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

We report on a primary mediastinal large B-cell lymphoma with aberrant expression of beta-human chorionic gonadotropin (beta-hCG). The patient, a 33-year-old man, had cough, dyspnea, fever, superior vena cava syndrome, and a mediastinal bulky tumor. A biopsy showed that the latter was characterized by large cells, sclerosis, and compartmentalization. The neoplastic elements expressed CD45, CD20, CD79a and, partially, CD30, whereas they were negative for CD3, epithelial membrane antigen and cytokeratins. Surprisingly, they displayed a clear-cut positivity for beta-hCG. The remaining oncofetal markers applied (PLAP and alpha1-fetoprotein) were negative. Electron microscopy demonstrated the presence of numerous nuclear pockets and the lack of intercellular junctions. DNA analysis by polymerase chain reaction showed clonal rearrangement of Ig heavy-chain genes. The patient responded promptly to the administration of MACOP-B. To the best of our knowledge, this is the first example of B-cell lymphoma showing positivity for beta-hCG; a similar aberrant expression was previously observed only in three Japanese patients with human T-cell lymphotropic virus type I+ adult T-cell lymphoma/leukemia. Because primary mediastinal large B-cell lymphoma has in the past been frequently confused with germ cell tumors, pathologists should be aware of possible beta-hCG expression by lymphomatous cells to avoid the risk of misdiagnosis.
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PMID:Beta-HCG aberrant expression in primary mediastinal large B-cell lymphoma. 1036 55

We evaluated the relationship of clinical characteristics and survival in 1,635 patients with non-small cell lung cancer (NSCLC) treated in Brazil. The following variables were included: sex, age, smoking, Karnofsky's performance status (PS), weight loss, symptoms at diagnosis (cough, dyspnea, hemoptysis, chest pain, wheezing, and hoarseness), presence of superior vena cava syndrome (SVCS), histologic type, TNM stage, and therapeutic modality (surgery, chemotherapy [CT] and radiotherapy [RT]). Multivariate prognostic models were obtained by Cox regression. Patients unsuitable for surgery or who had recidivant disease were elected to further RT and/or CT, and long-term results in this group were equivalent to those in the group treated only by surgery. A diagnosis of bronchioloalveolar carcinoma, small tumors, absence of hoarseness, treatment by surgery, and RT were independent factors related to good overall survival in stage I and II. Weight loss and clinical signs of SVCS were related to poor prognosis in stage III. PS, diagnosis of adenocarcinoma or undifferentiated carcinoma, absence of weight loss and dyspnea, NO or N1 disease, ability to receive RT, CT, and to perform some palliative surgical procedure were good prognostic factors in stage IV. Clinical features of patients with NSCLC at diagnosis offer additional information to estimate their prognosis.
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PMID:Clinical factors and prognosis in non-small cell lung cancer. 1052 Oct 57

Superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary artery bypasses are performed every year, there are not many reports on patients with superior vena cava syndrome who successfully undergo cardiopulmonary bypass and coronary artery grafting with an internal mammary artery as the conduit. The results of the case and alternative recommended methods are discussed.
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PMID:Coronary artery bypass and superior vena cava syndrome. 1065 58

Lipoblastoma is a benign adipose tumor in children that has been described in various anatomic locations, most commonly the extremities. We describe the case of a 17-month-old boy diagnosed with cardiac lipoblastoma, a previously unreported primary cardiac tumor in children. Our patient presented with symptoms of coughing, wheezing, and hoarseness and was found to have a large mediastinal mass, which narrowed the left mainstem bronchus and compressed the right atrium and superior vena cava, causing superior vena cava syndrome. Surgical exploration revealed an intrapericardial soft tissue mass arising from the area of the posterior interatrial septum. Grossly, the resected mass was lobulated, pale yellow, and fatty with focal areas of gray myxoid tissue. Microscopically, the tumor consisted of both immature and mature adipocytes, with focal vascular myxoid areas containing lipoblasts, diagnostic of lipoblastoma. Two months after surgery, the patient was in good health without evidence of recurrence.
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PMID:Primary cardiac lipoblastoma. 1137 Feb 65

Mediastinal masses in children are a heterogeneous group of asymptomatic or potentially life-threatening congenital, infectious, or neoplastic lesions that present complex diagnostic and therapeutic dilemmas. Some patients are asymptomatic; in others, the mass may compress mediastinal structures and cause sudden asphyxia. In these cases, close cooperation is needed among pediatric surgeons, anesthesiologists, intensivists, oncologists, and radiologists. The files of 45 children with mediastinal masses admitted between 1986 and 1999 to the Pediatric Intensive Care Unit (PICU) of Schneider Children's Medical Center of Israel were reviewed. Twenty-one were admitted for perioperative care, and 21 for emergency care, including 19 with respiratory distress. Five of the emergency care group had asphyxia and 10 needed assisted ventilation. Two children were admitted for evaluation and 1 for leukopheresis. The children admitted on an emergency basis had more clinical findings than the postoperative group: almost 80% had dyspnea and more than 45% had oxygen desaturation; 33% had cough and noisy breathing, and 25%, superior vena cava syndrome or hepatosplenomegaly. Eight patients (17.8%) had benign disease and 37 (82.2%) malignant disease. The patients with a benign mass were significantly younger than the patients with a malignant mass (p<0.005); in 5 cases (12.5%), a congenital anomaly presented as a mediastinal mass. Most of the malignant masses were of hematologic origin (40.5%), followed by neurogenic tumors (27%). Twenty-seven patients underwent surgery, including 6 emergency procedures (3 partial resections, 2 biopsies, 1 lymph node biopsy). There were no intraoperative or postoperative deaths. The present series emphasizes the complex care children with a mediastinal mass require. They should be treated in a tertiary center with a multidisciplinary approach.
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PMID:Mediastinal tumors in children: a single institution experience. 1204 17

Primary chest tumours in children are rare and appear in 3% of cases, 83% of which are malignant. Early diagnosis is very difficult because of delayed symptoms and highly advanced stage. Symptoms of chest tumours depend on the tumour mass, localization and time of progression. These tumours can cause cough, dyspnoea, Horner's syndrome and superior vena cava syndrome. The purpose of this study was to analyze the kind of chest tumours, clinical symptoms before diagnosis, their duration and results of treatment.
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PMID:Primary chest tumours in children. 1532 75

Between 1997 and 2002, 107 patients with symptoms of superior vena cava (SVC) obstruction presented at a university hospital in Northeast Thailand. Age averaged 50.7 years (range, 1 to 84). The male to female ratio was 5.7:1. Duration of symptoms before diagnosis was 29.4 days (range, 2 to 240), including facial swelling, cough, and chest discomfort. About 20% of cases developed respiratory failure and 11.2% died shortly after admission. The mean hospital stay was 23.7 days. Anteroposterior and lateral chest radiographs and computed chest tomography helped locate the lesion. Transbronchial biopsy through bronchoscopy, transthoracic needle biopsy under computed tomography, lymph node biopsy, pleural fluid cytology and/or biopsy were used for histopathologic sampling. High levels of alpha-fetoprotein and beta-HCG indicated an anterior mediastinal mass. The most common etiology of SVC obstruction was bronchogenic carcinoma (51.8%), followed by an anterior mediastinal mass (14.5%), lymphoma (13.6%--with an LDH of 262 to 1459 U/l), metastatic cancer (9.1%), and acute lymphoblastic leukemia (1.8%). Benign SVC thrombosis was found in four patients with Behcet's disease or some other idiopathy. Mediastinal fibrosis from melioidosis occurred in three patients, which is rare, has not been previouly reported. Most patients (63.6%) received a combination of radiotherapy and corticosteroid and this helped 55.2% improve.
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PMID:Etiology and outcome of superior vena cava (SVC) obstruction in adults. 1569 Nov 55

Mediastinal fibrosis can present with a multitude of symptoms, most commonly cough, dyspnea and hemoptysis. We describe a case of mediastinal fibrosis secondary to histoplasmosis, which presented with both superior vena cava syndrome (SVCS) and hemoptysis. Our patient was successfully treated with bronchial artery embolization followed by SVC stent placement during a brief hospital stay.
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PMID:Treatment of SVC syndrome and hemoptysis in a patient with mediastinal fibrosis. 1657 7

The symptoms that result from compression of the superior vena cava are known as superior vena cava syndrome. The syndrome was originally described as secondary to infection such as tuberculosis or syphilitic aortic aneurysm. Currently, the origin is generally cancer or thrombotic events. Adenocarcinoma of the lung is the most common cause. Thrombotic causes are increasing because of the rise in use of pacemakers and central venous catheters for access or treatment purposes. Symptoms may include a feeling of fullness in the head, dyspnea, and cough. Clinical findings may include facial and neck swelling; dilated venous channels over the trunk, upper extremities, and neck; facial flushing; cyanosis; respiratory stridor and distress; and neurologic signs. Primary symptoms are in the neck and head. Treatment of superior vena cava syndrome will depend on the cause of the compression. If thrombosis is found, thrombolysis and anticoagulation may be indicated. With carcinoma or infection, specific drugs or radiation may be used. In cases of compression, dilation and stenting of the superior vena cava may be performed. In some cases a bypass of the superior vena cava may be indicated.
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PMID:Superior vena cava syndrome. 1732 62

Advanced-stage malignancies are often characterized by systemic complications related to primary tumor progression. Pulmonary complications such as cough and dyspnea are relatively common and can dramatically reduce quality of life and lead to inpatient or intensive care unit admission. Although cancer-induced cough can be improved with radiation therapy or chemotherapy, or both, it is often best managed with central-acting opioids. Dyspnea can arise from a range of etiologies that may or may not be related to the underlying malignant pulmonary disease. Recent advances in the management of malignant pleural effusion, central airway obstruction, and superior vena cava syndrome have allowed relatively noninvasive interventions to be performed that can significantly reduce dyspnea, minimize inpatient hospitalization, and improve the quality of life in patients where the major focus is palliative care.
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PMID:Recent advances in the palliative management of respiratory symptoms in advanced-stage oncology patients. 1750 41


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