID:28133558

  19. Extramedullary haematopoiesis in Thalassaemia: results of radiotherapy: a report of three patients

    Pistevou-Gompaki, K.; Paraskevopoulos, P.; Kotsa, K. [Theagenion Cancer Center, Thessaloniki (Greece); Skaragas, G.; Repanta, E. [Saint Paul`s Hospital, Thessaloniki (Greece)


    Extramedullary haematopoiesis is sometimes encountered in serve anaemia. Rarely, it may cause neurological symptoms, leading to spinal cord or cauda equina compression. Three patients with thalassaemia intermedia, who developed neurological complications, are described. The diagnoses were based on the clinical findings, computed tomography and magnetic resonance imaging. Small doses of radiotherapy (10-20 Gy in 5-10 fractions) relieved symptoms in all of these patients. Our experience supports the role of radiation therapy as a treatment for this complication. (Author).

  20. Management of Extramedullary Haematopoises in Thalassaemia with Radiotherapy: A case report and review of literature

    Thejaswini b,


    Full Text Available Extramedullary haematopoises (EMH is a very rare cause for spinal cord compression but is a well described entity with relation to chronic haemolytic anemias like thalassemia. Radiation therapy has a documented role in the management of this condition. We would like to report a case of a 28 year old man with underlying thalassemia major presenting with paraparesis and sensory loss, successfully treated with radiotherapy. [Natl J Med Res 2015; 5(2.000: 163-165

  1. Isolated extra-medullary relapse of acute leukemia following allogeneic bone marrow transplantation.

    Firas, Al Sabty; Demeckova, E; Bojtarova, E; Czako, B; Hrubisko, M; Mistrik, M


    Isolated extramedullary relapse (IEMR) of acute leukemia (AL) after allogeneic bone marrow transplantation (BMT) is a rare occurrence. It is seen more commonly after BMT than after conventional chemotherapy (CHT) alone. We describe the natural history and response to treatment in four patients with IEMR following allogeneic BMT. The results indicate a stronger graft-versus-leukemia (GVL) effect in the marrow than in the peripheral tissues (Fig. 4, Ref. 13). Full Text (Free, PDF)

  2. Clonal diversification of primary BALB/c plasmacytomas harboring T(12;15) chromosomal translocations.

    Kovalchuk, A L; Mushinski, E B; Janz, S


    DNA sequence analysis of PCR amplified Igh/c-myc junction fragments of T(12;15) chromosome translocations and immunohistochemical determination of immunoglobulin isotype production were employed to study the clonal diversification of neoplastic translocated plasma cells that resided in peritoneal inflammatory granulomas of BALB/c mice harboring primary plasmacytomas. The diversity of plasma cells was found to take two major forms when the fine structure of the T(12;15) translocation was used as the clonotypic marker. First, mosaics of clones containing translocations that were apparently unrelated to each other were detected in nine out of 17 (53%) mice. Second, subclones derived from common T(12;15)+ progenitors by either secondary deletions in translocation breakpoint regions or aberrant isotype switching near translocation breaksites were found in five of 17 (29.5%) mice. When Ig expression was utilized as the clonotypic marker, clonal mosaics were shown to occur in all mice. This was demonstrated by the finding that the prevalent IgA- or IgG-producing plasmacytoma clone was invariably accompanied by smaller clones of IgG- or IgA-expressing neoplastic plasma cells, respectively. These results provided new insights into the clonal diversification at the terminal stage of plasmacytomagenesis. In addition, they suggested that BALB/c plasmacytomas may be uniquely useful for studying clonal diversity during B cell oncogenesis, since clonal evolution can be evaluated in a pool of tumor and tumor precursor cells that is clearly defined by the T(12;15) chromosomal translocation and the production of monoclonal immunoglobulin.

  3. Correlation of magnetic resonance imaging findings of spinal intradural extramedullary schwannomas with pathologic findings

    Kim, Yeo Ju; Park, In Suh; Yoon, Seung Hwan; Choi, Suk Jin; Kim, Youn Jeong; Kang, Young Hye; Lee, Ha Young; Kim, Woo Chul; Han, Jun Gu; Cho, Soon Gu [Inha University Hospital, Incheon (Korea, Republic of)


    To evaluate the magnetic resonance imaging (MRI) findings of spinal intradural extramedullary schwannomas with pathologic correlation and to determine whether these schwannomas share the imaging features of schwannomas in the peripheral nerves. The MRIs of 17 cases of pathologically proven spinal intradural extramedullary schwannomas were reviewed retrospectively, and cystic changes, enhancement, and intratumoral hemorrhage of the tumors were evaluated. Imaging features known to be common findings of schwannoma in the peripheral nerves, such as encapsulation, the target sign, the fascicular sign, and visualization of entering or exiting nerve rootlets, were also evaluated. The histopathology of the tumors was correlated with the MRI findings. Cystic changes were detected in 14 cases by MRI and in 16 cases by pathology. The most common pattern of enhancement was a thick peripheral septal pattern (70.59%). Intratumoral hemorrhage was detected in four cases on MRI, but in all cases on pathology. Encapsulation was observed in all cases. The fascicular sign was seen in only four cases, and thickening of an exiting rootlet was visualized in one case. None of the cases showed the target sign. Spinal intradural extramedullary schwannomas were typical encapsulated cystic tumors and had few imaging features of schwannomas in the peripheral nerves.

  4. [Extramedullary onset of mixed phenotype acute leukemia with MLL gene rearrangement].

    Kawashima, Ichiro; Shobu, Yuki; Yamamoto, Takeo; Hamanaka, Satoshi; Nozaki, Yumi; Nakajima, Kei; Mitsumori, Toru; Kirito, Keita


    Rearrangements of the mixed lineage leukemia MLL gene at chromosome 11q23 are common chromosomal abnormalities in human leukemia. MLL fused with numerous partner genes causes different leukemia phenotypes that depend on the function of partner genes. MLLT3-MLL is generated by translocation t(9;11), which primarily induces acute myeloid leukemia in humans, whereas MLLT3-MLL induces ALL or biphenotypic leukemia in mice. The microenvironment that surrounds leukemia cells plays a central role in this process. We report a patient with mixed phenotype acute leukemia with MLLT3-MLL. This patient, a 44-year-old woman, initially exhibited extramedullary leukemia with multiple tumors and subsequently developed bone marrow disease. The leukemia cells exhibited myeloid (CD13 and MPO) and B cell (CD19 and CD79a) phenotypes. Chromosomal analysis and RT-PCR assay revealed tumor cells with the MLLT3-MLL fusion gene. We treated this patient with a drug regimen for AML (Ara-C plus anthracycline), and complete remission was obtained. This report describes the fourth case of mixed phenotypic leukemia with extramedullary disease. The extramedullary circumstance may underlie the biphenotypic features of these patients.

  5. Successful treatment of primary advanced gastric plasmacytoma using a combination of surgical resection and chemotherapy with bortezomib: A case report

    Sotaro Fukuhara


    Conclusions: This is the first reported case of advanced gastric plasmacytoma using adjuvant chemotherapy involving bortezomib and auto-PBSCT after the resection, and the patient has maintained a good course over a year. This protocol could be a new way to treat these tumors.

  6. Plasmacytoma Mimicking Mediastinal Parathyroid Tumour in a Patient with Primary Hyperparathyroidism

    Jubbin Jagan Jacob


    Full Text Available The association of monoclonal gammopathies with primary hyperparathyroidism is well documented. Many case reports have documented the coexistence of primary hyperparathyroidism and multiple myeloma. The cause of this relationship is not known. We report the case of a 49-year-old gentleman who was treated for primary hyperparathyroidism. His initial preoperative nuclear scan had shown persistent activity and retention of tracer in the retrosternal region in addition to the discrete hot spot in the region of the lower pole of the left lobe of the thyroid. During surgery, the enlarged left inferior parathyroid gland was removed. In addition, the retrosternal area was also explored and found to be normal. Ten months later, he developed a mass in the region of the manubrium sternii which was proven to be a plasmacytoma. We review the literature for similar cases and suggest hypotheses for a possible association. In conclusion, coexisting plasma cell dyscrasias including plasmacytoma should be considered in patients with primary hyperparathyroidism.

  7. Transversally periodic solitary gravity–capillary waves

    Milewski, Paul A.; Wang, Zhan


    When both gravity and surface tension effects are present, surface solitary water waves are known to exist in both two- and three-dimensional infinitely deep fluids. We describe here solutions bridging these two cases: travelling waves which are localized in the propagation direction and periodic in the transverse direction. These transversally periodic gravity–capillary solitary waves are found to be of either elevation or depression type, tend to plane waves below a critical transverse period and tend to solitary lumps as the transverse period tends to infinity. The waves are found numerically in a Hamiltonian system for water waves simplified by a cubic truncation of the Dirichlet-to-Neumann operator. This approximation has been proved to be very accurate for both two- and three-dimensional computations of fully localized gravity–capillary solitary waves. The stability properties of these waves are then investigated via the time evolution of perturbed wave profiles. PMID:24399922

  8. Solitary Fibrous Tumor of the Uterus

    Po-Wei Chu


    Conclusion: The behavior of solitary fibrous tumors arising from the uterus is difficult to evaluate; therefore, complete surgical excision featuring clear margins and comprehensive follow-up is recommended.

  9. Management of the Solitary Pulmonary Nodule.

    Chan, Edward Y; Gaur, Puja; Ge, Yimin; Kopas, Lisa; Santacruz, Jose F; Gupta, Nakul; Munden, Reginald F; Cagle, Philip T; Kim, Min P


    Context .- Optimal management of the patient with a solitary pulmonary nodule entails early diagnosis and appropriate treatment for patients with malignant tumors, and minimization of unnecessary interventions and procedures for those with ultimately benign nodules. With the growing number of high-resolution imaging modalities and studies available, incidentally found solitary pulmonary nodules are an increasingly common occurrence. Objective .- To provide guidance to clinicians involved in the management of patients with a solitary pulmonary nodule, including aspects of risk stratification, workup, diagnosis, and management. Data Sources .- Data for this review were gathered from an extensive literature review on the topic. Conclusions .- Logical evaluation and management pathways for a patient with a solitary pulmonary nodule will allow providers to diagnose and treat individuals with early stage lung cancer and minimize morbidity from invasive procedures for patients with benign lesions.

  10. Conservative numerical methods for solitary wave interactions

    Duran, A; Lopez-Marcos, M A [Departamento de Matematica Aplicada y Computacion, Facultad de Ciencias, Universidad de Valladolid, Paseo del Prado de la Magdalena s/n, 47005 Valladolid (Spain)


    The purpose of this paper is to show the advantages that represent the use of numerical methods that preserve invariant quantities in the study of solitary wave interactions for the regularized long wave equation. It is shown that the so-called conservative methods are more appropriate to study the phenomenon and provide a dynamic point of view that allows us to estimate the changes in the parameters of the solitary waves after the collision.

  11. Comparison of extramedullary and intramedullary devices for treatment of subtrochanteric femoral fractures at tertiary level center

    Yadav Sanjay


    Full Text Available Objective: The treatment of subtrochanteric fractures is challenging and treatment modalities and implants are constantly evolving. This study attempts to revisit and compare extramedullary vs. intramedullary devices in relatively young population. Methods: Thirty patients with subtrochanteric fractures were enrolled and treated with extramedullary or intramedullary devices and follow-up continued one year for clinico-radiological assessment. Results: The mean age of patients was 37.53 years. Most were males between 21-40 years old. The dominant mode of injury was traffic accidents (66%. Fractures were classifi ed according to Russell-Taylor classifi cation. Forty percent were Russell-Taylor type IA, 37% type IB and 23% type IIA. Average time to surgery was 3.6 days from the time of admission to hospital. Mean duration of surgery was 45 minutes for intramedullary device (group A and 105 minutes for extramedullary device (group B. Average blood loss was 100 ml in group A and 200 ml in group B. Mean duration of radiation exposure was 130 seconds and 140 seconds for groups A and B, while average duration of hospital stay was 12 days and 16 days respectively. Excellent results were seen in 47% of cases in group A and 33% of cases in group B. Conclusion: Intramedullary device is a reliable implant for subtrochanteric fractures. It has high rates of union with minimal soft-tissue damage. Intramedullary fixation has biological and biomechanical advantages, but surgery is technically demanding. Gradual learning and patience is needed to make this method truly rewarding. Key words: Subtrochanteric fractures; Intramedullary; Dynamic hip screw

  12. Comparison of minimally invasive transspinous and open approaches for thoracolumbar intradural-extramedullary spinal tumors.

    Raygor, Kunal P; Than, Khoi D; Chou, Dean; Mummaneni, Praveen V


    OBJECT Spinal tumor resection has historically been performed via open approaches, although minimally invasive approaches have recently been found to be effective in small cohort series. The authors compare surgical characteristics and clinical outcomes of surgery in patients undergoing mini-open and open approaches for intradural-extramedullary tumor resection. METHODS The authors retrospectively reviewed 65 consecutive intradural-extramedullary tumor resections performed at their institution from 2007 to 2014. Patients with cervical tumors or pathology demonstrating neurofibroma were excluded (n = 14). The nonparametric Mann-Whitney U-test and Pearson chi-square test were used to compare continuous and categorical variables, respectively. Statistical analyses were performed using SPSS, with significance set at p Spinal Injury Association (ASIA) score, preoperative symptom duration, American Society of Anesthesiologists (ASA) physical status class, tumor size, or tumor location. There was no statistically significant difference between groups with respect to the duration of the operation or extent of resection, but the mean estimated blood loss was significantly lower in the minimally invasive surgery (MIS) cohort (142 vs 320 ml, p meningioma. There were no statistically significant differences in length of hospitalization, ASIA score improvement, complication rate, or recurrence rate. The mean duration of follow-up was 2 years for the MIS group and 1.6 years for the open surgery group. CONCLUSIONS This is one of the largest comparisons of minimally invasive and open approaches to the resection of thoracolumbar intradural-extramedullary tumors. With well-matched cohorts, the minimally invasive transspinous approach appears to be as safe and effective as the open technique, with the advantage of significantly reduced intraoperative blood loss.

  13. Comparison of extramedullary and intramedullary devices for treatment of subtrochanteric femoral fractures at tertiary level center

    Sanjay Yadav; Shivendra Sinha; Edwin Luther; Naresh Chander Arora; Manish Prasad; Rohit Varma


    Objective:The treatment of subtrochanteric fractures is challenging and treatment modalities and implants are constantly evolving.This study attempts to revisit and compare extramedullary vs.intramedullary devices in relatively young population.Methods:Thirty patients with subtrochanteric fractures were enrolled and treated with extramedullary or intramedullary devices and follow-up continued one year for clinico-radiological assessment.Results:The mean age of patients was 37.53 years.Most were males between 21-40 years.The dominant mode of injury was traffic accidents (66%).Fractures were classified according to Russell-Taylor classification.Forty percent were Russell-Taylor type ⅠA,37% type ⅠB and 23% type ⅡA.Average time to surgery was 3.6 days from the time of admission to hospital.Mean duration of surgery was 45 minutes for intramedullary device (group A) and 105 minutes for extramedullary device (group B).Average blood loss was 100 ml in group A and 200ml in group B.Mean duration of radiation exposure was 130 seconds and 140 seconds for groups A and B,while average duration of hospital stay was 12 days and 16 days respectively.Excellent results were seen in 47% of cases in group A and 33% of cases in group B.Conclusion:Intramedullary device is a reliable implant for subtrochanteric fractures.It has high rates of union with minimal soft-tissue damage.Intramedullary fixation has biological and biomechanical advantages,but surgery is technically demanding.Gradual leaming and patience is needed to make this method truly rewarding.

  14. Improved patient quality of life following intradural extramedullary spinal tumor resection.

    Viereck, Matthew J; Ghobrial, George M; Beygi, Sara; Harrop, James S


    OBJECTIVE Resection significantly improves the clinical symptoms and functional outcomes of patients with intradural extramedullary tumors. However, patient quality of life following resection has not been adequately investigated. The aim in this retrospective analysis of prospectively collected quality of life outcomes is to analyze the efficacy of resection of intradural extramedullary spinal tumors in terms of quality of life markers. METHODS A retrospective review of a single institutional neurosurgical administrative database was conducted to analyze clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) for pain, and the EQ-5D-3 L descriptive system were used to analyze quality of life preoperatively, less than 1 month postoperatively, 1-3 months postoperatively, 3-12 months postoperatively, and more than 12 months postoperatively. RESULTS The ODI scores increased perioperatively at the 12 months to 23, 17, and 20, respectively. VAS scores significantly decreased from 6.1 to 3.5, 2.4, 2.0, and 2.9 at the 12-month follow-ups, respectively. EQ-5D mobility significantly worsened at the 12-month follow-ups. EQ-5D self-care significantly worsened at the 12-month follow-ups. EQ-5D pain and discomfort significantly improved at all follow-up points. EQ-5D anxiety and depression significantly improved at 1- to 3-month and 3- to 12-month follow-ups. CONCLUSIONS Resection of intradural extramedullary spine tumors appears to significantly improve patient quality of life by decreasing patient disability and pain and by improving each of the EQ-5D domains.

  15. Biomechanical Comparison of an Intramedullary and Extramedullary Free-Tissue Graft Reconstruction of the Acromioclavicular Joint Complex

    Garg, Rishi; Javidan, Pooya; Lee, Thay Q.


    Background Several different surgical techniques have been described to address the coracoclavicular (CC) ligaments in acromioclavicular (AC) joint injuries. However, very few techniques focus on reconstructing the AC ligaments, despite its importance in providing stability. The purpose of our study was to compare the biomechanical properties of two free-tissue graft techniques that reconstruct both the AC and CC ligaments in cadaveric shoulders, one with an extramedullary AC reconstruction and the other with an intramedullary AC reconstruction. We hypothesized intramedullary AC reconstruction will provide greater anteroposterior translational stability and improved load to failure characteristics than an extramedullary technique. Methods Six matched cadaveric shoulders underwent translational testing at 10 N and 15 N in the anteroposterior and superoinferior directions, under AC joint compression loads of 10 N, 20 N, and 30 N. After the AC and CC ligaments were transected, one of the specimens was randomly assigned the intramedullary free-tissue graft reconstruction while its matched pair received the extramedullary graft reconstruction. Both reconstructed specimens then underwent repeat translational testing, followed by load to failure testing, via superior clavicle distraction, at a rate of 50 mm/min. Results Intramedullary reconstruction provided significantly greater translational stability in the anteroposterior direction than the extramedullary technique for four of six loading conditions (p < 0.05). There were no significant differences in translational stability in the superoinferior direction for any loading condition. The intramedullary reconstructed specimens demonstrated improved load to failure characteristics with the intramedullary reconstruction having a lower deformation at yield and a higher ultimate load than the extramedullary reconstruction (p < 0.05). Conclusions Intramedullary reconstruction of the AC joint provides greater stability in the

  16. Osseous metaplasia and mature bone formation with extramedullary hematopoiesis in follicular adenoma of thyroid gland

    Harsh Mohan


    Full Text Available Follicular adenomas of the thyroid may be subjected to degenerative changes like hemorrhagic and cystic changes, fibrosis, and calcification. Mature bone formation is a rare phenomenon, but extramedullary hematopoiesis (EMH has also been rarely reported in thyroid gland. The combination of mature bone formation and EMH is rarer and has been reported, in a single case report, in a multinodular goitre. We describe a case of follicular adenoma with histologically proven osseous metaplasia and mature bone formation with EMH in a middle- aged woman, which, to our knowledge, is the first case in English language literature.

  17. PET CT imaging in extramedullary hematopoiesis and lung cancer surprise in a case with thalassemia intermedia

    Semra Paydaş


    Full Text Available Extramedullary hematopoiesis (EMH is the production of hematopoietic precursors outside the bone marrow cavity, and it causes mass effects according to its localization. Magnetic resonance imaging (MRI and/or computed tomography (CT scans are used most commonly to detect EMH foci. We report herein a case with thalassemia intermedia causing paravertebral mass associated with EMH detected by CT scan. We further evaluated the case with positron emission tomography (PET CT, and lung cancer, which was not revealed in the CT scan, was detected coincidentally.

  18. Extramedullary Hematopoiesis in a Man With β-Thalassemia: An Uncommon Cause of an Adrenal Mass



    Full Text Available Introduction Extramedullary hematopoiesis (EMH commonly occurs in the spleen, liver and lymph nodes. Rare cases of EMH in the adrenal gland have been reported. Case Presentation We report the case of a 33-year-old man from the South of Iran suffering from major β-thalassemia, who underwent open left adrenalectomy and the histopathology revealed EMH. Conclusions In patients in which a history of hematologic disorders exists, careful imaging and hormonal assay should be done to certify a diagnosis of EMH. However, the surgical management becomes inevitable in certain cases.

  19. Intradural extramedullary spinal cord tumours: A retrospective study of sur­gical outcomes

    Md. Kamrul Ahsan


    Full Text Available Background: Intradural extramedullary spinal cord tumours (IESCT accounts for approximately two thirds of all intraspinal neoplasm and are of important clinical consideration and surgery is the essence in cases with neurological deterioration.Objective: To share our experience on the outcome of surgical excision of intradural extramedullary spinal cord tumours. Methods: Results of 60 patients surgically treated intradural extramedullary spinal tumours between Octo­ber 2003 and October 2015 at Bangabandhu Sheikh Mujib Medical University and in our private settings, Dhaka, were analyzed retrospectively. There were 32 males, 28 females with an average age of 52.4 years (13-70 years and followed up for at least a year. The preoperative symptom with duration, tumours location and intradural space occupancy and the histopathological diagnosis were analyzed. Pain was evaluated by the visual analogue scale (VAS and the neurologic function was assessed by Nurick's grade.Results: The tumours were located as, thoracic 32 (53.33%, lumbar 16 (26.67%, cervical 04 (6.67%, and junctional 08 (13.33%, CervicoThoracic-01, Thoracolumbar-07. The histopathological diagnosis included schwannoma 35 (58.33%, meningiomas 14 (23.33%, neurofbroma 4 (6.67%, arachnoid cyst and myxopapillary ependymoma 03 (05.00% each and paraganglioma 01 (01.67%. The VAS score was reduced in all cases from 8.0 ± 1.2 to 1.2 ± 0.8 (p < 0.003 and the Nurick's grade was improved in all cases from 3.0 ± 1.3 to 1.0 ± 0.0 (p < 0.005. The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Complications included cerebrospinal fluid leakage, parasthesia, dependant bedsore 02 (3.33% each and recurrence 03 (05.00%. and further neurological deterioration 1 (01.67% case.Conclusion: lntradural extramedullary tumors detected by MRI are mostly benign and good clinical results can be obtained when treated surgi

  20. Bloody nipple discharge in 2 infants with interesting cytologic findings of extramedullary hematopoiesis and hemophagocytosis.

    Pampal, Arzu; Gokoz, Aytac; Sipahi, Tansu; Dogan, Handan; Ergur, Ayca Torel


    Bloody nipple discharge in the infantile period is an uncommon finding. Despite its stressful course to the parents, it is generally a benign condition with a spontaneous resolution. The approach to bloody nipple discharge in the infantile period is well documented in the literature even though the number of these cases is limited. We report 2 infants with unilateral bloody nipple discharge. Their physical examination, laboratory, and ultrasound findings were normal but the cytologic examinations of the discharge revealed signs of extramedullary hematopoiesis and hemophagocytosis. These extraordinary findings made us brainstorm on the probable ongoing processes in the infantile breast tissue.

  1. Intracranial involvement in extramedullary hematopoiesis: case report and review of the literature

    Haidar, Salwa; Ortiz-Neira, Clara; Shroff, Manohar; Gilday, David; Blaser, Susan [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)


    Intracranial involvement in extramedullary hematopoiesis (EMH) is rare, but it should be suspected in patients with myelofibrosis presenting with chronic severe headache. We present a 9-year-old girl with known myelofibrosis whose headaches were unresponsive to routine treatment. CT and MRI studies of the brain showed diffuse pachymeningeal thickening. CT examinations of the chest and abdomen had demonstrated bilateral thoracic paraspinal masses caused by EMH, suggesting the possibility that the intracranial involvement might also be related to EMH. The diagnosis was confirmed by sulfur colloid isotope scan. (orig.)

  2. Colloidal solitary waves with temperature dependent compressibility

    Azmi, A.; Marchant, T. R.


    Spatial solitary waves which form in colloidal suspensions of dielectric nanoparticles are considered. The interactions, or compressibility, of the colloidal particles, is modelled using a series in the particle density, or packing fraction, where the virial, or series, coefficients depend on the type of particle interaction model. Both the theoretical hard disk and sphere repulsive models, and a model with temperature dependent compressibility, are considered. Experimental results show that particle interactions can be temperature dependent and either repulsive or attractive in nature, so we model the second virial coefficient using a physically realistic temperature power law. One- and two-dimensional semi-analytical colloidal solitary wave solutions are found. Trial functions, based on the form of the nonlinear Schrödinger equation soliton, are used, together with averaging, to develop the semi-analytical solutions. When the background packing fraction is low, the one-dimensional solitary waves have three solutions branches (with a bistable regime) while the two-dimensional solitary waves have two solution branches, with a single stable branch. The temperature dependent second virial coefficient results in changes to the solitary wave properties and the parameter space, in which multiple solutions branches occur. An excellent comparison is found between the semi-analytical and numerical solutions.

  3. Adjustable solitary waves in electroactive rods

    Wang, Y. Z.; Zhang, C. L.; Dai, H.-H.; Chen, W. Q.


    This paper presents an asymptotic analysis of solitary waves propagating in an incompressible isotropic electroactive circular rod subjected to a biasing longitudinal electric displacement. Several asymptotic expansions are introduced to simplify the rod governing equations. The boundary conditions on the lateral surface of the rod are satisfied from the asymptotic point of view. In the limit of finite-small amplitude and long wavelength, a set of ten simplified one-dimensional nonlinear governing equations is established. To validate our approach and the derivation, we compare the linear dispersion relation with the one directly derived from the three-dimensional linear theory in the limit of long wavelength. Then, by the reductive perturbation method, we deduce the far-field equation (i.e. the KdV equation). Finally, the leading order of the electroelastic solitary wave solution is presented. Numerical examples are provided to show the influences of the biasing electric displacement and material constants on the solitary waves. It is found that the biasing electric displacement can modulate the velocity of solitary waves with a prescribed amplitude in the electroactive rod, a very interesting result which may promote the particular application of solitary waves in solids with multi-field coupling.

  4. Solitary Spinal Epidural Metastasis from Gastric Cancer

    Taisei Sako


    Full Text Available Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or important organs were observed, and a solitary mass was present in the thoracic spinal epidural space. The mass was excised for diagnosis and treatment and was histopathologically diagnosed as metastasis from gastric cancer. No solitary metastatic epidural tumor from gastric cancer has been reported in English. Among the Japanese, 3 cases have been reported, in which the outcome was poor in all cases and no definite diagnosis could be made before surgery in any case. Our patient developed concomitant pneumonia after surgery and died shortly after the surgery. When a patient has a past medical history of malignant tumor, the possibility of a solitary metastatic tumor in the epidural space should be considered.

  5. Increased NHC Cells in the Peritoneal Cavity of Plasmacytoma Susceptible BALB/c Mouse

    Berenice Sánchez-González


    Full Text Available BALB/c strain mice are unique in that they develop murine plasmacytoma (MPC as a consequence of the inflammation induced by pristane oil injection in the peritoneal cavity. In this work the Treg, Th17, B1, B2, and NHC lymphocyte populations from the peritoneal environment of BALB/c, the susceptible strain, and C57BL/6 mice, which do not develop MPC after oil treatment, were studied. Both oil-treated strains showed decreased levels of Th17 lymphocytes, no significant variation in Treg lymphocytes, and a drastic decrease of all B lymphocyte populations. However, only oil-induced BALB/c showed increased levels of natural helper cells (NHC which could be important in the myeloma induction.

  6. Interleukin-6-related genotypes, body mass index, and risk of multiple myeloma and plasmacytoma.

    Cozen, Wendy; Gebregziabher, Mulugeta; Conti, David V; Van Den Berg, David J; Coetzee, Gerhard A; Wang, Sophia S; Rothman, Nathaniel; Bernstein, Leslie; Hartge, Patricia; Morhbacher, Ann; Coetzee, Simon G; Salam, Muhammad T; Wang, Wei; Zadnick, John; Ingles, Sue A


    Interleukin-6 (IL-6) promotes normal plasma cell development and proliferation of myeloma cells in culture. We evaluated IL-6 genotypes and body mass index (BMI) in a case-control study of multiple myeloma and plasmacytoma. DNA samples and questionnaires were obtained from incident cases of multiple myeloma (n = 134) and plasmacytoma (n = 16; plasma cell neoplasms) ascertained from the Los Angeles County population-based cancer registry and from siblings or cousins of cases (family controls, n = 112) and population controls (n = 126). Genotypes evaluated included IL-6 promoter gene single nucleotide polymorphisms (SNP) at positions -174, -572, and -597; one variable number of tandem repeats (-373 A(n)T(n)); and one SNP in the IL-6 receptor (IL-6ralpha) gene at position -358. The variant allele of the IL-6 promoter SNP -572 was associated with a roughly 2-fold increased risk of plasma cell neoplasms when cases were compared with family [odds ratio (OR), 1.8; 95% confidence interval (95% CI), 0.7-4.7] or population controls (OR, 2.4; 95% CI, 1.2-4.7). The -373 9A/9A genotype was associated with a decreased risk compared with the most common genotype (OR for cases versus family controls, 0.4; 95% CI, 0.1-1.7; OR for cases versus population controls, 0.3; 95% CI, 0.1-0.9). No other SNPs were associated with risk. Obesity (BMI >or= 30 kg/m(2)) increased risk nonsignificantly by 40% and 80% when cases were compared with family controls or population controls, respectively, relative to persons with a BMI of <25 kg/m(2). These results suggest that IL-6 promoter genotypes may be associated with increased risk of plasma cell neoplasms.

  7. Extramedullary plasmocytoma associated with a massive deposit of amyloid in the duodenum

    Fabiana Pirani Carneiro; Maria de Nazareth Machado Sobreira; Livia Bravo Maia; Alesso Cervantes Sartorelli; Luiz Eduardo de Almeida Prado Franceschi; Mauro Brito Brandao; Bárbara Wosnjuk Calaca; Fernando Silva Lustosa; Joao Vieira Lopes


    We report a rare case of extramedullary plasmocytoma associated with a massive deposit of amyloid in the duodenum. A 72-year-old Japanese man was admitted to our hospital presenting with a 3-mo history of epigastric pain, vomiting and weight loss. On computed tomography (CT) a wall thickening of the fourth part of the duodenum was observed. Multiple biopsies obtained from the lesion showed infiltration of plasma cells and lymphocytes, but they were not conclusive. The patient underwent resection of the lesion and, on histopathological examination, the lesion consisted of a dense and diffuse infiltrate of plasma cells and a few admixed lymphocytes with reactive follicles extending to the muscular propria. An extensive deposition of amyloid was also observed. Immunohistochemical stains revealed that a few plasmacytoid cells showed λ light chain staining, though most were κ light chain positive. These cells also were positive for CD138 and CD56 but negative for CD20 and CD79. The findings were consistent with extramedullary plasmocytoma associated with a massive deposit of amyloid in duodenum. A subsequent workup for multiple myeloma was completely negative. The patient showed no signs of local recurrence or dissemination of the disease after 12 mo follow-up. Because of the association of plasmocytoma and amyloidosis, the patient must be followed up because of the possible systemic involvement of the neoplasm and amyloidosis in future.

  8. Extramedullary Acute Myeloid Leukemia (AML: Leukemic Pleural Effusion, Case Report and Review of the Literature

    Naveen ePemmaraju


    Full Text Available Objective and Importance: Malignant pleural effusions occur in the setting of both solid and hematologic malignancies. Pleural effusion caused by leukemic infiltration is an unusual extramedullary manifestation of acute myeloid leukemia (AML with fewer than 20 cases reported.1-11 We report a case of pericardial and pleural effusions in a patient with AML and review the literature. Clinical presentation: In this case, a 55 year old man with previous history of myeloproliferative neoplasm (MPN experienced transformation AML, heralded by appearance of leukemic pleural effusions. The patient was identified to have leukemic pleural effusion based upon extended cytogenetic analysis of the pleural fluid, as morphologic analysis alone was insufficient. Intervention: The patient was treated with hypomethylator-based and intensive chemotherapy strategies, both of which maintained resolution of the effusions in the remission setting. Conclusion: Due to the rarity of diagnosis of leukemic pleural effusions, both cytogenetic and fluorescence in situ hybridization (FISH testing are recommended. Futhermore, systemic chemotherapy directed at the AML can lead to complete resolution of leukemic pleural effusions. Objective and ImportancePleural effusion caused by leukemic infiltration is an unusual extramedullary manifestation of acute myeloid leukemia (AML, but may be more common than previously thought. Fewer than 20 cases have been reported.1-11 We report a case of pericardial and pleural effusions in a patient with AML and review the literature.

  9. Intraoral solitary neurofibroma in an infant

    Narwal Anjali


    Full Text Available Neurofibroma is a non-circumscribed, thick and irregular benign tumor of the peripheral nerve sheath. On the skin, the diffuse and soft nature of neurofibroma often resembles "a bag of worms". It can develop at any point along a nerve and often form by late adolescence. Although neurofibromas occur predominantly as a feature of neurofibromatosis affecting the soft tissue, a few cases of solitary intraoral neurofibromas have also been reported. Solitary intraosseous neurofibroma in the oral cavity is a rare benign tumor with very few cases reported in literature. This case report presents a case of intraosseous solitary neurofibroma of maxilla in a 5-month-old male child due to the rarity of this tumor at this site in very early age, along with a discussion of its clinical, radiological, and histopathological presentation.

  10. A radiographic study of solitary bone cysts

    Kim, Kyung Rak; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, Division of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)


    The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary bone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University. The obtained results were as follows; 1. The incidence of solitary bone cyst was almost equal in males (52.2%) and in females(42.8%) and the prevalent age of the solitary bone cyst were the second decade (47.8%) and the third decade (21.7%). 2. In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 43.5% were a symptom and the tooth vitality involved in the solitary bone cyst, 76.5% were posterior and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partially, and 30.4% were not seen. 5. In the change of tooth, 59.1% were loss of the alveolar lamina dura, 13.6% were root resorption 4.55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11.1% were thickened myxo-fibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

  11. Uphill solitary waves in granular flows

    Martínez, E.; Pérez-Penichet, C.; Sotolongo-Costa, O.; Ramos, O.; Måløy, K. J.; Douady, S.; Altshuler, E.


    We have experimentally observed uphill solitary waves in the surface flow on a granular material. A heap is constructed by injecting sand between two vertical glass plates separated by a distance much larger than the average grain size, with an open boundary. As the heap reaches the open boundary, solitary fluctuations appear on the flowing layer and move “up the hill” (i.e., against the direction of the flow). We explain the phenomenon in the context of stop-and-go traffic models.

  12. Serial CT Findings of Resolving Extramedullary Hematopoiesis as Unilateral Posterior Mediastinal Mass after Splenectomy in Hereditary Spherocytosis: A Case Report

    Nam, Mi Yeon; Lee, Ju Won; Kim, Yeo Ju; Kim, Youn Jeong; Kang, Young Hye; Lee, Kyung Hee [Dept. of Radiology, Inha University Hospital, Incheon (Korea, Republic of)


    Intrathoracic extramedullary hematopoiesis (EMH) is a rare condition of the hereditary spherocytosis. EMH usually regresses or disappears after treatment; such as splenectomy in the case of spherocytosis. We report a case of hereditary spherocytosis. It is presented with an unilateral paravertebral posterior mediastinal mass. After splenectomy, it revealed shrinkage and fatty replacement on serial CT scans.

  13. From bell-shaped solitary wave to W/M-shaped solitary wave solutions in an integrable nonlinear wave equation

    Aiyong Chen; Jibin Li; Chunhai Li; Yuanduo Zhang


    The bifurcation theory of dynamical systems is applied to an integrable non-linear wave equation. As a result, it is pointed out that the solitary waves of this equation evolve from bell-shaped solitary waves to W/M-shaped solitary waves when wave speed passes certain critical wave speed. Under different parameter conditions, all exact explicit parametric representations of solitary wave solutions are obtained.

  14. Minimally invasive removal of lumbar intradural extramedullary lesions using the interlaminar approach.

    Zhu, Yong-Jian; Ying, Guang-Yu; Chen, Ai-Qin; Wang, Lin-Lin; Yu, Dan-Feng; Zhu, Liang-Liang; Ren, Yu-Cheng; Wang, Chen; Wu, Peng-Cheng; Yao, Ying; Shen, Fang; Zhang, Jian-Min


    OBJECT Posterior midline laminectomy or hemilaminectomy has been successfully applied as the standard microsurgical technique for the treatment of spinal intradural pathologies. However, the associated risks of postoperative spinal instability increase the need for subsequent fusion surgery to prevent potential long-term spinal deformity. Continuous efforts have been made to minimize injuries to the surrounding tissue resulting from surgical manipulations. The authors report here their experiences with a novel minimally invasive surgical approach, namely the interlaminar approach, for the treatment of lumbar intraspinal tumors. METHODS A retrospective review was conducted of patients at the Second Affiliated Hospital of Zhejiang University School of Medicine who underwent minimally invasive resection of lumbar intradural-extramedullary tumors. By using an operative microscope, in addition to an endoscope when necessary, the authors were able to treat all patients with a unilateral, paramedian, bone-sparing interlaminar technique. Data including preoperative neurological status, tumor location, size, pathological diagnosis, extension of resections, intraoperative blood loss, length of hospital stay, and clinical outcomes were obtained through clinical and radiological examinations. RESULTS Eighteen patients diagnosed with lumbar intradural-extramedullary tumors were treated from October 2013 to March 2015 by this interlaminar technique. A microscope was used in 15 cases, and the remaining 3 cases were treated using a microscope as well as an endoscope. There were 14 schwannomas, 2 ependymomas, 1 epidermoid cyst, and 1 enterogenous cyst. Postoperative radiological follow-up revealed complete removal of all the lesions and no signs of bone defects in the lamina. At clinical follow-up, 14 of the 18 patients had less pain, and patients' motor/sensory functions improved or remained normal in all cases except 1. CONClUSIONS When meeting certain selection criteria

  15. Clinical implications of the solitary functioning kidney

    Westland, R.; Schreuder, M.F.; Goudoever, J.B. van; Sanna-Cherchi, S.; Wijk, J.A. van


    Congenital anomalies of the kidney and urinary tract are the major cause of ESRD in childhood. Children with a solitary functioning kidney form an important subgroup of congenital anomalies of the kidney and urinary tract patients, and a significant fraction of these children is at risk for progress

  16. Solitary waves on nonlinear elastic rods. I

    Sørensen, Mads Peter; Christiansen, Peter Leth; Lomdahl, P. S.


    Acoustic waves on elastic rods with circular cross section are governed by improved Boussinesq equations when transverse motion and nonlinearity in the elastic medium are taken into account. Solitary wave solutions to these equations have been found. The present paper treats the interaction between...

  17. Shallow Water Waves and Solitary Waves

    Hereman, Willy


    Encyclopedic article covering shallow water wave models used in oceanography and atmospheric science. Sections: Definition of the Subject; Introduction and Historical Perspective; Completely Integrable Shallow Water Wave Equations; Shallow Water Wave Equations of Geophysical Fluid Dynamics; Computation of Solitary Wave Solutions; Numerical Methods; Water Wave Experiments and Observations; Future Directions, and Bibliography.

  18. Solitary waves on nonlinear elastic rods. II

    Sørensen, Mads Peter; Christiansen, Peter Leth; Lomdahl, P. S.


    In continuation of an earlier study of propagation of solitary waves on nonlinear elastic rods, numerical investigations of blowup, reflection, and fission at continuous and discontinuous variation of the cross section for the rod and reflection at the end of the rod are presented. The results...

  19. Peptide Toxins in Solitary Wasp Venoms

    Konno, Katsuhiro; Kazuma, Kohei; Nihei, Ken-ichi


    Solitary wasps paralyze insects or spiders with stinging venom and feed the paralyzed preys to their larva. Accordingly, the venoms should contain a variety of constituents acting on nervous systems. However, only a few solitary wasp venoms have been chemically studied despite thousands of species inhabiting the planet. We have surveyed bioactive substances in solitary wasp venoms found in Japan and discovered a variety of novel bioactive peptides. Pompilidotoxins (PMTXs), in the venoms of the pompilid wasps Anoplius samariensis and Batozonellus maculifrons, are small peptides consisting of 13 amino acids without a disulfide bond. PMTXs slowed Na+ channel inactivation, in particular against neuronal type Na+ channels, and were rather selective to the Nav1.6 channel. Mastoparan-like cytolytic and antimicrobial peptides are the major components of eumenine wasp venoms. They are rich in hydrophobic and basic amino acids, adopting a α-helical secondary structure, and showing mast cell degranulating, antimicrobial and hemolytic activities. The venom of the spider wasp Cyphononyx fulvognathus contained four bradykinin-related peptides. They are hyperalgesic and, dependent on the structure, differently associated with B1 or B2 receptors. Further survey led to the isolation of leucomyosuppressin-like FMRFamide peptides from the venoms of the digger wasps Sphex argentatus and Isodontia harmandi. These results of peptide toxins in solitary wasp venoms from our studies are summarized. PMID:27096870

  20. Peptide Toxins in Solitary Wasp Venoms

    Katsuhiro Konno


    Full Text Available Solitary wasps paralyze insects or spiders with stinging venom and feed the paralyzed preys to their larva. Accordingly, the venoms should contain a variety of constituents acting on nervous systems. However, only a few solitary wasp venoms have been chemically studied despite thousands of species inhabiting the planet. We have surveyed bioactive substances in solitary wasp venoms found in Japan and discovered a variety of novel bioactive peptides. Pompilidotoxins (PMTXs, in the venoms of the pompilid wasps Anoplius samariensis and Batozonellus maculifrons, are small peptides consisting of 13 amino acids without a disulfide bond. PMTXs slowed Na+ channel inactivation, in particular against neuronal type Na+ channels, and were rather selective to the Nav1.6 channel. Mastoparan-like cytolytic and antimicrobial peptides are the major components of eumenine wasp venoms. They are rich in hydrophobic and basic amino acids, adopting a α-helical secondary structure, and showing mast cell degranulating, antimicrobial and hemolytic activities. The venom of the spider wasp Cyphononyx fulvognathus contained four bradykinin-related peptides. They are hyperalgesic and, dependent on the structure, differently associated with B1 or B2 receptors. Further survey led to the isolation of leucomyosuppressin-like FMRFamide peptides from the venoms of the digger wasps Sphex argentatus and Isodontia harmandi. These results of peptide toxins in solitary wasp venoms from our studies are summarized.

  1. Giant solitary fibrous tumour of the liver

    T. Terkivatan (Türkan); M. Kliffen (Mike); J.H.W. de Wilt (Johannes); A.N. van Geel (Albert); A.M.M. Eggermont (Alexander); C. Verhoef (Kees)


    textabstractBackground: Solitary fibrous tumour (SFT) is an uncommon mesenchymal neoplasm that most frequently affects the pleura, although it has been reported with increasing frequency in various other sites such as in the peritoneum, pericardium and in non-serosal sites such as lung parenchyma,

  2. Solitary Wave Solutions for Zoomeron Equation

    Amna IRSHAD


    Full Text Available Tanh-Coth Method is applied to find solitary wave solutions of the Zoomeron equation which is of extreme importance in mathematical physics. The proposed scheme is fully compatible with the complexity of the problem and is highly efficient. Moreover, suggested combination is capable to handle nonlinear problems of versatile physical nature.

  3. Solitary fibrous tumour of the vagus nerve.

    Scholsem, Martin; Scholtes, Felix


    We describe the complete removal of a foramen magnum solitary fibrous tumour in a 36-year-old woman. It originated on a caudal vagus nerve rootlet, classically described as the 'cranial' accessory nerve root. This ninth case of immunohistologically confirmed cranial or spinal nerve SFT is the first of the vagus nerve.

  4. Solitary Wave Propagation Influenced by Submerged Breakwater

    王锦; 左其华; 王登婷


    The form of Boussinesq equation derived by Nwogu (1993) using velocity at an arbitrary distance and surface elevation as variables is used to simulate wave surface elevation changes. In the numerical experiment, water depth was divided into five layers with six layer interfaces to simulate velocity at each layer interface. Besides, a physical experiment was carried out to validate numerical model and study solitary wave propagation.“Water column collapsing”method (WCCM) was used to generate solitary wave. A series of wave gauges around an impervious breakwater were set-up in the flume to measure the solitary wave shoaling, run-up, and breaking processes. The results show that the measured data and simulated data are in good agreement. Moreover, simulated and measured surface elevations were analyzed by the wavelet transform method. It shows that different wave frequencies stratified in the wavelet amplitude spectrum. Finally, horizontal and vertical velocities of each layer interface were analyzed in the process of solitary wave propagation through submerged breakwater.

  5. Solitary wave interactions of the GRLW equation

    Ramos, J.I. [Room I-320-D, E.T.S. Ingenieros Industriales, Universidad de Malaga, Plaza El Ejido, s/n 29013 Malaga (Spain)]. E-mail:


    An approximate quasilinearization method for the solution of the generalized regularized long-wave (GRLW) equation based on the separation of the temporal and spatial derivatives, three-point, fourth-order accurate, compact difference equations, is presented. The method results in a system of linear equations with tridiagonal matrices, and is applied to determine the effects of the parameters of the GRLW equation and initial conditions on the formation of undular bores and interactions/collisions between two solitary waves. It is shown that the method preserves very accurately the first two invariants of the GRLW equation, the formation of secondary waves is a strong function of the amplitude and width of the initial Gaussian conditions, and the collision between two solitary waves is a strong function of the parameters that appear in the GRLW equation and the amplitude and speed of the initial conditions. It is also shown that the steepening of the leading and trailing waves may result in the formation of multiple secondary waves and/or an undular bore; the former interacts with the trailing solitary wave which may move parallel to or converge onto the leading solitary wave.

  6. Conus medullaris hematomyelia associated with an intradural-extramedullary cavernous angioma.

    Mastronardi, L; Frondizi, D; Guiducci, A; Nardi, M; Maira, G


    A unique case of a 50-year-old woman with a conus medullaris hematomyelia associated with a low thoracic intradural-extramedullary cavernous angioma localized 2 cm above is reported. The patient had a 2-month history of progressive paraparesis, hypoesthesia of legs, and bowel and bladder disturbances. The symptoms worsened acutely during the last days before admission. A thoraco-lumbar MRI showed a space-occupying lesion at T10-T11 (vertebral interspace associated with a hematomyelia localized about 2 cm below. A T10-L1 laminectomy was performed and complete removal of both lesions was obtained with microsurgical technique. A non-traumatic hematomyelia should always prompt the suspicion of a spinal AVM or, more rarely, of a cavernous angioma. The possible anatomical and clinical correlations of this unusual association are discussed.

  7. Case report and literature review: cardiac tamponade as a complication of pericardial extramedullary hematopoiesis.

    Mahadevan, Navin R; Morgan, Elizabeth A; Mitchell, Richard N


    Pericardial effusion can cause cardiac tamponade physiology with resultant cardiogenic shock and death. Myelofibrosis, the replacement of marrow cavity by fibrous connective tissue, is a secondary complication of a group of disorders known as myeloproliferative neoplasms, which are clonal processes characterized by abnormal proliferative growth of one or more hematopoietic lineages. One consequence of myelofibrosis is the development of hematopoiesis at other anatomic sites, most commonly the spleen and liver, a phenomenon known as extramedullary hematopoiesis (EMH). Herein we report a case of a man who died from pericardial tamponade due to a subacute pericardial effusion secondary to EMH in the pericardium in the setting of myelofibrosis. This case highlights an unusual etiology for pericardial effusion and tamponade that should be considered in cases of myelofibrosis and stimulates a discussion regarding the mechanisms and anatomic distribution of EMH.

  8. Cord Compression due to Extramedullary Hematopoiesis in an Adolescent with Known Beta Thalassemia Major

    Alan COHLER


    Full Text Available We describe a 16 year-old male with ß thalassemia major and gait disturbances that had not been given blood transfusions due to a severe childhood transfusion reaction. Thoracic spine MRI demonstrated hematopoietic marrow throughout the spine and epidural masses causing cord compression consistent with extramedullary hematopoiesis (EMH. After treatment with steroids, radiotherapy and monitored blood transfusions, the patient demonstrated significant improvement of his paraspinal lesions and near complete resolution of his neurological symptoms. While EMH causing cord compression in adolescents is rare in the current era of bone marrow transplantation or chronic transfusions, it should be considered when thalassemia major patients present with neurological deficits. The well defined imaging features of EMH can play a central role in its diagnosis and management, especially because surgical and / or radiotherapeutic intervention are often considered in cases of failed medical treatment.

  9. Ferrokinetic study of splenic erythropoiesis: Relationships among clinical diagnosis, myelofibrosis, splenomegaly, and extramedullary erythropoiesis

    Beguin, Y.; Fillet, G.; Bury, J.; Fairon, Y. (Univ. of Liege (Belgium))


    Splenic erythropoiesis was demonstrated by surface counting of {sup 59}Fe in 129 of 1,350 ferrokinetic studies performed over a 15 year period. These 129 studies were carried out in 108 patients, including 40 with chronic myelogenous leukemia (CML), 24 with agnogenic myeloid metaplasia (AMM), 18 with polycythemia vera (PV), six with a myelodysplastic syndrome, five with acute leukemia, three with prostate or breast carcinoma, two each with aplastic anemia or Hodgkin's disease, and one each with idiopathic thrombocythemia, multiple myeloma, chronic renal failure, or treated hypopituitarism. Splenomegaly was present in 83% of the studies and hepatomegaly in 72%. Grade II-III myelofibrosis was demonstrated in 62% of the cases. Hepatic erythropoiesis was present in 77% of the studies (only 38% in PV), and marrow erythropoiesis was undetectable in 33%. Total erythropoiesis was about twice normal (range 0.2 to 8 times normal) but was ineffective to varying degrees in 86% of the studies. Relationships between organomegaly, myelofibrosis, and extramedullary erythropoiesis, as well as differences among clinical disorders, are discussed. Differences observed between CML in chronic or blastic phase suggested that the erythroid cell line was involved in the proliferative process. It is concluded that splenic erythropoiesis (1) is encountered in a variety of clinical conditions; (2) is not necessarily associated with splenomegaly or myelofibrosis, even in the myeloproliferative disorders; (3) is part of a predominantly extramedullary (in the liver as well as in the spleen), expanded, and largely inefficient total erythropoiesis; and (4) can be evaluated in a semiquantitative manner by surface counting.

  10. Extramedullary Relapse of Acute Myeloid and Lymphoid Leukemia in Children: A Retrospective Analysis

    Jee Young Kim


    Full Text Available Background Extramedullary relapse (EMR is a recurrence of leukemia in sites other than the bone marrow, and it exhibits a relatively rare presentation of relapse of acute leukemia. However, EMR is an important cause of treatment failure among patients with acute leukemia. Therefore, early detection of these relapses may improve the prognosis. Objectives To describe the disease-related demographic and clinical features and radiologic findings for children diagnosed with EMR in acute leukemia. Patients and Methods The study was based on 22 children (M: F = 14: 8; mean age 7.30 (2.1 - 15.7 years with 8 acute myeloid leukemia (AML and 14 acute lymphoid leukemia (ALL who had experienced an EMR. Age, gender, clinical symptoms, initial extramedullary disease (EMD, French-American-British (FAB morphology, cytogenetics, time to and site of EMR, concurrent bone marrow relapse (BMR, radiologic findings, and outcomes were evaluated. Results No definite relationship was found between initial EMD and EMR. A predilection for AML to relapse in the central nervous system (CNS, except for the CSF and bone, and for ALL to relapse in the CSF and kidney seemed to occur. Patients with EMR had a significantly higher incidence of t(8: 21 cytogenetics and FAB M2 and L1 morphologies. EMR accompanied with concurrent BMR occurred in 31.8% of the patients, who exhibited a relatively grave clinical course. Radiologic findings were nonspecific and had a great variety of structure involved, including bulging enhancing mass in the CT scan, hypoechoic mass in the US, and enhanced mass-like lesion in the MRI. Conclusions Knowledge of the potential sites of EMR, their risk factors, and their clinical and radiologic features may be helpful in the early diagnosis of relapse and planning for therapy.

  11. An unusual presentation of multiple myeloma with unilateral sudden vision loss: A case report.

    Wu, Pei-Wen; Lee, Ta-Jen; Chen, Jim-Ray; Huang, Chien-Chia


    Plasma cell neoplasms are categorized by neoplastic proliferation of a single clone of plasma cells which produce a monoclonal immunoglobulin. Plasma cell neoplasms can present as a solitary plasmacytoma or as multiple myeloma. Both of them can progress to multiple myeloma. Once a diagnosis of plasmacytoma has been made, thorough examinations should be carried out for identifying the disease entity. Herein, we describe an extraordinary rare case of multiple myeloma with initial presentation of a left sphenoid neoplasm resulting in left-sided headache and rapid deterioration of visual acuity. Histo-pathologic analysis revealed a plasma cell neoplasm with positive immunostaining for cluster of differentiation (CD)138, CD79a, and kappa light chain of immunoglobulin. A bone marrow aspiration was then performed, and the diagnosis of multiple myeloma was then confirmed. After investigative workup, our patient received chemotherapy, localized radiotherapy, and autologous stem cell transplantation. Her visual acuity recovered to the baseline and she sustained a partial response without subjective discomfort. Extramedullary plasmacytoma is an interesting but infrequent presentation of multiple myeloma. Moreover, involvement of the sphenoid sinus in multiple myeloma resulting in extrinsic optic nerve compression is extremely rare. Clinicians should consider plasmacytoma as a diagnostic possibility when presented with cases of solitary sphenoid neoplasm and rapid progression of clinical course.

  12. A Case of Post-Radiotherapy Gastritis: Radiation Does Not Explain Everything

    André Abrunhosa-Branquinho


    Full Text Available Hemorrhagic gastritis is a possible late toxicity outcome after radical radiotherapy but it is nowadays a very rare condition and most likely depends on other clinical factors. We report the case of a 77-year-old woman with a symptomatic solitary extramedullary intra-abdominal plasmacytoma and multiple gastric comorbidities, treated with external beam radiotherapy. Despite the good response to radiotherapy, the patient experienced multiple gastric bleeding a few months later, with the need of multiple treatments for its control. In this paper we will discuss in detail all aspects related to the different causes of hemorrhagic gastritis.

  13. On the solitary wave paradigm for tsunamis

    Madsen, Per A.; Fuhrman, David R.; Schäffer, Hemming Andreas


    Since the 1970s, solitary waves have commonly been used to model tsunamis especially in experimental and mathematical studies. Unfortunately, the link to geophysical scales is not well established, and in this work we question the geophysical relevance of this paradigm. In part 1, we simulate...... of finite amplitude solitary wave theory in laboratory studies of tsunamis. We conclude that order-of-magnitude errors in effective temporal and spatial duration occur when this theory is used as an approximation for long waves on a sloping bottom. In part 3, we investigate the phenomenon of disintegration...... of long waves into shorter waves, which has been observed e.g. in connection with the Indian Ocean tsunami in 2004. This happens if the front of the tsunami becomes sufficently steep, and as a result the front turns into an undular bore. We discuss the importance of these very short waves in connection...

  14. Hypokalemia associated with a solitary pulmonary nodule

    Saeian, Samira; Ghayumi, Seiyed Mohammad Ali; Shams, Mesbah


    Abstract Background: Differential diagnosis of hypokalemia and adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome often presents challenging in endocrinology and requires careful clinical, biochemical, radiological, and pathological investigations. Hypokalemia is a common abnormality and systematic approach is required to avoid delays in diagnosis of important underlying causes. Case Summary: A 49-year-old woman presented with moderate hypokalemia. Further evaluation showed hypercortisolism due to ectopic ACTH secretion. Chest computed tomography (CT) revealed a peripheral solitary pulmonary nodule. Excision biopsy of the nodule showed carcinoid tumor. After excision biopsy, all of the patient's symptoms improved and electrolytes and ACTH levels also became normal. Conclusion: Carciniod tumors should be considered as a differential diagnosis in patients presenting with hypokalemia and ectopic ACTH syndrome. Carcinoid tumor often present as solitary pulmonary nodule and excision biopsy can be curative. PMID:27977570

  15. Asymptotic Linear Stability of Solitary Water Waves

    Pego, Robert L.; Sun, Shu-Ming


    We prove an asymptotic stability result for the water wave equations linearized around small solitary waves. The equations we consider govern irrotational flow of a fluid with constant density bounded below by a rigid horizontal bottom and above by a free surface under the influence of gravity neglecting surface tension. For sufficiently small amplitude waves, with waveform well-approximated by the well-known sech-squared shape of the KdV soliton, solutions of the linearized equations decay at an exponential rate in an energy norm with exponential weight translated with the wave profile. This holds for all solutions with no component in (that is, symplectically orthogonal to) the two-dimensional neutral-mode space arising from infinitesimal translational and wave-speed variation of solitary waves. We also obtain spectral stability in an unweighted energy norm.

  16. From solitary wave to traveling surge



    The solution of kinetic Alfven wave under action of anomalous resistance has two branches: the slow wave, VPVA cosθ will be in a wave-broken state. Such traveling surge structure is a typical self-organization phenomenon and its wave form is determined by parameter β which represents the magnitude of resistance. High β leads to shock-like structure and low β to the appearance of some solitary waves in front of the shock. According to the study on solitary wave, shock wave and traveling surge in conjunction with self-organization of nonlinear dynamics, a general definition of wave can be given.

  17. Partial Differential Equations and Solitary Waves Theory

    Wazwaz, Abdul-Majid


    "Partial Differential Equations and Solitary Waves Theory" is a self-contained book divided into two parts: Part I is a coherent survey bringing together newly developed methods for solving PDEs. While some traditional techniques are presented, this part does not require thorough understanding of abstract theories or compact concepts. Well-selected worked examples and exercises shall guide the reader through the text. Part II provides an extensive exposition of the solitary waves theory. This part handles nonlinear evolution equations by methods such as Hirota’s bilinear method or the tanh-coth method. A self-contained treatment is presented to discuss complete integrability of a wide class of nonlinear equations. This part presents in an accessible manner a systematic presentation of solitons, multi-soliton solutions, kinks, peakons, cuspons, and compactons. While the whole book can be used as a text for advanced undergraduate and graduate students in applied mathematics, physics and engineering, Part II w...

  18. Murine IgA-secreting plasmacytoma MOPC-315 expresses somatostatin receptors

    Scicchitano, R.; Dazin, P.; Bienenstock, J.; Payan, D.G.; Stanisz, A.M.


    We have previously shown that some neuropeptides had a profound effect on in vitro Ig synthesis (especially IgA) and mitogen-driven murine lymphocyte proliferation. MOPC-315, an IgA-secreting plasmacytoma line, has been extensively used in studies of the regulation of IgA synthesis. In this report we show that the neuropeptide somatostatin (SOM) inhibits proliferation ((/sup 3/H)thymidine uptake) of MOPC-315 and also inhibits IgA synthesis in vitro. MOPC-315 cells bind both fluorescent SOM and (/sup 125/I)SOM specifically. On cytofluorimetric analysis, 68 +/- 6.8% (mean +/- SE, n = 7) of MOPC 315 cells labeled with fluorescent SOM and this staining was compatible by incubation with an excess of unlabeled peptide. Specific (/sup 125/I)SOM binding increased linearly with cell concentration, was rapid and achieved equilibrium after 20 min at 4 degrees C. It was temperature-dependent, readily reversible, and under equilibrium conditions demonstrated a dissociation constant of 1.6 +/- 0.7 nM (mean +/- SE, n = 5). Scatchard analysis showed that MOPC-315 cells had 40,733 +/- 16,050 (mean +/- SE) binding sites for SOM per cell. The characteristics of the interactions of SOM with MOPC-315 cells suggest a specific receptor-mediated mechanism whereby this neuropeptide may modulate lymphocyte function.

  19. Successful Treatment of Posttransplant EBV-Associated Lymphoma and Plasmacytoma Solely Localized to the CNS

    Per Boye Hansen


    Full Text Available Two patients with diabetic nephropathy were diagnosed with primary central nervous system posttransplant Epstein-Barr-virus-associated lymphoproliferative disorder (PTLD 3 years after renal transplantation. The histological diagnoses of the isolated brain tumors were diffuse large B-cell lymphoma and plasmacytoma. Considerable co-morbidity precluded intensive chemotherapy. The first patient with lymphoid CD20+ PTLD had a partial resection of her tumor performed. She was treated with 4 weekly doses of rituximab, ganciclovir and prednisolone; the posttransplant immune suppression (tacrolimus was reduced. After 4 weeks of treatment a magnetic resonance imaging (MRI demonstrated complete regression of the CNS lesion. The patient continues to receive rituximab (every second month, valgangciclovir and low-dose prednisolone. Twenty-two months after initiation of therapy, she is still in complete remission. The second patient was only treated with craniospinal irradiation involving the medulla to the second cervical vertebra and valgangciclovir. Moreover, the posttransplant immune suppression was reduced. A new MRI two months after initiation of therapy showed a complete regression of the lesions in the CNS; this was again demonstrated by a MRI after 19 months. These 2 cases illustrate interesting alternative treatments of PTLD. To our knowledge, an EBV-associated PTLD of plasmacytic origin isolated to the CNS has never been described before.

  20. [Solitary fibrous tumours of the kidney].

    Gres, Pascal; Avances, Christophe; Ben Naoum, Kamel; Chapuis, Héliette; Costa, Pierre


    Solitary fibrous tumours (SFT) are mesenchymal tumours that usually arise from the pleura. Renal SFT are exceptional (9 cases reported in the literature). The authors report a new case discovered during assessment of HT and treated by radical right nephrectomy. The histological appearance is characteristic: a tumour with a fibrous centre, composed of a monomorphic proliferation of spindle cells, with positive CD 34, CD 99, and bcl 2 labelling. The prognosis after complete resection is generally favourable.

  1. Solitary vascular malformation of the clitoris.

    Haritharan, T; Islah, M; Zulfiqar, A; Thambi Dorai, C R


    Isolated involvement of the clitoris by vascular malformation (VM) is very rare. Clinically, the lesion simulates female pseudohermaphroditism. A five-year-old girl presented with clitoromegaly and a clinical diagnosis of solitary VM of the clitoris was made. Magnetic resonance imaging showed characteristic features and confirmed the diagnosis and the extent of the VM. This is the first reported case of isolated involvement of the clitoris by VM to be diagnosed preoperatively.

  2. Two-color walking Peregrine solitary waves.

    Baronio, Fabio; Chen, Shihua; Mihalache, Dumitru


    We study the extreme localization of light, evolving upon a non-zero background, in two-color parametric wave interaction in nonlinear quadratic media. We report the existence of quadratic Peregrine solitary waves, in the presence of significant group-velocity mismatch between the waves (or Poynting vector beam walk-off), in the regime of cascading second-harmonic generation. This finding opens a novel path for the experimental demonstration of extreme rogue waves in ultrafast quadratic nonlinear optics.

  3. Cyto-morphological features of extramedullary acute megakaryoblastic leukemia on fine needle aspiration and cerebrospinal fluid cytology: A case report

    Sanjeev Chitragar


    Full Text Available Extramedullary deposits may be the presenting feature of acute myeloid leukemia. An early and accurate diagnosis on cytology will aid in correct patient management. This is especially true for patients with acute megakaryoblastic leukemia (AML M7, where bone marrow aspiration may yield only a dry tap. While cytomorphological features of myeloid sarcoma of other types are well recognized due to its rarity, there are only two case reports discussing the morphological details of megakaryoblastic differentiation on aspiration cytology. We present the case of a 25-year-old patient with extramedullary involvement of lymph node and cerebrospinal fluid by AML M7, describing in detail, the morphological features on aspiration as well as exfoliative cytology.

  4. Focal extra-axial hemorrahagic mass with subdural hemorrhage secondare to extramedullary hematopoiesis in idiopathic myelodysplastic sindrome.

    Di Ieva, A; Di Lieva, A; Aimar, E; Tancioni, F; Levi, D; Debernardi, A; Pisano, P; Rahal, D; Nozza, A; Magagnoli, M; Gaetani, P


    Idiopathic myelodysplastic syndrome is a disease characterized by a clonal stem cell disorder in which megacaryocitic and granulocytic lineages are mainly involved; extramedullary myeloid metaplasia is due to abnormal location of myeloid tissue in other organs than bone marrow. Rarely the central nervous system is involved. When it happens, it is typical to find masses around the brain and pachymeningeal thickening, but it is very rare to find it associated with subdural haemorrhage, as in the case we describe in the present article. Considering our case and the literature we can suggest that radiological images associated with the clinical history of the patient suggestive for extramedullary hematopoiesis can be sufficient for a correct diagnosis and for a radiotherapy treatment, demanding surgery in the case of diagnostic doubts, massive hemorrahages or neurological decifits caused by the focal lesions.

  5. Fifteen-year follow-up of a patient with beta thalassaemia and extramedullary haematopoietic tissue compressing the spinal cord

    Niggemann, P.; Krings, T.; Thron, A. [Dept. of Neuroradiology, RWTH-Aachen Hosital (Germany); Hans, F. [Dept. of Neurosurgery, RWTH Aachen Hospital (Germany); 1


    A long-term follow-up of a patient with beta thalassaemia with intra- and extraspinal extramedullary haematopoietic tissue compressing the spinal cord is presented. Extramedullary haematopoietic nodules are a rare cause of spinal cord compression and should be included in the differential diagnosis, especially in patients from Mediterranean countries. Treatment with radiation therapy solely failed, giving rise to the need of surgical intervention. Surgical decompression of the spine and the removal of the culprit lesion compressing the spine were performed. Postinterventional radiation therapy was applied to the spine. A relapse had to be treated again by surgical means combined with postinterventional radiation therapy. A complete relief of the symptoms and control of the lesion could be obtained.

  6. Intradural extramedullary hemangiopericytoma of the thoracic spine infiltrating a nerve root: a case report and literature review.

    Moscovici, Samuel; Ramirez-DeNoriega, Fernando; Fellig, Yakov; Rosenthal, Guy; Cohen, José E; Itshayek, Eyal


    Review the presentation and diagnosis of an intradural extramedullary hemangiopericytoma of the thoracic spine. To present a rare case of intradural, subpial hemangiopericytoma in the thoracic spine, with a brief overview of the literature. Spinal intradural extramedullary hemangiopericytoma is rare entity that radiographically mimics nerve-sheath tumors. These lesions are typically diagnosed at surgery performed due to suspicion of tumor. A 20-year-old man who presented with back pain, leg weakness, and sphincter incontinence. MR imaging demonstrated an intradural extramedullary lesion at the T9-T10 level that was isointense on T1- and T2-weighted images and homogeneously enhancing after administration of gadolinium, with cystic components seen on T2-weighted images. The preoperative diagnosis was meningioma or schwannoma. At surgery, the lesion was bluish and completely subpial, with apparent nerve root invasion. Pathological examination revealed a neoplasm adjacent to a nerve root with possible focal infiltration. Abundant reticulin fibers and widened, branching vascular channels imparting a staghorn appearance were seen. Up to five mitotic figures were counted in one high-power field. On immunostaining, the neoplastic cells were diffusely immunoreactive for CD99 and immunonegative for EMA, CD34, and S-100 protein. The pathological diagnosis was consistent with anaplastic hemangiopericytoma, WHO grade III. This is the ninth report of spinal intradural hemangiopericytoma. The location of the neoplasm supports the hypothesis that hemangiopericytoma may arise from the spinal pial capillaries.

  7. Stable complex solitary waves of Sasa Satsuma equation

    Sasanka Ghosh


    Existence of a new class of complex solitary waves is shown for Sasa Satsuma equation. These solitary waves are found to be stable in a certain domain of the parameter and become chaotic if the parameter exceeds the value 2.4. Significantly, the complex solitary waves propagate at higher bit rate over the most stable solitons under the same conditions of the input parameters.

  8. Numerical Study on Breaking Criteria for Solitary Waves

    Chung-ren CHOU; Ruey-syan SHIH; John Z. YIM


    Studies of the breaking criteria for solitary waves on a slope are presented in this paper. The boundary element method is used to model the processes of shoaling and breaking of solitary waves on various slopes. Empirical formulae that can be used to characterize the breaking of solitary waves are presented. These include the breaking index, the wave height, the water depth, and the maximum particle velocity at the point of breaking. Comparisons with the results of other researches are given.

  9. High-dose melphalan followed by radical radiotherapy for the treatment of massive plasmacytoma of the chest wall.

    Das-Gupta, E P; Sidra, G M; Bessell, E M; Lush, R J; Byrne, J L; Russell, N H


    We report three cases of massive chest wall plasmacytoma, each greater than 10 cm in diameter, without evidence of overt myeloma, whom we treated with a combination of VAD chemotherapy consolidated by high-dose melphalan and autologous peripheral blood stem cell transplantation and radical radiotherapy. All three patients completed all components of their therapy without experiencing any major side effects and one patient has had a durable remission. The other two patients have had disease progression but at sites other than the original tumour.

  10. The cruel and unusual phenomenology of solitary confinement

    Shaun eGallagher


    Full Text Available What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a cruel and unusual punishment, there is no consensus on the definition of the term ‘cruel’ in the use of that legal phrase. I argue that we can find a moral consensus on the meaning of ‘cruelty’ by looking specifically at the phenomenology and psychology of solitary confinement.

  11. The cruel and unusual phenomenology of solitary confinement.

    Gallagher, Shaun


    What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a "cruel and unusual punishment," there is no consensus on the definition of the term "cruel" in the use of that legal phrase. I argue that we can find a moral consensus on the meaning of "cruelty" by looking specifically at the phenomenology and psychology of solitary confinement.


    Shivaji D


    Full Text Available Cylindroma is a rare tumour which originates from skin appendages. Cylindromas are of two types namely solitary and multiple. Malignant transformation of cylindroma is unusual and is extremely rare in solitary type. They show strong predilection for middle aged and elderly females. We report a case of a 70 year old male patient presented with nodular swelling along with surface ulceration in the right axillary region since six months, which on histopathological examination revealed a case of malignant transformation of benign solitary cylindroma. We report a rare case of malignant cylindroma arising in a patient with solitary cylindroma at an unusual site

  13. Bulk solitary waves in elastic solids

    Samsonov, A. M.; Dreiden, G. V.; Semenova, I. V.; Shvartz, A. G.


    A short and object oriented conspectus of bulk solitary wave theory, numerical simulations and real experiments in condensed matter is given. Upon a brief description of the soliton history and development we focus on bulk solitary waves of strain, also known as waves of density and, sometimes, as elastic and/or acoustic solitons. We consider the problem of nonlinear bulk wave generation and detection in basic structural elements, rods, plates and shells, that are exhaustively studied and widely used in physics and engineering. However, it is mostly valid for linear elasticity, whereas dynamic nonlinear theory of these elements is still far from being completed. In order to show how the nonlinear waves can be used in various applications, we studied the solitary elastic wave propagation along lengthy wave guides, and remarkably small attenuation of elastic solitons was proven in physical experiments. Both theory and generation for strain soliton in a shell, however, remained unsolved problems until recently, and we consider in more details the nonlinear bulk wave propagation in a shell. We studied an axially symmetric deformation of an infinite nonlinearly elastic cylindrical shell without torsion. The problem for bulk longitudinal waves is shown to be reducible to the one equation, if a relation between transversal displacement and the longitudinal strain is found. It is found that both the 1+1D and even the 1+2D problems for long travelling waves in nonlinear solids can be reduced to the Weierstrass equation for elliptic functions, which provide the solitary wave solutions as appropriate limits. We show that the accuracy in the boundary conditions on free lateral surfaces is of crucial importance for solution, derive the only equation for longitudinal nonlinear strain wave and show, that the equation has, amongst others, a bidirectional solitary wave solution, which lead us to successful physical experiments. We observed first the compression solitary wave in the

  14. Functional characterization of the plasmacytoma variant translocation 1 gene (PVT1) in diabetic nephropathy.

    Alvarez, M Lucrecia; DiStefano, Johanna K


    We previously observed association between variants in the plasmacytoma variant translocation 1 gene (PVT1) and end-stage renal disease (ESRD) attributed to both type 1 and type 2 diabetes, and demonstrated PVT1 expression in a variety of renal cell types. While these findings suggest a role for PVT1 in the development of ESRD, potential mechanisms for involvement remain unknown. The goal of this study was to identify possible molecular mechanisms by which PVT1 may contribute to the development and progression of diabetic kidney disease. We knocked-down PVT1 expression in mesangial cells using RNA interference, and analyzed RNA and protein levels of fibronectin 1 (FN1), collagen, type IV, alpha 1 (COL4A1), transforming growth factor beta 1 (TGFB1) and plasminogen activator inhibitor-1 (SERPINE1 or PAI-1) by qPCR and ELISA, respectively. PVT1 expression was significantly upregulated by glucose treatment in human mesangial cells, as were levels of FN1, COL4A1, TGFB1, and PAI-1. Importantly, PVT1 knockdown significantly reduced mRNA and protein levels of the major ECM proteins, FN1 and COL4A1, and two key regulators of ECM proteins, TGFB1 and PAI-1. However, we observed a higher and more rapid reduction in levels of secreted FN1, COL4A1, and PAI-1 compared with TGFB1, suggesting that at least some of the PVT1 effects on ECM proteins may be independent of this cytokine. These results indicate that PVT1 may mediate the development and progression of diabetic nephropathy through mechanisms involving ECM accumulation.

  15. Functional characterization of the plasmacytoma variant translocation 1 gene (PVT1 in diabetic nephropathy.

    M Lucrecia Alvarez

    Full Text Available We previously observed association between variants in the plasmacytoma variant translocation 1 gene (PVT1 and end-stage renal disease (ESRD attributed to both type 1 and type 2 diabetes, and demonstrated PVT1 expression in a variety of renal cell types. While these findings suggest a role for PVT1 in the development of ESRD, potential mechanisms for involvement remain unknown. The goal of this study was to identify possible molecular mechanisms by which PVT1 may contribute to the development and progression of diabetic kidney disease. We knocked-down PVT1 expression in mesangial cells using RNA interference, and analyzed RNA and protein levels of fibronectin 1 (FN1, collagen, type IV, alpha 1 (COL4A1, transforming growth factor beta 1 (TGFB1 and plasminogen activator inhibitor-1 (SERPINE1 or PAI-1 by qPCR and ELISA, respectively. PVT1 expression was significantly upregulated by glucose treatment in human mesangial cells, as were levels of FN1, COL4A1, TGFB1, and PAI-1. Importantly, PVT1 knockdown significantly reduced mRNA and protein levels of the major ECM proteins, FN1 and COL4A1, and two key regulators of ECM proteins, TGFB1 and PAI-1. However, we observed a higher and more rapid reduction in levels of secreted FN1, COL4A1, and PAI-1 compared with TGFB1, suggesting that at least some of the PVT1 effects on ECM proteins may be independent of this cytokine. These results indicate that PVT1 may mediate the development and progression of diabetic nephropathy through mechanisms involving ECM accumulation.

  16. Changes in Nuclear Orientation Patterns of Chromosome 11 during Mouse Plasmacytoma Development

    Ann-Kristin Schmälter


    Full Text Available Studying changes in nuclear architecture is a unique approach toward the understanding of nuclear remodeling during tumor development. One aspect of nuclear architecture is the orientation of chromosomes in the three-dimensional nuclear space. We studied mouse chromosome 11 in lymphocytes of [T38HxBALB/c]N mice with a reciprocal translocation between chromosome X and 11 (T38HT(X;11 exhibiting a long chromosome T(11;X and a short chromosome T(X;11 and in fast-onset plasmacytomas (PCTs induced in the same strain. We determined the three-dimensional orientation of chromosome 11 using a mouse chromosome 11 specific multicolor banding probe. We also examined the nuclear position of the small translocation chromosome T(X;11 which contains cytoband 11E2 and parts of E1. Chromosomes can point either with their centromeric or with their telomeric end toward the nuclear center or periphery, or their position is found in parallel to the nuclear border. In T38HT(X;11 nuclei, the most frequently observed orientation pattern was with both chromosomes 11 in parallel to the nuclear border (“PP”. PCT cells showed nuclei with two or more copies of chromosome 11. In PCTs, the most frequent orientation pattern was with one chromosome in parallel and the other pointing with its centromeric end toward the nuclear periphery (“CP”. There is a significant difference between the orientation patterns observed in T38HT(X;11 and in PCT nuclei (P < .0001.

  17. Intradural Extramedullary Capillary Hemangioma in the Upper Thoracic Spine: A Review of the Literature

    Yoichiro Takata


    Full Text Available Capillary hemangiomas are benign tumors found in the skin and soft tissues in younger people. They occur in the central nervous system only rarely, and intradural occurrence is extremely rare. We report here a 60-year-old man presenting with thoracic girdle pain and progressive gait disturbance. Magnetic resonance images of the thoracic spine showed a 12×8×20 mm, well-defined intradural mass at the T2 level, compressing the spinal cord laterally. Relative to the spinal cord, the mass was hypo- to isointense on T1-weighted images and relatively hyperintense on T2-weighted images, with strong enhancement on contrast-enhanced T1-weighted images. The patient underwent T1-2 hemilaminectomy with resection of the intradural extramedullary tumor, which showed characteristics of a capillary hemangioma on histologic examination. The patient’s symptoms improved following the surgery and no clinical or radiological evidence of recurrence was noted at the 2-year follow-up. We present this case with a review of the literature, highlighting features for differential diagnosis.

  18. Intradural Extramedullary Capillary Hemangioma in the Upper Thoracic Spine: A Review of the Literature

    Sakai, Toshinori; Higashino, Kosaku; Goda, Yuichiro; Tezuka, Fumitake; Sairyo, Koichi


    Capillary hemangiomas are benign tumors found in the skin and soft tissues in younger people. They occur in the central nervous system only rarely, and intradural occurrence is extremely rare. We report here a 60-year-old man presenting with thoracic girdle pain and progressive gait disturbance. Magnetic resonance images of the thoracic spine showed a 12 × 8 × 20 mm, well-defined intradural mass at the T2 level, compressing the spinal cord laterally. Relative to the spinal cord, the mass was hypo- to isointense on T1-weighted images and relatively hyperintense on T2-weighted images, with strong enhancement on contrast-enhanced T1-weighted images. The patient underwent T1-2 hemilaminectomy with resection of the intradural extramedullary tumor, which showed characteristics of a capillary hemangioma on histologic examination. The patient's symptoms improved following the surgery and no clinical or radiological evidence of recurrence was noted at the 2-year follow-up. We present this case with a review of the literature, highlighting features for differential diagnosis. PMID:25045565

  19. Primary extramedullary spinal melanoma mimicking spinal meningioma: A case report and literature review.

    Li, Yu-Ping; Zhang, Heng-Zhu; She, Lei; Wang, Xiao-Dong; Dong, Lun; Xu, Enxi; Wang, Xing-Dong


    Primary spinal melanoma is a rare lesion, which occurs throughout the cranial and spinal regions, however, is primarily observed in the middle or lower thoracic spine. The clinical features of primary spinal melanoma are complex and unspecific, resulting in a high misdiagnosis rate. In the present case report, a rare case of spinal melanoma exhibiting the dural tail sign and mimicking spinal meningioma is reported. The initial diagnosis, using magnetic resonance imaging (MRI), was unclear. Thus, melanin-containing tumors and spinal meningioma should have been considered in the differential diagnosis. The tumor was completely resected using a standard posterior midline approach, which was followed by chemotherapy. Subsequent to the surgery, the patient was discharged with improved motor capacity and a follow-up MRI scan showed no recurrence after six months. The present study demonstrates that it is critical for neurosurgeons to focus on increasing the accuracy of initial diagnoses in order to make informed decisions regarding the requirement for surgical resection. The present case report presents the clinical, radiological and pathological features of primary extramedullary spinal melanoma mimicking spinal meningioma to emphasize the importance of early identification and diagnosis.

  20. Localization and solitary waves in solid mechanics

    Champneys, A R; Thompson, J M T


    This book is a collection of recent reprints and new material on fundamentally nonlinear problems in structural systems which demonstrate localized responses to continuous inputs. It has two intended audiences. For mathematicians and physicists it should provide useful new insights into a classical yet rapidly developing area of application of the rich subject of dynamical systems theory. For workers in structural and solid mechanics it introduces a new methodology for dealing with structural localization and the related topic of the generation of solitary waves. Applications range from classi

  1. Microtubules: A network for solitary waves

    Zdravković Slobodan


    Full Text Available In the present paper we deal with nonlinear dynamics of microtubules. The structure and role of microtubules in cells are explained as well as one of models explaining their dynamics. Solutions of the crucial nonlinear differential equation depend on used mathematical methods. Two commonly used procedures, continuum and semi-discrete approximations, are explained. These solutions are solitary waves usually called as kink solitons, breathers and bell-type solitons. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III45010

  2. Asymptotic Methods for Solitary Solutions and Compactons

    Ji-Huan He


    Full Text Available This paper is an elementary introduction to some new asymptotic methods for the search for the solitary solutions of nonlinear differential equations, nonlinear differential-difference equations, and nonlinear fractional differential equations. Particular attention is paid throughout the paper to giving an intuitive grasp for the variational approach, the Hamiltonian approach, the variational iteration method, the homotopy perturbation method, the parameter-expansion method, the Yang-Laplace transform, the Yang-Fourier transform, and ancient Chinese mathematics. Hamilton principle and variational principles are also emphasized. The reviewed asymptotic methods are easy to be followed for various applications. Some ideas on this paper are first appeared.

  3. Solitary lucent epiphyseal lesions in children

    Gardner, D.J.; Azouz, E.M.


    We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. 40% of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyoxid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

  4. [Solitary naso-sinusal fibrous tumor].

    Martínez, V; Jiménez, M L; Cuatrecasas, M; Jürgens, A; de Amesti, C; Orus, C; Fabra, J M


    Here we present two clinical cases of solitary naso-sinusal fibrous tumour. This tumour has a mesenchymal origin and has an evident pleural location, with well defined immunohistochemical and ultrastructural characteristics. The clinical manifestation is an apparent benign tumour with an inclination to local aggressiveness. The most effective treatment seems to be surgical removal, but given the low number of cases mentioned (there are only eight cases reported in international literature), and the tendency to eventual recurrence, called for cobalt therapy after surgery. The evolution of clinical cases is irregular.

  5. Study on Solitary Waves of a General Boussinesq Model


    In this paper, we employ the bifurcation method of dynamical systems to study the solitary waves and periodic waves of a generalized Boussinesq equations. All possible phase portraits in the parameter plane for the travelling wave systems are obtained. The possible solitary wave solutions, periodic wave solutions and cusp waves for the general Boussinesq type fluid model are also investigated.

  6. Exact solitary wave solutions of nonlinear wave equations


    The hyperbolic function method for nonlinear wave equations ispresented. In support of a computer algebra system, many exact solitary wave solutions of a class of nonlinear wave equations are obtained via the method. The method is based on the fact that the solitary wave solutions are essentially of a localized nature. Writing the solitary wave solutions of a nonlinear wave equation as the polynomials of hyperbolic functions, the nonlinear wave equation can be changed into a nonlinear system of algebraic equations. The system can be solved via Wu Elimination or Grbner base method. The exact solitary wave solutions of the nonlinear wave equation are obtained including many new exact solitary wave solutions.

  7. The lifecycle of axisymmetric internal solitary waves

    J. M. McMillan


    Full Text Available The generation and evolution of solitary waves by intrusive gravity currents in an approximate two-layer fluid with equal upper- and lower-layer depths is examined in a cylindrical geometry by way of theory and numerical simulations. The study is limited to vertically symmetric cases in which the density of the intruding fluid is equal to the average density of the ambient. We show that even though the head height of the intrusion decreases, it propagates at a constant speed well beyond 3 lock radii. This is because the strong stratification at the interface supports the formation of a mode-2 solitary wave that surrounds the intrusion head and carries it outwards at a constant speed. The wave and intrusion propagate faster than a linear long wave; therefore, there is strong supporting evidence that the wave is indeed nonlinear. Rectilinear Korteweg-de Vries theory is extended to allow the wave amplitude to decay as r-p with p=½ and the theory is compared to the observed waves to demonstrate that the width of the wave scales with its amplitude. After propagating beyond 7 lock radii the intrusion runs out of fluid. Thereafter, the wave continues to spread radially at a constant speed, however, the amplitude decreases sufficiently so that linear dispersion dominates and the amplitude decays with distance as r-1.

  8. Long solitary internal waves in stable stratifications

    W. B. Zimmerman


    Full Text Available Observations of internal solitary waves over an antarctic ice shelf (Rees and Rottman, 1994 demonstrate that even large amplitude disturbances have wavelengths that are bounded by simple heuristic arguments following from the Scorer parameter based on linear theory for wave trapping. Classical weak nonlinear theories that have been applied to stable stratifications all begin with perturbations of simple long waves, with corrections for weak nonlinearity and dispersion resulting in nonlinear wave equations (Korteweg-deVries (KdV or Benjamin-Davis-Ono that admit localized propagating solutions. It is shown that these theories are apparently inappropriate when the Scorer parameter, which gives the lowest wavenumber that does not radiate vertically, is positive. In this paper, a new nonlinear evolution equation is derived for an arbitrary wave packet thus including one bounded below by the Scorer parameter. The new theory shows that solitary internal waves excited in high Richardson number waveguides are predicted to have a halfwidth inversely proportional to the Scorer parameter, in agreement with atmospheric observations. A localized analytic solution for the new wave equation is demonstrated, and its soliton-like properties are demonstrated by numerical simulation.

  9. Solitary fibrous tumor surrounding the carotid sheath.

    Gómez-Oliveira, Guillermo; Alvarez-Flores, Modesto; Arribas-García, Ignacio; Martínez-Gimeno, Carlos


    Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms that are mostly found arising from the pleura. Although SFTs recently have been reported in other regions, they are rare in the head and neck and have often been misdiagnosed due to their rarity. SFTs are benign in most cases. Clinically, SFTs usually manifest as well-circumscribed, slow-growing, smooth and painless masses. Symptoms are often minimal, although they may include sore throat, difficulty in swallowing, change of voice or trismus. CT-Scan and MRI are the most sensitive imaging procedures used. The treatment of choice is complete surgical excision of the lesion. Because recurrences have been noted up to 30 years after surgery, long-term follow up is mandatory. In this article, we present a case of a Solitary Fibrous Tumor arising in the parapharyngeal space in a 20-year-old man, involving the carotid sheath, treated by surgical excision with no recurrence after 1 year. The clinical presentation, surgical management and pathological findings are described.

  10. Extramedullary hematopoiesis presenting as a compressive cord and cerebral lesion in a patient without a significant hematologic disorder: a case report

    Seddighi Amir


    Full Text Available Abstract Introduction Intracranial or spinal compressive lesions due to extramedullary hematopoiesis have been reported in the medical literature. Most of the reported cases are extradural lesions or, on rare occasions, foci within another neoplasm such as hemangioblastoma, meningioma or pilocytic astrocytoma. Often these cases occur in patients with an underlying hematological disorder such as acute myelogenic leukemia, myelofibrosis, or other myelodysplastic syndromes. Such lesions have also been reported in thalassemia major. Case presentation We report the case of a 43-year-old Iranian woman in whom extramedullary hematopoiesis presented as a compressive cord lesion and then later as an intracranial lesion. Conclusions To the best of our knowledge, we document the first reported case of sacral, lumbar, thoracic and cranial involvement in the same patient with extramedullary hematopoiesis, which seems both rare and remarkable.

  11. The efficacy of resection of an intradural extramedullary foramen magnum cavernous malformation presenting with repeated subarachnoid hemorrhage: a case report.

    Oishi, Tomoya; Sakai, Naoto; Sameshima, Tetsuro; Kawaji, Hiroshi; Namba, Hiroki


    Intradural extramedullary cavernous angiomas of the central nervous system are a rare type of cavernous angioma, but they can cause fatal subarachnoid hemorrhage. The efficacy of resection for this type of cavernous malformations remains uncertain. This is the first report to recommend surgical resection of these types of lesions regardless of the fatal condition. Our patient was a 70-year-old Japanese man who experienced a sudden onset of an occipital headache, followed by bilateral abducens nerve palsy. Magnetic resonance imaging revealed a small amount of hemorrhage in both of the lateral ventricles and an intradural extramedullary mass lesion in the left side of his foramen magnum. Two weeks after the appearance of initial symptoms, he became comatose. A computed tomography scan showed an increase in the subarachnoid intraventricular hemorrhaging and of the acute hydrocephalus. Following ventricular drainage, total tumor resection was performed using the lateral suboccipital transcondylar approach in conjunction with a first cervical hemilaminectomy. We observed a grape-like vascular-rich tumor with calcification that was adhering tightly to the wall of his left vertebral artery. A histopathological examination of the surgery specimen identified it as a cavernous angioma. After placement of a ventriculoperitoneal shunt and 2 months of rehabilitation, he recovered completely. An intradural extramedullary foramen magnum cavernous malformation is quite rare. The fragile surface of our patient's lesion was causing repeated subarachnoid hemorrhage and consequently progressive fatal neurological deterioration. Surgical resection of the lesion to prevent repeated hemorrhage was performed and he recovered fully. Therefore, we recommend surgical resection of the lesion regardless of the potentially fatal condition.

  12. Extramedullary hematopoiesis is associated with lower cardiac iron loading in chronically transfused thalassemia patients.

    Ricchi, Paolo; Meloni, Antonella; Spasiano, Anna; Neri, Maria Giovanna; Gamberini, Maria Rita; Cuccia, Liana; Caruso, Vincenzo; Gerardi, Calogera; D'Ascola, Domenico Giuseppe; Rosso, Rosamaria; Campisi, Saveria; Rizzo, Michele; Terrazzino, Fabrizia; Vangosa, Alessandra Briatico; Chiodi, Elisabetta; Missere, Massimiliano; Mangione, Maurizio; Positano, Vincenzo; Pepe, Alessia


    The aim of this study was to evaluate, in a large cohort of chronically transfused patients, whether the presence of extramedullary hematopoiesis (EMH) accounts for the typical patterns of cardiac iron distribution and/or cardiac function parameters. We retrospectively selected 1,266 thalassemia major patients who had undergone regular transfusions (611 men and 655 women; mean age: 31.3 ± 8.9 years, range: 4.2-66.6 years) and were consecutively enrolled within the Myocardial Iron Overload in Thalassemia network. The presence of EMH was evaluated based on steady-state free precession sequences; cardiac and liver iron overloads were quantified using a multiecho T2* approach; cardiac function parameters and pulmonary diameter were quantified using the steady-state free precession sequences; and myocardial fibrosis was evaluated using the late gadolinium enhancement technique. EMH was detected in 167 (13.2%) patients. The EMH+ patients had significantly lower cardiac iron overload than that of the EMH- patients (P = 0.003). The patterns of cardiac iron distribution were significantly different in the EMH+ and EMH- patients (P < 0.0001), with a higher prevalence of patients with no myocardial iron overload and heterogeneous myocardial iron overload and no significant global heart iron in the EMH+ group EMH+ patients had a significantly higher left ventricle mass index (P = 0.001) and a significantly higher pulmonary artery diameter (P = 0.002). In conclusion, in regularly transfused thalassemia patients, EMH was common and was associated with a thalassemia intermedia-like pattern of cardiac iron deposition despite regular transfusion therapy.

  13. Extramedullary Relapse Following Total Marrow and Lymphoid Irradiation in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation

    Kim, Ji Hyun [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Stein, Anthony [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Tsai, Nicole [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Schultheiss, Timothy E. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Palmer, Joycelynne [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Liu, An [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Rosenthal, Joseph [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Department of Pediatrics, City of Hope National Medical Center, Duarte, California (United States); Forman, Stephen J. [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Wong, Jeffrey Y.C., E-mail: [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States)


    Purpose: Approximately 5% to 20% of patients who undergo total body irradiation (TBI) in preparation for hematopoietic cell transplantation (HCT) can develop extramedullary (EM) relapse. Whereas total marrow and lymphoid irradiation (TMLI) provides a more conformally targeted radiation therapy for patients, organ sparing has the potential to place the patient at a higher risk for EM relapse than TBI. This study evaluated EM relapse in patients treated with TMLI at our institution. Methods and Materials: Patients eligible for analysis had been enrolled in 1 of 3 prospective TMLI trials between 2006 and 2012. The TMLI targeted bones, major lymph node chains, liver, spleen, testes, and brain, using image-guided tomotherapy with total dose ranging from 12 to 15 Gy. Results: A total of 101 patients with a median age of 47 years were studied. The median follow-up was 12.8 months. Incidence of EM relapse and bone marrow (BM) relapse were 12.9% and 25.7%, respectively. Of the 13 patients who had EM relapse, 4 also had BM relapse, and 7 had EM disease prior to HCT. There were a total of 19 EM relapse sites as the site of initial recurrence: 11 soft tissue, 6 lymph node, 2 skin. Nine of these sites were within the target region and received ≥12 Gy. Ten initial EM relapse sites were outside of the target region: 5 sites received 10.1 to 11.4 Gy while 5 sites received <10 Gy. Pretransplantation EM was the only significant predictor of subsequent EM relapse. The cumulative incidence of EM relapse was 4% at 1 year and 11.4% at 2 years. Conclusions: EM relapse incidence was as frequent in regions receiving ≥10 Gy as those receiving <10 Gy. EM relapse rates following TMLI that included HCT regimens were comparable to published results with regimens including TBI and suggest that TMLI is not associated with an increased EM relapse risk.

  14. Extramedullary foramen magnum tumors and their surgical management: An experience with 29 cases.

    Das, Kuntal Kanti; Kumar, Rajan; Ashish, Kumar; Bettaswamy, Guruprasad; Mehrotra, Anant; Jaiswal, Sushila; Sahu, Rabi Narayan; Jaiswal, Awadhesh Kumar; Behari, Sanjay


    Surgical management of foramen magnum (FM) tumors is challenging by virtue of their location and vital neurovascular relationships. The ideal approach to anterior/anterolateral tumors continue to evoke controversy even in the modern era. In this article, we present and discuss our experience in the surgical management of these tumors. This retrospective study includes 29 consecutive patients (mean age 36.6 years, M: F = 2.63:1) of extramedullary tumors at the surgical foramen magnum, operated at our center, between 2007 and 2012. Their mean duration of symptoms was 14. 6 months. A majority of the patients presented with motor symptoms (quadri/paraparesis, n = 21, 72.4%), neck pain with/without suboccipital radiation (n = 16, 55.2%) and sensory symptoms like tingling/numbness (n = 16, 55.2%). There were nine extradural (31%) and 20 intradural tumors (69%). Most of the tumors were located posterolateral to the neuraxis (n = 13, 44.8%). Nerve sheath tumors (n = 11, 38%) and meningiomas (n = 5, 17.2%) were the most commonly encountered histologies in our series. The standard posterior approach was the most frequently employed surgical approach (n = 20, 69%). Operative mortality and morbidity were 3.4 and 18.9%, respectively. At a mean follow-up of 27.3 months, 13 out of the 18 available patients improved. A majority of the foramen magnum tumors are amenable to excision via the standard posterior approach. Small anterior dural-based meningiomas/recurrent tumors may require a lateral approach like the far lateral approach.

  15. Extramedullary (EMP) relapse in unusual locations in multiple myeloma: Is there an association with precedent thalidomide administration and a correlation of special biological features with treatment and outcome?

    Katodritou, E; Gastari, V; Verrou, E; Hadjiaggelidou, C; Varthaliti, M; Georgiadou, S; Laschos, K; Xirou, P; Yiannaki, E; Constantinou, N; Markala, D; Zervas, K


    Extramedullary relapse constitutes an uncommon manifestation of multiple myeloma (MM), characterized by highly malignant histology, special biological features, resistance to treatment and poor outcome. Its incidence has been increased during the last years, probably due to the introduction of novel strategies in the management of MM, including intensified treatment and immunomodulatory drugs. Here we report nine cases of extramedullary relapse of MM, presented in unusual locations, seven of which had previously been treated with thalidomide-containing regimens (TCR). Our aim was to explore the morphological, immunophenotypical, molecular and laboratory characteristics accompanying EMP-relapse and seek possible correlations with treatment and clinical outcome.

  16. Daunorubicin, Cytarabine, and Cladribine Regimen Plus Radiotherapy and Donor Lymphocyte Infusion for Extramedullary Relapse of Acute Myeloid Leukemia after Hematopoietic Stem Cell Transplantation

    Marco Sanna


    Full Text Available Myeloid sarcoma is a rare tumor consisting of myeloid blasts that involve anatomic sites outside the bone marrow. Fatal prognosis is inevitable in patients with extramedullary relapse after hematopoietic stem cell transplantation (HSCT, and no standard treatments are available yet. We report the first case of extramedullary relapse after HSCT treated with a combination of daunorubicin, cytarabine, and cladribine (DAC regimen plus radiotherapy and donor lymphocyte infusion (DLI. This treatment induced a new and durable remission in our patient. The favorable toxicity profile and the reduced cost make this combination worthy of further investigations.

  17. Weak bond detection in composites using highly nonlinear solitary waves

    Singhal, Taru; Kim, Eunho; Kim, Tae-Yeon; Yang, Jinkyu


    We experimentally investigate a diagnostic technique for identifying a weak bond in composites using highly nonlinear solitary waves (HNSWs). We set up a one-dimensional chain of granular crystals, consisting of spherical particles with nonlinear interactions, to generate HNSWs. These solitary wave packets are transmitted into an inspection area of composites by making a direct contact with the chain. We demonstrate that a strong type of solitary waves injected to the weak bond area can break the weak bond of laminates, thereby causing delamination. Then, to identify the creation of the delamination, we transmit a weak type of solitary waves by employing the same apparatus, and measure the solitary waves reflected from the specimens. By analyzing these reflected solitary waves, we differentiate the weak bond samples with the pristine bond ones in an efficient and fast manner. The diagnostic results based on the proposed method are compared with the strength and energy release rate at bond interfaces, which are measured via standard testing methods such as three point bending and end notched flexure tests. This study shows the potential of solitary wave-based detection of weak bonds for hot spot monitoring of composite-based structures.

  18. {sup 18}F-F.D.G. PET for staging and monitoring of solitary plasmocytomas;La TEP au {sup 18}F-FDG dans le diagnostic et le suivi evolutif des plasmocytomes solitaires

    Adib, S.; Robua, D.; Huglo, D.; Steinling, M. [CHU de Lille, rue Michel-Polonovski, Service de medecine nucleaire, hopital Claude-Huriez, 59 - Lille (France); Robua, D.; Leleu, X. [CHU de Lille, rue Michel-Polonovski, Service des maladies du sang, hopital Claude-Huriez, 59 - Lille (France)


    Aim: To assess the role of [{sup 18}F]F.D.G.-PET in solitary plasmocytomas with regards to staging, therapeutic follow-up and monitoring. Patients and methods. Twenty consecutive patients were included in the present study when following conditions were met: (1) solitary plasmocytomas histologically confirmed (bone, n = 16; extramedullary, n = 4); (2) [{sup 18}F]F.D.G.-PET scan from July 2004 to April 2009. The clinical follow-up was over than 2 years for 13 patients. Ten patients underwent a post-therapy PET scan. PET scans were visually analysed. Results. PET scan enabled confirmation of all main lesions (sensitivity: 100%) and also detected infra-clinical lesions in eight cases. Follow-up for more than 2 years showed a progression disease into myeloma in five from six cases (83%) with infra clinical lesions at the baseline PET scan. Among 10 patients who underwent post-therapeutic PET scan, six experienced a complete response at the main lesion site and four experienced a partial response. Conclusion: F.D.G.-PET may play an important role in plasmocytomas staging and enables detection of smaller lesions (otherwise undetected). (authors)

  19. A solitary fibrous tumor of the kidney

    Anuruddha M Abeygunasekera


    Full Text Available A solitary fibrous tumor (SFT is an uncommon spindle cell neoplasm that usually occurs in the pleura, but may occur in extrapleural sites. Its occurrence in the kidney is rare. We report a SFT, clinically thought to be a renal cell carcinoma arising in the kidney of a 68-year-old female. The tumor was well-circumscribed and composed of a mixture of spindle cells and dense collagenous bands. Immunohistochemical studies revealed reactivity for CD34, CD99, and Bcl-2 protein, with no staining for keratin or muscle markers, confirming the diagnosis. The immunohistochemical study was the key to diagnosis. Several younger members of her family had colorectal and lung cancers suggesting the possibility of a familial or genetic susceptibility.

  20. Solitary waves of the splitted RLW equation

    Zaki, S. I.


    A combination of the splitting method and the cubic B-spline finite elements is used to solve the non-linear regularized long wave (RLW) equation. This approach involves a Bubnov-Galerkin method with cubic B-spline finite elements so that there is continuity of the dependent variable and its first derivative throughout the solution region. Time integration of the resulting systems is effected using a Crank-Nicholson approximation. In simulations of the migration of a single solitary wave this algorithm is shown to have higher accuracy and better conservation than a recent splitting difference scheme based on cubic spline interpolation functions, for different amplitudes ranging from a very small ( ⩾0.03) to a considerably high amplitudes ( ⩽0.3). The development of an undular bore is modeled.

  1. Numerical Simulation of Solitary Kinetic Alfven Waves

    DING Jian; LI Yi; WANG Shui


    Using the two-fluid model in the case of α1 (α=β/2Q, β is the ratio of thermal pressure to magnetic pressure, and Q=m,e/m,I), we numerically investigate the interactions between two solitary kinetic Alfven waves (SKAWs) and between an SKAW and a density discontinuity. The results show that the two SKAWs would remain in their original shapes and propagate at their initiating speeds, which indicates that SKAWs behave just like standard solitons. The simulation also shows that SKAWs will reflect and refract when crossing a discontinuity and propagating into a higher density region. The transmission wave is an SKAW with increasing density, and the reverberation is a disturbance with lower amplitude.

  2. Benign solitary solid cold thyroid nodules

    Døssing, Helle; Bennedbaek, Finn Noe; Karstrup, Steen;


    PURPOSE: To evaluate the effects of ultrasonography (US)-guided interstitial laser photocoagulation (ILP) on the volume of benign solitary solid cold thyroid nodules and any nodule-related symptoms. MATERIALS AND METHODS: ILP was performed in 16 patients with normal thyroid function and a solid...... to evaluate the size of the untreated thyroid nodule. RESULTS: In the 16 patients treated with ILP, the mean thyroid nodule volume decreased from 10 to 5.4 mL (P .... Pressure symptoms were significantly reduced (P =.0002) after 6 months. The treatment was well-tolerated in all patients. No significant change in thyroid nodule volume was seen in the control group. CONCLUSION: US-guided ILP could become a useful nonsurgical alternative in the treatment of the benign...

  3. Transparent lattices and their solitary waves.

    Sadurní, E


    We provide a family of transparent tight-binding models with nontrivial potentials and site-dependent hopping parameters. Their feasibility is discussed in electromagnetic resonators, dielectric slabs, and quantum-mechanical traps. In the second part of the paper, the arrays are obtained through a generalization of supersymmetric quantum mechanics in discrete variables. The formalism includes a finite-difference Darboux transformation applied to the scattering matrix of a periodic array. A procedure for constructing a hierarchy of discrete Hamiltonians is indicated and a particular biparametric family is given. The corresponding potentials and hopping functions are identified as solitary waves, pointing to a discrete spinorial generalization of the Korteweg-deVries family.

  4. Solitary vortex couples in viscoelastic Couette flow

    Groisman, A; Groisman, Alexander; Steinberg, Victor


    We report experimental observation of a localized structure, which is of a new type for dissipative systems. It appears as a solitary vortex couple ("diwhirl") in Couette flow with highly elastic polymer solutions. A unique property of the diwhirls is that they are stationary, in contrast to the usual localized wave structures in both Hamiltonian and dissipative systems which are stabilized by wave dispersion. It is also a new object in fluid dynamics - a couple of vortices that build a single entity somewhat similar to a magnetic dipole. The diwhirls arise as a result of a purely elastic instability through a hysteretic transition at negligible Reynolds numbers. It is suggested that the vortex flow is driven by the same forces that cause the Weissenberg effect. The diwhirls have a striking asymmetry between the inflow and outflow, which is also an essential feature of the suggested elastic instability mechanism.

  5. Solitary Fibrous Tumor of the Cerebello-Pontine Angle

    Biggs, Nigel D.; Fagan, Paul A.; Turner, Jennifer J.; Doust, Bruce


    A case is presented of solitary fibrous tumor occurring in the cerebello-pontine angle. There have been only two other reported cases of a solitary fibrous tumors in this region. Imaging studies showed the tumor to be characteristic in shape and position of an acoustic tumor. However, at surgery the tumor was found to have a “rock hard” consistency. Solitary fibrous tumor differs from acoustic schwannoma and meningioma in its histopathological features and in this case, regrowth, after incomplete excision, was extremely rapid. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6 PMID:17171119

  6. Generation of Solitary Rossby Waves by Unstable Topography

    YANG Hong-Wei; YIN Bao-Shu; DONG Huan-He


    The effect of topography on generation of the solitary Rossby waves is researched. Here, the topography, as a forcing for waves generation, is taken as a function of longitude variable x and time variable t, which is called unstable topography. With the help of a perturbation expansion method, a forced mKdv equation governing the evolution of amplitude of the solitary Rossby waves is derived from quasi-geostrophic vortieity equation and is solved by the pseudo-spectral method. Basing on the waterfall plots, the generational features of the solitary Rossby waves under the influence of unstable topography and stable topography are compared and some conclusions are obtained.

  7. Head-on collision and overtaking collision between an envelope solitary wave and a KdV solitary wave in a dusty plasma.

    Zhang, Heng; Duan, Wen-Shan; Qi, Xin; Yang, Lei


    Head-on collision and overtaking collision between a KdV solitary wave and an envelope solitary wave are first studied in present paper by using Particle-in-cell (PIC) method in a dusty plasma. There are phase shifts of the KdV solitary wave in both head-on collision and the overtaking collision, while no phase shift is found for the envelop solitary wave in any cases. The remarkable difference between head-on collision and the overtaking collision is that the phase shift of KdV solitary wave increases as amplitude of KdV solitary wave increases in head-on collision, while it decreases as amplitude of the KdV solitary wave increases in the overtaking collision. It is found that the maximum amplitude during the collision process is less than sum of two amplitudes of both solitary waves, but is larger than either of the amplitude.

  8. A plethora of generalised solitary gravity-capillary water waves

    Clamond, Didier; Duran, Angel


    The present study describes, first, an efficient algorithm for computing gravity-capillary solitary waves solutions of the irrotational Euler equations and, second, provides numerical evidences of the existence of (likely) an infinite number of generalised solitary waves (i.e. solitary waves with undamped oscillatory wings). Using conformal mapping, the unknown fluid domain (which is to be determined) is mapped into a uniform strip of the complex plane. A Babenko-like equation is then derived from a Lagrangian expressed in the transformed domain. The Babenko equation is then solved numerically using a Levenberg-Marquardt algorithm. Various interesting solutions are computed, some of them being known, some seem to be new. The emergence of generalised solitary waves is shown when the Bond number is increased.

  9. Oblique solitary waves in a five component plasma

    Sijo, S.; Manesh, M.; Sreekala, G.; Venugopal, C., E-mail: [School of Pure and Applied Physics, Mahatma Gandhi University, Kottayam, 686 560 Kerala (India); Neethu, T. W. [Department of Physics, CMS College, Mahatma Gandhi University, Kottayam, 686 001 Kerala (India); Renuka, G. [Kerala State Council for Science, Technology and Environment, Thiruvananthapuram, 695 004 Kerala (India)


    We investigate the influence of a second electron component on oblique dust ion acoustic solitary waves in a five component plasma consisting of positively and negatively charged dust, hydrogen ions, and hotter and colder electrons. Of these, the heavier dust and colder photo-electrons are of cometary origin while the other two are of solar origin; electron components are described by kappa distributions. The K-dV equation is derived, and different attributes of the soliton such as amplitude and width are plotted for parameters relevant to comet Halley. We find that the second electron component has a profound influence on the solitary wave, decreasing both its amplitude and width. The normalized hydrogen density strongly influences the solitary wave by decreasing its width; the amplitude of the solitary wave, however, increases with increasing solar electron temperatures.

  10. Solitary pulmonary granuloma with marked enhancement on dynamic CT scanning

    Stark, P.; Wong, V.; Gold, P.


    A patient is described who presented with a vividly enhancing solitary pulmonary nodule during dynamic CT scanning. This mass proved to represent a granuloma due to coccidioidomycosis. The presumptive mechanism of enhancement as well as the differential diagnosis are discussed.

  11. Solitary mesenteric vascular anomaly presenting as acute abdomen

    Thambidorai C


    Full Text Available A 4-year-old girl with a solitary vascular anomaly of the mesentery presented with acute lower abdominal pain. Despite the use of ultrasound, computed tomography scan and image-guided core biopsies, the lesion was initially mistaken for an inflammatory intra-abdominal mass. The correct diagnosis was made at laparotomy. Solitary vascular anomaly of the mesentery is rare and its presentation as an acute abdomen has not been reported before.

  12. Solitary osteochondroma arising from cervical spina bifida occulta.

    Ofluoglu, Ali Ender; Abdallah, Anas; Gokcedag, Akin


    Solitary osteochondromas are common benign long bone tumors originating from cartilage. They may produce a wide variety of symptoms and complications depending on their spinal location. These may include compressive myelopathy, nerve root compression, pathologic fracture and malignant degeneration, or in some cases only pain. Solitary cervical spine osteochondromas have been reported mostly in the neural arch or vertebral body. This report describes a patient presenting with neck pain, with a benign osteochondroma arising in the right bifid C5 lamina.

  13. [Adenocarcinoma of lung cancer with solitary metastasis to the stomach].

    Koh, Sung Ae; Lee, Kyung Hee


    Although hematogenous metastasis of cancer to the gastrointestinal track is rare, it sometime has been reported in patients with malignant melanoma and breast cancer. However, it is extremely rare for lung cancer to metastasize to the stomach, not to mention solitary gastric metastasis. Herein, the authors report a case of a 69-year-old man who was initially diagnosed with lung cancer with synchronous primary gastric cancer which proved to be lung cancer with solitary gastric metastasis after the operation.

  14. A Case of Multiple Myeloma with Lung Involvement

    Kaushik Saha


    Full Text Available Plasmacytoma are extramedullary accumulations of plasma cells. Mostextramedullary plasmacytomas are associated with the upper respiratory tract. The lung is rarely involved. We report a rare case of lung plasmacytoma with multiple myeloma. The patient is a 60-year-old male who presented with chest pain and a lung mass visualized on CT scan. A preliminary diagnosis of occult lung cancer with widespread skeletal metastasis was made. The diagnosis of lung plasmacytoma with multiplemyeloma was made after extensive investigations.

  15. Solitary Wave in One-dimensional Buckyball System at Nanoscale

    Xu, Jun; Zheng, Bowen; Liu, Yilun


    We have studied the stress wave propagation in one-dimensional (1-D) nanoscopic buckyball (C60) system by molecular dynamics (MD) simulation and quantitative modeling. Simulation results have shown that solitary waves are generated and propagating in the buckyball system through impacting one buckyball at one end of the buckyball chain. We have found the solitary wave behaviors are closely dependent on the initial temperature and impacting speed of the buckyball chain. There are almost no dispersion and dissipation of the solitary waves (stationary solitary wave) for relatively low temperature and high impacting speed. While for relatively high temperature and low impacting speed the profile of the solitary waves is highly distorted and dissipated after propagating several tens of buckyballs. A phase diagram is proposed to describe the effect of the temperature and impacting speed on the solitary wave behaviors in buckyball system. In order to quantitatively describe the wave behavior in buckyball system, a simple nonlinear-spring model is established, which can describe the MD simulation results at low temperature very well. The results presented in this work may lay a solid step towards the further understanding and manipulation of stress wave propagation and impact energy mitigation at nanoscale. PMID:26891624

  16. On cusped solitary waves in finite water depth

    Liao, Shijun


    It is well-known that the Camassa-Holm (CH) equation admits both of the peaked and cusped solitary waves in shallow water. However, it was an open question whether or not the exact wave equations can admit them in finite water depth. Besides, it was traditionally believed that cusped solitary waves, whose 1st-derivative tends to infinity at crest, are essentially different from peaked solitary ones with finite 1st-derivative. Currently, based on the symmetry and the exact water wave equations, Liao [1] proposed a unified wave model (UWM) for progressive gravity waves in finite water depth. The UWM admits not only all traditional smooth progressive waves but also the peaked solitary waves in finite water depth: in other words, the peaked solitary progressive waves are consistent with the traditional smooth ones. In this paper, in the frame of the linearized UWM, we further give, for the first time, the cusped solitary waves in finite water depth, and besides reveal a close relationship between the cusped and p...

  17. Solitary mammals provide an animal model for autism spectrum disorders.

    Reser, Jared Edward


    Species of solitary mammals are known to exhibit specialized, neurological adaptations that prepare them to focus working memory on food procurement and survival rather than on social interaction. Solitary and nonmonogamous mammals, which do not form strong social bonds, have been documented to exhibit behaviors and biomarkers that are similar to endophenotypes in autism. Both individuals on the autism spectrum and certain solitary mammals have been reported to be low on measures of affiliative need, bodily expressiveness, bonding and attachment, direct and shared gazing, emotional engagement, conspecific recognition, partner preference, separation distress, and social approach behavior. Solitary mammals also exhibit certain biomarkers that are characteristic of autism, including diminished oxytocin and vasopressin signaling, dysregulation of the endogenous opioid system, increased Hypothalamic-pituitary-adrenal axis (HPA) activity to social encounters, and reduced HPA activity to separation and isolation. The extent of these similarities suggests that solitary mammals may offer a useful model of autism spectrum disorders and an opportunity for investigating genetic and epigenetic etiological factors. If the brain in autism can be shown to exhibit distinct homologous or homoplastic similarities to the brains of solitary animals, it will reveal that they may be central to the phenotype and should be targeted for further investigation. Research of the neurological, cellular, and molecular basis of these specializations in other mammals may provide insight for behavioral analysis, communication intervention, and psychopharmacology for autism.

  18. Solitary fibrous tumor of the pleura.

    Marak, Creticus P; Dorokhova, Olena; Guddati, Achuta K


    Solitary fibrous tumor of the pleura (SFTP) is a rare tumor of mesenchymal origin which can grow to a large size and present with symptoms of cough and pleuritic chest pain. No specific etiological factors for SFTPs are known and they may grow undetected for several years. These tumors are usually benign and may mimic a variety of malignancies. SFTPs are often detected as peripheral opacities on chest X-ray. Unfortunately, fine needle aspiration rarely provides adequate information for a definitive diagnosis. Imaging with computed tomography provides details about the size and extent of any invasion into adjacent tissues. Surgical resection is the mainstay of treatment, and immunohistochemistry of the resected tumor often provides confirmation of the diagnosis. Some SFTPs have been observed to be malignant, and surgical intervention is often lifesaving. There is no adequate data to support the usage of radiotherapy and chemotherapy in the treatment of SFTPs. This tumor exemplifies malignancies which require surgical resection to preempt worse outcomes. Awareness of their presentation and clinical course may help the clinician provide a prompt referral to the thoracic surgeon for resection.

  19. Food searching and superparasitism in solitary parasitoids

    Sirot, Etienne; Bernstein, Carlos

    Optimality theory predicts that, provided that a larva resulting from superparasitism has some chance of winning the competition with the other larvae present in the host, under certain conditions, solitatry parasitoids should resort to superparasitism. Both theoretical and experimental studies have shown that the life expectancy of the parasitoid has a strong influence on the decision to reject or to accept superparasitism. In many species, life expectancy on its turn depends on the feeding behaviour of the parasitoids, which have to forage for non-host food (mainly plant materials), for the maintenance of their energy reseves. As many solitary parasitoids do not find non-host food in their host patches, they have to choose at each instant whether to search for food or to search for hosts. In this paper, we develop a stochastic dynamic programming model to study the behavioural choice between host and food searching, and its consequences for the acceptance and rejection of superparasitism. We study the influence of habitat quality and parasitoid physiological state on the optimal choice. The model predicts that the crucial point determining the optimal strategy is the balance between egg-and time-limitation.

  20. Intracranial solitary fibrous tumor: Imaging findings

    Clarencon, Frederic, E-mail: [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Bonneville, Fabrice [Department of Neuroradiology, Hopital Rangueil, Toulouse University Hospital, 31000 Toulouse (France); Rousseau, Audrey [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Galanaud, Damien [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Kujas, Michele [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Naggara, Olivier [Department of Neuroradiology, St Anne Hospital, 75014 Paris (France); Cornu, Philippe [Department of Neurosurgery, Pitie-Salpetriere Hospital (France); Chiras, Jacques [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France)


    Objective: To study the neuroimaging features of intracranial solitary fibrous tumors (ISFTs). Materials and methods: Retrospective study of neuroimaging features of 9 consecutive histopathologically proven ISFT cases. Location, size, shape, density, signal intensity and gadolinium uptake were studied at CT and MRI. Data collected from diffusion-weighted imaging (DWI) (3 patients), perfusion imaging and MR spectroscopy (2 patients), and DSA (4 patients) were also analyzed. Results: The tumors most frequently arose from the intracranial meninges (7/9), while the other lesions were intraventricular. Tumor size ranged from 2.5 to 10 cm (mean = 6.6 cm). They presented multilobular shape in 6/9 patients. Most ISFTs were heterogeneous (7/9) with areas of low T2 signal intensity that strongly enhanced after gadolinium administration (6/8). Erosion of the skull was present in about half of the cases (4/9). Components with decreased apparent diffusion coefficient were seen in 2/3 ISFTs on DWI. Spectroscopy revealed elevated peaks of choline and myo-inositol. MR perfusion showed features of hyperperfusion. Conclusion: ISFT should be considered in cases of extra-axial, supratentorial, heterogeneous, hypervascular tumor. Areas of low T2 signal intensity that strongly enhance after gadolinium injection are suggestive of this diagnosis. Restricted diffusion and elevated peak of myo-inositol may be additional valuable features.

  1. Solitary magnetic perturbations at the ELM onset

    Wenninger, RP; Boom, JE; Burckhart, A; Dunne, MG; Dux, R; Eich, T; Fischer, R; Fuchs, C; Garcia-Munoz, M; Igochine, V; Hoelzl, M; Luhmann, NC; Lunt, T; Maraschek, M; Mueller, HW; Park, HK; Schneider, PA; Sommer, F; Suttrop, W; Viezzer, E


    Edge localised modes (ELMs) allow maintaining sufficient purity of tokamak H-mode plasmas and thus enable stationary H-mode. On the other hand in a future device ELMs may cause divertor power flux densities far in excess of tolerable material limits. The size of the energy loss per ELM is determined by saturation effects in the non-linear phase of the ELM, which at present is hardly understood. Solitary magnetic perturbations (SMPs) are identified as dominant features in the radial magnetic fluctuations below 100kHz. They are typically observed close (+-0.1ms) to the onset of pedestal erosion. SMPs are field aligned structures rotating in the electron diamagnetic drift direction with perpendicular velocities of about 10km/s. A comparison of perpendicular velocities suggests that the perturbation evoking SMPs is located at or inside the separatrix. Analysis of very pronounced examples showed that the number of peaks per toroidal turn is 1 or 2, which is clearly lower than corresponding numbers in linear stabil...

  2. Solitary caecum diverticulitis mimicking acute appendicitis.

    Hot, Semih; Eğin, Seracettin; Gökçek, Berk; Yeşiltaş, Metin; Alemdar, Ali; Akan, Arzu; Karahan, Servet Rüştü


    Solitary cecum diverticulum is a benign formation, but it can be complicated with inflammation, perforation and bleeding. Cecum diverticulitis (CD) is the most common complication of caecal diverticulum and it has the highest incidence among Asians, but it is a rare condition in the western world. The incidence of colonic diverticular disease can vary according to national origin, cultural structure and nutritional habits. CD is not common in our country, but it is an important situation because of its clinical similarity with the commonly seen acute right side abdominal diseases like acute appendicitis. Preoperative diagnosis is difficult, and hence, the actual frequency is not known. The treatment of CD can vary from medical therapy to right hemi colectomy. In this study, we presented ten CD cases on whom surgical resection was performed in our surgery unit during the last 8 years. Our purpose was to increase the awareness of surgeons about this situation, and so, make them pay attention for not having their first experience in the operating room.

  3. Solitary infantile myofibromatosis of the cranial vault: case report.

    Merciadri, Paolo; Pavanello, Marco; Nozza, Paolo; Consales, Alessandro; Ravegnani, Giuseppe Marcello; Piatelli, Gianluca; Gandolfo, Carlo; Cama, Armando


    Infantile myofibromatosis is a mesenchymal disorder of early childhood characterized by the formation of tumors in the skin, muscle, viscera, bone, and subcutaneous tissue. Although relatively rare overall, it represents the most common fibrous tumor of infancy. The etiology of this disorder is unknown. Infantile myofibromatosis can present as a solitary or multicentric form. With the multicentric form, bone is often involved, but solitary bone lesions account for only 10% of the cases. Imaging findings are not pathognomonic, and the differential diagnosis usually includes eosinophilic granuloma (Langerhans cell histiocytosis), osteomyelitis, metastasis, osteoblastoma, epidermoid cyst, hemangioma, fibrous dysplasia, fibrosarcoma, and meningioma. A histological pattern is typical, but there are no histopathological differences between the solitary and multicentric forms. Solitary lesions generally have a favorable prognosis if totally removed, with a 10% recurrence rate; incompletely resected lesions recur. We report the case of a 9-year-old boy who came to our attention with a solitary infantile myofibroma of the calvarium, appearing as a tight-elastic, lightly tender mass in the left frontal area, eroding both the inner and the outer tables. Histopathologically, the specimens showed a spindle-cell tumor with dense reticulin fiber network and expression of smooth muscle actin. Fifty-eight months MR follow-up after total removal showed no residual or relapse.

  4. Laparoscopic Rectopexy in Solitary Rectal Ulcer

    Hassan Salmanroughani


    Full Text Available Patients with Solitary Rectal Ulcer Syndrome (SRUS come to a physician with passage of mucus and bloody liquid within defecation. The treatment for SRUS is depended to the severity of symptoms and the existance of rectal prolapse. This study is a report of the assessing of rectopexy as surgical modalities for 62 medical treatment resistant SRUS patients who were referred to the gastrointestinal department of Shahid Sadoughi Medical University and Mojibian hospital. The present non-randomized clinical trial was carried out in 62 SRUS patients from 1991 till 2005. In these patients SRUS was confirmed by histology. They were symptomatic after conservative therapy and referred for surgical intervention. All of them had been undergone abdominal rectopexy by two laparoscopic surgeons. In our study, rectal bleeding and history of digitalization had the highest and lowest frequency of symptoms and signs in our cases respectively. Abdominal rectopexy was done in 39 cases and complete recovery in our cases was 69.23%. Complete recovery rate in cases with dysplasia (63.8% was significantly higher than cases without that (P=0.04. Complete recovery rate in cases that had finger defecation (85% was significantly higher than cases without that (50% (P=0.03. Laparoscopic rectopexy is one of the main surgical techniques for treatment of SRUS. This technique can present complete recovery for SRUS patients. Some of them include topical medications, behavior modification supplemented by fiber and biofeedback and surgery were more available and studied. But it seems that education of SRUS patient conservative treatment remain cornerstone in the SRUS management.

  5. Solitary pancreas retransplant: Study of 22 cases

    Tércio Genzini


    Full Text Available Objective: To present our experience with pancreas retransplantin patients previously submitted to simultaneous pancreas-kidneytransplant, pancreas after kidney transplant and pancreastransplant alone. Methods: Between January/1996 and December/2005, 330 pancreas transplants were performed: 308 primarytransplants and 22 (6% retransplants of solitary pancreas. Thefollowing variables were analyzed: patient age; time elapsedbetween the first and the second transplant; causes of loss of thefirst graft; technical characteristics of the transplant andretransplant and the criteria for selecting donors for retransplant.These clinical data were submitted to statistical analysis. Results:The mean age of patients was 34.3 years and the mean elapsedtime between the first and second transplant was 19.3 months.The causes of the first graft loss were venous (8; 35% and arterial(5; 23% thrombosis, chronic rejection (4; 18%, ischemia/reperfusion injury (2, reflux pancreatitis (1, primary non-function(1 and sepsis (1. A second transplant was performed in thesame iliac fossa in 16 patients (72%. Venous drainage wasperformed in the iliac vein in 16 patients (72%, in the inferior venacava in 5 patients (22% and in the portal vein in one patient. 6 allbladder drainage was the technique used in 18 (82% cases andenteric drainage, in 4 patients (18%. Immunosuppressive regimenapplied to all cases was quadruple therapy with antilymphocyteinduction, tacrolimus, mycophenolate mofetil and steroids. Therewas one early death due to sepsis. One-year patient and pancreasgraft survival rates for retransplants were, respectively, 95% and85%. There was no additional risk for removing the pancreas graftat retransplant. Conclusion: Pancreas retransplant was technicallyfeasible in all cases and results similar to those described in theliterature were found for primary pancreas transplant.

  6. Clinicopathological analysis of solitary fibrous tumor

    Xiumei Zhang; Hai Wang; Shujing Wang; Jinfeng Miao; Zhengai Piao; Yingying Dong


    Objective: The aim of this study was to investigate the clinicopathologic characteristics, diagnosis and differential diagnosis, molecular genetics, treatment and prognosis of solitary fibrous tumor (SFT). Methods: The clinicopathological manifestations were analyzed retrospectively in 22 patients with surgically confirmed SFT. Results: There were 12 male patients and 10 female patients, with the age range 33–67 (mean 48.62) years. The SFTs originated from different from parts of the body, including 13 in the chest, 2 in the lungs, 3 in the abdomen, 1 in the lumbosacral area, 2 in the pelvis, and 1 in the left shoulder. There were 19 benign and 3 malignant tumors. Major clinical presentations were local masses and compression symptoms. Microscopy: the tumor was composed of areas of alternating hypercellularity and hypocellularity. The tumor cells were spindle to short-spindle shaped and arranged in fascicular or storiform pattern and hemangiopericytoma-like structure was presented. Immunohistochemically, Vimentin positive rate was 100% (22/22), Bcl-2 positive rate was 95.5% (21/22), CD99 positive rate was 86.4% (19/22), CD34 positive rate was 81.8 (18/22), focally positive for P53, as well as negative CK, S100 and Desmin. Ki67 labelling index was 2%–30%. Conclusion: SFT is a rare tumor which may be found in various parts of human body. SFT mostly is a benign tumor, but a few could be malignant. Its diagnosis mainly rely on its morphologic features and immunohistochemical profiles. The major treatment is to completely resect it by operation and long-term clinical follow-up is necessary.

  7. Gene expression profiling of solitary fibrous tumors.

    François Bertucci

    Full Text Available BACKGROUND: Solitary fibrous tumors (SFTs are rare spindle-cell tumors. Their cell-of-origin and molecular basis are poorly known. They raise several clinical problems. Differential diagnosis may be difficult, prognosis is poorly apprehended by histoclinical features, and no effective therapy exists for advanced stages. METHODS: We profiled 16 SFT samples using whole-genome DNA microarrays and analyzed their expression profiles with publicly available profiles of 36 additional SFTs and 212 soft tissue sarcomas (STSs. Immunohistochemistry was applied to validate the expression of some discriminating genes. RESULTS: SFTs displayed whole-genome expression profiles more homogeneous and different from STSs, but closer to genetically-simple than genetically-complex STSs. The SFTs/STSs comparison identified a high percentage (∼30% of genes as differentially expressed, most of them without any DNA copy number alteration. One of the genes most overexpressed in SFTs encoded the ALDH1 stem cell marker. Several upregulated genes and associated ontologies were also related to progenitor/stem cells. SFTs also overexpressed genes encoding therapeutic targets such as kinases (EGFR, ERBB2, FGFR1, JAK2, histone deacetylases, or retinoic acid receptors. Their overexpression was found in all SFTs, regardless the anatomical location. Finally, we identified a 31-gene signature associated with the mitotic count, containing many genes related to cell cycle/mitosis, including AURKA. CONCLUSION: We established a robust repertoire of genes differentially expressed in SFTs. Certain overexpressed genes could provide new diagnostic (ALDH1A1, prognostic (AURKA and/or therapeutic targets.

  8. Solitary median maxillary central incisor (SMMCI syndrome

    Hall Roger K


    Full Text Available Abstract Solitary median maxillary central incisor syndrome (SMMCI is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s operating in utero about the 35th–38th day(s from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.

  9. The novel multi-solitary wave solution to the fifth-order KdV equation

    Zhang Yi; Chen Deng-Yuan


    By using Hirota's method, the novel multi-solitary wave solutions to the fifth-order KdV equation are obtained.Furthermore, various new solitary wave solutions are also derived by a reconstructed bilinear Backlund transformation.

  10. Diffractons: Solitary Waves Created by Diffraction in Periodic Media

    Ketcheson, David I.


    A new class of solitary waves arises in the solution of nonlinear wave equations with constant impedance and no dispersive terms. These solitary waves depend on a balance between nonlinearity and a dispersion-like effect due to spatial variation in the sound speed of the medium. A high-order homogenized model confirms this effective dispersive behavior, and its solutions agree well with those obtained by direct simulation of the variable-coefficient system. These waves are observed to be long-time stable, globally attracting solutions that arise in general as solutions to nonlinear wave problems with periodically varying sound speed. They share some properties with known classes of solitary waves but possess important differences as well.

  11. Shoaling Large Amplitude Internal Solitary Waves in a Laboratory Tank

    Allshouse, Michael; Larue, Conner; Swinney, Harry


    The shoaling of internal solitary waves onto the continental shelf can change both the wave dynamics and the state of the environment. Previous observations have demonstrated that these waves can trap fluid and transport it over long distances. Through the use of a camshaft-based wavemaker, we produce large amplitude shoaling waves in a stratified fluid in a laboratory tank. Simulations of solitary waves are used to guide the tuning of the wave generator to approximate solitary waves; thus nonlinear waves can be produced within the 4m long tank. PIV and synthetic schlieren measurements are made to study the transport of fluid by the wave as it moves up a sloping boundary. The results are then compared to numerical simulations and analyzed using finite time Lyapunov exponent calculations. This Lagrangian analysis provides an objective measure of barriers surrounding trapped regions in the flow. Supported by ONR MURI Grant N000141110701 (WHOI).

  12. A rare gigantic solitary cysticercosis pseudotumour of the neck

    Seif J Uledi


    Full Text Available Cysticercosis is one of the ancient parasitic infections and endemic in many parts of the developing world. Humans acquire cysticercosis when they ingest pork tapeworm eggs either through faecal-oral route by eating faecally contaminated food or by auto infection.The clinical picture largely depends on the location of larval encystment. Neurocysticercosis is the most common form of presentation. Solitary extra neural lesions are quite rare and fairly small in size.We present a very unique case of 56 year old Malawian female with a very rare, long standing gigantic solitary cysticercosis pseudo tumour of the neck. By far, there is no documented report on incorrigible cysticercosis lesion with such a sheer size.Solitary extraneural cysticercosis lesions may mimic other soft tissue masses; therefore it is important for clinicians working in endemic regions to consider cysticercosis as a differential diagnosis when evaluating patients with soft tissue lesions.

  13. Giant solitary trichoepithelioma with desmoplasia on histopathology: An unusual finding

    Sundeep Chowdhry


    Full Text Available Trichoepithelioma is a well-recognized hamartoma of hair germ clinically presenting as solitary or multiple papules. Uncommonly, it may present as a large solitary lesion, termed as giant solitary trichoepithelioma (GST. A 50-year old man presented with a large, pedunculated mass over the root of nose obstructing visual field. It was excised and sent for histopathological examination. H&E staining revealed in addition to characteristic features of trichoepithelioma, a desmoplastic hypocellular stroma. After taking into account the clinical and histopathological features, a diagnosis of GST was made. This case is the first case to the best of authors’ knowledge describing desmoplastic stroma in a case of GST. It is also noteworthy because it reports the largest GST described so far over the nose.

  14. On solitary patterns in Lotka-Volterra chains

    Zilburg, Alon; Rosenau, Philip


    We present and study a class of Lotka-Volterra chains with symmetric 2N-neighbors interactions. To identify the types of solitary waves which may propagate along the chain, we study their quasi-continuum approximations which, depending on the coupling between neighbors, reduce into a large variety of partial differential equations. Notable among the emerging equations is a bi-cubic equation {u}t={[{{bu}}2+2κ {{uu}}{xx}+{({u}{xx})}2]}x which we study in some detail. It begets remarkably stable topological and non-topological solitary compactons that interact almost elastically. They are used to identify discretons, their solitary discrete antecedents on the lattice, which decay at a doubly exponential rate. Many of the discrete modes are robust while others either decompose or evolve into breathers.

  15. Solitary calvarial metastases : An unusual presentation of thoracic neuroblastoma

    Grover S


    Full Text Available A primary thoracic origin occurs only in 20% of neuroblastomas, and their classical presentation is mediastinal or cord compression. Skeletal metastases of neuroblastomas are characteristically multiple, and calvarial deposits usually show simultaneous involvement of orbit. Solitary metastases in neuroblastoma, is an unusual entity and its presentation as a large calvarial mass, especially from a thoracic primary, is rare. Furthermore, calvarial metastases are relatively uncommon in children compared to adults. We discuss the clinical, radiographic, CT features, and differential diagnosis of a large calvarial mass with sunray spiculation in a child, which was due to a solitary metastases from an occult thoracic neuroblastoma. The possibility of neuroblastoma presenting in this unique fashion and the importance of considering a chemosensitive tumor such as neuroblastoma in the differential diagnosis of a solitary calvarial mass in a child is highlighted by our report.

  16. Solitary and freak waves in superthermal plasma with ion jet

    Abdelsalam, U. M.; Abdelsalam


    The nonlinear solitary and freak waves in a plasma composed of positive and negative ions, superthermal electrons, ion beam, and stationary dust particles have been investigated. The reductive perturbation method is used to obtain the Korteweg-de Vries (KdV) equation describing the system. The latter admits solitary wave solution, while the dynamics of the modulationally unstable wavepackets described by the KdV equation gives rise to the formation of freak/rogue excitation described by the nonlinear Schrödinger equation. In order to show that the characteristics of solitary and freak waves are influenced by plasma parameters, relevant numerical analysis of appropriate nonlinear solutions are presented. The results from this work predict nonlinear excitations that may associate with ion jet and superthermal electrons in Herbig-Haro objects.

  17. Quantum ion-acoustic solitary waves in weak relativistic plasma

    Biswajit Sahu


    Small amplitude quantum ion-acoustic solitary waves are studied in an unmagnetized twospecies relativistic quantum plasma system, comprised of electrons and ions. The one-dimensional quantum hydrodynamic model (QHD) is used to obtain a deformed Korteweg–de Vries (dKdV) equation by reductive perturbation method. A linear dispersion relation is also obtained taking into account the relativistic effect. The properties of quantum ion-acoustic solitary waves, obtained from the deformed KdV equation, are studied taking into account the quantum mechanical effects in the weak relativistic limit. It is found that relativistic effects significantly modify the properties of quantum ion-acoustic waves. Also the effect of the quantum parameter on the nature of solitary wave solutions is studied in some detail.

  18. Numerical Simulation of Cylindrical Solitary Waves in Periodic Media

    Quezada de Luna, Manuel


    We study the behavior of nonlinear waves in a two-dimensional medium with density and stress relation that vary periodically in space. Efficient approximate Riemann solvers are developed for the corresponding variable-coefficient first-order hyperbolic system. We present direct numerical simulations of this multiscale problem, focused on the propagation of a single localized perturbation in media with strongly varying impedance. For the conditions studied, we find little evidence of shock formation. Instead, solutions consist primarily of solitary waves. These solitary waves are observed to be stable over long times and to interact in a manner approximately like solitons. The system considered has no dispersive terms; these solitary waves arise due to the material heterogeneity, which leads to strong reflections and effective dispersion.

  19. Clinical analysis of bone scanning in solitary lesion


    A rational analysis procedure for solitary lesions on whole bone scan-ning was offered. This study was undertaken to analyze retrospectively solitary le-sions which obtained final diagnose through the following aspects: (1) diagnosis ofbone metastasis, (2) the incidence of bone metastasis in different tumor, (3) the mostpossible lesion sites indicating bone metastasis, (4) morphological analysis of solitarylesions. The results are: (1) The incidence of solitary lesions in 2465 cases on wholebone scanning is 15.3%. (2) The rate of bone metastasis is 24.8% in 282 patientswith primary malignancy. The rate of bone metastasis is 6.3% in 64 patients withoutprimary malignancy, and the total diagnostic rate of bone metastasis is 21.4% in 346patients. (3) In patients with primary malignancy, the incidence of bone metastasis ofsolitary lesions is as follows respectively: bronchi cancer 36.1%(22/61); breast cancer23.8%(20/84); prostate gland 17.2%(5/29); other urinary system cancer 22.2%(4/18):G.I. system cancer 16.9%(10/59); others 29.0%(9/31). There is no significant differ-ence in different cancer. (4) In patients without primary malignancy, 93.7%(60/64) ofsolitary lesions are benign. (5) From anatomical point of view, we found the diagnos-tic rate of bone metastasis is as follow: 30% in spine; 34.2% in pelvis; 36.4% in skull;10.8% in other bones. There are significant differences in four groups. It is concludedthat: (1) The diagnostic rate of bone metastasis in solitary lesions is 21.4%. (2) Themost possible solitary lesions indicating osseous tumor spread are at spine, pelvic andskull. (3) Special attention to "cold" and streak like lesions should be paid. (4) Aclinical analysis procedure for diagnosis of solitary lesions has been summarized outhere.``

  20. Serotonin enhances solitariness in phase transition of the migratory locust

    Xiaojiao eGuo


    Full Text Available The behavioral plasticity of locusts is a striking trait presented during the reversible phase transition between solitary and gregarious individuals. However, the results of serotonin as a neurotransmitter from the migratory locust Locusta migratoria in phase transition showed an alternative profile compared to the results from the desert locust Schistoserca gregaria. In this study, we investigated the roles of serotonin in the brain during the phase change of the migratory locust. During the isolation of gregarious nymphs, the concentration of serotonin in the brain increased significantly, whereas serotonin receptors (i.e. 5-HT1, 5-HT2 and 5-HT7 we identified here showed invariable expression patterns. Pharmacological intervention showed that serotonin injection in the brain of gregarious nymphs did not induced the behavior change toward solitariness, but injection of this chemical in isolated gregarious nymphs accelerated the behavioral change from gregarious to solitary phase. During the crowding of solitary nymphs, the concentration of serotonin in the brain remained unchanged, whereas 5-HT2 increased after 1 h of crowding and maintained stable expression level thereafter. Activation of serotonin-5-HT2 signaling with a pharmaceutical agonist inhibited the gregariousness of solitary nymphs in crowding treatment. These results indicate that the fluctuations of serotonin content and 5-HT2 expression are results of locust phase change. Overall, this study demonstrates that serotonin enhances the solitariness of the gregarious locusts. Serotonin may regulate the withdrawal-like behavioral pattern displayed during locust phase change and this mechanism is conserved in different locust species.

  1. Solitary Eccrine Syringofibroadenoma and Successful Treatment with Cryotherapy.

    Ozkaya, Dilek Biyik; Su, Ozlem; Bahalı, Anıl Gülsel; Topukçu, Bugce; Dizman, Didem; Tosuner, Zeynep; Demirkesen, Cuyan; Onsun, Nahide


    First described in 1963, eccrine syringofibroadenoma (ESFA) is a rare benign tumor that proliferates with differentiation toward ductal eccrine structures. There are many clinical presentations, including plaques, papules, verrucous plaques, keratotic tumors, and solitary tumors. The age of onset varies, with presentation between 16 and 80 years; however, solitary lesions are seen most commonly in the seventh and eighth decades. Here, we present the case of a 72-year-old woman referred to our outpatient clinic with a nodule on her leg. The histopathology result was ESFA. The lesion regressed after six cryotherapy sessions. Physicians should consider the possibility of ESFA and must remember its malignant potential in elderly patients.

  2. A case of congenital solitary Langerhans cell histiocytoma.

    Ricciardo, Bernadette


    A newborn baby boy was referred to the Paediatric Dermatology Unit with a solitary asymptomatic nodule overlying his right nasolabial fold. Complete physical examination, full blood count, serum chemistry, liver function tests and baseline imaging were unremarkable. Histopathological examination showed an atypical dermal infiltrate of mononuclear cells that stained positive with CD1a and S100. A diagnosis of congenital solitary Langerhans cell histiocytoma was made. The lesion completely resolved by 4 months of age. The baby is now 15 months old and repeat systemic evaluation has remained normal.

  3. Measurement of velocity field in parametrically excited solitary waves

    Gordillo, Leonardo


    Paramerically excited solitary waves emerge as localized structures in high-aspect-ratio free surfaces subject to vertical vibrations. Herein, we provide the first experimental characterization of the hydrodynamics of thess waves using Particle Image Velocimetry. We show that the underlying velocity field of parametrically excited solitary waves is mainly composed by an oscillatory velocity field. Our results confirm the accuracy of Hamiltonian models with added dissipation in describing this field. Remarkably, our measurements also uncover the onset of a streaming velocity field which is shown to be as important as other crucial nonlinear terms in the current theory. The observed streaming pattern is particularly interesting due to the presence of oscillatory meniscii.

  4. Solitary structures with ion and electron thermal anisotropy

    Khusroo, Murchana


    Formation of electrostatic solitary structures are analysed for a magnetised plasma with ion and electron thermal anisotropies. The ion thermal anisotropy is modelled with the help of the Chew-Goldberger-Low (CGL) double adiabatic equations of state while the electrons are treated as inertia-less species with an anisotropic bi-Maxwellian velocity distribution function. A negative electron thermal anisotropy $(T_{e\\perp}/T_e{\\parallel}>1)$ is found to help form large amplitude solitary structures which are in agreement with observational data.

  5. Effect of nonthermal ion distribution and dust temperature on nonlinear dust-acoustic solitary waves

    K Annou; R Annou


    Dust-acoustic solitary waves in unmagnetized dusty plasma whose constituents are inertial charged dust grains, Boltzmannian electrons and nonthermal ions have been investigated by taking into account finite dust temperature. The pseudopotential has been used to study solitary solution. The existence of solitary waves having negative potential is reported.

  6. Single-peak solitary wave solutions for the variant Boussinesq equations

    Hong Li; Lilin Ma; Dahe Feng


    This paper presents all possible smooth, cusped solitary wave solutions for the variant Boussinesq equations under the inhomogeneous boundary condition. The parametric conditions for the existence of smooth, cusped solitary wave solutions are given using the phase portrait analytical technique. Asymptotic analysis and numerical simulations are provided for smooth, cusped solitary wave solutions of the variant Boussinesq equations.

  7. Existence,Orbital Stability and Instability of Solitary Waves for Coupled BBM Equations

    Li-wei Cui


    This paper is concerned with the orbital stability/instability of solitary waves for coupled BBM equations which have Hamiltonian form.The explicit solitary wave solutions will be worked out first.Then by detailed spectral analysis and decaying estimates of solutions for the initial value problem,we obtain the orbital stability/instability of solitary waves.

  8. Postsplenectomy sclerosing extramedullary hematopoietic tumor with unexpected good clinical evolution: morphologic, immunohistochemical, and molecular analysis of one case and review of the literature.

    Gualco, Gabriela; Ojopi, Elida B P; Chioato, Lucimara; Cordeiro, Danielle Leão; Negretti, Fabio; Bacchi, Carlos E


    Sclerosing extramedullary hematopoietic tumor has been described as a rare manifestation of chronic myeloproliferative neoplasm. The lack of knowledge about this entity has caused it to be mistaken for many types of nonhematopoietic and hematopoietic tumors. We present the case of a 71-year-old lady with a long history of primary myelofibrosis, which developed multiple abdominal sclerosing extramedullary hematopoietic tumors with good clinical evolution. Nonchronic myeloid leukemia myeloproliferative neoplasm included a JAK2 mutation as part of the diagnosis algorithm. Particularly, idiopathic myelofibrosis is related with a JAK2 mutation in 50% of the cases with a pejorative prognosis. The absence of JAK2 demonstrated in the paraffin samples of the tumors may be related to the unusual evolution in this particular case. Morphologically differential diagnoses considered in the evaluation of this entity and in our case included sarcomas mainly liposarcoma, anaplastic carcinoma, and Hodgkin lymphoma.

  9. 气管浆细胞瘤的手术治疗及文献复习%Surgical treatment of tracheal extramedullary plasmocytoma and pertinent literature review

    Shanqing Li; Naixin Liang; Hongsheng Liu; Cheng Huang; Yingzhi Qin


    Objective:To study the diagnostic method, surgical management and complications of the tracheal malignant tumor, as well as the characteristics of plasmocytoma. Methods:One patient with tracheal plasmocytoma and pertinent literature were analyzed retrospectively. Results:Resection of the tracheal tumor and reconstruction of the trachea were performed successfully in this case, and the pathological diagnosis is plasmocytoma. Conclusion:The nature, location and extent of tracheal tumor are precisely determined from radiologic studies before resection, as well as tracheal intubation and tracheal anastomosis without tension in operative procedures, are very important for triumphal operation. Even extramedullary plasmocytoma may occur in a lot of organs, but the incidence of it is rare. Both surgery and radiotherapy are cardinal methods for extramedullary plasmocytoma.


    ZhuYanjuan; ZhangChunhua


    The solitary wave solutions of the combined KdV-mKdV-Burgers equation and the Kolmogorov-Petrovskii-Piskunov equation are obtained by means of the direct algebra method, which can be generalized to deal with high dimensional nonlinear evolution equations.

  11. Reconstructive surgery in eight children with solitary kidneys

    Thorup, Jørgen Mogens


    Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two...

  12. Observations of Solitary Structures in a Magnetized, Plasma Loaded Waveguide

    Lynov, Jens-Peter; Michelsen, Poul; Pécseli, Hans;


    Two types of solitary structure were investigated experimentally and numerically in a magnetized, plasma-loaded waveguide. One was identified as an ordinary KdV soliton and its properties were investigated with particular attention to the damping by resonant particles. The other type of pulse...


    王涛; 高天赋


    Remote sensing and in situ observations of internal tides, solitary waves and bores in shallow water are briefly reviewed in this paper. The emphasis is laid on interpreting SAR images based on oceanographic measurements, and analyzing characteristics of internal waves in the China Seas. Direc-tions for future research are discussed.



    Remote sensing and in situ observations of internal tides, solitary waves and bores in shallow water are briefly reviewed in this paper. The emphasis is laid on interpreting SAR images based on oceanographic measurements, and analyzing characteristics of internal waves in the China Seas. Directions for future research are discussed.

  15. Sound exposure of professional orchestral musicians during solitary practice.

    O'Brien, Ian; Driscoll, Tim; Ackermann, Bronwen


    It is broadly acknowledged that professional orchestral musicians risk noise-induced hearing pathologies due to sound exposure in rehearsal and performance. While much has been published regarding orchestral sound levels, little is known of the sound exposure these musicians experience during solitary practice, despite the many hours they spend engaged in this activity. This study aimed to determine sound exposure during solitary practice of 35 professional orchestral musicians, representing players of most orchestral instruments. To allow cross-comparison, participants were assessed playing similar repertoire in a controlled environment, recording simultaneously at each ear to determine sound exposure levels. Sound levels were recorded between 60 and 107 dB L(Aeq), with peak levels between 101 and 130 dB L(C,peak). For average reported practice durations (2.1 h per day, five days a week) 53% would exceed accepted permissible daily noise exposure in solitary practice, in addition to sound exposure during orchestral rehearsals and performances. Significant inter-aural differences were noted in violin, viola, flute/piccolo, horn, trombone, and tuba. Only 40% used hearing protection at any time while practicing. These findings indicate orchestral musicians at risk of noise-induced hearing loss in ensemble face significant additional risks during solitary practice. Data presented will enable more effective and targeted management strategies for this population.

  16. Solitary waves in a nonintegrable Fermi-Pasta-Ulam chain

    Truskinovsky, Lev; Vainchtein, Anna


    We present a family of exact solutions describing discrete solitary waves in a nonintegrable Fermi-Pasta-Ulam chain. The family is sufficiently rich to cover the whole spectrum of known behaviors from delocalized quasicontinuum waves moving with near-sonic velocities to highly localized anticontinuum excitations with only one particle moving at a time.

  17. Transarterial Onyx Embolization of an Orbital Solitary Fibrous Tumor

    Hashemi, Nafiseh; Ling, Jeanie D.; Soparkar, Charles; Sami, Mirwat; Ellezam, Benjamin; Klucznik, Richard; Lee, Andrew G.; Chévez-Barrios, Patricia


    Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm sometimes found in the orbit. We report a case of an aggressive orbital SFT with enlarged feeding vessels that was successfully resected immediately after transarterial embolization with Onyx (ethylene vinyl alcohol copolymer). To our knowledge, this is the first report showing the histopathology of Onyx embolization material in an orbital SFT. PMID:27171911

  18. Solitary Wave in Linear ODE with Variable Coefficients

    LIU Shi-Da; FU Zun-Tao; LIU Shi-Kuo; XIN Guo-Jun; LIANG Fu-Ming; FENG Bei-Ye


    In this paper, the linear ordinary differential equations with variable coefficients are obtained from thecontrolling equations satisfied by wavelet transform or atmospheric internal gravity waves, and these linear equationscan be further transformed into Weber equations. From Weber equations, the homoclinic orbit solutions can be derived,so the solitary wave solutions to linear equations with variable coefficients are obtained.

  19. Solitary Wave and Wave Front as Viewed From Curvature

    LIU Shi-Kuo; FU Zun-Tao; LIU Shi-Da; LIANG Fu-Ming; XIN Guo-Jun


    The solitary wave and wave front are two important behaviors of nonlinear evolution equations. Geometri cally, solitary wave and wave front are all plane curve. In this paper, they can be represented in terms of curvature c(s), which varies with arc length s. For solitary wave when s →±∞, then its curvature c(s) approaches zero, and when s = 0, the curvature c(s) reaches its maximum. For wave front, when s →±∞, then its curvature c(s) approaches zero, and when s = 0, the curvature c(s) is still zero, but c'(s) ≠ 0. That is, s = 0 is a turning point. When c(s) is given, the variance at some point (x, y) in stream line with arc length s satisfies a 2-order linear variable-coefficient ordinary differential equation. From this equation, it can be determined qualitatively whether the given curvature is a solitary wave or wave front.

  20. Solitary plane waves in an isotropic hexagonal lattice

    Zolotaryuk, Yaroslav; Savin, A.V.; Christiansen, Peter Leth


    Solitary plane-wave solutions in a two-dimensional hexagonal lattice which can propagate in different directions on the plane are found by using the pseudospectral method. The main point of our studies is that the lattice model is isotropic and we show that the sound velocity is the same for diff...

  1. A Stylistic Appreciation of William Wordsworth's The Solitary Reaper



    This paper, based on the literary stylistic approach, is about the analysis of William Wordsworth's lyrics The Solitary Reaper. The features in its metrics, lexis and imagery explicitly reveal the poet's love for human, passion for nature and principle of simplicity.

  2. Exact Periodic Solitary Solutions to the Shallow Water Wave Equation

    LI Dong-Long; ZHAO Jun-Xiao


    Exact solutions to the shallow wave equation are studied based on the idea of the extended homoclinic test and bilinear method. Some explicit solutions, such as the one soliton solution, the doubly-periodic wave solution and the periodic solitary wave solutions, are obtained. In addition, the properties of the solutions are investigated.

  3. Internal solitary waves in the Red Sea: An unfolding mystery

    da Silva, J.C.B.; Magalhães, J.M.; Gerkema, T.; Maas, L.R.M.


    The off-shelf region between 16.0 degrees and 16.5 degrees N in the southern Red Sea is identified as a new hotspot for the occurrence of oceanic internal solitary waves. Satellite observations reveal trains of solitons that, surprisingly, appear to propagate from the center of the Red Sea, where it

  4. Solitary Wave and Wave Front as Viewed From Curvature

    LIUShi-Kuo; FUZun-Tao; LIUShi-Da; LIANGFu-Ming; XINGuo-Jun


    The solitary wave and wave front are two important behaviors of nonlinear evolution equations. Geometrically, solitary wave and wave front are all plane curve. In this paper, they can be represented in terms of curvature c(s),which varies with arc length s. For solitary wave when s→±∞, then its curvature c(s) approaches zero, and whens = 0, the curvature c(s) reaches its maximum. For wave front, when s→±∞, then its curvature c(s) approaches zero,and when s = 0, the curvature c(s) is still zero, but c'(s)≠0. That is, s = 0 is a turning point. When c(s) is given,the variance at some point (x, y) in stream line with arc length s satisfies a 2-order linear variable-coeffcient ordinary differential equation. From this equation, it can be determined qualitatively whether the given curvature is a solitary wave or wave front.

  5. Solitary fibrous tumor of the thyroid with capsular invasion.

    Bohórquez, Concepción Lara; González-Cámpora, Ricardo; Loscertales, Miguel Congregado; Escudero, Antonio García; Mezquita, Jesús Congregado


    This report describes the clinical and pathologic findings of a peculiar case of solitary fibrous tumor of the thyroid gland that showed capsular invasion. After four and a half years of follow-up, neither local recurrence nor metastasis has developed.

  6. Percutaneous nephrolithotomy in patients with a solitary kidney

    Tufan Süelözgen


    Full Text Available Material and method: The results of percutaneous nephrolithotomy applied to 716 patients in our clinic between January 2008 and January 2014 were retrospectively evaluated. Age, gender, urinary calculi size (mm2, urinary calculi localization, ESWL history, operation duration (min, fluoroscopy duration (sec, access type, reason of solitary kidney, hemoglobin drawdown (g/dl and operation success of the patients with a solitary kidney were recorded. The patients having no preoperative and postoperative non contrast abdominal tomography were excluded from the study. Results: Fifteen of nineteen patients (79% were men and 4 of them (21% were women. The average age of the patients was 42.52 ± 16.72 (14-72. Ten patients had anatomical solitary kidney and nine patients had physiological solitary kidney. In fact counter kidney was non functional in 9 patients (47% whereas there was agenesis in 2 (11% and outcome of nephrectomy in 8 (42% patients. In our study, presence of residual stone less than 4 mm at 1st month postoperative non contrast abdominal tomography was accepted as a successful result and accordingly our success rate was detected as 84%. Mean urinary calculi size was 405 ± 252.9 mm2; urinary calculi localization was pelvic, lower pole, upper-middle pole, middle-lower pole and staghorn in 11 (58%, 4 (21%, 1 (5%, 1 (5% and 1 (5% patients, respectively; previous ESWL history was 16%; operation duration was 55.47-± 28.1 min and fluoroscopy duration 131.10 ± 87.6 sec; access type was subcostal in 79%, supracostal in 10.5% and multiple in 10.5%; hemoglobin drawdown was 1.75 ± 0.97 mg/dl. Conclusions: PNL can be effectively and safely administered for the treatment of solitary kidney. In the treatment of large urinary calculi in patients with a solitary kidney, PNL has some advantages such as short surgery duration, less complication, acceptable hemoglobin drawdown and high success rates. According to our study, PNL operation in patients with a

  7. Solitary Large Hepatocellular Carcinoma: Staging and Treatment Strategy.

    Po-Hong Liu

    Full Text Available Controversies exist on staging and management of solitary large (>5 cm hepatocellular carcinoma (HCC. This study aims to evaluate the impact of tumor size on Barcelona Clinic Liver Cancer (BCLC staging and treatment strategy.BCLC stage A and B patients were included and re-classified as single tumor 2-5 cm or up to 3 tumors ≤3 cm (group A; n = 657, single tumor >5 cm (group SL; n = 224, and multiple tumors >3 cm (group B; n = 351. Alternatively, 240 and 229 patients with solitary large HCC regardless of tumor stage received surgical resection (SR and transarterial chemoembolization (TACE, respectively. The propensity score analysis identified 156 pairs of patients from each treatment arm for survival comparison.The survival was significantly higher for group A but was comparable between group SL and group B patients. Of patients with solitary large HCC, the 1-, 3- and 5-year survival rates were 88% versus 74%, 76% versus 44%, and 63% versus 35% between SR and TACE group, respectively (p<0.001. When baseline demographics were adjusted in the propensity model, the respective 1-, 3- and 5-year survival rates were 87% versus 79%, 76% versus 46%, and 61% versus 36% (p<0.001. The Cox proportional hazards model identified TACE with a 2.765-fold increased risk of mortality compared with SR (95% confidence interval: 1.853-4.127, p<0.001.Patients with solitary large HCC should be classified at least as intermediate stage HCC. SR provides significantly better survival than TACE for solitary large HCC regardless of tumor stage. Further amendment to the BCLC classification is mandatory.

  8. Solitary waves of the EW and RLW equations

    Ramos, J.I. [Room I-320-D, E.T.S. Ingenieros Industriales, Universidad de Malaga, Plaza El Ejido, s/n, 29013 Malaga (Spain)]. E-mail:


    Eight finite difference methods are employed to study the solitary waves of the equal-width (EW) and regularized long-wave (RLW) equations. The methods include second-order accurate (in space) implicit and linearly implicit techniques, a three-point, fourth-order accurate, compact operator algorithm, an exponential method based on the local integration of linear, second-order ordinary differential equations, and first- and second-order accurate temporal discretizations. It is shown that the compact operator method with a Crank-Nicolson discretization is more accurate than the other seven techniques as assessed for the three invariants of the EW and RLW equations and the L {sub 2}-norm errors when the exact solution is available. It is also shown that the use of Gaussian initial conditions may result in the formation of either positive or negative secondary solitary waves for the EW equation and the formation of positive solitary waves with or without oscillating tails for the RLW equation depending on the amplitude and width of the Gaussian initial conditions. In either case, it is shown that the creation of the secondary wave may be preceded by a steepening and an narrowing of the initial condition. The creation of a secondary wave is reported to also occur in the dissipative RLW equation, whereas the effects of dissipation in the EW equation are characterized by a decrease in amplitude, an increase of the width and a curving of the trajectory of the solitary wave. The collision and divergence of solitary waves of the EW and RLW equations are also considered in terms of the wave amplitude and the invariants of these equations.

  9. Tracking the extramedullary PML-RARα-positive cell reservoirs in a preclinical model: biomarker of long-term drug efficacy.

    Pokorna, Katerina; Le Pogam, Carole; Chopin, Martine; Balitrand, Nicole; Reboul, Murielle; Cassinat, Bruno; Chomienne, Christine; Padua, Rose Ann; Pla, Marika


    Using an acute promyelocytic leukemia (APL) preclinical model, we show that oncogene-specific PCR (Polymerase Chain Reaction)-based assays allow to evaluate the efficacy of immunotherapy combining all-trans retinoic acid (ATRA) and a DNA-based vaccine targeting the promyelocytic leukemia-retinoic acid receptor alpha (PML-RARα) oncogene. Kaplan-Meier survival analysis according to the peripheral blood PML-RARα normalized copy number (NCN) clearly shows that ATRA + DNA-treated mice with an NCN lower than 10 (43%) formed the group with a highly significant (p < 0.0001) survival advantage. Furthermore, a PCR assay was used to assess various tissues and organs for the presence of PML-RARα-positive cells in long-term survivors (n = 15). As expected, the majority of mice (n = 10) had no measurable tissue level of PML-RARα. However, five mice showed a weak positive signal in both the brain and spleen (n = 2), in the brain only (n = 2) and in the spleen only (n = 1). Thus tracking the oncogene-positive cells in long-term survivors reveals for the first time that extramedullary PML-RARα-positive cell reservoirs such as the brain may persist and be involved in relapses.

  10. The Effect of Patient-Specific Instrumentation Incorporating an Extramedullary Tibial Guide on Operative Efficiency for Total Knee Arthroplasty

    Oh-Ryong Kwon


    Full Text Available This retrospective study was to determine if patient-specific instrumentation (PSI for total knee arthroplasty (TKA leads to shortened surgical time through increased operating room efficiency according to different tibial PSI designs. 166 patients underwent primary TKA and were categorized into three groups as follows: PSI without extramedullary (EM tibial guide (group 1, n=48, PSI with EM tibial guide (group 2, n=68, and conventional instrumentation (CI group (group 3, n=50. Four factors were compared between groups, namely, operative room time, thickness of bone resection, tibial slope, and rotation of the component. The mean surgical time was significantly shorter in the PSI with EM tibial guide group (group 2, 63.9±13.6 min compared to the CI group (group 3, 82.8±24.9 min (P<0.001. However, there was no significant difference in the PSI without EM tibial guide group (group 1, 75.3±18.8 min. This study suggests that PSI incorporating an EM tibial guide may lead to high operative efficiency in TKA compared to CI. This trial is registered with KCT0002384.

  11. Primary Myelofibrosis Presenting as Extramedullary Hematopoiesis in a Transplanted Liver Graft: Case Report and Review of the Literature

    Ghulam Rehman Mohyuddin


    Full Text Available Primary myelofibrosis (PMF commonly results in extramedullary hematopoiesis (EMH in the spleen and liver as well as a variety of other organs. We present a first report of a unique presentation of PMF in a liver transplant recipient patient as EMH in the transplanted liver graft. A 76-year-old man with history of cryptogenic cirrhosis received cadaveric liver transplantation in 1996. He maintained a normal graft function and stable hematologic parameters until 2013 when he presented with anemia and progressive fatigue. Extensive work-up did not identify the etiology of the recent decline in his hemoglobin; thus a liver biopsy was done which showed findings of EMH within the sinusoids with increased megakaryocytes, some with atypical morphology. A BM biopsy revealed a hypercellular marrow, moderately increased reticulin fibrosis, and features consistent with primary myelofibrosis. Abdominal imaging showed a normal-size spleen and did not identify any sites of EMH outside of the liver. The diagnosis of myelofibrosis was thus made, and this case demonstrated predominant tropism to a transplanted liver graft with absence of EMH elsewhere. We would thus like to emphasize that findings of EMH in subjects with no preexisting hematologic neoplasm should warrant close follow-up and assessment.

  12. Reconstructive surgery in eight children with solitary kidneys

    Thorup, Jørgen Mogens


    Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two...... of them because of reflux. In two children pyeloureteroplasty was performed, and in one both ureteroneocystostomy and pyeloureteroplasty. The multicystic kidneys were removed. The renal function was poor preoperatively in five children; two of these also had urosepsis. These children were all under 15...... months of age. Postoperatively, the renal function was subnormal (although improved) in two children; in six it was normal. The most important prognostic factors in solitary kidneys with urinary tract obstruction are infection and developmental injury....

  13. Electron acoustic solitary waves with kappa-distributed electrons

    Devanandhan, S; Singh, S V; Lakhina, G S, E-mail: [Indian Institute of Geomagnetism, New Panvel (West), Navi Mumbai (India)


    Electron acoustic solitary waves are studied in a three-component, unmagnetized plasma composed of hot electrons, fluid cold electrons and ions having finite temperatures. Hot electrons are assumed to have kappa distribution. The Sagdeev pseudo-potential technique is used to study the arbitrary amplitude electron-acoustic solitary waves. It is found that inclusion of cold electron temperature shrinks the existence regime of the solitons, and soliton electric field amplitude decreases with an increase in cold electron temperature. A decrease in spectral index, {kappa}, i.e. an increase in the superthermal component of hot electrons, leads to a decrease in soliton electric field amplitude as well as the soliton velocity range. The soliton solutions do not exist beyond T{sub c}/T{sub h}>0.13 for {kappa}=3.0 and Mach number M=0.9 for the dayside auroral region parameters.


    LU Ji; YU Xi-ping


    Solitary wave fission over an underwater step is numerically investigated. The numerical model is based on the enhanced Boussinesq equations, which appropriately represent both the nonlinearity and dispersivity of surface water waves. The finite difference method defined on the staggered grid in space with an implicit scheme for time stepping is employed for the numerical solution of the governing equations. It is demonstrated that Boussinesq type equations, though they are vertically integrated, can describe the details of the solitary wave fission process with very good accuracy. Numerical results of the reflected and transmitting wave heights, the number of solitons emitted from the transmitting wave and their amplitudes all agree very well with the analytical solution derived from KdV equation by virtue of a linear long wave approximation in the vicinity of the underwater step.

  15. [Solitary fibrous tumor of endometrium--a case report].

    Dvořák, O; Dvořáková, E; Laco, J; Spaček, J


    Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor. We present a case of SFT occurring in endometrium. Case report. Department of Obstetrics and Gynecology, The Fingerland Department of Pathology, Medical Faculty of Charles University and Faculty Hospital Hradec Králové. We report a case of 57 years old woman with SFT arising from the endometrium, which was diagnosed and treated at our department. Histological finding was supported by typical immunohistochemical profile of the tumor. Aggressive nature of the tumor wasnt showed. The patient underwent abdominal hysterectomy with bilateral adnexectomy and is followed up in regular periods. Occurence of solitary fibrous tumor (SFT) in the female genital tract is extremely rare. To the best of our knowledge, we report the first case of SFT occurring in endometrium. Because of potencial aggressive behaviour of the tumor complete surgical excision and close follow-up is highly recommended.

  16. Primary Intrapulmonary Thymoma Presenting as a Solitary Pulmonary Nodule

    Jung, Woohyun; Kang, Chang Hyun; Kim, Young Tae; Park, In Kyu


    Primary intrapulmonary thymoma (PIT) is a very rare lesion of uncertain pathogenesis. PIT should be considered when the histopathological appearance of a lung tumor shows features that are uncommon but similar to those of a thymoma. In this case report, we discuss the case of a 59-year-old female with a solitary pulmonary nodule that was confirmed to be PIT on the basis of pathological tests. Treatment with complete resection showed good results. PMID:28180106

  17. The frustrated Brownian motion of nonlocal solitary waves

    Folli, Viola


    We investigate the evolution of solitary waves in a nonlocal medium in the presence of disorder. By using a perturbational approach, we show that an increasing degree of nonlocality may largely hamper the Brownian motion of self-trapped wave-packets. The result is valid for any kind of nonlocality and in the presence of non-paraxial effects. Analytical predictions are compared with numerical simulations based on stochastic partial differential equation

  18. Exact Solitary Wave Solution in the ZK-BBM Equation

    Juan Zhao


    Full Text Available The traveling wave solution for the ZK-BBM equation is considered, which is governed by a nonlinear ODE system. The bifurcation structure of fixed points and bifurcation phase portraits with respect to the wave speed c are analyzed by using the dynamical system theory. Furthermore, the exact solutions of the homoclinic orbits for the nonlinear ODE system are obtained which corresponds to the solitary wave solution curve of the ZK-BBM equation.

  19. Existence of solitary waves in dipolar quantum gases

    Antonelli, Paolo


    We study a nonlinear Schrdinger equation arising in the mean field description of dipolar quantum gases. Under the assumption of sufficiently strong dipolar interactions, the existence of standing waves, and hence solitons, is proved together with some of their properties. This gives a rigorous argument for the possible existence of solitary waves in BoseEinstein condensates, which originate solely due to the dipolar interaction between the particles. © 2010 Elsevier B.V. All rights reserved.

  20. Nonlinear dynamics of DNA - Riccati generalized solitary wave solutions

    Alka, W.; Goyal, Amit [Department of Physics, Panjab University, Chandigarh-160014 (India); Nagaraja Kumar, C., E-mail: [Department of Physics, Panjab University, Chandigarh-160014 (India)


    We study the nonlinear dynamics of DNA, for longitudinal and transverse motions, in the framework of the microscopic model of Peyrard and Bishop. The coupled nonlinear partial differential equations for dynamics of DNA model, which consists of two long elastic homogeneous strands connected with each other by an elastic membrane, have been solved for solitary wave solution which is further generalized using Riccati parameterized factorization method.

  1. Nonlinear dynamics of DNA - Riccati generalized solitary wave solutions

    Alka, W.; Goyal, Amit; Nagaraja Kumar, C.


    We study the nonlinear dynamics of DNA, for longitudinal and transverse motions, in the framework of the microscopic model of Peyrard and Bishop. The coupled nonlinear partial differential equations for dynamics of DNA model, which consists of two long elastic homogeneous strands connected with each other by an elastic membrane, have been solved for solitary wave solution which is further generalized using Riccati parameterized factorization method.

  2. Phase modulated solitary waves controlled by bottom boundary condition

    Mukherjee, Abhik


    A forced KdV equation is derived to describe weakly nonlinear, shallow water surface wave propagation over non trivial bottom boundary condition. We show that different functional forms of bottom boundary conditions self-consistently produce different forced kdV equations as the evolution equations for the free surface. Solitary wave solutions have been analytically obtained where phase gets modulated controlled by bottom boundary condition whereas amplitude remains constant.

  3. Conjugate flows and amplitude bounds for internal solitary waves

    N. I. Makarenko


    Full Text Available Amplitude bounds imposed by the conservation of mass, momentum and energy for strongly nonlinear waves in stratified fluid are considered. We discuss the theoretical scheme which allows to determine broadening limits for solitary waves in the terms of a given upstream density profile. Attention is focused on the continuously stratified flows having multiple broadening limits. The role of the mean density profile and the influence of fine-scale stratification are analyzed.

  4. Solitary rectal ulcer syndrome in children: A literature review

    Dehghani, Seyed Mohsen; Malekpour, Abdorrasoul; HAGHIGHAT, MAHMOOD


    Solitary rectal ulcer syndrome (SRUS) is a benign and chronic disorder well known in young adults and less in children. It is often related to prolonged excessive straining or abnormal defecation and clinically presents as rectal bleeding, copious mucus discharge, feeling of incomplete defecation, and rarely rectal prolapse. SRUS is diagnosed based on clinical symptoms and endoscopic and histological findings. The current treatments are suboptimal, and despite correct diagnosis, outcomes can ...

  5. Solitary Fibrous Tumors and So-Called Hemangiopericytoma

    Nicolas Penel


    Full Text Available We have reviewed the literature data regarding the spectrum of tumors including solitary fibrous tumor and hemangiopericytoma with special focus on definition of the disease, discussion of the criteria for malignancy, and the key elements of standard treatment of localized disease. We have discussed the emerging concepts on the tumor biology and the different systemic treatments (chemotherapy and molecular-targeted therapies.

  6. Turing patterns and solitary structures under global control

    Pismen, L M


    Striped Turing patterns and solitary band and disk structures are constructed using a three-variable multiscale model with cubic nonlinearity and global control. The existence and stability conditions of regular structures are analysed using the equation of motion of curved boundaries between alternative states of the short-range component. The combined picture of transitions between striped and spotted patterns with changing level of global control is in qualitative agreement with the results of the computer experiment by Middya and Luss

  7. Energetics of internal solitary waves in a background sheared current

    K. G. Lamb


    Full Text Available The energetics of internal waves in the presence of a background sheared current is explored via numerical simulations for four different situations based on oceanographic conditions: the nonlinear interaction of two internal solitary waves; an internal solitary wave shoaling through a turning point; internal solitary wave reflection from a sloping boundary and a deep-water internal seiche trapped in a deep basin. In the simulations with variable water depth using the Boussinesq approximation the combination of a background sheared current, bathymetry and a rigid lid results in a change in the total energy of the system due to the work done by a pressure change that is established across the domain. A final simulation of the deep-water internal seiche in which the Boussinesq approximation is not invoked and a diffuse air-water interface is added to the system results in the energy remaining constant because the generation of surface waves prevents the establishment of a net pressure increase across the domain. The difference in the perturbation energy in the Boussinesq and non-Boussinesq simulations is accounted for by the surface waves.

  8. Solitary wave shoaling and breaking in a regularized Boussinesq system

    Senthilkumar, Amutha


    A coupled BBM system of equations is studied in the situation of water waves propagating over decreasing fluid depth. A conservation equation for mass and a wave breaking criterion valid in the Boussinesq approximation is found. A Fourier collocation method coupled with a 4-stage Runge-Kutta time integration scheme is employed to approximate solutions of the BBM system. The mass conservation equation is used to quantify the role of reflection in the shoaling of solitary waves on a sloping bottom. Shoaling results based on an adiabatic approximation are analyzed. Wave shoaling and the criterion of breaking solitary waves on a sloping bottom is studied. To validate the numerical model the simulation results are compared with those obtained by Grilli et al.[16] and a good agreement between them is observed. Shoaling of solitary waves of two different types of mild slope model systems in [8] and [13] are compared, and it is found that each of these models works well in their respective regimes of applicability.

  9. Numerical Modelling of Solitary Wave Experiments on Rubble Mound Breakwaters

    Guler, H. G.; Arikawa, T.; Baykal, C.; Yalciner, A. C.


    Performance of a rubble mound breakwater protecting Haydarpasa Port, Turkey, has been tested under tsunami attack by physical model tests conducted at Port and Airport Research Institute (Guler et al, 2015). It is aimed to understand dynamic force of the tsunami by conducting solitary wave tests (Arikawa, 2015). In this study, the main objective is to perform numerical modelling of solitary wave tests in order to verify accuracy of the CFD model IHFOAM, developed in OpenFOAM environment (Higuera et al, 2013), by comparing results of the numerical computations with the experimental results. IHFOAM is the numerical modelling tool which is based on VARANS equations with a k-ω SST turbulence model including realistic wave generation, and active wave absorption. Experiments are performed using a Froude scale of 1/30, measuring surface elevation and flow velocity at several locations in the wave channel, and wave pressure around the crown wall of the breakwater. Solitary wave tests with wave heights of H=7.5 cm and H=10 cm are selected which represent the results of the experiments. The first test (H=7.5 cm) is the case that resulted in no damage whereas the second case (H=10 cm) resulted in total damage due to the sliding of the crown wall. After comparison of the preliminary results of numerical simulations with experimental data for both cases, it is observed that solitary wave experiments could be accurately modeled using IHFOAM focusing water surface elevations, flow velocities, and wave pressures on the crown wall of the breakwater (Figure, result of sim. at t=29.6 sec). ACKNOWLEDGEMENTSThe authors acknowledge developers of IHFOAM, further extend their acknowledgements for the partial supports from the research projects MarDiM, ASTARTE, RAPSODI, and TUBITAK 213M534. REFERENCESArikawa (2015) "Consideration of Characteristics of Pressure on Seawall by Solitary Waves Based on Hydraulic Experiments", Jour. of Japan. Soc. of Civ. Eng. Ser. B2 (Coast. Eng.), Vol 71, p I

  10. Bifurcation and Solitary-Like Solutions for Compound KdV-Burgers-Type Equation

    Yin Li


    Full Text Available Firstly, based on the improved sub-ODE method and the bifurcation method of dynamical systems, we investigate the bifurcation of solitary waves in the compound KdV-Burgers-type equation. Secondly, numbers of solitary patterns solutions are given for each parameter condition and numerical simulations are used to display the dynamical characteristics. Finally, we obtain twelve solitary patterns solutions under some parameter conditions, such as the trigonometric function solutions and the hyperbolic function solutions.

  11. Transition from Solitons to Solitary Waves in the Fermi-Pasta-Ulam Lattice

    Wen, Zhenying; Wei, Nian


    In this paper, we study the smooth transition from solitons to solitary waves in localization, relation between energy and velocity, propagation and scattering property in the Fermi-Pasta-Ulam lattice analytically and numerically. A soliton is a very stable solitary wave that retains its permanent structure after interacting with other solitary waves. A soliton exists when the energy is small, and it becomes a solitary wave when the energy increases to the threshold. The transition could help to understand the distinctly different heat conduction behaviors of the Fermi-Pasta-Ulam lattice at low and high temperature.

  12. Experimental study of nonlinear dust acoustic solitary waves in a dusty plasma

    Bandyopadhyay, P; Sen, A; Kaw, P K


    The excitation and propagation of finite amplitude low frequency solitary waves are investigated in an Argon plasma impregnated with kaolin dust particles. A nonlinear longitudinal dust acoustic solitary wave is excited by pulse modulating the discharge voltage with a negative potential. It is found that the velocity of the solitary wave increases and the width decreases with the increase of the modulating voltage, but the product of the solitary wave amplitude and the square of the width remains nearly constant. The experimental findings are compared with analytic soliton solutions of a model Kortweg-de Vries equation.

  13. Calculation and analysis of solitary waves and kinks in elastic tubes


    The paper is devoted to analysis of different models that describe waves in fluid-filled and gas-filled elastic tubes and development of methods of calculation and numerical analysis of solutions with solitary waves and kinks for these models. Membrane model and plate model are used for tube. Two types of solitary waves are found. One-parametric families are stable and may be used as shock structures. Null-parametric solitary waves are unstable. The process of split of such solitary waves is ...

  14. Interaction of Submerged Breakwater by a Solitary Wave Using WC-SPH Method

    Afshin Mansouri


    Full Text Available Interaction of a solitary wave and submerged breakwater is studied in a meshless, Lagrangian approach. For this purpose, a two-dimensional smoothed particle hydrodynamics (SPH code is developed. Furthermore, an extensive set of simulations is conducted. In the first step, the generated solitary wave is validated. Subsequently, the interaction of solitary wave and submerged breakwater is investigated thoroughly. Results of the interaction of solitary wave and a submerged breakwater are also shown to be in good agreement with published experimental studies. Afterwards, the effects of the inclination and length of breakwater as well as distance between two breakwaters are evaluated on damping ratio of breakwater.

  15. Acute myelocytic leukemia and plasmacytoma secondary to chemotherapy and radiotherapy in a long-term survivor of small cell lung cancer

    Fukunishi, Keiichi; Kurokawa, Teruo; Takeshita, Atsushi [Osaka Medical Coll., Takatsuki (Japan)] [and others


    A 68 year-old man was given a diagnosis of lung cancer of the right upper lobe (small cell carcinoma, T 4 N 2 M 0, stage IIIB) in February 1991. The tumor diminished after chemotherapy and radiotherapy. In February 1992, a partial resection of the lower lobe of the right lung was performed because of the appearance of a metastatic tumor. In September 1994, squamous cell carcinoma developed in the lower part of the esophagus, but disappeared after radiotherapy. In February 1998, a diagnosis of myelodysplastic syndrome was made. Two months later, the patient had an attack of acute myelocytic leukemia and died of cardiac tamponade. An autopsy determined that both the lung cancer and esophageal cancer had disappeared. Acute myelocytic leukemia and plasmacytoma of lymph nodes in the irradiated area were confirmed. These were regarded as secondary malignancies induced by chemotherapy and radiotherapy. (author)

  16. Regulator of G protein signaling 1 suppresses CXCL12-mediated migration and AKT activation in RPMI 8226 human plasmacytoma cells and plasmablasts.

    Pak, Hyo-Kyung; Gil, Minchan; Lee, Yoonkyung; Lee, Hyunji; Lee, A-Neum; Roh, Jin; Park, Chan-Sik


    Migration of plasma cells to the bone marrow is critical factor to humoral immunity and controlled by chemokines. Regulator of G protein signaling 1 (RGS1) is a GTPase-activating protein that controls various crucial functions such as migration. Here, we show that RGS1 controls the chemotactic migration of RPMI 8226 human plasmacytoma cells and human plasmablasts. LPS strongly increased RGS1 expression and retarded the migration of RPMI 8226 cells by suppressing CXCL12-mediated AKT activation. RGS1 knockdown by siRNA abolished the retardation of migration and AKT suppression by LPS. RGS1-dependent regulation of migration via AKT is also observed in cultured plasmablasts. We propose novel functions of RGS1 that suppress AKT activation and the migration of RPMI 8226 cells and plasmablasts in CXCL12-mediated chemotaxis.

  17. Minimally invasive surgery for benign intradural extramedullary spinal meningiomas: experience of a single institution in a cohort of elderly patients and review of the literature

    Iacoangeli M


    Full Text Available Maurizio Iacoangeli, Maurizio Gladi, Alessandro Di Rienzo, Mauro Dobran, Lorenzo Alvaro, Niccolò Nocchi, Lucia Giovanna Maria Di Somma, Roberto Colasanti, Massimo ScerratiDepartment of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: Meningiomas of the spine are the most common benign intradural extramedullary lesions and account for 25%–46% of all spinal cord tumors in adults. The goal of treatment is complete surgical resection while preserving spinal stability. Usually, these lesions occur in the thoracic region and in middle-aged women. Clinical presentation is usually nonspecific and the symptoms could precede the diagnosis by several months to years, especially in older people, in whom associated age-related diseases can mask the tumor for a long time. We report a series of 30 patients, aged 70 years or more, harboring intradural extramedullary spinal meningiomas. No subjects had major contraindications to surgery. A minimally invasive approach (hemilaminectomy and preservation of the outer dural layer was used to remove the tumor, while preserving spinal stability and improving the watertight dural closure. We retrospectively compared the outcomes in these patients with those in a control group subjected to laminectomy or laminotomy with different dural management. In our experience, the minimally invasive approach allows the same chances of complete tumor removal, while providing a better postoperative course than in a control group.Keywords: spinal meningioma, elderly, hemilaminectomy, outer dural layer, inner dural layer, minimally invasive surgery

  18. Integrative proteome and transcriptome analysis of extramedullary erythropoiesis and its reversal by transferrin treatment in a mouse model of beta-thalassemia.

    Vallelian, Florence; Gelderman-Fuhrmann, Monique P; Schaer, Christian A; Puglia, Michele; Opitz, Lennart; Baek, Jin Hyen; Vostal, Jaroslav; Buehler, Paul W; Schaer, Dominik J


    Beta-thalassemia results from mutations of the β-hemoglobin (Hbb) gene and reduced functional Hbb synthesis. Excess α-Hb causes globin chain aggregation, oxidation, cytoskeletal damage, and increased red blood cell clearance. These events result in anemia, altered iron homeostasis, and expansion of extramedullary erythropoiesis. Serum transferrin (Tf) is suggested to be an important regulator of erythropoiesis in murine models of thalassemia. The present study was conducted to establish a quantitative proteomic and transcriptomic analysis of transferrin-modulated extramedullary erythropoiesis in the spleen of wild type and thalassemic Hbb(th3/+) mice. Our LC-MS/MS protein analysis and mRNA sequencing data provide quantitative expression estimates of 1590 proteins and 24,581 transcripts of the murine spleen and characterize key processes of erythropoiesis and RBC homeostasis such as the whole heme synthesis pathway as well as critical components of the red blood cell antioxidant systems and the proliferative cell cycling pathway. The data confirm that Tf treatment of nontransfused Hbb(th3/+) mice induces a systematic correction of these processes at a molecular level. Tf treatment of Hbb(th3/+) mice for 60 days leads to a complete molecular restoration of the normal murine spleen phenotype. These findings support further investigation of plasma-derived Tf as a treatment for thalassemia.

  19. Interaction between the solitary bee Chelostoma florisomne and its nest parasite Sapyga clavicornis-empty cells reduce the impact of parasites

    Munster-Swendsen, Mikael; Calabuig, Isabel


    Chelostoma, empty cells, interaction, mortality, nest architecture, nest parasite, protection, Sapyga, solitary bee......Chelostoma, empty cells, interaction, mortality, nest architecture, nest parasite, protection, Sapyga, solitary bee...

  20. BGK electron solitary waves: 1D and 3D

    L.-J. Chen


    Full Text Available This paper presents new results for 1D BGK electron solitary wave (phase-space electron hole solutions and, based on the new results, extends the solutions to include the 3D electrical interaction (E ~ 1/r 2 of charged particles. Our approach for extending to 3D is to solve the nonlinear 3D Poisson and 1D Vlasov equations based on a key feature of 1D electron hole (EH solutions; the positive core of an EH is screened by electrons trapped inside the potential energy trough. This feature has not been considered in previous studies. We illustrate this key feature using an analytical model and argue that the feature is independent of any specific model. We then construct azimuthally symmetric EH solutions under conditions where electrons are highly field-aligned and ions form a uniform background along the magnetic field. Our results indicate that, for a single humped electric potential, the parallel cut of the perpendicular component of the electric field (E⊥ is unipolar and that of the parallel component (E|| bipolar, reproducing the multi-dimensional features of the solitary waves observed by the FAST satellite. Our analytical solutions presented in this article capture the 3D electric interaction and the observed features of (E|| and E⊥. The solutions predict a dependence of the parallel width-amplitude relation on the perpendicular size of EHs. This dependence can be used in conjunction with experimental data to yield an estimate of the typical perpendicular size of observed EHs; this provides important information on the perpendicular span of the source region as well as on how much electrostatic energy is transported by the solitary waves.

  1. Eady Solitary Waves: A Theory of Type B Cyclogenesis.

    Mitsudera, Humio


    Localized baroclinic instability in a weakly nonlinear, long-wave limit using an Eady model is studied. The resulting evolution equations have a form of the KdV type, including extra terms representing linear coupling. Baroclinic instability is triggered locally by the collision between two neutral solitary waves (one trapped at the upper boundary and the other at the lower boundary) if their incident amplitudes are sufficiently large. This characteristic is explained from the viewpoint of resonance when the relative phase speed, which depends on the amplitudes, is less than a critical value. The upper and lower disturbances grow in a coupled manner (resembling a normal-mode structure) initially, but they reverse direction slowly as the amplitudes increase, and eventually separate from each other.The motivation of this study is to investigate a type of extratropical cyclogenesis that involves a preexisting upper trough (termed as Type B development) from the viewpoint of resonant solitary waves. Two cases are of particular interest. First, the author examines a case where an upper disturbance preexists over an undisturbed low-level waveguide. The solitary waves exhibit behavior similar to that conceived by Hoskins et al. for Type B development; the lower disturbance is forced one sidedly by a preexisting upper disturbance initially, but in turn forces the latter once the former attains a sufficient amplitude, thus resulting in mutual reinforcement. Second, if a weak perturbation exists at the surface ahead of the preexisting strong upper disturbance, baroclinic instability is triggered when the two waves interact. Even though the amplitude of the lower disturbance is initially much weaker, it is intensified quickly and catches up with the amplitude of the upper disturbance, so that the coupled vertical structure resembles that of an unstable normal mode eventually. These results describe the observed behavior in Type B atmospheric cyclogenesis quite well.

  2. En Bloc Resection of Solitary Functional Secreting Spinal Metastasis.

    Goodwin, C Rory; Clarke, Michelle J; Gokaslan, Ziya L; Fisher, Charles; Laufer, Ilya; Weber, Michael H; Sciubba, Daniel M


    Study Design Literature review. Objective Functional secretory tumors metastatic to the spine can secrete hormones, growth factors, peptides, and/or molecules into the systemic circulation that cause distinct syndromes, clinically symptomatic effects, and/or additional morbidity and mortality. En bloc resection has a limited role in metastatic spine disease due to the current paradigm that systemic burden usually determines morbidity and mortality. Our objective is to review the literature for studies focused on en bloc resection of functionally active spinal metastasis as the primary indication. Methods A review of the PubMed literature was performed to identify studies focused on functional secreting metastatic tumors to the spinal column. We identified five cases of patients undergoing en bloc resection of spinal metastases from functional secreting tumors. Results The primary histologies of these spinal metastases were pheochromocytoma, carcinoid tumor, choriocarcinoma, and a fibroblast growth factor 23-secreting phosphaturic mesenchymal tumor. Although studies of en bloc resection for these rare tumor subtypes are confined to case reports, this surgical treatment option resulted in metabolic cures and decreased clinical symptoms postoperatively for patients diagnosed with solitary functional secretory spinal metastasis. Conclusion Although the ability to formulate comprehensive conclusions is limited, case reports demonstrate that en bloc resection may be considered as a potential surgical option for the treatment of patients diagnosed with solitary functional secretory spinal metastatic tumors. Future prospective investigations into clinical outcomes should be conducted comparing intralesional resection and en bloc resection for patients diagnosed with solitary functional secretory spinal metastasis.



    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.


    Raza, Kazim


    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.

  5. Research on consistency of identifying solitary pulmonary masses with CT

    Qiuping Wang; Gang Niu; Yun Zhang; Yongqian Qiang; Zicheng Li; Youmin Guo


    Objective:To research on consistency of identifying solitary pulmonary masses with CT.Methods:Three observers with different working backgrounds in imaging diagnosis individually interpreted the same group images of solitary pulmonary mass, by 12 indexes of objective signs.The differences in interpretation resulted in ante- and post-interpretations were assessed by the x2 test.The agreement of two interpretations from the same observer was confirmed with the kappa test.A double-blind method was adopted for analysis.Results:The agreement rates of ante- and post-interpreting from the three observers were respectively 82.65%(486/588) 80.27%(472/588) and 84.86% (499/588) while their interpreting results were generally accordant without significant difference(x2 = 4.975, df= 2,P = 0.083) however there was difference between the observer 2 and observer 3(x2 = 4.875, df= 1, P = 0.027).There were five indexes with k > 0.40 of ante- and post-interpreting results of the three observers, including clarity of nodule borderline, presence of sentus, uniformity of density, existence of cavity and calcification in pathological region, among them, the agreement rate of interpreting borderline and cavity was higher(k > 0.07); the blood vessel convergence poorer(0 < k ≤ 0.40); the other six CT signs of interpretation were slightly different.Conclusion:The ability to identify solitary pulmonary mass was inconsistent, and needs to be improved further.

  6. Breathing solitary-pulse pairs in a linearly coupled system

    Dana, Brenda; Bahabad, Alon


    It is shown that pairs of solitary pulses (SPs) in a linearly-coupled system with opposite group-velocity dispersions form robust breathing bound states. The system can be realized by temporal-modulation coupling of SPs with different carrier frequencies propagating in the same medium, or by coupling of SPs in a dual-core waveguide. Broad SP pairs are produced in a virtually exact form by means of the variational approximation. Strong nonlinearity tends to destroy the periodic evolution of the SP pairs.

  7. Blastomycosis presenting as solitary nodule: A rare presentation

    Ashish Dhamija


    Full Text Available Blastomycosis is a chronic granulomatous and suppurative mycosis, caused by Blastomyces dermatitidis, which in the great majority of cases presents as a primary pulmonary disease. Primary cutaneous blastomycosis is very rare. We present a 57-year-old female patient with a solitary, slowly progressive nodule over upper lip of 2½ months duration. Initially, differential diagnosis of cutaneous leishmaniasis, pyoderma and deep mycoses were entertained. Slit smear preparation was suspicious of deep mycotic infection which was subsequently confirmed by biopsy and culture.

  8. Solitary Fibrous Tumor in Bladder:A Case Report

    王涛; 陈瑞宝; 乔建坤; 胡涛; 刘继红; 杨为民; 叶章群


    Solitary fibrous tumor(SFT) in bladder is extremely rare.In this study,we reported one case of bladder SFT and reviewed the only ten cases of the disease that had been reported so far.The patient suffered from residual urine sensation and urethral pain.Cystoscopy revealed a 7-cm protruding mass at the dome of the bladder,and bladder mucosa biopsy showed normal differentiation of the bladder mucosa with a small amount of inflammatory cells.Radical resection of the tumor was performed in this patient.Patholog...

  9. Coherent structures in wave boundary layers. Part 2. Solitary motion

    Sumer, B. Mutlu; Jensen, Palle Martin; Sørensen, Lone B.;


    in an oscillating water tunnel. Two kinds of measurements were made: bed shear stress measurements and velocity measurements. The experiments show that the solitary-motion boundary layer experiences three kinds of flow regimes as the Reynolds number is increased: (i) laminar regime; (ii) laminar regime where...... the boundary-layer flow experiences a regular array of vortex tubes near the bed over a short period of time during the deceleration stage; and (iii) transitional regime characterized with turbulent spots, revealed by single/multiple, or, sometimes, quite dense spikes in the bed shear stress traces...

  10. A case report of reactive solitary eccrine syringofibroadenoma

    Tiwary, Anup K.; Firdous, J.; Mishra, Dharmendra K.; Chaudhary, Shyam S.


    Eccrine syringofibroadenoma is a very rare benign tumour of acrosyringium of eccrine sweat duct. Based on the evidences of known etiological factors, two forms have been proposed; reactive and nonreactive. Reactive forms are rarer, and on even rarer occasions, trauma complicated by secondary nonspecific infections may lead to the development of reactive eccrine syringofibroadenoma, as in our case. Here, we are documenting a case of reactive solitary eccrine syringofibroadenoma in a 65-year-old male presenting with coalescing, firm, pinkish, verrucous nodules and painful deep ulceration on the right sole preceded by trauma and secondary infection. Histopathologic revelation of distinctive microscopic findings confirmed the diagnosis in our case. PMID:28217470

  11. Metastatic melanoma mimicking solitary fibrous tumor: report of two cases.

    Bekers, Elise M; van Engen-van Grunsven, Adriana C H; Groenen, Patricia J T A; Westdorp, Harm; Koornstra, Rutger H T; Bonenkamp, Johannes J; Flucke, Uta; Blokx, Willeke A M


    Malignant melanomas are known for their remarkable morphological variation and aberrant immunophenotype with loss of lineage-specific markers, especially in recurrences and metastases. Hot spot mutations in BRAF, NRAS, GNAQ, and GNA11 and mutations in KIT are oncogenic events in melanomas. Therefore, genotyping can be a useful ancillary diagnostic tool. We present one case each of recurrent and metastatic melanoma, both showing histological and immunohistochemical features of solitary fibrous tumor (SFT). Mutational analysis detected BRAF and NRAS mutations in the primary and secondary lesions, respectively. This result confirmed the diagnosis of recurrent/metastastic melanoma.

  12. Experiments and computation of onshore breaking solitary waves

    Jensen, A.; Mayer, Stefan; Pedersen, G.K.


    This is a combined experimental and computational study of solitary waves that break on-shore. Velocities and accelerations are measured by a two-camera PIV technique and compared to theoretical values from an Euler model with a VOF method for the free surface. In particular, the dynamics of a so......-called collapsing breaker is scrutinized and the closure between the breaker and the beach is found to be akin to slamming. To the knowledge of the authors, no velocity measurements for this kind of breaker have been previously reported....

  13. [A solitary neurofibroma in the parotid gland from nervus vagus].

    Fagö-Olsen, Helena Anna; Hahn, Christoffer Holst


    A 37-year-old male, without stigmata of neurofibromatosis type 1, developed a firm mass below the right ear over several months without facial palsy. Clinical examination and ultra-sonography revealed a tumour in the parotid gland. Fine needle aspirationbiopsy was inconclusive. During complete resection, the tumour revealed an unusual anatomic location from the superficial lobe of the parotid to the deep and further into the parapharyngeal space. The pathological examination showed a solitary neurofibroma. In this case report, preoperative diagnosis, therapy and follow-up of this rare tumour in the parotid gland from n. vagus are discussed.


    LIU Zhi-fang; ZHANG Shan-yuan


    A new nonlinear wave equation of a finite deformation elastic circular rod simultaneously introducing transverse inertia and shearing strain was derived by means of Hamilton principle. The nonlinear equation includes two nonlinear terms caused by finite deformation and double geometric dispersion effects caused by transverse inertia and transverse shearing strain. Nonlinear wave equation and corresponding truncated nonlinear wave equation were solved by the hyperbolic secant function finite expansion method. The solitary wave solutions of these nonlinear equations were obtained. The necessary condition of these solutions existence was given also.

  15. Flow and sediment transport induced by a plunging solitary wave

    Sumer, B. Mutlu; Sen, M.Berke; Karagali, Ioanna


    , and for observation of the morphological changes. The two experimental conditions were maintained as similar as possible. The experiments showed that the complete sequence of the plunging solitary wave involves the following processes: Shoaling and wave breaking; Runup; Rundown and hydraulic jump; and Trailing wave...... affected, by as much as a factor of 2, in the runup and hydraulic jump stages. The pore-water pressure measurements showed that the sediment at (or near) the surface of the bed experiences upward-directed pressure gradient forces during the downrush phase. The magnitude of this force can reach values...

  16. Solitary fibrous tumor arising in an intrathoracic goiter

    Larsen, Stine Rosenkilde; Godballe, Christian; Krogdahl, Annelise


    . CONCLUSION: The histological appearance and immunohistochemical reaction pattern of SFT is characteristic. The entity should be considered when dealing with a spindle cell lesion in the thyroid gland. All cases of this site of origin reported have had a benign clinical course. As only a small number of cases......BACKGROUND: Solitary fibrous tumor (SFT) is a rare spindle cell tumor most often found in the mediastinal pleura. Nineteen cases of SFT arising in the thyroid gland have been reported. We report a case of SFT of the thyroid gland with immunohistochemical and cytogenetic investigation. SUMMARY: A 58...

  17. Solitary fibrous tumor of the orbit presenting in pregnancy

    Das Jayanta


    Full Text Available A 32-year-old woman, three months pregnant, reported with the complaint of protrusion of the right eye for six months. She gave history of rapid protrusion of eyeball for the last two months along with the history of double vision for the last one month. Computer tomography (CT scan revealed a well-defined mass lesion in the intraconal space of the right orbit which was excised through a lateral orbitotomy approach. Histological examination and immunohistochemistry revealed a solitary fibrous tumor, which showed a rapid progression in pregnancy.



    Using direct algebraic method,exact solitary wave solutions are performed for a class of third order nonlinear dispersive disipative partial differential equations. These solutions are obtained under certain conditions for the relationship between the coefficients of the equation. The exact solitary waves of this class are rational functions of real exponentials of kink-type solutions.

  19. Laboratory Generation of Solitary Waves:An Inversion Technique to Improve Available Methods

    A.Romano; M.Guerrini; G.Bellotti; 琚烈红


    Solitary waves are often used in laboratory experiments to study tsunamis propagation and interaction with coasts. However, the experimental shape of the waves may differ from the theoretical one. In this paper, a correction technique aiming at minimizing the discrepancies between the two profiles is presented. Laboratory experiments reveal their effectiveness in correcting the experimental shape of solitary waves, mainly for low nonlinearities.

  20. Solitary Solution of Discrete mKdV Equation by Homotopy Analysis Method

    XU Xi-Xiang; WANG Zhen; YANG Hong-Xiang; ZOU Li; LU Rong-Wu; ZHANG Hong-Qing


    In this paper, we apply homotopy analysis method to solve discrete mKdV equation and successfully obtain the bell-shaped solitary solution to mKdV equation. Comparison between our solution and the exact solution shows that homotopy analysis method is effective and validity in solving hybrid nonlinear problems, including solitary solution of difference-differential equation.

  1. Large Amplitude Solitary Waves in a Fluid-Filled Elastic Tube



    By usign the potential method to a fluid filled elastic tube, we obtained a solitary wave solution.Compared with recluetive perturbation method, this method can be used for larger amplitude solitary waves. The result is in agreement with that of small amplitude approximation from reduetive perturbation method when the amplitude is small enough.

  2. Large Amplitude Solitary Waves in a Fluid-Filled Elastic Tube

    DUAN Wen-Shan


    By using the potential method to a fluid filled elastic tube, we obtained a solitary wave solution. Comparedwith reductive perturbation method, this method can be used for larger amplitude solitary waves. The result is inagreement with that of small amplitude approximation from reductive perturbation method when the amplitude is smallenough.

  3. Solitary cysticercosis of the biceps brachii in a vegetarian: a rare and unusual pseudotumor

    Abdelwahab, Ibrahim Fikry [Department of Radiology, New York Methodist Hospital Affiliated with Weill Medical College of Cornell University, 506 Sixth Street, Brooklyn, NY 11215 (United States); Klein, Michael J. [Department of Pathology, Mount Sinai Medical Center, 1 Gustave Levy Place, New York, NY 10029 (United States); Hermann, George [Department of Radiology, Mount Sinai Medical Center, 1 Gustave Levy Place, New York, NY 10029 (United States); Abdul-Quader, Mohammed [Department of Radiology, Columbia Presbyterian Medical Center, 177 Fort Washington Avenue, New York, NY 10032 (United States)


    We report a 40-year-old man with cysticercosis presenting as a solitary tumor in the biceps brachii muscle. Physical examination revealed an intramuscular mass and magnetic resonance imaging suggested a cyst. The histologic diagnosis was a cysticercus. Such solitary presentation of muscular cysticercosis is extremely rare with only a handful of sporadic reports in the literature. (orig.)

  4. A double optical solitary wave in a nonlinear Schr(o)dinger-type equation

    Yin Jiu-Li; Ding Shan-Yu


    A qualitative analysis method to efficiently solve the shallow wave equations is improved,so that a more complicated nonlinear Schr(o)dinger equation can be considered.By using the detailed study,some quite strange optical solitary waves are obtained in which the bright and dark optical solitary waves are allowed to coexist.

  5. Solitary Wave Generation from Constant Continuous Wave in Asymmetric Oppositely Directed Waveguide Coupler

    Kazantseva E.V.


    Full Text Available In a model which describes asymmetric oppositely directed nonlinear coupler it was observed in numerical simulations a phenomenon of solitary wave generation from the input constant continuous wave set at the entrance of a waveguide with negative refraction. The period of solitary wave formation decreases with increase of the continuum wave amplitude.

  6. Vlasov Simulation of Electrostatic Solitary Structures in Multi-Component Plasmas

    Umeda, Takayuki; Ashour-Abdalla, Maha; Pickett, Jolene S.; Goldstein, Melvyn L.


    Electrostatic solitary structures have been observed in the Earth's magnetosheath by the Cluster spacecraft. Recent theoretical work has suggested that these solitary structures are modeled by electron acoustic solitary waves existing in a four-component plasma system consisting of core electrons, two counter-streaming electron beams, and one species of background ions. In this paper, the excitation of electron acoustic waves and the formation of solitary structures are studied by means of a one-dimensional electrostatic Vlasov simulation. The present result first shows that either electron acoustic solitary waves with negative potential or electron phase-space holes with positive potential are excited in four-component plasma systems. However, these electrostatic solitary structures have longer duration times and higher wave amplitudes than the solitary structures observed in the magnetosheath. The result indicates that a high-speed and small free energy source may be needed as a fifth component. An additional simulation of a five-component plasma consisting of a stable four-component plasma and a weak electron beam shows the generation of small and fast electron phase-space holes by the bump-on-tail instability. The physical properties of the small and fast electron phase-space holes are very similar to those obtained by the previous theoretical analysis. The amplitude and duration time of solitary structures in the simulation are also in agreement with the Cluster observation.

  7. Dispersal of solitary bees and bumblebees in a winter oilseed rape field

    Calabuig, Isabel


    Dispersal distributions of solitary bees and bumblebees were studied in a winter oilseed rape field. Window-traps were placed in the rape field along a line transect perpendicular to the field edge. 19 species of solitary bees were recorded and all but four species are polylectic, including...

  8. Differential Properties of Venom Peptides and Proteins in Solitary vs. Social Hunting Wasps

    Lee, Si Hyeock; Baek, Ji Hyeong; Yoon, Kyungjae Andrew


    The primary functions of venoms from solitary and social wasps are different. Whereas most solitary wasps sting their prey to paralyze and preserve it, without killing, as the provisions for their progeny, social wasps usually sting to defend their colonies from vertebrate predators. Such distinctive venom properties of solitary and social wasps suggest that the main venom components are likely to be different depending on the wasps’ sociality. The present paper reviews venom components and properties of the Aculeata hunting wasps, with a particular emphasis on the comparative aspects of venom compositions and properties between solitary and social wasps. Common components in both solitary and social wasp venoms include hyaluronidase, phospholipase A2, metalloendopeptidase, etc. Although it has been expected that more diverse bioactive components with the functions of prey inactivation and physiology manipulation are present in solitary wasps, available studies on venom compositions of solitary wasps are simply too scarce to generalize this notion. Nevertheless, some neurotoxic peptides (e.g., pompilidotoxin and dendrotoxin-like peptide) and proteins (e.g., insulin-like peptide binding protein) appear to be specific to solitary wasp venom. In contrast, several proteins, such as venom allergen 5 protein, venom acid phosphatase, and various phospholipases, appear to be relatively more specific to social wasp venom. Finally, putative functions of main venom components and their application are also discussed. PMID:26805885

  9. Stability of Solitary Waves for Three Coupled Long Wave - Short Wave Interaction Equations

    Borluk, H.; Erbay, S.


    In this paper we consider a three-component system of one dimensional long wave-short wave interaction equations. The system has two-parameter family of solitary wave solutions. We prove orbital stability of the solitary wave solutions using variational methods.

  10. Solitary central osteoma of mandible in a geriatric patient: Report and review

    Bhujbal, Ravi B.; Nayak, Ajay G.


    Solitary central osteomas of jaw are extremely rare lesions with only few previously documented cases. This paper reports a case of large solitary central osteoma involving mandible symphysis- parasymphysis region in an elderly female patient. A brief review of similar cases reported in the literature is also provided in this paper. Key words:Osteomas, osteogenic,bone, tumor, jaw, mandible. PMID:27034765

  11. Oceanic pycnocline depth retrieval from SAR imagery in the existence of solitary internal waves


    Oceanic pycnocline depth is usually inferred from in situ measurements. It is attempted to estimate the depth remotely. As solitary internal waves occur on oceanic pycnocline and propagate along it, it is possible to retrieve the depth indirectly in virtue of the solitary internal waves. A numerical model is presented for retrieving the pycnocline depth from synthetic aperture radar (SAR) images where the solitary internal waves are visible and when ocean waters are fully stratified. This numerical model is constructed by combining the solitary internal wave model and a two-layer ocean model. It is also assumed that the observed groups of solitary internal wave packets on the SAR imagery are generated by local semidiurnal tides. A case study in the East China Sea shows a good agreement with in situ CTD (conductivity-temperature-depth) data.

  12. Electrostatic Korteweg-deVries solitary waves in a plasma with Kappa-distributed electrons

    Choi, C.-R.; Min, K.-W. [Department of Physics, Korea Advanced Institute of Science and Technology, Taejon 305-701 (Korea, Republic of); Rhee, T.-N. [National Fusion Research Institute, Daejeon 305-333 (Korea, Republic of)


    The Korteweg-deVries (KdV) equation that describes the evolution of nonlinear ion-acoustic solitary waves in plasmas with Kappa-distributed electrons is derived by using a reductive perturbation method in the small amplitude limit. We identified a dip-type (negative) electrostatic KdV solitary wave, in addition to the hump-type solution reported previously. The two types of solitary waves occupy different domains on the {kappa} (Kappa index)-V (propagation velocity) plane, separated by a curve corresponding to singular solutions with infinite amplitudes. For a given Kappa value, the dip-type solitary wave propagates faster than the hump-type. It was also found that the hump-type solitary waves cannot propagate faster than V = 1.32.

  13. Generation of internal solitary waves by frontally forced intrusions in geophysical flows.

    Bourgault, Daniel; Galbraith, Peter S; Chavanne, Cédric


    Internal solitary waves are hump-shaped, large-amplitude waves that are physically analogous to surface waves except that they propagate within the fluid, along density steps that typically characterize the layered vertical structure of lakes, oceans and the atmosphere. As do surface waves, internal solitary waves may overturn and break, and the process is thought to provide a globally significant source of turbulent mixing and energy dissipation. Although commonly observed in geophysical fluids, the origins of internal solitary waves remain unclear. Here we report a rarely observed natural case of the birth of internal solitary waves from a frontally forced interfacial gravity current intruding into a two-layer and vertically sheared background environment. The results of the analysis carried out suggest that fronts may represent additional and unexpected sources of internal solitary waves in regions of lakes, oceans and atmospheres that are dynamically similar to the situation examined here in the Saguenay Fjord, Canada.

  14. Fluorine-18 fluorodeoxyglucose positron emission tomography in the management of solitary pulmonary nodule: a review.

    Divisi, Duilio; Barone, Mirko; Zaccagna, Gino; Crisci, Roberto


    Solitary pulmonary nodules are common radiologic findings and their detection has increased due to the introduction and improvement of diagnostics. Since a nodule can be an expression of early lung cancers, a proper classification and management are required because its treatment might lead to decreased morbidity and mortality. In this regard, prominent guidelines are available although they are characterized sometimes by discordant and misleading evidences. Furthermore, the same results of studies in the literature appear conflicting. Aim of this work is to evaluate the role of imaging through an extensive literature review but focusing on 18-fluorine fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG-PET/CT) in order to assess the limits and future perspectives of solitary pulmonary nodule characterization in early detection of lung cancer. Key messages Detection of solitary pulmonary nodules has increased. Management of solitary pulmonary nodules is still debated. Future perspectives of early solitary pulmonary nodule characterization.

  15. Generation of internal solitary waves by frontally forced intrusions in geophysical flows

    Bourgault, Daniel; Galbraith, Peter S.; Chavanne, Cédric


    Internal solitary waves are hump-shaped, large-amplitude waves that are physically analogous to surface waves except that they propagate within the fluid, along density steps that typically characterize the layered vertical structure of lakes, oceans and the atmosphere. As do surface waves, internal solitary waves may overturn and break, and the process is thought to provide a globally significant source of turbulent mixing and energy dissipation. Although commonly observed in geophysical fluids, the origins of internal solitary waves remain unclear. Here we report a rarely observed natural case of the birth of internal solitary waves from a frontally forced interfacial gravity current intruding into a two-layer and vertically sheared background environment. The results of the analysis carried out suggest that fronts may represent additional and unexpected sources of internal solitary waves in regions of lakes, oceans and atmospheres that are dynamically similar to the situation examined here in the Saguenay Fjord, Canada.

  16. Dust Acoustic Solitary Waves in Saturn F-ring's Region

    E.K. El-Shewy; M.I. Abo el Maaty; H.G. Abdelwahed; M.A.Elmessary


    Effect of hot and cold dust charge on the propagation of dust-acoustic waves (DAWs) in unmagnetized plasma having electrons, singly charged ions, hot and cold dust grains has been investigated.The reductive perturbation method is employed to reduce the basic set of fluid equations to the Kortewege-de Vries (KdV) equation.At the critical hot dusty plasma density NhO, the KdV equation is not appropriate for describing the system.Hence, a set of stretched coordinates is considered to derive the modified KdV equation.It is found that the presence of hot and cold dust charge grains not only significantly modifies the basic properties of solitary structure, but also changes the polarity of the solitary profiles.In the vicinity of the critical hot dusty plasma density NhO, neither KdV nor mKdV equation is appropriate for describing the DAWs.Therefore, a further modified KdV (fmKdV) equation is derived, which admits both soliton and double layer solutions.

  17. Measurement of Ultra-Short Solitary Electromagnetic Pulses

    Eva Gescheidtova


    Full Text Available In connection with the events of the last few years and with the increased number of terrorist activities, the problem of identification and measurement of electromagnetic weapons or other systems impact occurred. Among these are also microwave sources, which can reach extensive peak power of up to Pmax = 100 MW. Solitary, in some cases several times repeated, impulses lasting from tp E <1, 60>ns, cause the destruction of semiconductor junctions. These days we can find scarcely no human activity, where semiconductor structures are not used. The problem of security support of the air traffic, transportation, computer nets, banks, national strategic data canter’s, and other applications crops up. Several types of system protection from the ultra-short electromagnetic pulses present itself, passive and active protection. The analysis of the possible measuring methods, convenient for the identification and measurement of the ultra-short solitary electromagnetic pulses in presented in this paper; some of the methods were chosen and used for practical measurement. This work is part of Research object MSM262200022 "Research of microelectronic systems".

  18. Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma by whole-body MRI: comparison with bone and {sup 67}Ga scintigraphies

    Iizuka-Mikami, Masami; Nagai, Kiyohisa; Yoshida, Koji; Tamada, Tsutomu; Imai, Shigeki; Kajihara, Yasumasa; Fukunaga, Masao [Department of Radiology, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Okayama (Japan); Sugihara, Takashi; Suetsugu, Yoshimasa; Mikami, Makoto [Department of Hematology, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Okayama (Japan)


    The aim of this study was to evaluate the diagnostic potential of whole-body MRI (WB-MRI) for the detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma. WB-MRI, which was performed on 34 patients, consisted of the recording of T1-weighted spin-echo images and a fast STIR sequence covering the entire skeleton. The WB-MRI findings for bone marrow and extramedullary involvement were compared with those from {sup 67}Ga and bone scintigraphies and bone marrow biopsy results. Two MRI specialists reviewed the WB-MRI results and two expert radiologists in the field of nuclear medicine reviewed the bone and {sup 67}Ga scintigraphy findings. Bone marrow and extramedullary involvement of non-Hodgkin's lymphoma were confirmed by follow-up radiographs and CT and/or a histological biopsy. The detection rate of WB-MRI was high. More bone marrow involvement was detected by biopsy, and more lesions were detected by scintigraphies. In total, 89 lesions were detected by WB-MRI, whereas 15 were found by biopsy, 5 by {sup 67}Ga scintigraphy, and 14 by bone scintigraphy. WB-MRI could also detect more extramedullary lesions than {sup 67}Ga scintigraphy; i.e., 72 lesions were detected by WB-MRI, whereas 54 were discovered by {sup 67}Ga scintigraphy. WB-MRI is useful for evaluating the involvement of bone marrow and extramedullary lesions throughout the skeleton in patients with non-Hodgkin's lymphoma. (orig.)

  19. Numerical study of interfacial solitary waves propagating under an elastic sheet

    Wang, Zhan; Părău, Emilian I.; Milewski, Paul A.; Vanden-Broeck, Jean-Marc


    Steady solitary and generalized solitary waves of a two-fluid problem where the upper layer is under a flexible elastic sheet are considered as a model for internal waves under an ice-covered ocean. The fluid consists of two layers of constant densities, separated by an interface. The elastic sheet resists bending forces and is mathematically described by a fully nonlinear thin shell model. Fully localized solitary waves are computed via a boundary integral method. Progression along the various branches of solutions shows that barotropic (i.e. surface modes) wave-packet solitary wave branches end with the free surface approaching the interface. On the other hand, the limiting configurations of long baroclinic (i.e. internal) solitary waves are characterized by an infinite broadening in the horizontal direction. Baroclinic wave-packet modes also exist for a large range of amplitudes and generalized solitary waves are computed in a case of a long internal mode in resonance with surface modes. In contrast to the pure gravity case (i.e without an elastic cover), these generalized solitary waves exhibit new Wilton-ripple-like periodic trains in the far field. PMID:25104909

  20. Clinical and radiographic features of solitary and cemento-osseous dysplasia-associated simple bone cysts.

    Chadwick, J W; Alsufyani, N A; Lam, E W N


    The simple bone cyst (SBC) is a pseudocyst that can occur as a solitary entity in the jaws or may occur in association with cemento-osseous dysplasia (COD). The purpose of this study was to review the clinical and radiographic features of solitary and COD-associated SBCs. Archived imaging reports from the Special Procedures Clinic in Oral and Maxillofacial Radiology at the Faculty of Dentistry at the University of Toronto between 1 January 1989 and 31 December 2009 revealed 23 COD-associated SBCs and 68 solitary SBCs. Almost all solitary and COD-associated SBCs were found in the mandible. Furthermore, 87.0% of COD-associated SBCs were found in females in their fifth decade of life (P < 0.001) while solitary SBCs were found in equal numbers in both sexes in their second decade of life (P < 0.005). COD-associated SBCs were also more likely to cause thinning of the endosteal cortex, bone expansion and scalloping of the superior border between teeth (all P < 0.001) than solitary SBCs that are classically described as having these characteristics. Finally, COD-associated SBC demonstrated a loss of lamina dura more often (P < 0.05) than solitary SBCs. Knowledge of the sporadic association between COD and SBC and their potential radiographic appearances should prevent inappropriate treatment and management of these patients.

  1. An experimental study on runup of two solitary waves on plane beaches

    XUAN Rui-tao; WU Wei; LIU Hua


    Experiments of the runup of two solitary waves on a plane beach are carried out in a wave flume.The two solitary waves with the same amplitude and the crest separating distances are generated by using an improved wave generation method.It is found that,with regard to the two solitary waves with same wave amplitude,the runup amplification of the second wave is less than that of the first wave if the relative crest separating distance is reduced to a certain threshold value.The rundown of the first solitary wave depresses the maximum runup of the second wave.If the leading solitary wave is of relatively smaller amplitude for the two solitary waves,the runup amplification is affected by the overtaking process of two solitary waves.It turns out that the runup amplification of the second wave is larger than that of the first wave if the similarity factor is approximately larger than 15,which means the larger wave overtakes the smaller one before the waves runup on a beach.

  2. 椎管内髓外囊性病变的MRI诊断及鉴别%MRI diagnosis and differential diagnosis of intraspinal extramedullary cysts

    陈明旺; 江新青; 魏新华; 郭永梅; 张鼎旋; 郑力强; 徐向东


    目的 探讨椎管内髓外囊性病变的MRI表现.方法 回顾分析30例经手术病理证实的椎管内髓外囊性病变的MRI及相关临床资料.结果 30例患者中脊膜囊肿15例,肠源性囊肿8例,胚胎性囊肿5例,囊性神经鞘瘤2例.脊膜囊肿中硬膜外囊肿(Ⅰa)3例,骶管脊膜囊肿(Ⅰ b)10例,神经根鞘囊肿2例(Ⅱ);均表现为有薄壁包裹长T1长T2信号,1例神经根鞘囊肿中可见神经纤维走行.肠源性囊肿位于脊髓腹侧的髓外硬膜下间隙,其中颈段椎管5例,颈胸段1例,胸段2例,平扫表现为长或等T1、长T2信号,3例见“脊髓嵌入征”.胚胎性囊肿表现为不同程度T1WI高信号,腰骶段常见.囊性神经鞘瘤强化边缘不规则.结论 椎管内髓外囊性病变在发病部位、形态、MRI信号特点及强化等方面有一定特点.%Objective To study the MRI manifestations of intraspinal extramedullary cysts. Methods The MRI findings and clinical data of 30 patients with intraspinal extramedullary cysts proved by surgery and pathology were analyzed. Results Fifteen lesions of 30 patients were meningeal cysts, 8 were enterogenous cysts, 5 were embryonic cyst and 2 were cystic schwannoma. Among spinal meningeal cysts, 3 were intraspinal epidural cyst (Ⅰ a), 2 were meningeal cysts within sacral canal, and 2 were nerve root sheath cysts( Ⅱ )· All spinal meningeal cysts showed prolong T1 and T2 signal and with thin capsule and nerve fiber through the cysts were seen in one case. Enterogenous cysts located in ventral spinal cord and intradural extramedullary space, among which 5 cases occurred in the cervical segment, 1 lesion in the junction of cervical and thoracic segments and 2 lesions in the thoracic segments. All the lesions with well-defined margin presented with long T1 and long T2 signal in plain MRI and had no enhancement on the postcontrast images. 3 lesions showed sign of spinal cord incuneation. Embryonic cyst presented high signal on both T1WI and T

  3. Rotating solitary wave at the wall of a cylindrical container

    Amaouche, Mustapha


    This paper deals with the theoretical modeling of a rotating solitary surface wave that was observed during water drainage from a cylindrical reservoir, when shallow water conditions were reached. It represents an improvement of our previous study, where the radial flow perturbation was neglected. This assumption led to the classical planar Korteweg–de Vries equation for the wall wave profile, which did not account for the rotational character of the base flow. The present formulation is based on a less restricting condition and consequently corrects the last shortcoming. Now the influence of the background flow appears in the wave characteristics. The theory provides a better physical depiction of the unique experiment by predicting fairly well the wave profile at least in the first half of its lifetime and estimating the speed of the observed wave with good accuracy.

  4. Solitary fibrous tumor of the pleura: 3 case reports

    Elias Amorim


    Full Text Available Summary Introduction: solitary fibrous tumor of the pleura (SFTP is a rare tumor arising from mesenchymatous cells in submesothelial pleural tissue which, unlike mesothelioma, is not related to asbestos or smoking. Methods: report of four patients who underwent surgical treatment for giant SFTP and review of the pertinent literature. Results: of the four patients operated, two presented symptoms including cough, chest pain and feeling of compression, whereas the other two subjects were asymptomatic. All patients underwent complete surgical resection by wide posterolateral thoracotomy, and surgical specimens removed with minimum bleeding. None of the cases required complementary lobectomy or segmentectomy. All tumors were histologically benign. Conclusion: complete resection of the lesion is the treatment of choice in all SFTP cases. Prognosis of the benign lesion is excellent, although close follow-up is necessary. In the rarer, more aggressive forms, treatment may be complemented by adjunctive chemotherapy or radiotherapy, the benefits of which have yet to be confirmed.

  5. Solitary-like waves in a liquid foam microchannel

    Bouret, Yann; Cohen, Alexandre; Fraysse, Nathalie; Argentina, Médéric; Raufaste, Christophe


    Plateau borders (PBs) are liquid microchannels located at the contact between three bubbles in liquid foams. They are stable, deformable, and can be thought of as quasi-one-dimensional model systems to study surface waves in fluid dynamics. We show that the burst of a bubble trapped in a PB produces local constrictions which travel along the liquid channel at constant velocity, without significant change in shape. These patterns are reminiscent of the depression solitary waves encountered in nonlinear systems. By coupling flow inertia to capillary stresses, we derive a simple model that admits solitonic solutions, which we characterized numerically and analytically in the limit of small deformation. These solutions capture most of the features observed experimentally.

  6. Solitary Large Intestinal Diverticulitis in Leatherback Turtles (Dermochelys coriacea).

    Stacy, B A; Innis, C J; Daoust, P-Y; Wyneken, J; Miller, M; Harris, H; James, M C; Christiansen, E F; Foley, A


    Leatherback sea turtles are globally distributed and endangered throughout their range. There are limited data available on disease in this species. Initial observations of solitary large intestinal diverticulitis in multiple leatherbacks led to a multi-institutional review of cases. Of 31 subadult and adult turtles for which complete records were available, all had a single exudate-filled diverticulum, as large as 9.0 cm in diameter, arising from the large intestine immediately distal to the ileocecal junction. All lesions were chronic and characterized by ongoing inflammation, numerous intralesional bacteria, marked attenuation of the muscularis, ulceration, and secondary mucosal changes. In three cases, Morganella morganii was isolated from lesions. Diverticulitis was unrelated to the cause of death in all cases, although risk of perforation and other complications are possible.

  7. Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule

    Basu S


    Full Text Available Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule, who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.

  8. [Solitary fibrous tumor of the pelvis: a rare extrathoracic manifestation].

    Gessmann, J; Seybold, D; Helwing, M; Muhr, G; Schildhauer, T A


    Solitary fibrous tumors (SFT) are rare spindle cell neoplasms. To date only very few cases of pelvic SFT have been reported in the literature. SFT are characterized by unique microscopic and immunohistochemical findings. Complete local resection is the treatment of choice. Recurrence and metastasis may be related to infrequent malignant histological features, but histology is not always a reliable predictor for prognosis. Therefore long-term follow-up is necessary.We report about a male patient with a malignant pelvic SFT. After complete resection the tumor recurred after a short period of 6 months posterior to the original location in the pelvis. The differential diagnoses and the therapy options are discussed with a review of the present literature.

  9. Solitary spinal metastasis of Hürthle cell thyroid carcinoma.

    Sciubba, Daniel M; Petteys, Rory J; Kang, Steven; Than, Khoi D; Gokaslan, Ziya L; Gallia, Gary L; Wolinsky, Jean-Paul


    Hürthle cell carcinoma is a rare variant of differentiated thyroid cancer that occasionally forms distant metastases. However, even in the presence of metastases, patients with Hürthle cell carcinoma have a relatively good prognosis. There are few reports of Hürthle cell carcinoma metastases to the vertebral column, and none describing aggressive resection of spinal metastases. Here, we report a 68-year-old woman with a solitary metastasis of Hürthle cell carcinoma to the T1 vertebral body causing severe kyphotic deformity, myelopathy, and pain. The patient was treated with aggressive excisional decompression of the spinal cord and T1 vertebral body resection from an entirely posterior approach. Reconstruction and stabilization of the anterior spine was accomplished with a transforaminal lumbar interbody fusion allograft spacer and posterior instrumentation. We discuss aspects of the diagnosis, management, patient selection, and surgical treatment of metastatic Hürthle cell carcinoma in reference to the literature.

  10. Solitary plexiform neurofibroma determining pyloric obstruction: a case report

    Eduardo Cambruzzi


    Full Text Available Solitary gastric plexiform neurofibroma (PN is a very rare tumor that originates from the peripheral nerves. PN is a rare cause of pyloric obstruction. A 58 year-old man, reported epigastric discomfort, nausea, and vomiting for two months. Upper digestive endoscopy showed a moderate/accentuated pyloric stenosis. Computed tomography (CT and echoendoscopy revealed a pyloric nodule. The patient underwent to distal gastrectomy. Macroscopically, a gray nodule measuring 1.1 × 1.0 × 1.0 cm was identified. Using microscopy, a benign tumor composed of enlarged tortuous nerve fascicles showing a neurofibromatous proliferation with mild atypia and myxoid matrix was found. The lesion showed positive immunoexpression for S100, Leu7, and epithelial membrane antigen (EMA, and was negative for CD117, DOG-1, desmin, and smooth muscle actin. The diagnosis of PN was then determined.

  11. Solitary wave generation from continuum in asymmetric oppositely directed nonlinear waveguide coupler

    Kazantseva, E. V.; Maimistov, A. I.


    In a model which describes asymmetric oppositely directed nonlinear waveguide coupler it was observed in the numerical simulation a phenomenon of solitary wave formation from the input constant continuous wave set at the entrance of a waveguide with negative index of refraction. Threshold value of the amplitude of the constant continuous wave, which defines the condition of appearance of the first solitary wave, decreases with increasing of the parameter of nonlinearity. The period of solitary wave formation decreases with increasing of the continuum wave amplitude.

  12. Effect of adiabatic variation of dust charges on dust acoustic solitary waves in magnetized dusty plasmas

    Duan Wen-Shan


    The effect of dust charging and the influence of its adiabatic variation on dust acoustic waves is investigated. By employing the reductive perturbation technique we derived a Zakharov-Kuznetsov (ZK) equation for small amplitude dust acoustic waves. We have analytically verified that there are only rarefactive solitary waves for this system. The instability region for one-dimensional solitary wave under transverse perturbations has also been obtained. The obliquely propagating solitary waves to the z-direction for the ZK equation are given in this paper as well.

  13. Developing Serpent-Type Wave Generators to Create Solitary Wave Simulations with BEM

    Wen-Kai WENG; Ruey-Syan SHIH; Chung-Ren CHOU


    Developing serpent-type wave generators to generate solitary waves in a 3D-basin was investigated in this study. Based on the Lagrangian description with time-marching procedures and finite differences of the time derivative, a 3D multiple directional wave basin with multidirectional piston wave generators was developed to simulate ocean waves by using BEM with quadrilateral elements, and to simulate wave-caused problems with fully nonlinear water surface conditions. The simulations of perpendicular solitary waves were conducted in the first instance to verify this scheme. Furthermore, the comparison of the waveform variations confirms that the estimation of 3D solitary waves is a feasible scheme.

  14. Periodic Semifolded Solitary Waves for (2+1)-Dimensional Variable Coefficient Broer-Kaup System

    JI Jie; HUANG Wen-Hua


    Applying the extended mapping method via Riccati equation, many exact variable separation solutions for the (2+1)-dimensional variable coefficient Broer-Kaup equation are obtained. Introducing multiple valued function and Jacobi elliptic function in the seed solution, special types of periodic semifolded solitary waves are derived. In the long wave limit these periodic semifolded solitary wave excitations may degenerate into single semifolded localized soliton structures. The interactions of the periodic semifolded solitary waves and their degenerated single semifolded soliton structures are investigated graphically and found to be completely elastic.

  15. The Solitary Variant of Mandibular Intraosseous Neurofibroma: Report of a Rare Entity

    Pavan Kumar Gujjar


    Full Text Available Neurofibroma (NF is a benign neoplasm derived from peripheral nerve cells. NF may extend either as a solitary lesion or as part of a generalized syndrome of neurofibromatosis. Intraorally, the intraosseous variant of neurofibroma is a very rare tumor. The literature provides only few cases of solitary intraosseous neurofibroma of the mandible. We report a case of 28-year-old female who was diagnosed with a solitary intraosseous neurofibroma involving the lower left quadrant of the mandible. The present case is rare in regard to its dimensions and its location.

  16. Scabies presenting as solitary mastocytoma-like eruption in an infant.

    Salces, Inés García; Alfaro, Jorge; Sáenz DE Santamaría, Maria Carmen; Sanchez, Milagros


    We report a case in which the initial clinical finding was a solitary cutaneous nodule on the wrist of a young infant which urticated when rubbed, and was diagnosed as a solitary mastocytoma. Two months later, she had the onset of a new vesiculo-pustular eruption on the palms and soles, consistent with scabies infestation and treatment with topical permethrin 5% cream resulted in resolution of the entire eruption, including the primary nodule. While scabies has been reported to mimick a variety of conditions including urticaria pigmentosa, to our knowledge no previous cases masquerading as solitary mastocytoma have been reported.

  17. Bifurcation and Solitary Waves of the Combined KdV and KdV Equation

    HUA Cun-Cai; LIU Yan-Zhu


    Bifurcation, bistability and solitary waves of the combined KdV and mKdV equation are investigatedsystematically. At first, bifurcation and bistability are analyzed by selecting an integral constant as the bifurcationparameter. Then, different conditions expressed in terms of the bifurcation parameter are obtained for the existence ofbreather-like, algebraic, pulse-like solitary waves, and shock waves. All types of the solitary wave and shock wave solutionsare given by direct integration. Finally, an approximate analytic method by employing the interpolation polynomials iscomplete and the theoretical methods are the simplest hitherto.

  18. Bifurcation and solitary waves of the nonlinear wave equation with quartic polynomial potential

    化存才; 刘延柱


    For the nonlinear wave equation with quartic polynomial potential, bifurcation and solitary waves are investigated. Based on the bifurcation and the energy integral of the two-dimensional dynamical system satisfied by the travelling waves, it is very interesting to find different sufficient and necessary conditions in terms of the bifurcation parameter for the existence and coexistence of bright, dark solitary waves and shock waves. The method of direct integration is developed to give all types of solitary wave solutions. Our method is simpler than other newly developed ones. Some results are similar to those obtained recently for the combined KdV-mKdV equation.

  19. An ancillary CT finding of intrapulmonary solitary fibrous tumor: A case report

    Lee, Dong Jun; Rho, Ji Young; Kwon, Ah Young [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)


    Intrapulmonary solitary fibrous tumor is extremely rare. A few reports have presented typical CT findings such as well-defined, variable—sized, heterogeneously or homogenously well-enhanced intrapulmonary nodules. We report herein a rare case of intrapulmonary solitary fibrous tumor that showed typical clinical and CT features, and we also provide an ancillary CT finding that shows a distinguishable tubular vascular structure within the nodule. The tubular vascular structure was conjoined to the proximal pulmonary vein. In this study, we highlight an ancillary CT finding reported for the first time for the diagnosis of a patient with intrapulmonary solitary fibrous tumor.

  20. Solitary SH waves in two-layered traction-free plates

    Djeran-Maigre, Irini; Kuznetsov, Sergey


    A solitary wave, resembling a soliton wave, is observed when analyzing the linear problem of polarized shear (SH) surface acoustic waves propagating in elastic orthotropic two-layered traction-free plates. The analysis is performed by applying a special complex formalism and the Modified Transfer Matrix (MTM) method. Conditions for the existence of solitary SH waves are obtained. Analytical expressions for the phase speed of the solitary wave are derived. To cite this article: I. Djeran-Maigre, S. Kuznetsov, C. R. Mecanique 336 (2008).

  1. Adenocarcinoma and infection in a solitary hepatic cyst: A case report

    Ching-Chung Lin; Shee-Chan Lin; Wen-Ching Ko; Kuo-Ming Chang; Shou-Chuan Shih


    Solitary non-parasitic liver cysts are being increasingly diagnosed due to the increased use of abdominal sonography. The majority of solitary liver cysts are asymptomatic; however, there are some complications which include infection, perforation, spontaneous hemorrhage, obstructive jaundice and neoplastic degeneration. In some cases a cystic liver lesion may mimic a tumor and is difficult to differentiate with standard imaging studies or fine needle aspiration cytology. Here in, we report a case of adenocarcinoma arising in a solitary hepatic cyst complicated with Klebsiella pneumoniae infection. High levels of CEA in the cyst fluid levels suggested malignancy, which was confirmed by pathology of the resected specimen.

  2. Solitary paraganglioma of the hypoglossal nerve: case report.

    Raza, Kazim


    BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 × 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.

  3. Numerical simulations of shoaling internal solitary waves of elevation

    Xu, Chengzhu; Subich, Christopher; Stastna, Marek


    We present high-resolution, two- and three-dimensional direct numerical simulations of large amplitude internal solitary waves of elevation on the laboratory scale, shoaling onto and over a small-amplitude shelf. The three-dimensional, mapped coordinate, spectral collocation method used for the simulations allows for accurate modelling of both the shoaling waves and the bottom boundary layer. The shoaling of the waves is characterized by the formation of a quasi-trapped core which undergoes a spatially growing stratified shear instability at its edge and a lobe-cleft instability in its nose. Both of these instabilities develop and three-dimensionalize concurrently, leading to strong bottom shear stress. We explore significant regions of Schmidt and Reynolds number space and demonstrate that the formation of shear instabilities during shoaling is robust and should be readily observable in a number of standard laboratory setups. In the experiments with a corrugated bottom boundary, boundary layer separation is found inside each of the corrugations during shoaling. This more complex boundary layer phenomenology precludes the formation of the lobe-cleft instability almost completely and hence provides a different mechanism for fluid and material exchange across the bottom boundary layer. Our analyses suggest that all of these wave-induced instabilities can lead to enhanced turbulence in the water column and increased shear stress on the bottom boundary. Through the generation and evolution of these instabilities, the shoaling of internal solitary waves of elevation is likely to provide systematic mechanisms for material mixing, cross-boundary layer transport, and sediment resuspension.

  4. Solitary paraganglioma of the hypoglossal nerve: case report.

    Raza, Kazim


    BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 x 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.

  5. VATS intraoperative tattooing to facilitate solitary pulmonary nodule resection

    Boutros Cherif


    Full Text Available Abstract Introduction Video-assisted thoracic surgery (VATS has become routine and widely accepted for the removal of solitary pulmonary nodules of unknown etiology. Thoracosopic techniques continue to evolve with better instruments, robotic applications, and increased patient acceptance and awareness. Several techniques have been described to localize peripheral pulmonary nodules, including pre-operative CT-guided tattooing with methylene blue, CT scan guided spiral/hook wire placement, and transthoracic ultrasound. As pulmonary surgeons well know, the lung and visceral pleura may appear featureless on top of a pulmonary nodule. Case description This paper presents a rapid, direct and inexpensive approach to peripheral lung lesion resection by marking the lung parenchyma on top of the nodule using direct methylene blue injection. Methods In two patients with peripherally located lung nodules (n = 3 scheduled for VATS, we used direct methylene blue injection for intraoperative localization of the pulmonary nodule. Our technique was the following: After finger palpation of the lung, a spinal 25 gauge needle was inserted through an existing port and 0.1 ml of methylene blue was used to tattoo the pleura perpendicular to the localized nodule. The methylene blue tattoo immediately marks the lung surface over the nodule. The surgeon avoids repeated finger palpation, while lining up stapler, graspers and camera, because of the visible tattoo. Our technique eliminates regrasping and repalpating the lung once again to identify a non marked lesion. Results Three lung nodules were resected in two patients. Once each lesion was palpated it was marked, and the area was resected with security of accurate localization. All lung nodules were resected in totality with normal lung parenchymal margins. Our technique added about one minute to the operative time. The two patients were discharged home on the second postoperative day, with no morbidity. Conclusion

  6. Solitary Wave and Non-traveling Wave Solutions to Two Nonlinear Evolution Equations


    By applying the extended homogeneous balance method, we find some new explicit solutions to two nonlinear evolution equations, which include n-resonance plane solitary wave and non-traveling wave solutions.

  7. Different Types of Solitary Wave Scattering in the Fermi-Pasta-Ulam Model

    WEN Zhen-Ying; ZHAO Hong


    @@ We show that the scattering between two solitary waves in the Fermi-Pasta-Ulam model with interaction potential V(x) = αx2/2 + x4/4 can be classified into four types according to the configurations of the solitary waves. For three of the four types, the large solitary wave can lose energy and the small one can gain in average by collision.For the other one type in a special parameter region we encounter an anomalous scattering, i.e. the large solitary wave gains energy and the small one loses energy. Numerical investigations are performed for the anharmonic limit case of α = 0 and the general case of α≠ 0 and comparisons between them are made.

  8. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    Rathi, Chetan Devendra; Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip


    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient.

  9. Open Partial Nephrectomy in Solitary Kidney with Multiple Renal Cell Carcinoma: a Case Report

    Ji-rui Niu; Quan-zong Mao; Zhi-gang Ji


    RENAL cell carcinoma (RCC) in a solitary kidney presents a unique clinical challenge to urological surgeons.Partial nephrectomy (PN) or nephron-sparing surgery in this condition provides good oncological and renal fuctional outcomes with an acceptable complication rate.1,2 Long-term renal function remains stable in most patients with solitary kidneys after a reduction of more than 50% in renal mass.3 PN is a surgical procedure reserved for patients with a tumor in a solitary kidney,bilateral renal tumors,or renal function impairment.4 The challenge of preserving renal parenchyma is significantly complicated with the discovery of multiple masses in a solitary kidney because any subsequent complications may result in a significant decline in quality of life.Particularly in the case of postoperative renal failure,dialysis becomes necessary.

  10. Resource effects on solitary bee reproduction in a managed crop pollination system

    The number of solitary bees (Megachile rotundata) released for pollination in a managed system (Medicago sativa seed production) and the number of flowers available for brood provisioning may affect reproduction through maternal resource allocation and investment. Overwhelming, limited, or adequate...

  11. [Solitary hepatic cyst. Presentation of a case diagnosed in neonatal period].

    Ruíz Jiménez, J I; Cuenca Burgos, M J; Vera Lorente, M; Espejo García, M P; Zambudio, G


    We reported one case of hepatic solitary cyst, in an infant seven days old. The precocious diagnostic was supported by the presence of an abdominal cyst mass in prenatal period. Different diagnostic and therapeutic consideration are made.

  12. MR Imaging Features of a Solitary Subcutaneous Metastasis from a Gastric Adenocarcinoma: A Case Report

    Kim, Jung Im; Choi, Jung Ah; Choi, Ja Young; Hong, Sung Hwan; Kang, Heung Sik [Seoul National University, Seoul (Korea, Republic of); Chung, Jin Haeng; Oh, Joo Han [Seoul National University Bundang Hospital, Seungnam (Korea, Republic of)


    Subcutaneous tissue is an unusual site for a metastasis from a gastric carcinoma. We present a case of a patient with a nodular solitary subcutaneous metastasis from a gastric cancer and describe its magnetic resonance imaging (MRI) features

  13. The risk-return trade-off between solitary and eusocial reproduction.

    Fu, Feng; Kocher, Sarah D; Nowak, Martin A


    Social insect colonies can be seen as a distinct form of biological organisation because they function as superorganisms. Understanding how natural selection acts on the emergence and maintenance of these colonies remains a major question in evolutionary biology and ecology. Here, we explore this by using multi-type branching processes to calculate the basic reproductive ratios and the extinction probabilities for solitary vs. eusocial reproductive strategies. We find that eusociality, albeit being hugely successful once established, is generally less stable than solitary reproduction unless large demographic advantages of eusociality arise for small colony sizes. We also demonstrate how such demographic constraints can be overcome by the presence of ecological niches that strongly favour eusociality. Our results characterise the risk-return trade-offs between solitary and eusocial reproduction, and help to explain why eusociality is taxonomically rare: eusociality is a high-risk, high-reward strategy, whereas solitary reproduction is more conservative.

  14. A unified approach in seeking the solitary wave solutions to sine-Gordon type equations

    Xie Yuan-Xi; Tang Jia-Shi


    By utilizing the solutions of an auxiliary ordinary differential equation introduced in this paper, we present a simple and direct method to uniformly construct the exact solitary wave solutions for sine-Gordon type equations.As illustrative examples, the exact solitary wave solutions of some physically significant sine-Gordon type equations,including the sine-Gordon equation, double sine-Gordon equation and mKdV-sine-Gordon equation, are investigated by means of this method.

  15. Contrast examination as a prognostic factor in the treatment of solitary bone cyst by cortisone injection

    Capanna, R.; Campanacci, M.; Albisinni, U.; Caroli, G.C.


    Local injection of radiopaque medium demonstrated the presence of intracystic fibrous septa in 13 patients with solitary bone cyst. Contrast examination was helpful in predicting the response of solitary bone cysts to treatment by injection of methylprednisolone-acetate (MPA). As the number of septa increased, an increased difficulty in obtaining an equal distribution of MPA inside the cyst and a higher incidence of incomplete healing of the cyst was encountered.

  16. Solitary myeloma with massive extracellular crystalline structures--a case report.

    Kim, Y. G.; Yang, K. H.; Gang, S. J.; Kim, B. K.; Kim, S. M.


    We describe a case of solitary myeloma showing cystic change filled with massive crystalline structures in a 54-year-old woman. A bone X-ray showed a solitary cystic osteolytic lesion in the right iliac bone. Serum and urine protein electrophoresis showed no demonstrable M-protein, and bone-marrow aspirates did not show any myeloma cells. Histologic examination of the tumor revealed aggregation of plasma cells with massive extracellular infiltration of the rhomboid-shaped crystalline structur...

  17. A rare cause of chronic rectal bleeding in children; solitary rectal ulcer: case report.

    Temiz, Abdulkerim; Tander, Burak; Temiz, Muhyittin; Barış, Sancar; Arıtürk, Ender


    Solitary rectal ulcer causing lower gastrointestinal bleeding is extremely rare in children. Rare presentation, non-specific symptoms, insufficient experience, and characteristics mimicking other rectal diseases may cause misdiagnosis or delay of diagnosis in some pediatric patients. Here, we report a 10-year-old boy with solitary rectal ulcer diagnosed two years after onset of the symptoms who responded well to the conservative therapy, including high-fiber diet, laxatives, defecation training, and sucralfate enema.

  18. Dust acoustic solitary and shock waves in strongly coupled dusty plasmas with nonthermal ions

    Hamid Reza Pakzad; Kurosh Javidan


    The Korteweg–de Vries–Burgers (KdV–Burgers) equation and modified Korteweg–de Vries–Burgers equation are derived in strongly coupled dusty plasmas containing nonthermal ions and Boltzmann distributed electrons. It is found that solitary waves and shock waves can be produced in this medium. The effects of important parameters such as ion nonthermal parameter, temperature, density and velocity on the properties of shock waves and solitary waves are discussed.

  19. Solitary wave solution to a singularly perturbed generalized Gardner equation with nonlinear terms of any order



    This paper is concerned with the existence of travelling wave solutions to a singularly perturbed generalized Gardner equation with nonlinear terms of any order. By using geometric singular perturbation theory and based on the relation between solitary wave solution and homoclinic orbits of the associated ordinary differential equations, the persistence of solitary wave solutions of this equation is proved when the perturbation parameter is sufficiently small. The numerical simulations verify our theoretical analysis.

  20. Polarized seismic and solitary waves run-up at the sea bed

    Dennis, L. C.C.; Zainal, A. A.; Faisal, S. Y. [Universiti Teknologi PETRONAS, 31750 Tronoh, Perak (Malaysia); Universiti Teknologi Malaysia, 81310 Johor Bahru (Malaysia)


    The polarization effects in hydrodynamics are studied. Hydrodynamic equation for the nonlinear wave is used along with the polarized solitary waves and seismic waves act as initial waves. The model is then solved by Fourier spectral and Runge-Kutta 4 methods, and the surface plot is drawn. The output demonstrates the inundation behaviors. Consequently, the polarized seismic waves along with the polarized solitary waves tend to generate dissimilar inundation which is more disastrous.

  1. Seizure recurrence in patients with solitary cystic granuloma or single parenchymal cerebral calcification: a comparative evaluation.

    Sharma, Laxmi Narayan; Garg, Ravindra Kumar; Verma, Rajesh; Singh, Maneesh Kumar; Malhotra, Hardeep Singh


    Solitary cysticercus granuloma and single parenchymal calcified lesion are two common neuroimaging abnormalities in Indian patients with epilepsy. In this study, we evaluated the frequency and predictors of seizure recurrence in patients presenting with new onset epilepsy or single epileptic seizures and these two different imaging findings. We enrolled 115 patients with newly diagnosed epilepsy. All patients were clinically evaluated and were treated with oxcarbazepine. No anti-helminthic treatment was prescribed. The patients were followed up for 6 months. In the solitary cystic granuloma group, repeat computed tomography was done after 6 months. The study included 80 patients with solitary cysticercus granuloma and 35 patients with a single calcified lesion. Twenty (25%) patients with solitary cysticercus granuloma and 12 (34.3%) patients with parenchymal calcified lesion had a seizure recurrence during the study period (p = 0.307). After 6 months, 57 (71.3%) patients in the solitary cysticercus granuloma group demonstrated complete resolution of the granuloma and in 21 (26.2%) patients the granuloma transformed into a calcified lesion. In the solitary cysticercus granuloma group, a family history of seizure, serial seizures and calcification on follow-up neuroimaging (p seizures. In patients with a single parenchymal calcified lesions, electroencephalographic abnormalities and serial seizures (p = seizure recurrence rate was insignificantly higher in patients with calcified lesions than in patients with solitary cysticercosis granulomas. In conclusion, in patients with solitary cysticercus granuloma, a family history of seizures, serial seizures and calcification of the granuloma, and in patients with a calcified brain lesion, electroencephalographic abnormalities, family history of epilepsy and serial seizures were associated with an increased risk of seizure recurrence. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights

  2. The superposition method in seeking the solitary wave solutions to the KdV-Burgers equation

    Yuanxi Xie; Jilashi Tang


    In this paper, starting from the careful analysis on the characteristics of the Burgers equation and the KdV equation as well as the KdV-Burgers equation, the superposition method is put forward for constructing the solitary wave solutions of the KdV-Burgers equation from those of the Burgers equation and the KdV equation. The solitary wave solutions for the KdV-Burgers equation are presented successfully by means of this method.

  3. Solitary fibrous tumor of the hard palate: a rare entity in oral cavity

    Pinto, Antonione Santos Bezerra; Department of Oral Pathology – São Leopoldo Mandic Institute and Research Center – Campinas – SP – Brazil.; De Araújo, Vera Cavalcanti; Department of Oral Pathology – São Leopoldo Mandic Institute and Research Center – Campinas – SP – Brazil.; Santos, Fabrício Passador; Department of Oral Pathology – São Leopoldo Mandic Institute and Research Center – Campinas – SP – Brazil.; Filho, José Ferreira de Menezes; Antonio Carlos Institute of Tocantins – Araguaína – TO – Brazil.; Siqueira, Viviane; Department of Oral Pathology – São Leopoldo Mandic Institute and Research Center – Campinas – SP – Brazil.; Soares, Andresa Borges; Department of Oral Pathology – São Leopoldo Mandic Institute and Research Center – Campinas – SP – Brazil.


    A case of solitary fibrous tumor is reported. Solitary fibrous tumor is a rare neoplasia characterized by the proliferation of fusiform cells of mesenchymal origin accounting for at least 2% of all soft tissue tumors. In this present case, the initial diagnosis was salivary gland tumor because of the location in the hard palate. Histologically, the tumor was composed by conjunctive tissue with proliferation of oval and fusiform cells. The immunohistochemical analysis was positive for CD34 and...

  4. Analytical solitary wave solutions of the nonlinear Kronig-Penney model in photonic structures.

    Kominis, Y


    A phase space method is employed for the construction of analytical solitary wave solutions of the nonlinear Kronig-Penney model in a photonic structure. This class of solutions is obtained under quite generic conditions, while the method is applicable to a large variety of systems. The location of the solutions on the spectral band gap structure as well as on the low dimensional space of system's conserved quantities is studied, and robust solitary wave propagation is shown.

  5. Magnetic resonance imaging findings of solitary infantile myofibromatosis of the skull: A case report

    Lee, Seung Eun; Cho, Kil Ho; Suh, Jang Ho; Choi, Joon Hyuk [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)


    Infantile myofibromatosis is a rare, benign mesenchymal disorder of early childhood characterized by solitary or multiple benign myofibroblastic tumors. The tumors may involve the skin, subcutaneous tissue, muscle, bone and visceral organs. We report magnetic resonance imaging findings of solitary infantile myofibromatosis arising in the temporal bone of a ten-month-old boy, and the diagnosis was confirmed by surgical excision and histopathological examination.

  6. Nonhydrostatic Numerical Investigations of Oscillating Flow Over Sills: Generation of Internal Tides and Solitary Waves


    northern South China Sea in idealized settings, and 3) to provide information on wave characteristics to principal investigators in NLIWI (Nonlinear...Solitary Waves in the Northern South China Sea : a Nonhydrostatic Numerical Investigation.” The study of waves in a two-ridge system emphasizes the...Solitary Waves in the Northern South China Sea : a Nonhydrostatic Numerical Investigation.” IMPLICATION/APPLICATIONS See the report for

  7. Modeling population dynamics of solitary bees in relation to habitat quality

    Ulbrich, K.; Seidelmann, K.


    To understand associations between habitat, individual behaviour, and population development of solitary bees we developed an individual-based model. This model is based on field observations of Osmia rufa (L) (Apoideae: Megachilidae) and describes population dynamics of solitary bees. Model rules are focused on maternal investment, in particular on the female’s individual decisions about sex and size of progeny. In the present paper, we address the effect of habi...

  8. Keratocystic odontogenic tumor: A biopsy service’s experience with 104 solitary, multiple and recurrent lesions


    Background Keratocystic odontogenic tumor (KCOT) is a clinically significant cystic lesion of odontogenic origin. This study aimed to retrospectively review and describe the clinicopathologic features of KCOT and to objectively compare the clinical and histological features of solitary, multiple and recurrent KCOT in a Saudi Arabian population. Material and Methods Biopsy request forms, pathology records and archival materials (all histological slides) of 104 cases of KCOT from 75 patients were retrieved. Demographic and clinical details as well as histological evaluation were analyzed and compared between the 3 groups using chi-squared or Mann-Whitney tests of association as appropriate. Results Significant differences were noted in the age of presentation, location and association with impaction between multiple and solitary cases. Histologically, there was a difference in the mitotic count, presence of satellite cysts and proliferating odontogenic epithelium between solitary and multiple lesions. There was no difference between the KCOT that later recurred and solitary lesion which did not recur even when matched clinically for age, sex and location. There were differences when solitary KCOT that later recurred or recurrent KCOT were compared with multiple lesions. Multiple lesions still had more significant proliferative activity parameters than solitary recurrence-related KCOT. Conclusions KCOTs in Saudi Arabians are not different from those reported from other parts of the world. Clinical and histological analyses showed multiple KCOT is different from its solitary recurrent or non-recurrent counterparts and has a higher proliferative activity than both. Clinicohistologic features alone cannot wholly explain the behavior of KCOT. Key words:Descriptive study, keratocystic odontogenic tumor, odontogenic keratocyst, solitary, multiple, recurrent. PMID:27475695

  9. Solitary luteinized follicle cyst of pregnancy complicated with persistent postpartum vaginal bleeding: case report

    ZHANG Song-ying; HUANG He-feng; TONG Xiao-mei


    @@ Solitary luteinized follicle cyst, a rare cause of ovarian enlargement during pregnancy and puerperium, is a self-limited disease that can regress spontaneously after labor. The complications of the disease include ovarian torsion, intracystic hemorrhage, and rupture; endocrine disturbances have not been reported.1-4 Here we report a case of solitary luteinized follicle cyst of pregnancy,which required surgical intervention owing to persistent postpartum vaginal bleeding.

  10. Prostate carcinoma, presenting with a solitary osteolytic bone lesion to the right hip

    Agheli, Aref; Patsiornik, Yelena; Chen, Yu; Chaudhry, M. Rashid; Gerber, Howard; Wang, Jen C.


    Prostate cancer is the most common malignancy and the second most common cause of cancer-associated mortality in males. Bone metastasis is frequent and generally multiple and osteoblastic. Presentation of a pure osteolytic and solitary metastasis from a prostate carcinoma is extremely rare. We report a case of prostate cancer in a 70-year-old man who presented with progressive severe right hip pain and stiffness with no urinary symptom. A whole-body bone scan revealed a solitary metastasis to...

  11. Oncologic progression of bone plasmacytomas to multiple myeloma Evolução oncológica dos plasmocitomas ósseos para mieloma múltiplo

    Fernanda Bertanha


    Full Text Available PURPOSE: To evaluate the clinical aspects, diagnoses, prognostic factors, and percent progression of plasmacytoma to multiple myeloma. MATERIALS AND METHODS: 103 medical records of patients suspected of plasmacytoma were surveyed covering the period between 1950 and 1998, and 30 were selected for analysis. Patients were classified into 2 groups: patients who did (n = 17 and did not (n = 13 progress to multiple myeloma. Comparative statistics regarding a variety of clincial aspects were developed. RESULTS: Patients who progressed to multiple myeloma were younger than those who did not (52.3 ± 2.6 vs 62.6 ± 3.4 years; mean ± SEM; P = 0.02. There were no significant differences in gender between groups. A higher incidence of multiple recurrence was observed in patients who progressed to multiple myeloma (75%, P = 0.049. Both groups showed a prevalence of vertebral column injuries. No significant differences were found between groups regarding the disease period (from the onset of symptoms until diagnosis (P = 0.20 and survival (P = 0.34. The average time to progression from plasmacytoma to myeloma was 41 ± 39 months (mean ± SD, and the progression rate was 57%. CONCLUSION: Patients who progressed to multiple myeloma were younger than those who did not. No significant differences were found between groups regarding sex, time from symptom onset to diagnosis, and survival time. In both groups, the most affected anatomic location was the vertebral column, and most affected sex was male. The average time to progression to multiple myeloma was 41 months. It was not possible to determine the factors that influenced the survival of patients with plasmacytoma or for those who progressed to multiple myeloma.OBJETIVO: Avaliar os aspectos clínicos, diagnósticos, fatores de prognóstico e porcentagem de evolução dos casos de plasmocitoma para mieloma múltiplo. MATERIAS E MÉTODOS: Foram levantados 103 prontuários do Hospital das Clínicas da FMUSP

  12. Anomalous width variation of rarefactive ion acoustic solitary waves in the context of auroral plasmas

    S. S. Ghosh


    Full Text Available The presence of dynamic, large amplitude solitary waves in the auroral regions of space is well known. Since their velocities are of the order of the ion acoustic speed, they may well be considered as being generated from the nonlinear evolution of ion acoustic waves. However, they do not show the expected width-amplitude correlation for K-dV solitons. Recent POLAR observations have actually revealed that the low altitude rarefactive ion acoustic solitary waves are associated with an increase in the width with increasing amplitude. This indicates that a weakly nonlinear theory is not appropriate to describe the solitary structures in the auroral regions. In the present work, a fully nonlinear analysis based on Sagdeev pseudopotential technique has been adopted for both parallel and oblique propagation of rarefactive solitary waves in a two electron temperature multi-ion plasma. The large amplitude solutions have consistently shown an increase in the width with increasing amplitude. The width-amplitude variation profile of obliquely propagating rarefactive solitary waves in a magnetized plasma have been compared with the recent POLAR observations. The width-amplitude variation pattern is found to fit well with the analytical results. It indicates that a fully nonlinear theory of ion acoustic solitary waves may well explain the observed anomalous width variations of large amplitude structures in the auroral region.

  13. Measuring blood delivery to solitary pulmonary nodules using perfusion magnetic resonance imaging

    Zheng, Wei; Wang, Zhifeng; Shen, Li; Gao, Ling; Ford, James C.; Makedon, Fillia S.; Pearlman, Justin D.


    With perfusion magnetic resonance imaging (pMRI), perfusion describes the amount of blood passing through a block of tissue in a certain period of time. In pMRI, the tissue having more blood passing through will show higher intensity value as more contrast-labeled blood arrives. Perfusion reflects the delivery of essential nutrients to a block of tissue, and is an important parameter for the tissue status. Considering solitary pulmonary nodules (SPN), perfusion differences between malignant and benign nodules have been studied by different techniques. Much effort has been put into its characterization. In this paper, we proposed and implemented extraction of the SPN time intensity profile to measure blood delivery to solitary pulmonary nodules, describing their perfusion effects. In this method, a SPN time intensity profile is created based on intensity values of the solitary pulmonary nodule in lung pMRI images over time. This method has two steps: nodule tracking and profile clustering. Nodule tracking aligns the solitary pulmonary nodule in pMRI images taken at different time points, dealing with nodule movement resulted from breathing and body movement. Profile clustering implements segmentation of the nodule region and extraction of the time intensity profile of a solitary pulmonary nodule. SPN time intensity profiles reflect patterns of blood delivery to solitary pulmonary nodules, giving us a description of perfusion effect and indirect evidence of tumor angiogenesis. Analysis on SPN time intensity profiles will help the diagnosis of malignant nodules for early lung cancer detection.

  14. Body Image in Dyadic and Solitary Sexual Desire: The Role of Encoding Style and Distracting Thoughts.

    Dosch, Alessandra; Ghisletta, Paolo; Van der Linden, Martial


    This study explored the link between body image and desire to engage in sexual activity (dyadic and solitary desire) in adult women living in a long-term couple relationship. Moreover, it considered two psychological factors that may underlie such a link: the occurrence of body-related distracting thoughts during sexual activity and encoding style (i.e., the tendency to rely on preexisting internal schemata versus external information at encoding). A total of 53 women (29 to 47 years old) in heterosexual relationships completed questionnaires assessing sexual desire (dyadic, solitary), body image, body-related distracting thoughts during sexual activity, and encoding style. Results showed that poor body image was associated with low dyadic and solitary sexual desire. Body-related distracting thoughts during sexual activity mediated the link between body image and solitary (but not dyadic) sexual desire. Finally, the mediation of body-related distracting thoughts between body image and solitary sexual desire was moderated by encoding style. A negative body image promoted the occurrence of body-related distracting thoughts during sexual activity, especially in internal encoders. Our study highlights the importance of body image, distracting thoughts, and encoding style in women's solitary sexuality and suggests possible factors that may reduce the impact of those body-related factors in dyadic sexual desire.

  15. Solitary cannabis use in adolescence as a correlate and predictor of cannabis problems.

    Creswell, Kasey G; Chung, Tammy; Clark, Duncan B; Martin, Christopher S


    Most adolescent cannabis use occurs in social settings among peers. Solitary cannabis use during adolescence may represent an informative divergence from normative behavior with important implications for understanding risk for cannabis problems. This longitudinal study examined associations of adolescent solitary cannabis use with levels of cannabis use and problems in adolescence and in young adulthood. Cannabis using-adolescents aged 12-18 were recruited from clinical programs (n=354; 43.8% female; 83.3% Caucasian) and community sources (n=93; 52.7% female; 80.6% Caucasian). Participants reported on cannabis use patterns and diagnostic symptoms at baseline and multiple follow-ups into young adulthood. Compared to social-only users, adolescent solitary cannabis users were more likely to be male and reported more frequent cannabis use and more DSM-IV cannabis use disorder (CUD) symptoms. Regression analyses showed that solitary cannabis use in adolescence predicted CUD symptom counts in young adulthood (age 25) after controlling for demographic variables and the frequency of adolescent cannabis use. However, solitary adolescent cannabis use was no longer predictive of age 25 CUD symptoms after additionally controlling for adolescent CUD symptoms. Solitary cannabis use is associated with greater cannabis use and problems during adolescence, but evidence is mixed that it predicts young adult cannabis problems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Modeling of modified electron-acoustic solitary waves in a relativistic degenerate plasma

    Hossen, M. R.; Mamun, A. A. [Jahangirnagar University, Savar, Dhaka (Bangladesh)


    The modeling of a theoretical and numerical study on the nonlinear propagation of modified electron-acoustic (mEA) solitary waves has been carried out in an unmagnetized, collisionless, relativistic, degenerate quantum plasma (containing non-relativistic degenerate inertial cold electrons, both non-relativistic and ultra-relativistic degenerate hot electron and inertial positron fluids, and positively-charged static ions). A reductive perturbation technique is used to derive the planar and the nonplanar Korteweg-de Vries (K-dV) equations, which admit a localized wave solution for the solitary profile. The solitary wave's characteristics are found to have been influenced significantly for the non-relativistic and the ultra-relativistic limits. The mEA solitary waves are also found to have been significantly modified due to the effects of the degenerate pressure and the number densities of this dense plasma's constituents. The properties of the planar K-dV solitary wave are quite different from those of the nonplanar K-dV solitary wave. The relevance of our results to astrophysical objects (like white dwarfs and neutron stars), which are of scientific interest, is briefly mentioned.

  17. AKNS eigenvalue spectrum for densely spaced envelope solitary waves

    Slunyaev, Alexey; Starobor, Alexey


    The problem of the influence of one envelope soliton to the discrete eigenvalues of the associated scattering problem for the other envelope soliton, which is situated close to the first one, is discussed. Envelope solitons are exact solutions of the integrable nonlinear Schrödinger equation (NLS). Their generalizations (taking into account the background nonlinear waves [1-4] or strongly nonlinear effects [5, 6]) are possible candidates to rogue waves in the ocean. The envelope solitary waves could be in principle detected in the stochastic wave field by approaches based on the Inverse Scattering Technique in terms of ‘unstable modes' (see [1-3]), or envelope solitons [7-8]. However, densely spaced intense groups influence the spectrum of the associated scattering problem, so that the solitary trains cannot be considered alone. Here we solve the initial-value problem exactly for some simplified configurations of the wave field, representing two closely placed intense wave groups, within the frameworks of the NLS equation by virtue of the solution of the AKNS system [9]. We show that the analogues of the level splitting and the tunneling effects, known in quantum physics, exist in the context of the NLS equation, and thus may be observed in application to sea waves [10]. These effects make the detecting of single solitary wave groups surrounded by other nonlinear wave groups difficult. [1]. A.L. Islas, C.M. Schober (2005) Predicting rogue waves in random oceanic sea states. Phys. Fluids 17, 031701-1-4. [2]. A.R. Osborne, M. Onorato, M. Serio (2005) Nonlinear Fourier analysis of deep-water random surface waves: Theoretical formulation and and experimental observations of rogue waves. 14th Aha Huliko's Winter Workshop, Honolulu, Hawaii. [3]. C.M. Schober, A. Calini (2008) Rogue waves in higher order nonlinear Schrödinger models. In: Extreme Waves (Eds.: E. Pelinovsky & C. Kharif), Springer. [4]. N. Akhmediev, A. Ankiewicz, M. Taki (2009) Waves that appear from

  18. A unified intrinsic functional expansion theory for solitary waves

    Theodore Yaotsu Wu; John Kao; Jin E. Zhang


    A new theory is developed here for evaluating solitary waves on water, with results of high accuracy uniformly valid for waves of all heights, from the highest wave with a corner crest of 120° down to very low ones of diminishing height. Solutions are sought for the Euler model by employing a unified expansion of the logarithmic hodograph in terms of a set of intrinsic component functions analytically determined to represent all the intrinsic properties of the wave entity from the wave crest to its outskirts. The unknown coefficients in the expansion are determined by minimization of the mean-square error of the solution, with the minimization optimized so as to take as few terms as needed to attain results as high in accuracy as attainable. In this regard, Stokes's formula, F2μπ = tanμπ, relating the wave speed (the Froude number F) and the logarithmic decrement μ of its wave field in the outskirt, is generalized to establish a new criterion requiring (for minimizing solution error) the functional expansion to contain a finite power series in M terms of Stokes's basic term (singular inμ), such that 2Mμ is just somewhat beyond unity, i.e. 2Mμ (~-) 1. This fundamental criterion is fully validated by solutions for waves Dedicated to Zhemin Zheng for celebration of his Eightieth Anniversary It gives us a great pleasure to dedicate this study to Prof. Zhemin Zheng and join our distinguished colleagues and friends for the jubilant celebration of his Eightieth Anniversary. Warmest tribute is due from us, as from many others unlimited by borders and boundaries, for his contributions of great significance to science, engineering science and engineering, his tremendous influence as a source of inspiration and unerring guide to countless workers in the field, his admirable leadership in fostering the Institute of Mechanics of world renown, as well as for his untiring endeavor in promoting international interaction and cooperation between academies of various nations

  19. Research progress of pathogenesis of extramedullary infiltration of multiple myeloma%多发性骨髓瘤髓外浸润发病机制的研究进展



    多发性骨髓瘤(MM)为恶性浆细胞病,病灶通常局限于骨髓内,在初诊或疾病进展过程中往往发生髓外浸润.MM髓外浸润一旦发生则提示患者预后不良.MM髓外浸润的机制尚不明确,可能与MM细胞归巢受阻、MM细胞侵袭力增强、新生血管形成增强、不依赖于骨髓基质的生长及增殖相关.黏附分子、趋化因子、血管生成因子等多种细胞因子在发病过程中发挥重要作用,对其深入研究可为MM的治疗靶点提供依据.笔者拟就上述4个方面对MM髓外浸润的发病机制进行综述.%Multiple myeloma (MM) is a kind of hematologic malignancies.Its lesions are generally localized in bone marrow.Extramedullary infiltration is often tend to appear when MM is newly diagnosed or in the progress,which indicates a poor prognosis.It's a pity that the mechanisms of MM extramedullary infiltration are still unknown.Blocked homing of myeloma cells,enhanced invasiveness,increased angiogenesis,growth and proliferation without bone marrow stroma may be involved in the pathogenesis.Studies on the pathogenesis of the extramedullary disease of MM will help us to find new treating targets.This article reviews literatures on the pathogenesis of extramedullary infiltration of MM from these four aforementioned aspects.

  20. Solitary waves observed in the auroral zone: the Cluster multi-spacecraft perspective

    J. S. Pickett


    Full Text Available We report on recent measurements of solitary waves made by the Wideband Plasma Wave Receiver located on each of the four Cluster spacecraft at 4.5-6.5RE (well above the auroral acceleration region as they cross field lines that map to the auroral zones. These solitary waves are observed in the Wideband data as isolated bipolar and tripolar waveforms. Examples of the two types of pulses are provided. The time durations of the majority of both types of solitary waves observed in this region range from about 0.3 up to 5ms. Their peak-to-peak amplitudes range from about 0.05 up to 20mV/m, with a few reaching up to almost 70mV/m. There is essentially no potential change across the bipolar pulses. There appears to be a small, measurable potential change, up to 0.5V, across the tripolar pulses, which is consistent with weak or hybrid double layers. A limited cross-spacecraft correlation study was carried out in order to identify the same solitary wave on more than one spacecraft. We found no convincing correlations of the bipolar solitary waves. In the two cases of possible correlation of the tripolar pulses, we found that the solitary waves are propagating at several hundred to a few thousand km/s and that they are possibly evolving (growing, decaying as they propagate from one spacecraft to the next. Further, they have a perpendicular (to the magnetic field width of 50km or greater and a parallel width of about 2-5km. We conclude, in general, however, that the Cluster spacecraft at separations along and perpendicular to the local magnetic field direction of tens of km and greater are too large to obtain positive correlations in this region. Looking at the macroscale of the auroral zone at 4.5-6.5RE, we find that the onsets of the broadband electrostatic noise associated with the solitary waves observed in the spectrograms of the WBD data are generally consistent with propagation of the solitary waves up the field lines (away from Earth, or with

  1. Differential expression of estrogen receptor α and β isoforms in multiple and solitary leiomyomas

    Shao, Ruyue; Fang, Liaoqiong [State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and The Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Xing, Ruoxi [Institute of Life Science, Chongqing Medical University, Chongqing 400016 (China); Xiong, Yu [Department of Obstetrics and Gynecology, Chongqing Hifu Hospital, Chongqing 401121 (China); Fang, Liaoqiong, E-mail: [State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and The Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Wang, Zhibiao, E-mail: [State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and The Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China)


    Uterine leiomyomas are benign myometrial neoplasms that function as one of the common indications for hysterectomy. Clinical and biological evidences indicate that uterine leiomyomas are estrogen-dependent. Estrogen stimulates cell proliferation through binding to the estrogen receptor (ER), of which both subtypes α and β are present in leiomyomas. Clinically, leiomyomas may be singular or multiple, where the first one is rarely recurring if removed and the latter associated to a relatively young age or genetic predisposition. These markedly different clinical phenotypes indicate that there may different mechanism causing a similar smooth muscle response. To investigate the relative expression of ERα and ERβ in multiple and solitary uterine leiomyomas, we collected samples from 35 Chinese women (multiple leiomyomas n = 20, solitary leiomyoma n = 15) undergoing surgery to remove uterine leiomyomas. ELISA assay was performed to detect estrogen(E{sub 2}) concentration. Quantitative real-time PCR analysis was performed to detect ERα and ERβ mRNA expression. Western blot and immunohistochemical analysis were performed to detect ERα and ERβ protein expression. We found that ERα mRNA and protein levels of in multiple leiomyomas were significantly lower than those of solitary leiomyomas, whereas ERβ mRNA and protein levels in multiple leiomyomas were significantly higher than those in solitary leiomyomas, irrespectively of the menstrual cycle stage. In both multiple and solitary leiomyomas, ERα expression was higher than that of ERβ. E{sub 2} concentration in multiple and solitary leiomyomas correlated with that of ERα expression. ERα was present in nuclus and cytoplasma while estrogen receptor β localized only in nuclei in both multiple and solitary leiomyomas. Our findings suggest that the difference of ERα and ERβ expression between multiple and solitary leiomyomas may be responsible for the course of the disease subtypes. - Highlights: • In both

  2. Basic properties of solitary waves in granular crystals

    Hasan, M. Arif; Nemat-Nasser, Sia

    We consider a chain of lightly contacting identical spherical elastic granules and provide explicit analytical expressions to fully characterize solitary waves (SWs) that may be generated in the chain by an impact or an applied shock force. These SWs consist of individual packages of linear momentum/energy transmitted across the granules through Hertzian contacts. They are nonlinear translational waves (involving no vibrations) that propagate through the granular chain without distortion, i.e., without any temporal evolution in shape or size. In particular, we focus on a fully-formed SW and provide analytical expressions for the associated peak value as well as the time variation of the granules' displacement, velocity, acceleration, and compressive contact force acting across any two contacting granules. In addition, by considering a SW as an "effective particle", we provide explicit analytical expressions for its linear momentum, total energy, equivalent (or effective) mass and effective velocity. All of the above mentioned results are shown to depend only on the peak value of the SW's contact force and the properties of the granules, i.e., their diameter, density, and elastic moduli. Then we provide a simple recipe to calculate the peak value of the SW's contact force in terms of a given shock force. Finally, we check by numerical simulations the accuracy of the analytical predictions.

  3. Giant solitary fibrous tumor arising from greater omentum

    Liang Zong; Ping Chen; Guang-Yao Wang; Qun-Shan Zhu


    Extrathoracic solitary fibrous tumors (SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from greater omentum.Computed tomography revealed a 15.8 cm x 21.0 cm solid mass located at superior aspect of stomach.Open laparotomy confirmed its mesenchymal origin.Microscopically,its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei,which were divided up by branching vessel and collagen bundles.Immunohistochemical staining showed that this tumor was negative for CD117,CD99,CD68,cytokeratin,calretinin,desmin,epithelial membrane antigen,F8 and S-100,but positive for CD34,bcl-2,α-smooth muscle actin and vimentin.The patient presented no evidence of recurrence during follow-up.SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers,especially for CD34 and bcl-2 positive cases.

  4. Infanticide by a solitary koinobiont ichneumonid ectoparasitoid of spiders

    Takasuka, Keizo; Matsumoto, Rikio


    When encountering an already parasitized host, a parasitoid's optimal choices (superparasitism, host rejection, host feeding or infanticide) seem to depend on the individual species' life history, because the same choice may have different fitness consequences. We demonstrate infanticide under laboratory conditions by a polysphinctine, Zatypota albicoxa, which is a solitary koinobiont ectoparasitoid of spiders. The female always removed any previously attached egg or larva from the body of the host spider, Parasteatoda tepidariorum, with a rubbing behaviour. She rubbed her ovipositor back and forth toward the undersurface of the attached egg or of the saddle under the attached larva to pry it off and laid an egg after removal. When removing a larva, the infanticidal female engaged exclusively in unfastening the `saddle' which fastens the larva to the body of the spider. All larvae were removed with the `saddle' attached to the ventral surface of the body. The female invested more time to remove the medium second and the large penultimate instar larvae than to remove eggs and first instar larvae because of the labour involved in unfastening the saddle. Oviposition with infanticide of the medium second and the penultimate instar larvae imposed more time upon the female than that on an unparasitized host. Removal of any previous occupant in spite of the associated labour costs suggests that infanticide will always be adaptive, no matter the time costs to Z. albicoxa, because so much is invested in attacking the host and because the parasitoid cannot detect whether the spider is already parasitized until she achieves subjugation.

  5. Solitary paralysis of the triceps muscle due to trauma.

    Mizuno, K; Fujita, K; Yamada, M; Saura, R; Hirohata, K


    We report a rare solitary paralysis of the triceps muscle. The patient, an 18-year-old man who had had a work-related accident, sustained a severe contusion of the proximal posterolateral arm after being struck by a piece of lumber. This injury produced an extraordinary amount of soft-tissue swelling in the region of the trauma. After the accident it was noted that active flexion of the elbow was preserved, but active extension was absent. Three months after injury, surgical exploration of the radial nerve and its rami musculares to the three heads of the triceps muscle was undertaken. Dense adhesions were found fixing the rami musculares to the surfaces of the triceps muscle. Neurolysis of the rami musculares was performed, leading to complete recovery of the triceps muscle. The etiology of this isolated paralysis of the triceps muscle was determined to be dense adhesions compressing and compromising the function of the rami musculares to the three heads of the triceps muscle. These adhesions formed because of severe posttraumatic bleeding into the potential posterior humeral space, where the rami musculares are found.

  6. Internal solitary waves in the East China Sea

    LI Xiaofeng; ZHAO Zhongxiang; HAN Zhen; XU Liuxiong


    A European Space Agency's ENVISAT advanced synthetic aperture radar (ASAR) image covering Zhejiang coastal water in the East China Sea (ECS) was acquired on 1 August 2007. This image shows that there are about 20 coherent internal solitary wave (ISW) packets propagating southwestward toward Zhejiang coast. These ISW packets are separated by about 10 kin, suggesting that these ISWs are tide-generated waves. Each ISW packet contains 5--15 wave crests. The wavelengths of the wave crests with-in the ISW packets are about 300 m. The lengths of the leading wave crests are about 50 km. The ISW amplitude is estimated from solving KdV equation in an ideal two-layer ocean model. It is found that the ISW amplitudes is about 8 m. Further analysis of the ASAR image and ocean stratification profiles show that the observed ISWs are depression waves. Analyzing the tidal current finds that these waves are locally generated. The wavelength and amplitude of the ECS ISW are much smaller than their counter-parts in the South China Sea (SCS). The propagation speed of the ECS ISW is also an order of magnitude smaller than that of the SCS ISW. The observed ISWs in the ECS happened during a spring tide period.

  7. Solitary rectal ulcer syndrome: A single-center case series

    Abdulaziz I AlGhulayqah


    Full Text Available Background/Aim: Solitary rectal ulcer syndrome (SRUS is a benign, chronic defecation disorder with varied presentations. The aim of this study is to summarize the clinical features, endoscopic findings, histological appearance, and treatment strategies associated with SRUS. Patients and Methods: This is a retrospective study of all patients diagnosed with SRUS at the King Faisal Specialist Hospital and Research Centre in Riyadh from January 2003 to December 2013. Cases were identified using the Department of Pathology database. Data were obtained from medical records that included clinical manifestation, endoscopic findings, and histopathological features. Results: Twenty patients were identified. The mean age was 42.5 years (±18.5 and 55% were females. Most of the patients presented with bleeding per rectum (85%, constipation (75%, and straining (50%, with a mean symptom duration of 26.7 months. The most common associated factors identified were constipation (75%, history of rectal surgery (25%, digital rectal manipulation (20%, and rectal prolapse (20%. Endoscopic findings included a single ulcer (50% and multiple ulcers (30%; 55% had a polypoidal appearance. On histopathology, there was surface ulceration (95%, fibrosis of the lamina propria (60%, distorted architecture (55%, and muscle hypertrophy with increased mucin production (50%. Patients were treated conservatively and none required surgery. Conclusion: SRUS is a rare disorder with variable clinical presentations. Stool softeners, a high fiber diet in addition to topical mesalamine, and biofeedback proved to be effective in this patient population.

  8. Electrostatic solitary waves in dusty pair-ion plasmas

    Misra, A P


    The propagation of electrostatic waves in an unmagnetized collisionless pair-ion plasma with immobile positively charged dusts is studied for both large- and small-amplitude perturbations. Using a two-fluid model for pair-ions, it is shown that there appear two linear ion modes, namely the "fast" and "slow" waves in dusty pair-ion plasmas. The properties of these wave modes are studied with different mass $(m)$ and temperature $(T)$ ratios of negative to positive ions, as well as the effects of immobile charged dusts $(\\delta)$. For large-amplitude waves, the pseudopotential approach is performed, whereas the standard reductive perturbation technique (RPT) is used to study the small-amplitude Korteweg-de Vries (KdV) solitons. The profiles of the pseudopotential, the large amplitude solitons as well as the dynamical evolution of KdV solitons are numerically studied with the system parameters as above. It is found that the pair-ion plasmas with positively charged dusts support the propagation of solitary waves ...

  9. Electrostatic solitary waves in dusty pair-ion plasmas

    Misra, A. P. [Department of Mathematics, Siksha Bhavana, Visva-Bharati University, Santiniketan-731 235, West Bengal (India); Adhikary, N. C. [Physical Sciences Division, Institute of Advanced Study in Science and Technology, Vigyan Path, Paschim Boragaon, Garchuk, Guwahati-781035, Assam (India)


    The propagation of electrostatic waves in an unmagnetized collisionless pair-ion plasma with immobile positively charged dusts is studied for both large- and small-amplitude perturbations. Using a two-fluid model for pair-ions, it is shown that there appear two linear ion modes, namely the “fast” and “slow” waves in dusty pair-ion plasmas. The properties of these wave modes are studied with different mass (m) and temperature (T) ratios of negative to positive ions, as well as the effects of immobile charged dusts (δ). For large-amplitude waves, the pseudopotential approach is performed, whereas the standard reductive perturbation technique is used to study the small-amplitude Korteweg-de Vries (KdV) solitons. The profiles of the pseudopotential, the large amplitude solitons as well as the dynamical evolution of KdV solitons, are numerically studied with the system parameters as above. It is found that the pair-ion plasmas with positively charged dusts support the propagation of solitary waves (SWs) with only the negative potential. The results may be useful for the excitation of SWs in laboratory dusty pair-ion plasmas, electron-free industrial plasmas as well as for observation in space plasmas where electron density is negligibly small compared to that of negative ions.

  10. Deep-water bedforms induced by refracting Internal Solitary Waves

    Falcini, Federico; Droghei, Riccardo; Casalbore, Daniele; Martorelli, Eleonora; Mosetti, Renzo; Sannino, Gianmaria; Santoleri, Rosalia; Latino Chiocci, Francesco


    Subaqueous bedforms (or sand waves) are typically observed in those environments that are exposed to strong currents, characterized by a dominant unidirectional flow. However, sand-wave fields may be also observed in marine environments where no such current exists; the physical processes driving their formation are enigmatic or not well understood. We propose that internal solitary waves (ISWs), induced by tides, can produce an effective, unidirectional boundary flow filed that forms asymmetric sand waves. We test this idea by examining a sand-wave field off the Messina Strait, where we hypothesize that ISWs formed at the interface between intermediate and surface waters are refracted by topography. Hence, we argue that the deflected pattern (i.e., the depth-dependent orientation) of the sand-wave field is due to refraction of such ISWs. Combining field observations and numerical modelling, we show that ISWs can account for three key features: ISWs produce fluid velocities capable of mobilizing bottom sediments; the predicted refraction pattern resulting from the interaction of ISWs with bottom topography matches the observed deflection of the sand waves; and predicted migration rates of sand waves match empirical estimates. This work shows how ISWs may contribute to sculpting the structure of continental margins and it represents a promising link between the geological and oceanographic communities.

  11. Solitary Contralateral Adrenal Metastases after Nephrectomy for Renal Cell Carcinoma

    Nikolaos Antoniou


    Full Text Available Two cases are reported of patients with a single metastasis in the contralateral adrenal, one and nine years respectively after nephrectomy for localized cancer in the opposite kidney. These types of metastases are usually asymptomatic they do not appear with signs of adrenal insufficiency, they are detected incidentally and the diagnosis is confirmed mainly with CT scan, which comprises the method of choice for the detection of such types of metastases. Many adrenal metastases probably have been overlooked in the past when advanced imaging techniques were not available. Both patients underwent adrenalectomy and replacement therapy with corticosteroids. Approximately 50% of all patients with renal cell carcinoma either present with metastases at diagnosis or will have metastatic disease after nephrectomy11. In order of decreasing frequency, the most common metastatic sites are the lungs, lymph nodes, liver, bone, contralateral kidney and ipsilateral adrenal glands. Adrenal involvement has been reported in 7 to 19% of autopsystudies. 1,3 Solitary metachronous metastatic involvement of the contralateral adrenal from renal cell carcinoma is rarely diagnosed during life and only 4 cases have been reported. 4,5 Recent advances in imaging techniques have allowed the diagnosis of adrenal involvement by renal cancer. Two cases of contralateral adrenal metastasis are reported 1 and 9 years after radical nephrectomy for localized renal cell carcinoma. Both patients underwent adrenalectomy and steroid replacement therapy.

  12. De novo malignant solitary fibrous tumor of the kidney

    Chen Siu-Chung


    Full Text Available Abstract The kidney is a relatively infrequent site for solitary fibrous tumor (SFT. Among the previously reported cases, only two cases of malignant renal SFT developing via dedifferentiation from a pre-existing benign SFT have been reported. Here we reported a case of de novo malignant renal SFT clinically diagnosed as renal cell carcinoma in a 50-year-old woman. The tumor was circumscribed but unencapsulated and showed obvious hemorrhagic necrosis. Microscopically, the tumor was composed of patternless sheets of alternating hypercellular and hypocellular areas of spindle cells displaying mild to moderate nuclear atypia, frequent mitoses up to 8 per 10 high power fields, and a 20% Ki-67 proliferative index. Immunohistochemical studies revealed reactivity for CD34, CD99 and vimentin, with no staining for all other markers, confirming the diagnosis of SFT. No areas of dedifferentiation were seen after extensive sampling. Based on the pathologic and immunohistochemical features, a diagnosis of de novo malignant renal SFT was warranted. Our report expands the spectrum of malignant progression in renal SFTs. Even though this patient has been disease-free for 30 months, long-term follow-up is still mandatory.

  13. De novo malignant solitary fibrous tumor of the kidney.

    Hsieh, Tsan-Yu; ChangChien, Yi-Che; Chen, Wen-Hsiang; Chen, Siu-Chung; Chang, Liang-Che; Hwang, Cheng-Cheng; Chein, Hui-Ping; Chen, Jim-Ray


    The kidney is a relatively infrequent site for solitary fibrous tumor (SFT). Among the previously reported cases, only two cases of malignant renal SFT developing via dedifferentiation from a pre-existing benign SFT have been reported. Here we reported a case of de novo malignant renal SFT clinically diagnosed as renal cell carcinoma in a 50-year-old woman. The tumor was circumscribed but unencapsulated and showed obvious hemorrhagic necrosis. Microscopically, the tumor was composed of patternless sheets of alternating hypercellular and hypocellular areas of spindle cells displaying mild to moderate nuclear atypia, frequent mitoses up to 8 per 10 high power fields, and a 20% Ki-67 proliferative index. Immunohistochemical studies revealed reactivity for CD34, CD99 and vimentin, with no staining for all other markers, confirming the diagnosis of SFT. No areas of dedifferentiation were seen after extensive sampling. Based on the pathologic and immunohistochemical features, a diagnosis of de novo malignant renal SFT was warranted. Our report expands the spectrum of malignant progression in renal SFTs. Even though this patient has been disease-free for 30 months, long-term follow-up is still mandatory.

  14. Thoracic solitary pedunculated osteochondroma in a child: a case report

    Wali Z


    Full Text Available Zubair Wali,1 Khalid I Khoshhal21Department of Orthopedic Surgery, King Fahd Hospital, Almadinah Almunawwarah, Saudi Arabia; 2Department of Orthopedic Surgery, College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi ArabiaObjective: This case report describes the rare presentation of a thoracic pedunculated osteochondroma in a child, arising from the lamina of the fourth thoracic vertebra.Clinical features: A 7-year-old girl was referred for the evaluation of a swelling in her back. The patient was suffering from atraumatic, progressive painless back swelling, of approximately 2 years duration. The physical examination showed a healthy child, with a well-defined mass, about 4 × 6 cm, located around the midline of the upper thoracic spine. No clinical signs of hereditary multiple exostoses were detected. Plain radiographs and computerized tomography were suggestive of a pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra.Intervention and outcome: The patient underwent surgical excision of the mass. The pathologist confirmed the diagnosis. Follow up for 2 years did not show any evidence of clinical or radiological recurrence.Conclusion: The current report describes a rare case and the management of a solitary pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra in a child below the age of 10 years.Keywords: benign tumors, hereditary multiple exostoses, spine column tumors, thoracic vertebra

  15. Solitary granular avalanches: stability, fingering and theoretical modeling

    Malloggi, Florent; Andreotti, Bruno; Clément, Eric; Aronson, Igor; Tsimring, Lev


    Avalanching processes do not only occur in the air as we know of snow avalanches, mud flows and land-slides. Such events frequently happen below the see level as they take many forms from turbidity currents to thick sediment waves. In this study we report results on laboratory scale avalanche experiments taking place both in the air and under-water. In both cases a family of stable solitary erosion/deposition waves is observed [1]. At higher inclination angles, we show the existence of a long wavelength transverse instability followed by a coarsening and the onset of a fingering pattern. While the experiments strongly differ by the spatial and time scales, the agreement between the stability diagrams, the wavelengths selection and the avalanche morphology suggest a common erosion/deposition scenario. We also use these erosion/deposition waves to investigate the dynamics of granular flow and jamming in the frame work of the Partial Fluidization Theory (PFT) proposed by Aronson et al. to describe the dynamics of granular matter near jamming [2]. [1] F. Malloggi et al. Europhysics Letters, 2006, Erosion waves: Transverse instabilities and fingering 75, 825-831 [2] I. S. Aranson et al.. Transverse instability of avalanches in granular flows down an incline. Physical Review E, 2006, 73, 050302; I.S.Aronson et al., Non rheological properties of granular flows: exploring the near jamming limit, preprint (2007).

  16. Solitary rectal ulcer syndrome in children: A literature review

    Seyed Mohsen Dehghani; Abdorrasoul Malekpour; Mahmood Haghighat


    Solitary rectal ulcer syndrome (SRUS) is a benign and chronic disorder well known in young adults and less in children.It is often related to prolonged excessive straining or abnormal defecation and clinically presents as rectal bleeding,copious mucus discharge,feeling of incomplete defecation,and rarely rectal prolapse.SRUS is diagnosed based on clinical symptoms and endoscopic and histological findings.The current treatments are suboptimal,and despite correct diagnosis,outcomes can be unsatisfactory.Some treatment protocols for SRUS include conservative management such as family reassurance,regulation of toilet habits,avoidance of straining,encouragement of a high-fiber diet,topical treatments with salicylate,sulfasalazine,steroids and sucralfate,and surgery.In children,SRUS is relatively uncommon but troublesome and easily misdiagnosed with other common diseases,however,it is being reported more than in the past.This condition in children is benign; however,morbidity is an important problem as reflected by persistence of symptoms,especially rectal bleeding.In this review,we discuss current diagnosis and treatment for SRUS.

  17. Solitary wave propagation through two-dimensional treelike structures.

    Falls, William J; Sen, Surajit


    It is well known that a velocity perturbation can travel through a mass spring chain with strongly nonlinear interactions as a solitary and antisolitary wave pair. In recent years, nonlinear wave propagation in 2D structures have also been explored. Here we first consider the propagation of such a velocity perturbation for cases where the system has a 2D "Y"-shaped structure. Here each of the three pieces that make up the "Y" are made of a small mass spring chain. In addition, we consider a case where multiple "Y"-shaped structures are used to generate a "tree." We explore the early time dynamical behavior associated with the propagation of a velocity perturbation initiated at the trunk and at the extremities for both cases. We are looking for the energy transmission properties from one branch to another of these "Y"-shaped structures. Our dynamical simulations suggest the following broad observations: (i) for strongly nonlinear interactions, mechanical energy propagation resembles pulse propagation with the energy propagation being dispersive in the linear case; (ii) for strong nonlinear interactions, the tree-like structure acts as an energy gate showing preference for large perturbations in the system while the behavior of the linear case shows no such preference, thereby suggesting that such structures can possibly act as switches that activate at sufficiently high energies. The study aspires to develop insights into the nature of nonlinear wave propagation through a network of linear chains.

  18. Solitary bone cyst: an analysis of 12 cases

    Lilian Cristina Vessoni Iwaki


    Full Text Available To present further information about SBCs based on a retrospective study of 12 cases, by describing their clinical and radiographic characteristics, and comparing them with recent findings.  The study examined SBCs from the Projeto Lesões Bucais ‘treatment and epidemiology of diseases of the oral cavity’, run at State University of Maringá, Paraná State, Brazil, between 1995 and 2014. Twelve cases were found among the records of 2.424 patients who had been submitted to different types of biopsy. All cases occurred in the mandible, predominantly in patients in the second decade of life, in the region posterior to canines, and among women. All lesions were solitary, 75% of them unilocular. Helicoidal CT showed expansion and rupture of the cortical bone in one case. Differential diagnosis was confirmed by means of histopathological examination. Treatment consisted of surgical exploration in all cases. Most SBCs are usually asymptomatic and diagnosed by chance on routine X-ray examination. However, SBC can cause bone expansion or bone rupture, only visible with more sophisticated imaging systems. This study showed that the diagnosis of SBC benefits with the use of conventional radiography and CT, associated with careful clinical examinations.

  19. [A case of solitary fibrous tumor in the sella turcica].

    Shimizu, Kiyoharu; Tominaga, Atsushi; Kinoshita, Yasuyuki; Usui, Satoshi; Sugiyama, Kazuhiko; Kurisu, Kaoru


    A 64-year-old male presented with an incidental tumor in the sella turcica during a brain medical checkup. Because he lacked any neurological symptoms or signs of pituitary dysfunction, the patient did not undergo surgery. Three years later, visual disturbances developed, including poor eyesight and visual field defects. The response to the growth hormone(GH)releasing peptide-2 demonstrated severe GH deficiency. MRI revealed an enlarged tumor appearing as a mosaic pattern of high and very low intensity on T2-weighted imaging. The region of very low intensity on T2-weighted imaging exhibited enhancement after T1 gadolinium-DTPA administration. The tumor was totally removed via the microscopic trans-sphenoidal approach in combination with endoscopic observation. The hard tumor adhered to the dura of the sella turcica and the medial wall of the left cavernous sinus. Histological verification confirmed a solitary fibrous tumor(SFT). Fourteen months after the operation, MRI revealed no recurrent tumors. SFT infrequently occurs in the sella turcica; however it should be included in the differential diagnosis in cases of enhanced tumors with marked low intensity on T2-weighted imaging.

  20. Integrability: mathematical methods for studying solitary waves theory

    Wazwaz, Abdul-Majid


    In recent decades, substantial experimental research efforts have been devoted to linear and nonlinear physical phenomena. In particular, studies of integrable nonlinear equations in solitary waves theory have attracted intensive interest from mathematicians, with the principal goal of fostering the development of new methods, and physicists, who are seeking solutions that represent physical phenomena and to form a bridge between mathematical results and scientific structures. The aim for both groups is to build up our current understanding and facilitate future developments, develop more creative results and create new trends in the rapidly developing field of solitary waves. The notion of the integrability of certain partial differential equations occupies an important role in current and future trends, but a unified rigorous definition of the integrability of differential equations still does not exist. For example, an integrable model in the Painlevé sense may not be integrable in the Lax sense. The Painlevé sense indicates that the solution can be represented as a Laurent series in powers of some function that vanishes on an arbitrary surface with the possibility of truncating the Laurent series at finite powers of this function. The concept of Lax pairs introduces another meaning of the notion of integrability. The Lax pair formulates the integrability of nonlinear equation as the compatibility condition of two linear equations. However, it was shown by many researchers that the necessary integrability conditions are the existence of an infinite series of generalized symmetries or conservation laws for the given equation. The existence of multiple soliton solutions often indicates the integrability of the equation but other tests, such as the Painlevé test or the Lax pair, are necessary to confirm the integrability for any equation. In the context of completely integrable equations, studies are flourishing because these equations are able to describe the

  1. Antecubital Fossa Solitary Osteochondroma with Associated Bicipitoradial Bursitis

    Colin Ng


    Full Text Available Antecubital fossa lesions are uncommon conditions that present to the orthopaedic clinic. Furthermore, the radius bone is an uncommonly reported location for an osteochondroma, especially when presenting with a concurrent reactive bicipitoradial bursitis. Osteochondromas are a type of developmental lesion rather than a true neoplasm. They constitute up to 15% of all bone tumours and up to 50% of benign bone tumours. They may occur as solitary or multiple lesions. Multiple lesions are usually associated with a syndrome known as hereditary multiple exostoses (HME. Malignant transformation is known to occur but is rare. Bicipitoradial bursitis is a condition which can occur as primary or secondary (reactive pathology. In our case, the radius bone osteochondroma caused reactive bicipitoradial bursitis. The differential diagnosis of such antecubital fossa masses is vast but may be narrowed down through a targeted history, stepwise radiological investigations, and histological confirmation. Our aim is to ensure that orthopaedic clinicians keep a wide differential in mind when dealing with antecubital fossa mass lesions.

  2. Obliquely propagating large amplitude solitary waves in charge neutral plasmas

    F. Verheest


    Full Text Available This paper deals in a consistent way with the implications, for the existence of large amplitude stationary structures in general plasmas, of assuming strict charge neutrality between electrons and ions. With the limit of pair plasmas in mind, electron inertia is retained. Combining in a fluid dynamic treatment the conservation of mass, momentum and energy with strict charge neutrality has indicated that nonlinear solitary waves (as e.g. oscillitons cannot exist in electron-ion plasmas, at no angle of propagation with respect to the static magnetic field. Specifically for oblique propagation, the proof has turned out to be more involved than for parallel or perpendicular modes. The only exception is pair plasmas that are able to support large charge neutral solitons, owing to the high degree of symmetry naturally inherent in such plasmas. The nonexistence, in particular, of oscillitons is attributed to the breakdown of the plasma approximation in dealing with Poisson's law, rather than to relativistic effects. It is hoped that future space observations will allow to discriminate between oscillitons and large wave packets, by focusing on the time variability (or not of the phase, since the amplitude or envelope graphs look very similar.

  3. Intraspinal Extramedullary Tumor:Misdiagnosis Analysis of 19 Cases%椎管内髓外肿瘤19例误漏诊分析

    白虎虎; 李宝宏; 叶红勋; 朱金银


    目的:探讨椎管内髓外肿瘤误漏诊的原因。方法分析我院2000年1月—2012年12月收治并误漏诊的19例椎管内髓外肿瘤的临床资料。结果本组早期多表现为根性痛,疼痛位于腰骶部13例,下肢7例,颈肩臂3例,胸腹部1 例,部分伴肢体麻木、感觉减退、肌力减退及病理反射阳性。本组误诊14例,漏诊5例。误诊为肌肉劳损5例,腰椎间盘突出症 4例,颈椎病 3例,腰椎管狭窄2例。 5例漏诊者因合并疾病行腰椎间盘摘除术或椎管减压术,4例术中发现椎管内髓外肿瘤,另1例术中漏诊,复诊时行 MR 检查确诊。14例按误诊疾病治疗效果不佳,行 MR 检查确诊。本组均行肿瘤摘除术并经病理证实诊断,术后恢复良好。结论椎管内髓外肿瘤早期临床表现不典型,易误漏诊。重视病史采集、仔细查体、及早行 MR 等影像学检查是减少误漏诊的关键。%Objective To evaluate the cause of misdiagnosis and missed diagnosis in patients with intraspinal extramedul-lary tumors. Methods Clinical data of 19 patients with intraspinal extramedullary tumors, admitted to our hospital and misdiag-nosed or missed diagnosis during January 2000 to December 2012, were analyzed. Results The early clinical manifestation was Ra-dicular pain in these patients. The pain was located in lumbosacral portion in 13 patients, 7 patients in lower limbs, 3 patients in neck, shoulder and arm, 1 patient in the chest and abdomen. Some patients had limb numbness, hypoesthesia, and positive patho-logic reflex. Of all of the 19 patients, 14 were misdiagnosed, 5 missed diagnosis. Of the 14 misdiagnosed patients, 5 were misdiag-nosed as muscular strain, 4 as lumbar disc herniation, 3 as cervical spondylosis, and 2 as lumbar spinal canal stenosis. 5 missed di-agnosis patients underwent lumbar discectomy or spinal canal decompression due to complications, and intraspinal extrameduallary tumors were found in 4 cases and 1 missed diagnosis

  4. Solitary osseous metastasis of rectal carcinoma masquerading as osteogenic sarcoma on post-chemotherapy imaging: A case report

    Udare, Amar; Sable, Nilesh; Kumar, Rajiv; Thakur, Meenakshi; Juvekar, Shashikant [Tata Memorial Hospital, Mumbai (India)


    Solitary metastases from colorectal carcinoma in the absence of hepatic or pulmonary metastases are rare. These can have a diverse imaging appearance, particularly after chemotherapy. It is important identify patients with solitary skeletal metastases, as they have a better prognosis than those with multiple skeletal or visceral metastases. We describe an unusual case of a solitary metastasis to the femur in a case of colon carcinoma that went undiagnosed and later presented with imaging features of osteogenic sarcoma.

  5. Allogeneic Hematopoietic Cell Transplantation in Multiple Myeloma: Focus on Longitudinal Assessment of Donor Chimerism, Extramedullary Disease, and High-Risk Cytogenetic Features.

    Rasche, Leo; Röllig, Christoph; Stuhler, Gernot; Danhof, Sophia; Mielke, Stephan; Grigoleit, Goetz Ulrich; Dissen, Lea; Schemmel, Lea; Middeke, Jan Moritz; Rücker, Viktoria; Schreder, Martin; Schetelig, Johannes; Bornhäuser, Martin; Einsele, Hermann; Thiede, Christian; Knop, Stefan


    Although generally not applied as first-line treatment of multiple myeloma, allogeneic hematopoietic cell transplantation (allo-SCT) can still be chosen as ultimate escalation approach in high-risk patients, preferentially within the framework of clinical trials. In this study, we investigated whether decreasing donor chimerism (DC) is predictive for relapse. In addition, we comprehensively determined the impact of several other disease- and treatment-related factors on outcome. One hundred fifty-five multiple myeloma patients whose DC status was followed serially by the short tandem repeat-based techniques at a single lab were included in this retrospective study. Outcome variables were studied in univariate and multivariable analyses. Available were 2.324 DC samples (median, 12 per patient). Loss of full DC was associated with shorter progression-free survival (PFS) (HR, 1.7; 95% CI, 1.1 to 2.6) but did not impact overall survival. Two-thirds of patients with International Myeloma Working Group-defined relapses still displayed a full DC in peripheral blood or bone marrow. Extramedullary manifestations were observed in 33% of patients, accounting for the discrepancy between DC analysis and the actual disease status. In multivariable analysis, the 2 most relevant variables for an unfavorable PFS were progressive disease before allo-SCT (HR, 3.0; 95% CI, 1.5 to 5.9) and allo-SCT at least the second relapse (HR, 2.8; 95% CI, 1.5 to 4.9), whereas for overall survival progressive disease or partial response before allo-SCT had the strongest negative effects (HR, 4.2; 95% CI, 1.9 to 9, and HR, 2.0; 95% CI, 1.0 to 3.8, respectively). Adverse cytogenetics such as del17p, t(4,14) or amp(1q21) were not associated with shorter survival after allo-SCT. Extensive DC sampling beyond robust engraftment does not appear to provide additional information helpful for disease management in most patients and is challenged by a significant incidence of extramedullary disease. In our

  6. On the generation of solitary waves observed by Cluster in the near-Earth magnetosheath

    J. S. Pickett


    Full Text Available Through case studies involving Cluster waveform observations, solitary waves in the form of bipolar and tripolar pulses have recently been found to be quite abundant in the near-Earth dayside magnetosheath. We expand on the results of those previous studies by examining the distribution of solitary waves from the bow shock to the magnetopause using Cluster waveform data. Cluster's orbit allows for the measurement of solitary waves in the magnetosheath from about 10 RE to 19.5 RE. Our results clearly show that within the magnetosheath, solitary waves are likely to be observed at any distance from the bow shock and that this distance has no dependence on the time durations and amplitudes of the solitary waves. In addition we have found that these same two quantities show no dependence on either the ion velocity or the angle between the ion velocity and the local magnetic field direction. These results point to the conclusion that the solitary waves are probably created locally in the magnetosheath at multiple locations, and that the generation mechanism is most likely not solely related to ion dynamics, if at all. To gain insight into a possible local generation mechanism, we have examined the electron differential energy flux characteristics parallel and perpendicular to the magnetic field, as well as the local electron plasma and cyclotron frequencies and the type of bow shock that Cluster is behind, for several time intervals where solitary waves were observed in the magnetosheath. We have found that solitary waves are most likely to be observed when there are counterstreaming (~parallel and anti-parallel to the magnetic field electrons at or below about 100eV. However, there are times when these counterstreaming electrons are present when solitary waves are not. During these times the background magnetic field strength is usually very low (<10nT, implying that the amplitudes of the solitary waves, if present, would be near or below those of

  7. A Solitary Feature-based Lung Nodule Detection Approach for Chest X-Ray Radiographs.

    Li, Xuechen; Shen, Linlin; Luo, Suhuai


    Lung cancer is one of the most deadly diseases. It has a high death rate and its incidence rate has been increasing all over the world. Lung cancer appears as a solitary nodule in chest x-ray radiograph (CXR). Therefore, lung nodule detection in CXR could have a significant impact on early detection of lung cancer. Radiologists define a lung nodule in chest x-ray radiographs as "solitary white nodule-like blob". However, the solitary feature has not been employed for lung nodule detection before. In this paper, a solitary feature-based lung nodule detection method was proposed. We employed stationary wavelet transform and convergence index filter to extract the texture features and used AdaBoost to generate white nodule-likeness map. A solitary feature was defined to evaluate the isolation degree of candidates. Both the isolation degree and the white nodule-likeness were used as final evaluation of lung nodule candidates. The proposed method shows better performance and robustness than those reported in previous research. More than 80% and 93% of lung nodules in the lung field in the JSRT database were detected when the false positives per image was two and five, respectively. The proposed approach has the potential of being used in clinical practice.

  8. Autonomous generation of a thermoacoustic solitary wave in an air-filled tube

    Shimizu, Dai; Sugimoto, Nobumasa


    Experiments are performed to demonstrate the autonomous generation of an acoustic solitary wave in an air-filled, looped tube with an array of Helmholtz resonators. The solitary wave is generated spontaneously due to thermoacoustic instability by a pair of stacks installed in the tube and subject to a temperature gradient axially. No external drivers are used to create initial disturbances. Once the solitary wave is generated, it keeps on propagating to circulate along the loop endlessly. The stacks, which are made of ceramics and of many pores of square cross section, are placed in the tube diametrically on exactly the opposite side of the loop, and they are sandwiched by hot and cold (ambient) heat exchangers. When the temperature gradient along both stacks is appropriate, pulses of smooth profiles are generated and propagated in both directions of the tube. From good agreements of not only the pressure profile measured but also the propagation speed with the theory, the pulse is identified as the acoustic solitary wave, and it can be called thermoacoustic solitary wave or thermoacoustic soliton corresponding to the soliton solution of the K-dV equation in one limit.

  9. Stability and dispersion relations of three-dimensional solitary waves in trapped Bose-Einstein condensates

    Muñoz Mateo, A.; Brand, J.


    We analyse the dynamical properties of three-dimensional solitary waves in cylindrically trapped Bose-Einstein condensates. Families of solitary waves bifurcate from the planar dark soliton and include the solitonic vortex, the vortex ring and more complex structures of intersecting vortex lines known collectively as Chladni solitons. The particle-like dynamics of these guided solitary waves provides potentially profitable features for their implementation in atomtronic circuits, and play a key role in the generation of metastable loop currents. Based on the time-dependent Gross-Pitaevskii equation we calculate the dispersion relations of moving solitary waves and their modes of dynamical instability. The dispersion relations reveal a complex crossing and bifurcation scenario. For stationary structures we find that for μ /{\\hslash }{ω }\\perp \\gt 2.65 the solitonic vortex is the only stable solitary wave. More complex Chladni solitons still have weaker instabilities than planar dark solitons and may be seen as transient structures in experiments. Fully time-dependent simulations illustrate typical decay scenarios, which may result in the generation of multiple separated solitonic vortices.

  10. Solitary Tracheobronchial Papilloma: Cytomorphology and ancillary studies with histologic correlation

    Tee U Lang


    Full Text Available Solitary tracheobronchial papilloma (STBP is a rare benign tumor that primarily involves the tracheobronchial tree. Human papilloma virus (HPV infection is associated with dysplasia and a high risk of carcinoma in these lesions. The cytomorphology of STBP is not well established in the literature. Our aim is to characterize the cytomorphologic features of STBP, with histologic correlation in a series of 6 patients - 4 males and 2 females - with a mean age of 67 years (range, 53-88 years. There were 5 biopsy-proven squamous papillomas and 1 glandular papilloma. On surgical biopsy, squamous papillomas exhibited cytological atypia (4 graded mild and 1 graded moderate with focal severe dysplasia, surface erosion, and inflammation. Cytology specimens available for review included a combination of 4 fine-needle aspirations (FNAs, 2 bronchoalveolar lavages and 2 (of 3 bronchial brushings. Cytologic findings associated with squamous papillomas included atypical squamous cells and rare squamous cell resembling koilocyte in 1 bronchial brushing. Sheets of squamous cells were identified in another specimen. Several cases had a prominent background of acute inflammation, and candida was present in 1 specimen. HPV in-situ hybridization was positive in 1 case and negative in 2 cases. A p16 immunocytochemical stain performed on 1 cell block was negative. In conclusion, although STBP is a rare neoplasm, these cases may be encountered in respiratory cytology samples. FNA of papillomas yields fewer lesional cells compared to exfoliative samples. These lesions may be mistaken in cytology specimens for squamous cell carcinoma, squamous-lined cavitary lesions, an infectious (fungal process, reactive squamous metaplasia, or oral contamination.

  11. Solitary rectal ulcer syndrome: A clinicopathological study of 13 cases

    Al-Brahim Nabeel


    Full Text Available Background/Aims: Solitary rectal ulcer syndrome (SRUS is a rare disorder that has a wide spectrum of clinical presentation and variable endoscopic findings. To further characterize the clinical and pathological features, a retrospective, hospital-based clinicopathological study was conducted. Materials and Methods: All cases of SRUS diagnosed at Farwania Hospital, Kuwait, between 2002 and 2007 were retrieved from the computerized filing system. The histological slides were reviewed by two authors to confirm the diagnosis. Immunohistochemical stain for smooth muscle actin (SMA was performed. The clinical files were reviewed for clinical features and endoscopic findings. Results: Thirteen cases were identified: 8 males and 5 females. The age range was 15-85. Rectal bleeding, constipation, and abdominal pain were the most common presenting symptoms and were seen, either alone or in various combinations, in 12 of the 13 cases. Rectal ulceration was the most common endoscopic finding, being seen in 9 of the13 cases; 3 of these cases had multiple ulcerations. Two patients had rectal polyps, with one of them having multiple polyps. The histological examination revealed surface serration, fibromuscular obliteration of the lamina propria, and crypts′ distortion in all the cases. Seven of the cases had diamond crypts. Ectatic mucosal vessels were a common finding. Positivity for SMA in the lamina propria was seen in all examined cases. Conclusion: SRUS is a rare disorder and only 13 cases were diagnosed in Farwania hospital over a 6-year period. The clinical presentation of our patients was variable. The presence of polyps and multiple ulcerations on endoscopy is further evidence that SRUS is a misnomer. Surface serration, fibromuscular obliteration, and crypts′ distortion are the most characteristic features. The presence of diamond crypts is an additional diagnostic feature.

  12. Spinal perimedullary vein enlargement sign: an added value for the differentiation between intradural-extramedullary and intramedullary tumors on magnetic resonance imaging

    Gong, Tao; Wang, Guangbin; Gao, Fei; Chen, Xin [Shandong University, Department of Shandong Medical Imaging Research Institute, Jinan (China); Liu, Yubo [Provincial Hospital Affiliated to Shandong University, Department of Radiology, Jinan (China); Yang, Li [Zhongshan Hospital, Department of Radiology, Shanghai (China); Chen, Weibo [Philips Healthcare, Shanghai (China)


    The purpose of this study was to determine the added value of the perimedullary spinal vein enlargement sign on magnetic resonance imaging (MRI) in distinguishing intradural-extramedullary tumors (IDEMTs) from intramedullary spinal tumors (IMTs). Two hundred and eight consecutive spinal intradural tumors with histopathologic confirmation (21 IMTs, 187 IDEMTs) were enrolled. Two readers blinded to the final pathological diagnosis and clinical data independently assessed the venous enlargement sign to determine the agreement between them and jointly distinguished IDEMTs from IMTs according to the common MRI findings. Sensitivity, specificity, and accuracy for the diagnosis of IDEMTs were calculated for the common MRI findings, vein enlargement sign, and a combination of both. Intraobserver agreement and interobserver agreement for both readers was excellent. The sensitivity, specificity, and accuracy of common MRI findings for differentiating IDEMTs from IMTs were 83.4, 95.2, and 89.3 %, respectively. Thirty-one IDEMTs were mistakenly diagnosed as IMTs, in which seven were cases with vein enlargement signs. By applying the vein enlargement sign to the common MRI findings, the specificity remained at 95.2 %, while the sensitivity improved to 89.3 % and the accuracy increased to 92.3 %. The spinal perimedullary vein enlargement sign is useful in assessing intradural tumors and to differentiate IDEMTs from IMTs. (orig.)

  13. Solitary fibrous tumor of the male breast: a case report and review of the literature

    Sessa Fausto


    Full Text Available Abstract Extrapleural solitary fibrous tumors are very rare and occasionally they appear in extraserosal soft tissues or parenchymatous organs. In such cases the right preoperative diagnosis is often difficult and challenging, because both radiological and cytological examinations are not exhaustive. For these reasons, surgical excision is frequently the only way to reach the correct diagnosis and to achieve definitive treatment. A few cases of solitary fibrous tumors have been also described in the breast. Although rare, this lesion opens difficulties in preoperative diagnosis entering in differential diagnosis with other benign lesions as well as with breast cancer. In this article we describe a case of a solitary fibrous tumor of the breast in a 49-year-old man. Problems related to differential diagnosis and the possible pitfalls that can be encountered in the diagnostic iter of such rare tumor are discussed.

  14. Weakly nonlinear models for internal waves: inverse scattering transform and solitary wave contents

    Chen, Shengqian


    The time evolution emanating from ``internal dam-break'' initial conditions is studied for a class of models of stratified Euler fluids in configurations close to two-homogeneous layers separated by a thin diffused interface. Direct numerical simulations and experiments in wave tanks show that such initial conditions eventually give rise to coherent structures that are close to solitary-wave solutions moving ahead of a region of dispersive wave motion and turbulent mixing close to the location of the initial dam step. A priori theoretical predictions of the main features of these solitary waves, such as their amplitudes and speeds, appear to be unavailable, even for simplified models of wave evolution in stratified fluids. With the aim of providing estimates of the existence, amplitude and speed of such solitary waves, an approach based on Inverse Scattering Transform (IST) for completely integrable models is developed here and tested against direct numerical simulations of Euler fluids and some of their mode...

  15. Solitary Wave Solutions of KP equation, Cylindrical KP Equation and Spherical KP Equation

    Li, Xiang-Zheng; Zhang, Jin-Liang; Wang, Ming-Liang


    Three (2+1)-dimensional equations-KP equation, cylindrical KP equation and spherical KP equation, have been reduced to the same KdV equation by different transformation of variables respectively. Since the single solitary wave solution and 2-solitary wave solution of the KdV equation have been known already, substituting the solutions of the KdV equation into the corresponding transformation of variables respectively, the single and 2-solitary wave solutions of the three (2+1)-dimensional equations can be obtained successfully. Supported by the National Natural Science Foundation of China under Grant No. 11301153 and the Doctoral Foundation of Henan University of Science and Technology under Grant No. 09001562, and the Science and Technology Innovation Platform of Henan University of Science and Technology under Grant No. 2015XPT001

  16. Transient evolution of solitary electron holes in low pressure laboratory plasma

    Choudhary, Mangilal; Mukherjee, Subroto


    Solitary electrons holes (SEHs) are localized electrostatic positive potential structures in collisionless plasmas. These are vortex-like structures in the electron phase space. Its existence is cause of distortion of the electron distribution in the resonant region. These are explained theoretically first time by Schamel [Phys. Scr. 20, 336 (1979) and Phys. Plasmas 19, 020501 (2012)]. Propagating solitary electron holes can also be formed in a laboratory plasma when a fast rising high positive voltage pulse is applied to a metallic electrode [Kar et. al., Phys. Plasmas 17, 102113 (2010)] immersed in a low pressure plasma. The temporal evolution of these structures can be studied by measuring the transient electron distribution function (EDF). In the present work, transient EDF is measured after formation of a solitary electron hole in nearly uniform, unmagnetized, and collisionless plasma for applied pulse width and, where and are applied pulse width and inverse of ion plasma frequency respectively. Fo...

  17. A mechanical analog of the two-bounce resonance of solitary waves: Modeling and experiment

    Goodman, Roy H.; Rahman, Aminur; Bellanich, Michael J.; Morrison, Catherine N.


    We describe a simple mechanical system, a ball rolling along a specially-designed landscape, which mimics the well-known two-bounce resonance in solitary wave collisions, a phenomenon that has been seen in countless numerical simulations but never in the laboratory. We provide a brief history of the solitary wave problem, stressing the fundamental role collective-coordinate models played in understanding this phenomenon. We derive the equations governing the motion of a point particle confined to such a surface and then design a surface on which to roll the ball, such that its motion will evolve under the same equations that approximately govern solitary wave collisions. We report on physical experiments, carried out in an undergraduate applied mathematics course, that seem to exhibit the two-bounce resonance.

  18. Differences between endocrinologists and endocrine surgeons in management of the solitary thyroid nodule

    Walsh, John P; Ryan, Simon A; Lisewski, Dean


    BACKGROUND: It is not known whether management of the solitary thyroid nodule differs between endocrinologists and endocrine surgeons. METHODS: A questionnaire containing a hypothetical case (a 42-year-old euthyroid woman with a 2-x-3-cm solitary thyroid nodule) and 13 clinical variations was sent...... to endocrinologists and endocrine surgeons in Australia. RESULTS: The response rate was 51%, including 122 endocrinologists and 48 endocrine surgeons. For the index case, serum thyroid-stimulating hormone (TSH), fine needle aspiration biopsy (FNAB) and ultrasonography were widely used by both groups, but thyroid...... Thyroid Association members (predominantly endocrinologists) demonstrated considerable international differences in management. CONCLUSION: There are clinically significant differences between Australian endocrinologists and endocrine surgeons in management of the solitary thyroid nodule...

  19. Electron-acoustic solitary waves in a beam plasma with electron trapping and nonextensivity effects

    Ali Shan, S.; Aman-ur-Rehman, Mushtaq, A.


    A theoretical investigation is carried out for understanding the properties of electron-acoustic solitary waves (EASWs) in a beam plasma whose constituents are a cold beam electron fluid, hot nonextensive electrons obeying a vortex-like distribution with nonextensive factor q, and stationary ions. An energy integral (Schamel KdV) equation is derived by employing pseudo-potential (reductive perturbation) approach. The presence of nonextensive q-distributed hot trapped electrons and cold electron beam has been shown to influence the soliton structure quite significantly. The nonlinear dispersion relation is derived to analyze the dependency of the electron acoustic solitary wave quantities. From the analysis of our results, it is shown that the present plasma model supports the compressive EASWs. As the real plasma situations are observed with plasma species having a relative flow, so our present analysis should be useful for understanding the electrostatic solitary structures observed in the dayside auroral zone and other regions of the magnetosphere.

  20. Damping solitary wave under the second and third boundary condition of a viscous plasma

    Li, G.; Ren, Y.-Q.


    In this paper, the solitary waves of a viscous plasma confined in a cylindrical pipe is investigated under two types of boundary condition. By using the reductive perturbation theory, a quasi-KdV equation is derived and a damping solitary wave is obtained. It is found that the damping rate increases with the viscosity coefficient of the plasma ν ' increasing and the radius of the cylindrical pipe R decreasing for second and third boundary condition. The magnitude of the damping rate is also dominated by boundary condition type. From the fact that the amplitude reduces rapidly when R approaches zero or ν ' approaches infinite, we confirm the existence of a damping solitary wave.