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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Breast-conserving surgery and postoperative radiotherapy play an important role in the treatment of early breast cancer. Bronchiolitis obliterans with organizing pneumonia (BOOP) is an uncommon syndrome reported to be one of the complications of adjuvant radiotherapy. We report the case of a 71-year-old woman who developed cough, dyspnea and fever three weeks after radiation therapy to the left breast for breast carcinoma. Chest X-ray and computed tomography scan demonstrated alveolar opacities within both lungs. Antibiotic therapy against any probable septic pathology did not improve the symptoms, while corticosteroid treatment resulted in rapid clinical improvement together with regression of the pulmonary opacities. Irradiation was thought to be the cause of the migratory pneumonitis, hence this case was clinically diagnosed as radiation-induced migratory pneumonitis similar to BOOP, without lung biopsy. The present case suggests that one should be mindful of this disease when treating patients with a history of irradiation to the breast. BOOP promptly responds to systemic corticosteroid therapy with rapid improvement of symptoms and regression of the pulmonary opacities.
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PMID:Unusual complication after radiotherapy for breast cancer bronchiolitis obliterans organizing pneumonia case report and review of the literature. 1645 40

Malignant pleural effusion is a common and debilitating complication of advanced malignant diseases. This problem seems to affect particularly those with lung and breast cancer, contributing to the poor quality of life. Approximately half of all patients with metastatic cancer develop a malignant pleural effusion at some point, which is likely to cause significant symptoms such as dyspnea and cough. Evacuation of the pleural fluid and prevention of its re-accumulation are the main goals of management. Optimal treatment is controversial and there is no universally standard approach. Intervention options range from observation in the case of asymptomatic effusions through simple thoracentesis to more invasive methods such as chemical and mechanical pleurodesis, pleur-X catheter drainage, pleuroperitoneal shunting, and pleurectomy. The best results are reported with thoracoscopy and talc insufflation, with an acceptable morbidity. Development of novel methods to control malignant pleural effusion should be a high priority in palliative care of cancer patients. This article reviews the current, as well as, novel approaches that show some promise for the future. The aim is to identify the proper approach for each individual patient.
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PMID:Malignant pleural effusion, current and evolving approaches for its diagnosis and management. 1711 89

Breast cancer rarely metastasizes to the pericardial cavity to cause cardiac tamponade. We have recently experienced a case of pericardial tamponade due to recurrent breast cancer. A 41-year-old woman who underwent modified radical mastectomy for a right breast cancer (T(1)N(3)M(0), Stage IIIA) 8 years and 8 months ago, was admitted for dyspnea and cough. Chest X-ray and CT scan revealed cardiomegaly and right pleural effusion, and cardiac echogram showed marked retention of pericardial effusion. A diagnosis of cardiac tamponade was made, and pericardiocentesis and thoracentesis were carried out immediately. Based on cytodiagnosis of pericardial and pleural effusion, the diagnosis was pericardial and intrapleural metastases of the breast cancer. Dyspnea was improved by pericardiocentesis and thocacentesis. Both intrapericardiac and intrathoracic instillation of CDDP prevented reaccumulation of pericardial and pleural effusion. After local chemotherapy with CDDP, systemic chemotherapy of CPT-11 was started. Thereafter the patient was discharged from the hospital and recovered her daily activities. This case indicates that intrapericardiac application of CDDP was effective for carcinomatous cardiac tamponade without serious side effects.
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PMID:[A case of pericardial tamponade caused by recurrent breast cancer treated with intrapericardial and intrapleural infusion of cisplatin (CDDP)]. 1691 34

It is reasonable to suppose that airway mucosa can be damaged by irradiation applied to chest and neck regions. The inflammatory process is a consequence of an injury. Airway inflammation is one mechanism responsible for cough induction. So, one can suppose that radiotherapy (RT) focused on the patients' chest or neck may injure airway mucosa, which might change sensitivity of the nerve-endings mediating the cough reflex. The purpose of this study was to examine cough reflex sensitivity (CRS) in patients who underwent RT in the chest and neck regions. CRS test using capsaicin was performed in patients with breast cancer (Group A, n=19), and with lung or neck cancer in (Group B, n=14) who underwent RT. Capsaicin aerosol in doubled concentrations (0.49-1000 microM) was inhaled by a single breath. CRS was defined as the lowest capsaicin concentration that evoked 2 or more coughs (C2). Radiation doses ranged from 40 to 70 Gy. Capsaicin cough challenge was performed before and then in the 2(nd) and 5(th) week of RT. We observed a significantly reduced value of C2, i.e., increased cough reflex sensitivity, in Group B in the 2(nd) week of RT (P= 0.04). We conclude that CRS in the lung or neck cancer patients undergoing RT is significantly enhanced, which could result from injury to the nerve endings in airway mucosa.
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PMID:Changes of cough reflex sensitivity induced by cancer radiotherapy of chest and neck regions. 1707 42

The patient was a 40-year-old woman who was admitted to our hospital because of severe cough and dyspnea due to multiple lung metastases from breast cancer, who had undergone Auchincloss operation for right breast cancer about five years earlier. While systemic chemotherapy (CAF) was started after admission,she presented with cardiac tamponade. A cardiac echogram revealed marked retention of pericardial effusion. Pericardiocentesis was carried out, and the cytology of the effusion showed class V, resulting in the diagnosis of carcinomatous cardiac tamponade due to breast cancer. She was treated with intrapericardial chemotherapy using OK-432 and mitomycin C (MMC), and has not suffered from pericardial effusion after the intrapericardial chemotherapy. Intrapericardial chemotherapy using OK-432 and MMC may be very useful for malignant pericardial effusion.
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PMID:[A case of carcinomatous cardiac tamponade due to breast cancer treated with OK-432 and mitomycin C]. 1735 39

Lipoid pneumonia is a rare disease resulting from the micro-aspiration of lipid formulations. Making a diagnosis of lipoid pneumonia requires a high degree of clinical suspicion. Herein, we report the case of a female patient with a history of breast cancer, presenting progressive dyspnea and cough, together with radiological findings of bilateral pulmonary infiltrate. The working diagnosis of lymphangitic carcinomatosis, for which chemotherapy would be indicated, was called into question based on the high-resolution computed tomography findings and on the fact that the patient had a history of chronic ingestion of laxatives containing mineral oil. A lung biopsy confirmed a diagnosis of lipoid pneumonia, which should always be considered in patients with diffuse lung disease having been exposed to potential causative agents.
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PMID:Exogenous lipoid pneumonia: importance of clinical history to the diagnosis. 1743 13

Malignant pleural effusion is a frequent condition with important prognostic repercussions on duration and quality of life. The neoplasms that more frequently determine pleural effusion are lung and breast cancer and pleural mesothelioma. Lymphomas, tumours of the genitourinary tract and gastrointestinal tract as a group account for a further 25%. Surgical treatment has palliative purposes and finalized to reduction symptoms and to improve quality of life. More frequent clinical presentation is a massive pleural efusion associated to dyspnoea and cough. Pleural aspiration is the first choice treatment but the recurrence rate equals to 100% within 1 month. Repeated pleural aspirations are indicated in those patients that have lower expectation of life. The recurrence risk can be reduced with chemical pleurodesis that allows the adhesion between pleural surfaces. Pleurodesis can be realized by the instillation of several substances by the tube of drainage (slurry) or during thoracoscopy (poudrage). Video Assisted Thoracoscopy (VATS) is a safe and well tolerated technique, a complication rate is lower than 0.5%, VATS can be used to obtain diagnosis and to treat patients with malignant pleural effusion and better expectation of life.
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PMID:[Malignant pleural effusion]. 1833 45

A 41-year-old woman had undergone a left mastectomy breast cancer three years prior to presentation. No for at six months she had recurrence, this time in the right breast and skin. Despite first-and second-line chemotherapy, the mass showed progression of the disease. Thereafter, a weekly treatment of vinorelbine and trastuzumab was started, but one month later, she developed a slight fever and dry cough. A chest CT scan revealed an infiltration shadow showing non-specific interstitial pattern in the right lung. A bronchoscopic examination showed lymphocyte dominance in bronchial lavage fluid, and lymphocyte infiltration into the interstium with fibrosis in the tissue specimens was found by transbronchial lung biopsy. After discontinuing the above vinorelbine therapy, the patient's condition improved. We therefore diagnosed this as a case of vinorelbine-and trastuzumab-induced interstitial pneumonia.
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PMID:Pulmonary toxicity associated with vinorelbine-based chemotherapy in breast cancer. 1879 25

A 55-year-old woman had a history of left mastectomy due to early breast cancer in 1998. She had been suffering from dyspnea on effort and dry cough since August in 2007, and visited our hospital 6 months later because the symptoms had been becoming worse. She was hypoxic and her chest radiograph showed bilateral diffuse shadows, so she was hospitalized. The specimen of transbronchial lung biopsy showed undifferentiated adenocarcinoma cells in lymphatics identified by lymphatic endothelium antibody D2-40 stain, so we diagnosed carcinomatous lymphangiosis. It also revealed the cells staining positive for Cytokeratin 7, negative for Cytokeratin 20, and positive for both estrogen receptor and progesterone receptor. These features were identical to the immunohistological findings of the specimen from the previously resected breast cancer. Chemotherapy with docetaxel was effective and improved her respiratory condition and the chest radiograph. The immunohistological findings are useful for diagnosis and selection of cancer therapy. We cannot find any case reports of recurrence with carcinomatous lymphangiosis over 10 years after resection of breast cancer in Japan. We must keep in mind that some cancers relapse after a long disease-free interval.
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PMID:[Pulmonary carcinomatous lymphangiosis from recurrent breast cancer 10 years after resection of the primary tumor]. 1963 2

The patient was a 74-year-old woman who was diagnosed with advanced breast cancer, T4aN0M0, stage IV. She was placed on chemotherapy of weekly paclitaxel (PTX) (60 mg/m(2) day 1, 8, 15 with 1 course consisting of 28 days). We used dexamethasone (8 mg/body) as premedication for chemotherapy every time. Three courses were performed with no severe adverse reaction. On the fourth course, day 8, she complained of nausea, vomiting, paroxysmal cough and fecal incontinence after a few minutes of dexamethasone administration. Her blood pressure dropped to a minimum of 64 mmHg (systolic pressure) and she soon became drowsy. We diagnosed the anaphylaxis-like reaction for dexamethasone, immediately discontinued dexamethasone infusion, and treated her successfully. Forty minutes after the episode had occurred, she recovered. The few reports on anaphylaxis or anaphylaxis-like reaction to dexamethasone must be taken into account when we use these drugs.
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PMID:[A case of advanced breast cancer with anaphylaxis-like reaction after intravenous administration of dexamethasone]. 1969 85


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