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Surmik D, Szczygielski T, Słowiak-Morkovina J, Sander M, Rothschild B, Duda P, Klein N. Bone abnormalities in the middle Anisian marine sauropsids from Winterswijk. J Morphol 2023; 284:e21550. [PMID: 36538608 DOI: 10.1002/jmor.21550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/11/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
While the occurrence of skeletal pathologies in Middle Triassic marine reptiles has been poorly documented until now, massive accumulations of bone remains from the Germanic Basin provide the opportunities for documentation. Herein, we describe skeletal abnormalities in the Middle Triassic bone material from the Vossenveld Formation of Winterswijk, the Netherlands. The aim of the study is to distinguish in the studied bones pathologies resulting from malady or trauma and taphonomic alterations. Furthermore, an attempt was made to assess on how the pathologies also represent paleoecological data. Our survey led to the identification of one broken and healed bone, one case of abnormal coossification, and one case of posttraumatic fibro-osseous dysplasia. While the latter two pathologies give little insight into the ecology and function of the affected animals, the fractured dentary is attributed to Nothosaurus marchicus, a common sauropterygian macropredator. It proves that the individual survived long enough to heal, despite the injury hampering its hunting potential. One abnormally shaped humerus is interpreted as postmortem taphonomic deformation, emphasizing the necessity of utilization of detailed diagnostics to distinguish actual paleopathologies from nonbiological distortion.
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Affiliation(s)
- Dawid Surmik
- Institute of Earth Sciences, Faculty of Natural Sciences, University of Silesia in Katowice, Sosnowiec, Poland
| | | | | | - Martin Sander
- Section Paleontology, Institute of Geosciences, University of Bonn, Bonn, Germany
| | - Bruce Rothschild
- Carnegie Museum of Natural History, Pittsburgh, Pennsylvania, USA
| | - Piotr Duda
- Faculty of Faculty of Exact and Technical Sciences, University of Silesia in Katowice, Sosnowiec, Poland
| | - Nicole Klein
- Section Paleontology, Institute of Geosciences, University of Bonn, Bonn, Germany
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2
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Rubini M, Gozzi A, Libianchi N, Dellù E, Spanò F, Di Biasi C, Pendenza M, Sala P, Filannino F, Zaio P. Metastatic cancer and endentulism: Exploring comorbidity to assist with differential diagnosis in a case from Vico nel Lazio (Fr, Italy), 13th-15th century CE. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2022; 38:1-12. [PMID: 35679660 DOI: 10.1016/j.ijpp.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 05/13/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To differentially diagnose cranial lesions noted on a medieval skeleton and explore the importance of comorbidity. MATERIALS A skull of an adult female with osteolytic and osteoblastic lesions, edentulism, and an ectopic tooth from an ossuary of the Church of Santa Maria in Vico del Lazio, Frosinone Italy, dating to the Middle Ages. METHODS Macroscopic observations of the remains, CT scan, and differential diagnosis was undertaken. RESULTS A diagnosis of metastatic cancer (potentially breast cancer) or metastatic neuroblastoma (NBL) is offered. CONCLUSIONS Considering the noted comorbidities, this case might represent a rare case of metastatic neuroblastoma. SIGNIFICANCE The exploration of comorbidity, in this case the presence of metastatic carcinoma and edentulism, has tremendous potential to expand our knowledge about cancer in the past. LIMITATIONS Lack of postcranial elements. SUGGESTIONS FOR FURTHER RESEARCH Clinical and paleopathological investigation of comorbidity in modern and archeological populations to develop an evolutionary perspective on the presence of cancer in the past.
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Affiliation(s)
- Mauro Rubini
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy; Department of Archeology, University of Foggia, Via Antonio Gramsci, 89, 71122 Foggia, Italy.
| | - Alessandro Gozzi
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy
| | - Nunzia Libianchi
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy
| | - Elena Dellù
- S.A.B.A.P.- BA, Physical Anthropology Service, Via Pier l'Eremita 25/B, 70122 Bari, Italy
| | - Ferdinando Spanò
- Emergency Diagnostics, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Claudio Di Biasi
- Emergency Diagnostics, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Matteo Pendenza
- Techniques of Medical Radiology, Imaging and Radiotherapy, Sapienza Università di Roma, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Paola Sala
- Techniques of Medical Radiology, Imaging and Radiotherapy, Sapienza Università di Roma, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Floriana Filannino
- Techniques of Medical Radiology, Imaging and Radiotherapy, Sapienza Università di Roma, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Paola Zaio
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy
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Rothschild BM, Jellema L, Lambert W. Demographics and significance of porotic hyperostosis as assessed by surface microscopy. Anat Rec (Hoboken) 2022; 305:2158-2165. [PMID: 35122474 DOI: 10.1002/ar.24881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/12/2021] [Accepted: 02/11/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Examination of parietal surface anatomy has been limited because standard techniques have insufficient resolution to identify and characterize the structures of interest. Perspectives derived thereof have not clarified their nature. Surface microscopy is pursued as a non-destructive technique to assess the character and implications of porotic pores (referred to as porotic hyperostosis), which have been subject of much speculation. METHODS The external surface of skulls, selected on the basis of age and gender, from the Hamann-Todd human collection are examined by epi-illumination microscopy for surface pores and to assess correlation with age, ethnicity, gender, anemia, infection, cancer, hypertrophic bone disorders, renal disease and fractures. RESULTS Pore-like surface defects are present in 2.7-5% of individuals in the third-fifth decades of life; 7%, in the sixth-eighth; and 25%, in the ninth-11th, but absent in the second decade of life. They are gender and birthdate-independent, but slightly more common in African Americans. Fractures are more common among individuals with parietal pores, while tuberculosis, cancer and hypertrophic bone diseases and anemia are less common. DISCUSSION This is the first study to actually examine the prevalence of parietal pores as a function of known age, race and sex and provides a baseline for comparison with populations in which those variables are not clearly identifiable. While some porotic pores may be related to marrow hyperplasia, trans-cortical circulation may explain the majority. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Lyman Jellema
- Cleveland Museum of Natural History, Wade Circle, Cleveland, OH, USA
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Mitchell PD, Dittmar JM, Mulder B, Inskip S, Littlewood A, Cessford C, Robb JE. The prevalence of cancer in Britain before industrialization. Cancer 2021; 127:3054-3059. [PMID: 33942897 DOI: 10.1002/cncr.33615] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/15/2021] [Accepted: 04/05/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND To plan for cancer services in the future, the long view of cancer prevalence is essential. It might be suspected that cancer prevalence before tobacco and industrial revolution pollutants was quite different to today. METHODS To quantify the degree to which cancer prevalence may be changing over time, the authors analyzed 143 skeletons from 6 cemeteries from the Cambridge area (6th-16th centuries). Visual inspection coupled with screening using both plain radiographs and computed tomography scans was used to detect malignant lesions. RESULTS A total of 3.5% of individuals showed evidence for metastases. Factoring in modern data for the proportion of those with cancer that die with bone metastases, this suggests a minimum prevalence of all cancers at the time of death in medieval Britain to be approximately 9% to 14% of adults. CONCLUSIONS This figure compares with a 40% to 50% prevalence of cancer at the time of death for modern Britain. The difference may be explained by the effects of modern carcinogens, the spread of viruses that trigger malignancy, industrial pollutants, and longer life expectancy. LAY SUMMARY Until now, no one has been able to work out how common cancer was before the time people were exposed to tumor-inducing chemicals from tobacco and industrial factories. In this novel study, the authors have determined the percentage of people living in medieval Britain who had cancer metastases to bone at the time of their death and then compared that with modern data. It was found that cancer was approximately 25% as common in medieval times as it is today. This article suggests cancer was much more widespread in medieval times than was previously realized.
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Affiliation(s)
- Piers D Mitchell
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
| | - Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom
| | - Bram Mulder
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom
| | - Alastair Littlewood
- Department of Radiology, Peterborough City Hospital, Peterborough, United Kingdom
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom.,Cambridge Archaeological Unit, University of Cambridge, Cambridge, United Kingdom
| | - John E Robb
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
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Dittmar JM, Berger ES, Mao R, Wang H, Yeh HY. A probable case of multiple myeloma from Bronze Age China. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 31:64-70. [PMID: 33091820 DOI: 10.1016/j.ijpp.2020.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Paleopathological evidence of cancer from past populations is rare, especially outside of Europe and North Africa. This study expands upon the current temporal and spatial distribution of cancer by presenting a probable case of multiple myeloma from Bronze Age China. MATERIAL The human skeletal remains of an adult male from the Qijia culture horizon (1750-1400 BCE) of the Bronze Age cemetery of Mogou (), located in Gansu Province, Northwest China. METHODS The human skeletal remains were assessed macroscopically and radiographically using plain x-rays. RESULTS Multiple ovoid-shaped osteolytic lesions with sharply demarcated margins were observed. The axial skeletal had the greatest involvement, specifically the vertebrae, ribs, and sternum. Radiographic imaging revealed more extensive destruction of cancellous than cortical bone, indicating that the marrow was the focal point of the disease. CONCLUSION Based on the nature, distribution, and radiographic appearance of the lesions, the most likely diagnosis is multiple myeloma. SIGNIFICANCE This is one of the only cases of cancer identified in archaeological human skeletal remains from East Asia and is the first published case of a hematopoietic malignancy from mainland China. The analysis and publication of examples of neoplasia from areas that expand upon the current known temporal and spatial distribution is necessary in order to better reconstruct the history and evolution of cancer. LIMITATIONS Poor skeletal preservation prevented the full extent of osteolytic lesions to be observed. SUGGESTIONS FOR FUTURE RESEARCH By placing case studies such as this into a temporal and spatial framework, it is possible for future research to begin to interrogate possible underlying causes of cancer in ancient populations within the context of changing environmental conditions and subsistence strategies.
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Affiliation(s)
- Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, CB2 3ER, UK.
| | - Elizabeth S Berger
- Department of Anthropology, University of California, Riverside, 1334 Watkins Hall, Riverside, CA, 92521, United States
| | - Ruilin Mao
- Gansu Provincial Institute for Cultural Relics and Archaeology, Heping Road No. 165, Lanzhou, 730000, China
| | - Hui Wang
- Gansu Provincial Institute for Cultural Relics and Archaeology, Heping Road No. 165, Lanzhou, 730000, China
| | - Hui-Yuan Yeh
- School of Humanities, Nanyang Technological University, 14 Nanyang Drive, 637332, Singapore
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Rothschild BM, Tanke D, Rühli F, Pokhojaev A, May H. Suggested Case of Langerhans Cell Histiocytosis in a Cretaceous dinosaur. Sci Rep 2020; 10:2203. [PMID: 32042034 PMCID: PMC7010826 DOI: 10.1038/s41598-020-59192-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/21/2020] [Indexed: 12/16/2022] Open
Abstract
Susceptibility to diseases is common to humans and dinosaurs. Since much of the biological history of every living creature is shaped by its diseases, recognizing them in fossilized bone can furnish us with important information on dinosaurs' physiology and anatomy, as well as on their daily activities and surrounding environment. In the present study, we examined the vertebrae of two humans from skeletal collections with Langerhans Cell Histiocytosis (LCH), a benign osteolytic tumor-like disorder involving mainly the skeleton; they were diagnosed in life, along with two hadrosaur vertebrae with an apparent lesion. Macroscopic and microscopic analyses of the hadrosaur vertebrae were compared to human LCH and to other pathologies observed via an extensive pathological survey of a human skeletal collection, as well as a three-dimensional reconstruction of the lesion and its associated blood vessels from a µCT scan. The hadrosaur pathology findings were indistinguishable from those of humans with LCH, supporting that diagnosis. This report suggests that hadrosaurids had suffered from larger variety of pathologies than previously reported. Furthermore, it seems that LCH may be independent of phylogeny.
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Affiliation(s)
- Bruce M Rothschild
- Indiana University, 2401W. University Ave., Muncie, IN, 47303, USA.
- Carnegie Museum, 4400 Forbes Ave., Pittsburgh, PA, 44272, USA.
| | - Darren Tanke
- Royal Tyrrell Museum of Palaeontology, 1500 N. Dinosaur Trail, Drumheller, AB, T0J 0Y0, Canada
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Ariel Pokhojaev
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Dan David Center for Human Evolution and Biohistory Research, Shmunis Family Anthropology Institute, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hila May
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Dan David Center for Human Evolution and Biohistory Research, Shmunis Family Anthropology Institute, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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7
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Jentgen-Ceschino B, Stein K, Fischer V. Case study of radial fibrolamellar bone tissues in the outer cortex of basal sauropods. Philos Trans R Soc Lond B Biol Sci 2020; 375:20190143. [PMID: 31928196 DOI: 10.1098/rstb.2019.0143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The histology of sauropod long bones often appears uniform and conservative along their evolutionary tree. One of the main aspects of their bone histology is to exhibit a fibrolamellar complex in the cortex of their long bones. Here, we report another bone tissue, the radial fibrolamellar bone (RFB), in the outer cortex of the humeri of a young adult cf. Isanosaurus (Early to Late Jurassic, Thailand) and an adult Spinophorosaurus nigerensis (Early to Middle Jurassic, Niger) that do not exhibit any pathological feature on the bone surface. Its location within the cortex is unexpected, because RFB is a rapidly deposited bone tissue that would rather be expected early in the ontogeny. A palaeopathological survey was conducted for these sampled specimens. Observed RFB occurrences are regarded as spiculated periosteal reactive bone, which is an aggressive form of periosteal reaction. A 'hair-on-end' pattern of neoplasmic origin (resembling a Ewing's sarcoma) is favoured for cf. Isanosaurus, while a sunburst pattern of viral or neoplasmic origin (resembling an avian osteopetrosis or haemangioma) is favoured for Spinophorosaurus. This study highlights the importance of bone histology in assessing the frequency and nature of palaeopathologies. This article is part of the theme issue 'Vertebrate palaeophysiology'.
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Affiliation(s)
- Benjamin Jentgen-Ceschino
- Department of Geology, Université de Liège, 14 Allée du 6 Aout, Liège 4000, Belgium.,Earth System Science - AMGC, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Koen Stein
- Earth System Science - AMGC, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.,Royal Belgian Institute of Natural Sciences, Directorate 'Earth and History of Life', Rue Vautier 29, 1000 Brussels, Belgium
| | - Valentin Fischer
- Department of Geology, Université de Liège, 14 Allée du 6 Aout, Liège 4000, Belgium
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8
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Biehler-Gomez L, Giordano G, Cattaneo C. The overlooked primary: bladder cancer metastases on dry bone. A study of the 20th century CAL Milano Cemetery Skeletal Collection. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:130-140. [PMID: 30388583 DOI: 10.1016/j.ijpp.2018.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/07/2018] [Accepted: 10/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of this article is to provide additional documentation of bone metastases to help anthropologists recognize the condition and potentially suggest the diagnosis of bladder carcinoma in differential diagnosis. MATERIALS AND METHODS Thirteen individuals clinically diagnosed with bladder carcinoma from the 20th century Milano Cemetery Skeletal Collection were macroscopically studied to document bone metastases in bladder cancer. RESULTS Bone metastases were found through macroscopic observation in three individuals or 23% of the study sample. Metastases were mostly of a mixed nature (45%), although both osteoblastic (13%) and osteolytic (9%) also occurred. In particular, mixed and osteoblastic metastases exhibited different distribution patterns, even when affecting the same bones. The vertebrae (24.7%), skull (12.9%), ribs (11.7%), proximal humeri (7.8%), pelvis (5.2%), proximal femora (2.6%), sacrum (1.3%) and sternum (1.3%) were the most commonly affected. Osteolytic lesions included coalescing superficial pits or lesions perforating the bone cortex. Proliferative lesions manifested as spongiosclerosis or periosteal new bone. Mixed metastases were osteolytic lesions exposing a thickened trabecular bone or coalescent porosity with reactive new bone. CONCLUSIONS Bladder carcinoma metastases were mostly mixed, exhibiting periosteal reactions, perforations of bone cortex, spongiosclerosis and coalescing porosity. SIGNIFICANCE Bladder carcinoma is rarely considered in the differential diagnosis of the primary organ. This study reports the macroscopic aspect of bone metastases in bladder carcinoma and may help anthropologists diagnose the condition in skeletons. LIMITATIONS Absence of evidence is not evidence of absence; some lesions may have been hidden from macroscopic observation and therefore missed. FURTHER RESEARCH Radiographic analysis and comparison with other neoplasms should provide additional details for the diagnosis of bladder cancer bone metastases.
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Affiliation(s)
- Lucie Biehler-Gomez
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy.
| | - Gaia Giordano
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | - Cristina Cattaneo
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense, Sezione Di Medicina Legale, Dipartimento Di Scienze Biomediche per La Salute, Università Degli Studi Di Milano, Milan, Italy
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Micarelli I, Paine RR, Tafuri MA, Manzi G. A possible case of mycosis in a post-classical burial from La Selvicciola (Italy). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:25-33. [PMID: 30245229 DOI: 10.1016/j.ijpp.2018.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 09/04/2018] [Accepted: 09/07/2018] [Indexed: 06/08/2023]
Abstract
An examination of an adult male buried from the post-classical necropolis of La Selvicciola (Viterbo, Latium, Italy; 4th-6th centuries AD) revealed a series of skeletal lesions. The lesions, both proliferative and lytic, ranging in size from small (around 0.01 mm) to extensive (up to 16.00 mm) pits, occurred at multiple sites. A holistic approach assessed lesion type, frequency and location in a differential diagnosis, which included myeloma, metastatic carcinoma, tuberculosis, leukemia, osteomyelitis, and mycoses. It was concluded that a mycosis, specifically Cryptococcosis, was the most likely cause of these lesions. Both macroscopic analyses and X-ray scans support our diagnosis. We also provide a methodological scheme as a model for examining unknown lesion patterns.
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Affiliation(s)
- Ileana Micarelli
- Sapienza Università di Roma, Dipartimento di Scienze dell'Antichità, P.le Aldo Moro 5, 00185, Roma, Italy; Sapienza Università di Roma, Dipartimento di Biologia Ambientale, P.le Aldo Moro 5, 00185, Roma, Italy
| | - Robert R Paine
- Sapienza Università di Roma, Dipartimento di Biologia Ambientale, P.le Aldo Moro 5, 00185, Roma, Italy
| | - Mary Anne Tafuri
- Sapienza Università di Roma, Dipartimento di Biologia Ambientale, P.le Aldo Moro 5, 00185, Roma, Italy.
| | - Giorgio Manzi
- Sapienza Università di Roma, Dipartimento di Biologia Ambientale, P.le Aldo Moro 5, 00185, Roma, Italy
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10
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Riccomi G, Fornaciari G, Giuffra V. Multiple myeloma in paleopathology: A critical review. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:201-212. [PMID: 30530292 DOI: 10.1016/j.ijpp.2018.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 11/30/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
This paper provides a critical literature review concerning paleopathological evidence of multiple myeloma discovered both in the Old and in the New World. A critical assessment of the bioarchaeological and paleopathological documentary sources permitted to identify a total of 25 ascertained cases of multiple myeloma from different geographical areas in the world ranging from Prehistoric times up to the Contemporary age. The distribution of multiple myeloma findings in past times shows that the majority of cases have been discovered in the Old World (n = 18) and extend back to the Middle Ages, while the evidences in the New World (n = 7) seems to date back to the pre-Columbian era. The demographic profile suggests a sex ratio of 1.3:1, while 91.7% of affected individuals (n = 24) are adults. This critical review also discusses the diagnostic criteria and methodological issues commonly attempted in paleo-oncological research, with particular regard to the differential diagnosis of multiple myeloma. As such, the main focus of this work is to present a comprehensive and exhaustive scrutiny of the skeletal manifestations identified as multiple myeloma in order to improve the accuracy of diagnoses within the field of paleopathology.
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Affiliation(s)
- Giulia Riccomi
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
| | - Gino Fornaciari
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Valentina Giuffra
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
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Ragsdale BD, Campbell RA, Kirkpatrick CL. Neoplasm or not? General principles of morphologic analysis of dry bone specimens. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 21:27-40. [PMID: 29776885 DOI: 10.1016/j.ijpp.2017.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 01/09/2017] [Accepted: 02/04/2017] [Indexed: 06/08/2023]
Abstract
Unlike modern diagnosticians, a paleopathologist will likely have only skeletonized human remains without medical records, radiologic studies over time, microbiologic culture results, etc. Macroscopic and radiologic analyses are usually the most accessible diagnostic methods for the study of ancient skeletal remains. This paper recommends an organized approach to the study of dry bone specimens with reference to specimen radiographs. For circumscribed lesions, the distribution (solitary vs. multifocal), character of margins, details of periosteal reactions, and remnants of mineralized matrix should point to the mechanism(s) producing the bony changes. In turn, this allows selecting a likely category of disease (e.g. neoplastic) within which a differential diagnosis can be elaborated and from which a favored specific diagnosis can be chosen.
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Affiliation(s)
- Bruce D Ragsdale
- Western Diagnostic Services Laboratory, San Luis Obispo, CA, USA; School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.
| | - Roselyn A Campbell
- Cotsen Institute of Archaeology, University of California, Los Angeles, 308 Charles E. Young Drive North, A210 Fowler Building/Box 951510, Los Angeles, CA, 90095-1510, USA; Paleo-oncology Research Organization, Minneapolis, MN, USA.
| | - Casey L Kirkpatrick
- Paleo-oncology Research Organization, Minneapolis, MN, USA; Department of Anthropology, Social Science Center Room 3326, University of Western Ontario, 1151 Richmond St., London, Ontario, N6A 3K7, Canada.
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12
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Molto E, Sheldrick P. Paleo-oncology in the Dakhleh Oasis, Egypt: Case studies and a paleoepidemiological perspective. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 21:96-110. [PMID: 29499961 DOI: 10.1016/j.ijpp.2018.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/07/2018] [Accepted: 02/13/2018] [Indexed: 06/08/2023]
Abstract
This article describes six cases of cancer from the Dakhleh Oasis, Egypt. A mummy had a confirmed 'primary' diagnosis of adenocarcinoma of the rectum. The remaining diagnoses were based on the distribution and types of skeletal lesions in conjunction with age, sex, and/or the molecular phylogeny of the Human Papillomavirus (HPV). HPV is a confirmed cause of cancer of the uterine cervix (UC) and testes (TC) and it evolved in Africa long before Homo sapiens emerged. Today these cancers are common in young adult females and males, a fact which was pivotal in respectively including them in the differential diagnosis of UC and TC. The remaining diagnoses were acute lymphocytic leukemia in a 3-5 year old child and an older female with metastatic carcinoma. Due to problems of determining specific diagnoses and their prevalence in 'paleo' populations, we opted for a lifetime cancer risk statistic (LTCR). The LTCR in ancient Dakhleh was ∼5/1000 (6/1087). In modern Western societies the LTCR cancer approaches 50% (500/1000). Thus the LTCR in today's western societies is 100 times greater than in ancient Dakhleh. These cases demonstrate that oncogenes and their environmental cofactors were present in antiquity, but were significantly less pervasive than today.
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Affiliation(s)
- El Molto
- Department of Anthropology, University of Western Ontario, N6A 5C2, Canada.
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Arrieta MA, Mendonça OJ, Bordach MA. Differential diagnosis of a neoplastic condition in a prehistoric juvenile individual from La Falda site, Northwest Argentina. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 21:111-120. [PMID: 29776877 DOI: 10.1016/j.ijpp.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 06/08/2023]
Abstract
Bone neoplasms or tumors are of great interest for paleopathological studies due to their close relationship with health and survivorship as well as for their epidemiologic and demographic relevance. However, the identification of these lesions in archaeological specimens is very uncommon. The aim of this paper is to report the case of skeleton R5 E#1 from the prehistoric cemetery La Falda, in the Northwest region of Argentina. During the osteopathological analysis of the skeletal series, proliferative lesions in several bones of the skeleton of a 7-10-year-old juvenile were observed (i.e., both scapulae; left clavicle, humerus, and ulna, both os coxae, femora, and fibulae, and right foot bones). Age-at-death estimation, location and distribution pattern, and morphological appearances of the lesions indicated that this juvenile suffered from a neoplastic condition. A comprehensive differential diagnosis was carried out, suggesting that these lesions were compatible with hereditary multiple osteochondromas. However, Ewing's sarcoma was not definitively ruled out as a probable diagnosis. Thus, this work adds new evidence to the existence of neoplastic conditions in the prehistoric populations of the Americas, and it contributes original data to perform a differential diagnosis for multiple proliferative lesions.
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Affiliation(s)
- Mario A Arrieta
- Laboratorio de Osteología y Anatomía Funcional Humana, Universidad Nacional de Río Cuarto-CONICET, Río Cuarto, Argentina.
| | - Osvaldo J Mendonça
- Laboratorio de Osteología y Anatomía Funcional Humana, Universidad Nacional de Río Cuarto-CONICET, Río Cuarto, Argentina
| | - María A Bordach
- Laboratorio de Osteología y Anatomía Funcional Humana, Universidad Nacional de Río Cuarto, Río Cuarto, Argentina
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Kirkpatrick CL, Campbell RA, Hunt KJ. Paleo-oncology: Taking stock and moving forward. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 21:3-11. [PMID: 29778410 DOI: 10.1016/j.ijpp.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 06/08/2023]
Abstract
This article serves as an introduction to the International Journal of Paleopathology's special issue, Paleo-oncology: Taking Stock and Moving Forward. Reflecting the goals of the special issue, this paper has been designed to provide an overview of the current state of paleo-oncology, to introduce new and innovative paleo-oncological research and ideas, and to serve as a catalyst for future discussions and progress. This paper begins with an overview of the paleo-oncological evidence that can be found in ancient remains, followed by a summary of significant paleo-oncological findings and methodological advances to date. Thereafter, challenges in estimating past prevalence of cancer are highlighted and recommendations are made for future advancements in paleo-oncological research. The ground-breaking studies included in the special issue and referenced throughout this introduction embody the many ways in which progress can be made in the field of paleo-oncology.
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Affiliation(s)
- Casey L Kirkpatrick
- Department of Anthropology, Social Science Center Room 3326, University of Western Ontario, 1151 Richmond St., London, Ontario, N6A 3K7, Canada; Paleo-oncology Research Organization, Minneapolis, MN, USA.
| | - Roselyn A Campbell
- Cotsen Institute of Archaeology, University of California, Los Angeles, 308 Charles E. Young Drive North, A210 Fowler Building/Box 951510, Los Angeles, CL, 90095-1510, USA; Paleo-oncology Research Organization, Minneapolis, MN, USA.
| | - Kathryn J Hunt
- Paleo-oncology Research Organization, Minneapolis, MN, USA.
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Hunt KJ, Roberts C, Kirkpatrick C. Taking stock: A systematic review of archaeological evidence of cancers in human and early hominin remains. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 21:12-26. [PMID: 29773338 DOI: 10.1016/j.ijpp.2018.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 06/08/2023]
Abstract
This study summarizes data from 154 paleopathological studies documenting 272 archaeologically recovered individuals exhibiting skeletal or soft tissue evidence of cancer (malignant neoplastic disease) between 1.8 million years ago and 1900 CE. The paper reviews and summarizes the temporal, spatial and demographic distribution of the evidence and the methods used to provide the cancer diagnoses. Metastasis to bone is the most widely reported evidence (n = 161), followed by multiple myeloma (n = 55). In the dataset, males were represented more than females (M = 127, F = 94), and middle-adults (35-49) and old-adults (50+) were represented most among age groups (MA = 77, OA = 66). The majority of the evidence comes from Northern Europe (n = 51) and Northern Africa (n = 46). The data are summarized in the Cancer Research in Ancient Bodies (CRAB) Database, a growing online resource for future paleo-oncological research. This systematic review contributes to broader studies of malignant neoplastic disease in antiquity; it provides an overview of paleo-oncological data, discusses the many practical and methodological challenges of paleo-oncological research, and dispels presumptions about cancer's rarity in the past.
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Affiliation(s)
- Kathryn J Hunt
- Paleo-Oncology Research Organization; 106 Group, United States.
| | | | - Casey Kirkpatrick
- Western Ontario University, Canada; Paleo-Oncology Research Organization, United States
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16
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Abegg C, Desideri J. A probable case of multiple myeloma in a female individual from the Simon Identified Skeletal Collection (late 19th-early 20th century, Vaud, Switzerland). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 21:158-165. [PMID: 29776886 DOI: 10.1016/j.ijpp.2017.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 02/02/2017] [Accepted: 02/04/2017] [Indexed: 06/08/2023]
Abstract
We present the case of an individual from the Simon Identified Skeletal Collection (Vaud, Switzerland) who appears to have been affected by a form of neoplastic disease. A detailed description and differential diagnosis of the lesions was conducted and is presented here. Considering the biological profile of the individual, the distribution of the lesions, and their appearance, a case is made for multiple myeloma as the most likely diagnosis. This case study demonstrates the importance of adopting a detailed approach for recording the metric and non-metric traits of lesions, using multiple methods of analysis, and providing graphic and photographic documentation in order to provide valuable comparison material through publication. The good preservation of the remains and the background information available for the individual also make this case ideal for inclusion in future comparative studies.
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Affiliation(s)
- Claudine Abegg
- Section of Earth and Environmental Sciences, Department F.-A. Forel for Environmental and Aquatic Sciences, Laboratory of Prehistoric Archaeology and Anthropology, University of Geneva, Switzerland.
| | - Jocelyne Desideri
- Section of Earth and Environmental Sciences, Department F.-A. Forel for Environmental and Aquatic Sciences, Laboratory of Prehistoric Archaeology and Anthropology, University of Geneva, Switzerland.
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17
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Klaus HD. Paleopathological rigor and differential diagnosis: Case studies involving terminology, description, and diagnostic frameworks for scurvy in skeletal remains. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2017; 19:96-110. [PMID: 29198404 DOI: 10.1016/j.ijpp.2015.10.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/01/2015] [Accepted: 10/08/2015] [Indexed: 06/07/2023]
Abstract
Diverse pathological processes can produce overlapping or even indistinguishable patterns of abnormal bone formation or destruction, representing a fundamental challenge in the understanding of ancient diseases. This paper discusses increasing rigor in differential diagnosis through the paleopathological study of scurvy. First, paleopathology's use of descriptive terminology can strive to more thoroughly incorporate international standards of anatomical terminology. Second, improved observation and description of abnormal skeletal features can help distinguish between anemia or vitamin C deficiency. Third, use of a structured rubric can assist in establishing a more systematic, replicable, and precise decision-making process in differential diagnosis. These issues are illustrated in the study of two new cases of suspected scurvy from northern Peru. From this, it appears possible that ectocranial vascular impressions may further examined as a morphological marker of scurvy in the skeleton. Also, increased paleopathological attention to pellagra is long overdue, especially as it may produce generally comparable lesions to scurvy. This paper reflexively speaks to the process of paleopathological problem solving and the epistemology of our discipline-particularly regarding the ways in which we can continuously improve description and the construction of diagnostic arguments.
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Affiliation(s)
- Haagen D Klaus
- Department of Sociology and Anthropology, George Mason University, United States; Museo Nacional Sicán, Peru; Museo Nacional de Arqueología y Etnografía Hans Heinrich Brüning de Lambayeque, Peru.
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Rothschild BM, Ruhli F, Rothschild C. Skeletal clues apparently distinguishing Waldenstrom's macroglobulinemia from multiple myeloma and leukemia. Am J Hum Biol 2002; 14:532-7. [PMID: 12112574 DOI: 10.1002/ajhb.10077] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study was conducted to characterize macroscopically and by conventional radiography the bony lesions in a case of Waldenstrom's macroglobulinemia and to compare and contrast it with those of the other major hematologic lymphoproliferative disorders, multiple myeloma and leukemia. Two varieties of lytic skeletal lesions were found in Waldenstrom's macroglobulinemia. One was sharply defined, spheroid lesions with smooth borders and effaced/erased trabeculae. The second was in the form of coalescing pits (holes) with smooth, minimally remodeled edges. The appearance combined features of multiple myeloma and leukemia, but were mutually exclusive in those diseases. Spheroid lesions with effaced edges were absent in leukemia, while pits were absent in multiple myeloma. Fronts of resorption were not noted in Waldenstrom's macroglobulinemia. The combination of some of the features of leukemia and myeloma appear to allow recognition of Waldenstrom's macroglobulinemia.
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Affiliation(s)
- B M Rothschild
- Arthritis Center of Northeast Ohio, Youngstown, Ohio 44512, USA.
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Rothschild BM, Hershkovitz I, Dutour O. Clues potentially distinguishing lytic lesions of multiple myeloma from those of metastatic carcinoma. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1998; 105:241-50. [PMID: 9511917 DOI: 10.1002/(sici)1096-8644(199802)105:2<241::aid-ajpa10>3.0.co;2-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study was conducted to determine whether individual bony lesions are specific for recognizing multiple myeloma and thereby distinguish it from metastatic cancer and leukemia. The lytic skeletal lesions of multiple myeloma are characterized by sharply defined, spheroid lesions. They have smooth borders and effaced/erased trabeculae. Unique spheroid myeloma lesions appear to be responsible for the "punched out" appearance of affected bone. The total absence of remodeling in myeloma forms a contrast to irregular preservation of trabeculae and buttressing, isolated "fronts of" cortical bone "resorption" coalescing to confluence, and the "golf-ball surface" phenomenon observed in metastatic cancer. The uniform effacement of both cortical and trabecular bone in multiple myeloma also contrasts with some cortical preservation in metastatic cancer. Leukemic lesions are more numerous than those of myeloma, but they lack the latter's "space-occupied" appearance. The relatively small holes and "fronts of resorption" of leukemia are quite different from the "space-occupied" lesions of multiple myeloma. Uniform size is a characteristic traditionally attributed to the bone lesions of multiple myeloma. The occurrence of isolated examples of uniform size lesions in metastatic cancer and of variable size lesions in some individuals with multiple myeloma precludes unequivocal use of size in differential diagnosis. Fortunately, the newly recognized macroscopic characteristics appear to separate multiple myeloma from metastatic cancer, and also distinguish myeloma from leukemia.
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Affiliation(s)
- B M Rothschild
- Arthritis Center of Northeast Ohio and Northeastern Ohio Universities College of Medicine, Youngstown 44512, USA.
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