Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

17 cases with bronchial carcinoid were reported. 16 cases of them were proved pathologically after pulmonary resection, and the remaining one was confirmed histopathologically through bronchoscopic biopsy. 64.7% was under 40 years of age. The main clinical manifestations were cough, hemoptysis, fever and repeated pneumonitis. In one patient, the carcinoid was associated with Cushing's syndrome. Chest roentgenograms showed lesions centrally located in 12 cases, and peripherally located in 5 cases. Histological examination revealed 15 typical and 2 atypical carcinoid tumors. This disease was usually misdiagnosed as lung cancer, tuberculoma and benign tumors. Chest X-ray examination and fiberoptic bronchoscopic biopsy are helpful to the diagnosis of the disease. Pulmonary resection was performed in 16 cases. Two patients had hilar lymph node metastases, one of them had also involvement of pericardium. There was no operative mortality. In the follow-up study, the disease-free actuarial survival following pulmonary resection was 92.9% at 5 years. 2 patients died. One died of respiratory failure 4 months after pneumonectomy, the other died of pericardium involvement of carcinoid 8 months after operation. Resection is the only effective treatment for bronchial carcinoid.
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PMID:[Bronchial carcinoid. A clinical, roentgenological and pathological study of 17 cases]. 147 26

A 41-yr-old psychologically disturbed woman presented with attacks of paroxystic dyspnea, laborious expiration, cough, and expiratory wheezing. She had been treated for bronchial asthma and had developed an iatrogenic Cushing's syndrome. Wheezing had maximal intensity over the larynx, and fiberoptic bronchoscopy showed an almost closed glottis orifice during its production. Lung function tests were normal both before and during the attacks. Inhalation challenge tests with acetylcholine and histamine were negative. During the attacks the patient breathed near residual volume, and tidal flows reached the maximal flow-volume envelope. We suggest that wheezing was produced by high flows passing through a narrow glottis orifice. The association of expiratory wheezing of laryngeal origin with normal overall lung function should be kept in mind, because it can be easily confounded with bronchial asthma, and result in therapeutic errors.
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PMID:Emotional laryngeal wheezing: a new syndrome. 683 58

Bronchial carcinoid tumors are usually indolent, slow-growing tumors with an excellent prognosis. However, even typical carcinoids can metastasize to regional lymph nodes or to distant sites. Atypical carcinoids tend to behave more invasively with more frequent nodal and distant metastases. Despite this, long-term survival can be expected as many tumors grow and spread slowly. At the end of the spectrum are the highly aggressive small cell carcinomas which have a very poor prognosis despite aggressive chemotherapy. Clinically, carcinoid tumors are frequently asymptomatic. Symptoms are most frequently due to obstruction (pneumonia, 'asthma', coughing) or bleeding. Carcinoid syndrome is seen infrequently and usually signifies metastatic disease. Cushing's syndrome is occasionally seen in association with these tumors. The treatment of carcinoid tumors is surgical. Resection should be complete and encompass the regional lymph nodes.
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PMID:Bronchial and thymic carcinoid tumors: a review. 769 41

Bronchial carcinoid tumors (BCT) are the most frequent primary pulmonary neoplasms of childhood. Seventeen of 208 patients diagnosed as having BCT at the Massachusetts General Hospital were between 10 and 21 years of age. We reviewed our records of the 17 patients and 8 other pediatric cases and compared their findings with those of seven large series of adults. Distribution was equal between the sexes. The average age at diagnosis was 17 years; 4 patients were < or = 15 years old. The duration of symptoms prior to diagnosis varied from 2 weeks to 2.6 years, with a median duration of 8.5 months. In contrast to adults, no child was asymptomatic. The majority of children presented with wheezing and atelectasis in addition to the characteristic adult triad of cough, hemoptysis, and pneumonitis. Five patients presented with weight loss and one patient presented with hoarseness. One of the 17 pediatric patients presented with Cushing's syndrome and a functional BCT. Twelve of 14 patients were disease free for 9 months to 34 years after surgical resection. We conclude that BCT should be suspected in children with pneumonitis resistant to therapy, atelectasis, wheezing, and hemoptysis. Surgical resection will result in symptom-free recovery in the majority of cases in spite of low-grade malignancy.
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PMID:Bronchial carcinoid tumors in pediatric patients. 838 19

Nineteen cases of thymic carcinoma treated in our hospital (mean age 60.0 years, seven males and twelve females) were studied clinically. Thirteen cases (68.4%) had subjective symptom; for example, chest pain, face edema or cough. Two cases (10.5%) had the associated diseases; one had gammaglobulinemia, the other one had Cushing syndrome and hypogammaglobulinemia. The histological subtypes were eleven squamous cell carcinomas (SCC) (57.9%), three undifferentiated carcinomas, two small cell carcinomas, one papillary adenocarcinoma and one lymphoepithelioma-like carcinoma. The 5 year survival rate of all cases was 42.7%. The 10 years survival rate was 21.4%. The median survival time was 56.1 months. There were one Stage I case, nine stage III cases, four stage IVa cases and five stage IVb cases. More than stage III cases were eighteen (94.7%). Five cases of stage IVb were T2N1M0, T3N1M0, T3N0M1 and T4N0M1. The 5 year survival rate of SCC was 65.6%, and that of the other subtypes was 14.3%. The cases resected completely were only eight cases (42.1%), and the 5 year survival rate of these was 70.0%. On the other hand, the rate of five cases resected incompletely was 53.3%. Metastasis occurred in 12 cases (63.2%). Metastasis occurred frequently in pleura, lymphnode, lung, bone and liver. The radiotherapy for SCC was effective and the 5 year survival rate was 83.3%. Furthermore, there were some long survivors in the cases undergone incomplete resections by postoperative radiotherapy jointly. On the other hand, the chemotherapy was not effective in our series. However, it was reported recently that the regimen including cisplatin was effective. So it was impressed that the combined therapy including surgery radiotherapy and induction chemotherapy would be important to obtain better results.
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PMID:[Clinical study of nineteen thymic carcinomas]. 871 65

Pulmonary carcinoid tumors are neuroendocrine malignant tumors that make up 1% to 2% of all lung tumors. According to histopathologic criteria, carcinoids can be divided into typical (TC) and atypical (AC) carcinoids. Carcinoids can be placed in a spectrum of neuroendocrine tumors, ranging from low-grade malignant TC to intermediate AC to high-grade large-cell neuroendocrine carcinoma and small-cell lung carcinoma. Familial pulmonary carcinoids are rare. The most common symptoms are hemoptysis, cough, recurrent pulmonary infection, fever, chest discomfort and chest pain, unilateral wheezing, and shortness of breath. Paraneoplastic syndromes are rare and include carcinoid syndrome, Cushing's syndrome, and ectopic growth hormone-releasing hormone secretion. The diagnosis is usually established by flexible bronchoscopy and biopsy, although occasionally this can result in severe hemorrhage. Immunoscintigraphy by somatostatin analogs can also be useful in diagnosis. The treatment of choice is surgical resection, and prognosis is relatively good in TC, although it is worse in AC. The role of radiotherapy and chemotherapy as part of multimodality treatment or palliation is still debated.
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PMID:Update in pulmonary carcinoid tumors: a review article. 1283 56

A case of pulmonary tumorlets with ectopic adrenocorticotropin (ACTH) production and lymph node metastasis in a bronchiectatic patient is reported. A 65-year-old man underwent right lower lobe lobectomy because of a sudden attack of cough and hemoptysis. Histological study revealed multiple discrete uniform small nests of tumor cells surrounding dilated bronchioles. Tumor nests were also found in the hilar lymph node. Immunohistochemically, the proliferating cells were confirmed to be neuroendocrine in origin with ectopic ACTH production, despite being clinically silent. The findings in the present case suggest that the clinical behavior of pulmonary tumorlets may be like a carcinoid, and need to be treated as tumor-like lesions. Ectopic hormonal production in the present case suggests pulmonary tumorlets should be considered in the differential diagnosis of Cushing's syndrome.
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PMID:Adrenocorticotropin-producing pulmonary tumorlets with lymph node metastasis. 1462 55

The authors present a case of a 26-year-old man, under investigation for Cushing syndrome, who presented acutely with a dry cough and fever. The blood tests were unremarkable apart from a moderate to severe leukopenia. Imaging tests were suggestive of an atypical pneumonia, which was proven to be Pneumocystis carinii pneumonia (PCP) on cytology examination of a bronchoalveolar lavage (BAL). The acute lung changes were demonstrated on a whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) study. After treatment, a follow-up study showed complete resolution of these changes. The authors suggest that FDG PET may have a role to play in the diagnosis and, in particular, the monitoring of PCP in immunocompromised patients.
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PMID:FDG-PET imaging in Pneumocystis carinii pneumonia. 1616 46

We report a case of an adolescent girl treated with high-dose oral steroids for prolonged coughing thought to be secondary to unstable asthma. Iatrogenic adrenal suppression led to clinical appearance of Cushing syndrome and associated bilateral early post-capsular cataracts, slowing of growth velocity and osteopenia. After weaning off steroids, there was a spontaneous increase in aeral lumbar bone mineral density and also catch-up growth evident over a 5-year period.
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PMID:Spontaneous recovery of steroid-induced osteopenia. 1648 94

When a 45-year-old man visited his local hospital with a complaint of chest discomfort and coughing, an abnormal chest X-ray shadow was found. On referral to our department, pigmentation was mainly observed on his face, however, no striae cutis distensae or facial swelling was observed. After a systemic examination, Stage IV small cell lung cancer with Cushing's syndrome was diagnosed. Marked increases in ACTH levels were observed, but no abnormality was found in the pituitary MRI findings, and therefore ACTH-producing small cell lung cancer was suspected. Chemotherapy was administered in addition to appropriate treatment for Cushing's syndrome. The tumor temporarily began to decrease in size, but hypercortisolemia remained, and thus adrenal hormone synthesis-inhibiting therapy was concurrently administered. Subsequently, cortisole began to decrease, but it could not be sufficiently controlled, resulting in occasional colonization by bacteria. Hypercortisolemia is believed to induce the suppression of the immune system, thereby affecting the outcome and QOL more than the immediate symptoms of cancer. Therefore, from an early stage, it is believed that adrenal cortical hormone synthesis-inhibiting therapy should be performed concurrently with chemotherapy, if hypercortisolemia cannot be controlled by radiation and chemotherapy alone.
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PMID:[A case of small cell lung cancer complicated by Cushing syndrome]. 1840 68


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