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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six of 106 older men with hemoptysis and a nonsuspicious chest roentgenogram who underwent fiberoptic bronchoscopy were found to have cancer. Four of the five bronchogenic carcinomas appeared to be surgically resectable. Cancer patients were significantly older, had smoked within the last five years, and had a significantly higher frequency of central abnormalities on chest roentgenogram. Six additional bronchogenic carcinomas were diagnosed at follow-up. Two of these were probably present but not detected at the time of bronchoscopy. We conclude that (1) hemoptysis with a nonsuspicious chest roentgenogram carries an appreciable risk of cancer in older men with substantial smoking histories, (2) these cancers are often resectable, (3) a chest roentgenogram in which the central lung fields are obscured in any way should not be considered negative in patients with hemoptysis, and (4) a negative bronchoscopic examination does not exclude the possibility of cancer in these patients.
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PMID:Bronchoscopy to evaluate hemoptysis in older men with nonsuspicious chest roentgenograms. 234 44

Between 1940 and 1985, 24 cases of primary carcinoma of the trachea were registered at the London Regional Cancer Centre. The most common presenting symptoms were hoarseness, haemoptysis and cough. Twenty patients had epidermoid carcinoma and four had adenoid cystic carcinoma. Because of different clinical behaviours, the two histologies were separately analyzed. Of the 20 patients with epidermoid carcinoma, 19 received radiotherapy as primary treatment and one patient did not receive radiotherapy because of advanced disease. Radiation doses ranged from 4000 to 6000 cGy and most patients had megavoltage irradiation. Treatment result was disappointing. Only one patient remained disease-free at 15-month follow-up and all other patients had persistent or recurrent tracheal tumour. Median survival for all 20 patients was 5 months (range 1 to 19 months). Of the four patients with adenoid cystic carcinoma, two had primary surgery and postoperative radiotherapy and two had primary radiotherapy. Two patients died of disease, at 5 months and 8 years from diagnosis. Two surviving patients had 15-month follow-up: one had persistent disease and the other was free from recurrence. In this study, radiotherapy within the range of doses given was found to be an ineffective primary treatment for tracheal carcinoma.
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PMID:Radiotherapy for primary carcinoma of the trachea. 254 38

Laser technology and the endoscope have been combined for the palliation of obstructive tracheobronchial malignant lesions. The neodymium-yttrium-aluminum-garnet (Nd-YAG) laser was used to treat 249 patients (447 operations), and the CO2 laser was used on 34 patients (59 operations). Hemorrhage, the major complication in both groups of patients, was more easily controlled with the Nd-YAG laser. One patient in the CO2 laser group died, and one patient in the group being treated with Nd-YAG laser bronchoscopy died. The Nd-YAG laser can be applied more efficiently through a fiber system, with better optic control and secure hemostasis. The commonest indications for treatment were dyspnea, obstructive pneumonia, and hemoptysis. Extrinsic compression was the most frequent reason for failure. The Nd-YAG laser, most often applied through open rigid bronchoscopes under general anesthesia, has become our treatment of choice for the palliation of tracheobronchial malignancy.
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PMID:Endoscopic treatment of tracheobronchial malignancy. Experience with Nd-YAG and CO2 lasers in 506 operations. 258 Dec 12

We reviewed the charts of 478 patients who had fiberoptic bronchoscopy (FOB) performed for evaluating hemoptysis with a normal chest roentgenogram. FOB provided a definite diagnosis of endobronchial lesion in only 10 patients (2.1%): bronchogenic carcinoma in 2 patients, bronchial adenoma in 1 patient, tracheal cancer in 1 patient, foreign body in 3 patients and endobronchial tuberculosis in 3 patients. FOB neither visualized tumor mass nor localized the bleeding site in 300 (95.8%) of 313 patients with mild hemoptysis. However, the bleeding site could be localized by FOB in 56% of the patients (n = 165) if the bleeding amount exceeded 60 ml/day. In conclusion, in patients with hemoptysis and normal chest roentgenograms, routine FOB may not rule out airway malignancy. In contrast, it is a good diagnostic tool for localizing the bleeding site if patients present with moderate amount of hemoptysis.
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PMID:The role of fiberoptic bronchoscopy in patients with hemoptysis and a normal chest roentgenogram. 262 Feb 83

The authors analysed 116 hospitalized patients who, in their routine cytologic examination of the sputum, had also a cytomorphologic finding of lymphocytes. The greatest majority of these patients, 63 of them or 54.3% suffered from malignant neoplasm. Out of these 63 patients, 53 of them or 45.7% suffered from primary bronchial carcinoma, whereas 10 patients or 8.6% had non-Hodgkin's lymphoma, metastatic lung cancer of extrathoracic primary localization, Hodgkin's lymphoma, while two patients were supposed to have lung neoplasm. Our study also revealed that 14 patients (out of 116 hospitalized patients) or 12.0% suffered from broncho-pleuropneumonia, 13 or 11.2% from an active pulmonary tuberculosis, 7 or 6.0% from a chronic obstructive bronchitis, 5.1% from sarcoidosis, 3.4% from post tuberculosis pulmonary changes while 2.5% of the patients were found to have a pleural empyema. One case of bronchial asthma, tuberculous pleurisy, bronchiectasis, hamartoma, hemoptysis and a pulmonary infarction were found as well. Due to their own experience the authors conclude that the lymphocytes in the sputum were found to be the most frequent in patients suffering from primary bronchial carcinoma, broncho-pleuropneumonia and pulmonary tuberculosis but that they could also be found in many others pathologic changes of pulmonary parenchyma.
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PMID:[Lymphocytes in sputum]. 263 95

An analysis of 1,454 percutaneous thin needle biopsies (PTNB) performed in 1,061 patients in the years 1976-1987 disclosed the sensitivity for the detection of malignancy 93.7%, specificity 95.8%, and accuracy 93.9%. The most commonly encountered indication for PTNB was a solitary lung lesion (56% of 1,061 patients), with a rate of true positive cytologic findings 93.4% of patients with proved malignant tumours. Indications for PTNB included pulmonary opacities of or without recognizable segmental distribution, enlargement of mediastinum or hilus, lesions of the pleura or chest wall, and cavitary lesions, with results not significantly worse than in circumscribed peripheral lesions. Pneumothorax occurred in 18%, hemoptysis in 1.9%, other minor complications very rarely. PTNB appears to be a safe, reliable, and accurate technique for diagnosing chest lesions with various types of roentgenographic image.
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PMID:Percutaneous thin needle biopsy of malignant and nonmalignant thoracic lesions. 266 40

To evaluate the diagnostic merit of fiberoptic bronchoscopy in pleural effusions, we performed fiberoptic bronchoscopy in addition to thoracocentesis and closed pleural biopsy in 140 patients who were admitted for diagnostic investigation of the causes of pleural effusions. The patients were divided into subgroups based on clinical features and roentgenographic findings of chest x-ray films. In 39 patients, the pleural effusions were due to various nonneoplastic disorders and in 95 patients it was caused by malignancy. In six patients, the causes of the pleural effusions remained undetermined. A final diagnosis was made by pleural examination in 68 patients, by fiberoptic bronchoscopy in 58 patients, and by either one or both in 100 patients. In 82 patients who had no hemoptysis, a final diagnosis was made by pleural examination in 57 cases and by fiberoptic bronchoscopy in 11 cases only. The diagnostic yield of fiberoptic bronchoscopy (47/58) was superior to that of pleural examination (11/58) in 58 patients presenting with hemoptysis. In 74 patients who had pleural effusions as the sole roentgenographic abnormality, the final entity was established by pleural examination in 45 and by fiberoptic bronchoscopy in 12. The diagnostic merit of fiberoptic bronchoscopy was significantly higher in 59 patients who had concurrent pulmonary abnormalities on their chest roentgenograms. A final diagnosis was made in 43 cases by fiberoptic bronchoscopy in comparison with 21 cases by pleural examination. For patients with unknown pleural effusions, fiberoptic bronchoscopy was more likely to yield a diagnosis than thoracocentesis with closed pleural biopsy in those who had hemoptysis or pulmonary abnormality on chest x-ray films, whereas the reverse applied when these features were absent.
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PMID:The role of fiberoptic bronchoscopy in evaluating the causes of pleural effusions. 270 35

Twenty-six cases of excavated pulmonary masses are reported. In 18 cases malignancy was proven by transparietal needle aspiration. A false-negative result was due to the needle being introduced too centrally and bringing pus, whereas the tumour was an epidermoid carcinoma. The seven non-malignant lesions consisted of abscess in 4 cases, tuberculosis in 1 case and pulmonary embolism in 2 cases. The sensitivity and specificity of the technique were similar to those observed in large series of transparietal needle aspiration of solid masses. Using thin needles and extemporaneous cytology reduced the number of complications: haemothorax 6 percent, haemoptysis 0.4 percent. The authors conclude that in excavated pulmonary masses transparietal needle aspiration provides a diagnosis of malignancy when the radiological and clinical courses and bronchial fibroscopy are inconclusive. Transparietal needle aspiration avoids the need for other investigations, such as exploratory thoracotomy, thereby reducing the cost of diagnosis.
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PMID:[Transthoracic puncture and excavated pulmonary lesion. Diagnostic contribution and value of the extemporaneous cytologic test]. 271 26

From 1959 to 1986, 24 patients with primary malignant tumors of the trachea received radiotherapy as all or part of treatment. Common presentations included respiratory symptoms in 20 patients and hemoptysis in 15. Thirteen patients had squamous carcinomas with undifferentiated and adenoid cystic cancers in five and four patients, respectively. Overall actuarial survival was 45% at 1 year, 25% at 5 years, and 13% at 10 years. Survival was significantly correlated to histologic type (adenoid cystic versus squamous, P less than 0.03), but not to tumor extent or to patient age or sex. Local control was attained in 10 of 24 patients overall and was more frequent for patients with tumors localized to the trachea and for patients who were treated with combined surgery and radiotherapy. For the 18 patients treated with radiotherapy alone, complete response (CR) was seen to be significantly (P less than 0.001) related to dose: six of seven (86%) patients receiving greater than or equal to 6000 cGy attained CR versus one of 11 (9%) receiving less than 6000 cGy. Three patients developed complications related to radiotherapy. Radiotherapy can provide durable local control of localized tracheal tumors and should be considered for medically inoperable patients with localized tumors and for patients with high risk of recurrence after resection.
Cancer 1989 Jun 15
PMID:Primary tumors of the trachea. Results of radiation therapy. 272 May 90

Pulmonary fungal infections complicating hematological malignancies are difficult to diagnose antemortem because clinical findings are actually considered to be not specific. From December 1984 to June 1986 we documented the clinical findings in sixteen patients, 9 with ANLL, 6 with ALL and 1 with CML + BC; all patients were diagnosed as pulmonary fungal infection and treated for this complication. Pulmonary infiltrates occurred after severe aplasia (range 5-90 days) or during bone marrow relapse. We studied pulmonary signs and symptoms (pleuritic pain, cough, hemoptysis, shortness of breath, rales, rub, bronchial murmur) both at the beginning and during the management of this infectious complication and we related them to chest x-ray findings, the duration of granulocytopenia, and fever. Our purpose was to identify clinical characteristics for these episodes and establish roentgenological criteria for prognosis. These findings should improve the possibilities for an early diagnosis and prompt treatment.
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PMID:[Pulmonary mycosis as a complication of acute leukemia in the adult. Diagnostic study]. 274 May 98


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