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

We reviewed the charts of 48 consecutive patients who had fiberoptic bronchoscopy performed in the evaluation of hemoptysis with a normal chest roentgenogram. Fiberoptic bronchoscopy provided a diagnosis other than endobronchial inflammation in only four patients--benign fibromuscular polyp in one patient, Mycobacterium tuberculosis in 1 patient, and carcinoma in two others. A literature review revealed an overall 3 percent incidence of bronchogenic carcinoma in patients with hemoptysis and normal findings on chest roentgenogram. Other than abnormal findings on chest roentgenogram, risk factors for carcinoma in patients with hemoptysis include: (1) age greater than 40; (2) significant smoking history; and (3) duration of hemoptysis for longer than one week. We concluded that in patients with hemoptysis and normal chest x-ray film findings, routine fiberoptic bronchoscopy may not always be indicated to rule out malignancy.
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PMID:Role of fiberoptic bronchoscopy in patients with hemoptysis and a normal chest roentgenogram. 396 21

Scalene node biopsy (SNB) has been performed in patients with lung cancer at the Saint Francis Hospital and Medical Center if any of the following criteria has been present: (1) potentially resectable central lesion by chest radiograph, or (2) significant cardiac or pulmonary dysfunction, thereby placing the patient at increased risk for thoracotomy, or (3) a diagnosis of adenocarcinoma prior to SNB. Within these guidelines, a retrospective study was undertaken to determine the benefit of routine SNB in the absence of clinically palpable scalene nodes. In a 2-year period beginning April 1981, 56 patients (37 males) presented with radiographic evidence of lung carcinoma without clinical evidence of scalene adenopathy. Approximately half of the lesions were of a central position. While the majority had symptoms of cough, hemoptysis, or chest pain, the primary lung lesion was identified on routine chest radiograph in 15 (27%). In only three was there no history of smoking, the remainder having at least a 20-pack-year history of cigarette use. Following a routine evaluation, 57 SNBs were performed alone or in concert with other surgical procedures (mediastinoscopy, bronchoscopy). Of these, only two (3.5%) were diagnostic and indicative of unresectable disease. While in one patient no additional procedure was performed, a simultaneous Chamberlain procedure in the other confirmed that the patient was unresectable for cure. In the remaining patients, tissue diagnosis of cancer was obtained through other maneuvers. Because of the low probability that SNB in the absence of clinically palpable nodes altered the management of lung cancer, we do not believe it to be of benefit in the diagnosis or staging of this disease.
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PMID:Effectiveness of scalene node biopsy for staging of lung cancer in the absence of palpable adenopathy. 399 Mar 11

Bronchoscopic examination to diagnose lung metastases has not been as rewarding as in primary lung cancer. Despite a lower expected yield, we believe the procedure has value in certain patients, ie, those with clinical findings of endobronchial disease. To determine better the value of bronchoscopy in this population, we retrospectively reviewed records of patients at five community teaching hospitals over a 66-month period. These patients all underwent fiberoptic bronchoscopy. They had a history of prior nonpulmonary malignancy and an abnormal chest roentgenogram suspicious for recurrent malignant disease, or they presented with abnormal chest roentgenographic findings and further evaluation showed the lung disease to be metastatic. Bronchoscopy for metastatic lung disease was most likely diagnostic in patients with primary colorectal cancer (79 percent) and breast cancer (57 percent), and least likely in patients with genitourinary tract cancer (33 percent). Hemoptysis, signs of local airway obstruction, or a roentgenogram showing either atelectasis or diffuse lung disease especially favored a positive biopsy. Bronchoscopy is a valuable diagnostic procedure in selected patients with metastatic lung disease.
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PMID:Sensitivity, specificity, and predictive values of bronchoscopy in neoplasm metastatic to lung. 400 60

The authors report the results of a retrospective study of 427 fiberoptic bronchoscopies in patients with haemoptysis. The patients were classified into 4 groups according to the results: Group I: a specific diagnosis was made (cancer, tuberculosis, infection); 151 cases (35 p. 100); Group II: inflammatory mucosa, 172 cases (40 p. 100); Group III: normal bronchoscopy, 84 cases (20 p. 100); Group IV, only blood, 20 cases (5 p. 100). Of the 151 patients in Group I, 12 had a normal chest X-ray (8 p. 100); seven of them had bronchopulmonary carcinoma (7 out of 65 cases of cancer: 10.7 p. 100). These results show that bronchoscopy is essential in cases of haemoptysis even when the chest X-ray is normal.
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PMID:[Is bronchial fiberscopy always indicated in hemoptysis? Apropos of 427 tests]. 409 57

Two years after para-aortic node radiotherapy following removal of a non seminomatous germ cell tumour (NSGCT) of the left testis, M.R., a 32 year old caucasian male developed haemoptysis and a hoarse voice. Chest x-ray revealed a left hilar mass and serum alphafoetoprotein (AFP) and beta-human chorionic gonadotrophin (beta HCG) levels were elevated. In spite of VB3 [1] therapy plus cis-platinum and mediastinal radiotherapy his voice remained hoarse, although serum markers returned to normal, and the hilar mass was reduced in size. Four months after stopping therapy serum AFP levels began to rise, although no clinical evidence of recurrence could be discovered in abdomen, brain or chest. Chemotherapy was restarted using VP16-213 + bleomycin + cis platinum [2]. After the first course of therapy the serum AFP level fell to normal and his hoarse voice disappeared. The patient received five courses of the above regimen, following which complete remission has been maintained for 7 months to date. This case suggest that VP16-213 combined with bleomycin + cis-platinum has great activity against NSGCT of the testis and may have a different spectrum of activity from vinblastine, bleomycin, and cis-platinum, making it a valuable addition to the drugs available for the management of these tumours. In this patient it would seem the complete eradication of the metastatic mass allowed complete and immediate recovery of function of the trapped nerve in spite of it having been paralysed for 15 months.
Cancer Chemother Pharmacol 1982
PMID:Reversal of recurrent laryngeal nerve palsy following VP16-213 combination therapy in a patient with metastatic teratoma of the testis. 617 38

Tracheal or endobronchial metastases from distant primary malignancies are rare. Hemoptysis, dyspnea and cough are common nonspecific presenting symptoms. Renal, breast, thyroid and colon cancers are the most common malignancies associated with tracheobronchial metastases. Since 1979, five patients with tracheobronchial metastases from distant sites have been treated by the otolaryngology service at the Boston University Medical Center. Patients with advanced tumors previously treated by conventional modalities were referred for palliation of airway obstruction. Satisfactory palliation without significant morbidity was achieved in four out of five patients utilizing a CO2 surgical laser through a rigid bronchoscope system. Four patients died from advanced cancer, 1 to 18 months after laser surgery. Although tracheobronchial metastasis from extrathoracic malignancy is associated with a poor prognosis, palliation of airway obstruction can be achieved in most patients with endobronchial or tracheal tumor.
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PMID:Tracheobronchial obstruction from metastatic distant malignancies. 618 6

We administered 45 Nd-YAG laser treatments in 29 patients (18 men) aged 39 to 82 years who had lung malignancy; 26 patients had primary non-oat cell lung cancer and three had metastatic airway malignancy. In all, 25 of the patients had been previously treated with combination(s) of surgical procedure, radiation therapy and chemotherapy. Indications for laser treatment included endobronchial airway obstruction with uncontrolled cough, hemoptysis, dyspnea or unresolved atelectasis-pneumonia. Of 15 patients with partially occluded tracheobronchial airway tumors, immediate palliative relief was achieved in 13 patients and lasted one to six months after a single treatment. In this group there was one postoperative death related to respiratory failure and two patients subsequently died of massive pulmonary hemorrhage. However, of 14 patients with totally obstructed airways, immediate palliative relief was achieved in only five patients and this lasted three weeks to three months after a single treatment. In this group there were two postoperative deaths related to progressive respiratory failure; in one case it was associated with endobronchial combustion of the fiberoptic bronchoscope. All three patients in both groups who died of respiratory failure were in acute respiratory distress and terminally ill before the procedure. These findings suggest that Nd-YAG laser therapy may be most beneficial in patients with partially rather than totally occluded airways due to lung malignancy.
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PMID:Nd-YAG laser in lung cancer. 620 Oct 11

We performed treatments with a Nd-YAG laser in 27 patients (19 men) with a mean age (+/- 1 SD) of 63 +/- 15 years for incomplete obstruction of the tracheobronchial tree due to non-oat cell malignant neoplasm associated with cough, dyspnea, hemoptysis, or unresolved atelectasis or pneumonia. Sixteen patients had been previously treated with surgery, chemotherapy, or irradiation. Before surgery,, their mean values were as follows: Karnofsky score, 41 +/- 15 percent; British Medical Research Council dyspnea index, 3.7 +/- 0.6; forced vital capacity (FVC), 64 +/- 23 percent of predicted; and mean forced expiratory volume in one second (FEV1), 52 +/- 19 percent of predicted. Immediate palliative relief was achieved in 23 patients and lasted one-half to six months after a single treatment. After surgery, the mean values were as follows: FVC, 77 +/- 26 percent of predicted; FEV1, 74 +/- 27 percent of predicted; Karnofsky score, 57 +/- 18 percent (p less than 0.05); and dyspnea index, 2.8 +/- 0.7 (p less than 0.05). Complications included one death, and two patients subsequently died of massive pulmonary hemorrhage within seven days of treatment. Rigid bronchoscopy was required in seven patients. We also performed laser treatments in 19 patients (eight men) with a mean age of 64 +/- 10 years who had complete bronchial obstruction due to non-oat cell malignant neoplasm; all but one had received previous non-laser treatment. Before surgery the mean values were as follows: Karnofsky score, 30 +/- 10 percent; dyspnea index, 3.7 +/- 0.5; FVC, 46 +/- 14 percent of predicted; and FEV1, 44 +/- 13 percent of predicted. Immediate relief was achieved in six cases and lasted 0.25 to 1.5 months after a single treatment. After surgery the mean values were as follows: FVC, 59 +/- 8 percent of predicted (p less than 0.05); FEV1, 48 +/- 13 percent of predicted; Karnofsky score, 34 +/- 16 percent; and dyspnea index, 3.4 +/- 0.5. Complications included two deaths, one associated with combustion of the outer sheath of the fiberoptic bronchoscope. Rigid bronchoscopy was required in five patients. Results suggest that laser therapy is most beneficial in patients with partial and not totally occluded airways (X2, p less than 0.05).
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PMID:Laser in treatment of lung cancer. 229 86

From 1963-1974, 141 patients with lung cancer were treated with curative intent in the A. Maxwell Evans Clinic in Vancouver. The clinical presentation, age and sex distribution, histology, and reasons for surgery not being carried out are examined. The results of this treatment are presented. An attempt has been made to isolate a group of patients who have a better prognosis so that treatment selection can be improved. Hemoptysis, cough, dyspnea, and incidental finding on routine chest x-ray were the most common manner of presentation. Thirty-four percent of the patients were over 70 years of age and 13% were women. The crude overall three- and five-year survival rates were 18 and 10% (19 and 9% in the men, 17 and 14% in the women). Patients presenting with dyspnea had a better survival than those presenting with cough and hemoptysis. Patients with lesions less than 3 cm in diameter had a 28% three-year survival, compared with 14% for lesions greater than 5 cm in diameter. The three- and five-year survival rates in patients over 70 years of age were 23 and 17% respectively. The response to treatment and the survival was better in the patients with squamous cell carcinoma. Twenty-two percent were alive at three years and 12% at five years as compared with 9 and 5% for other histologies. Fifty-four percent of the 35 patients with a complete response and with squamous cell carcinoma were alive at three years, compared with only 8% of the 12 patients with other histologies who showed a complete response.
Cancer 1980 Feb 15
PMID:The role of curative radiotherapy in the treatment of lung cancer. 624 73

During a retrospective analysis of 877 cases of lung cancer, we explored the relationships between cell type, site, cavitation, varying degrees of hemoptysis, and radiation therapy. Massive terminal hemoptysis (29 cases) was found to be significantly associated with cavitated (P less than 0.0001 squamous cell carcinoma (P = 0.0002), ARISING IN EITHER THE RIGHT OR LEFT MAIN BRONCHI (P less than 0.0001). Lesser, nonlethal degrees of hemoptysis (140 cases) were not cell-type associated, occurring in approximately 15% of cases of all major tumor types. Radiotherapy, although employed more frequently in the massive-hemoptysis population, did not appear to be causally related to hemoptysis of any degree. An interesting case, which provoked the above study, is described: a patient with bronchogenic squamous cell carcinoma and terminal hemoptysis due to a tumor fistula between the primary lesion and the left atrial chamber. The forms of cardiac involvement in lung cancer are discussed.
Cancer 1980 Jul 01
PMID:Hemorrhage from carcinoma of the lung. 624 89


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