Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Continued uncertainty about the prognosis for patients with bronchial adenomata led to a review of the experience of this condition in the Brompton Hospital. Of 72 patients seen between January 1955 and December 1972, 39 were women and 33 men, mean age 45 years, range 9-73 years. The commonest presenting symptoms were haemoptysis, cough, sputum, and repeated chest infections. Positive bronchoscopic biopsy occurred in 35 of 43 cases; five of these were originally reported as carcinomata, of oat-cell type in four. Plain chest film abnormality occurred in 69 patients. Seventy-three operative procedures comprised two endoscopic removals, two wedge resections, six bronchotomies, five pneumonectomies, and 58 lobectomies (seven with sleeve resection). Recurrence in three of six bronchotomies--two with adenoid cystic carcinomata (cylindromata)--necessitated further surgery. Lobectomy and lymph node dissection is usually the operation of choice. Histology confirmed 67 carcinoids (eight with atypical histology or lymph node metastases), two adenoid cystic carcinomata, one muco-epidermoid, and two mucous gland adenomata. Prolonged follow-up is especially indicated in patients with adenoid cyst carcinoma and in those with atypical or metastatic carcinoid histology. Although such pathology is not incompatible with long survival, of 10 patients in these categories, all five late deaths were probably related to the tumour. However, of 57 patients considered to have had typical carcinoid histology and adequate removal of the tumour, there has to date been no tumour-related death, but one patient developed radiosensitive atypical carcinoid tracheal tumours nine years later. The actuarially assessed survival of 71 patients undergoing surgery for bronchial adenomata was 75% at 15 years. Specific tumour types should replace the term bronchial adenoma.
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PMID:Bronchial adenoma: review of 18-year experience at the Brompton Hospital. 18 62

Twenty-four patients with bronchial adenoma seen over a 20-year period are reviewed. Follow-up data was available in all patients. They included 19 with carcinoid, 2 with adenoid-cystic carcinoma, and 3 with muco-epidermoid carcinoma. Recurrent pulmonary infection, cough and hemoptysis were the most common clinical manifestations. Surgical resection was performed in all but one patient, who was treated by irradiation; bronchoplastic and conservative resectional procedures were used in 5 patients with carcinoid adenoma. Carcinoid tumors are considered to be very slowly-growing malignant neoplasms that sometimes give rise to metastases to regional lymph nodes. Such metastases were present in only one patient. All patients are alive and well. Adenoid-cystic carcinoma is a more aggressive tumor with a tendency to recur. Much of the difficulty in its treatment is due to its close proximity to the bifurcation of the trachea. One patient was operated upon three times for local recurrences and ultimately died from respiratory failure after the third operation. The other patient received radiation therapy with cobalt and is well, without recurrence, 3 years after the treatment. The 3 muco-epidermoid carcinomas were histologically similar to such tumors of salivary glands but behaved clinically like highly malignant tumors, no patients surviving 8 months after resection. The term bronchial adenoma is a misnomer. The neoplasms grouped under this heading should be called carcinoid adenoma, adenoid-cystic carcinoma, and muco-epidermoid carcinoma and considered as separate entities, since the ultimate course and prognosis is definitely different.
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PMID:[Bronchial adenoma]. 19 6

28-year-old sportsman developed chest pain, dyspnoea, haemoptysis and swelling of the right leg. 8 weeks later he also complained of blurred vision. Ophthalmoscopy revealed subretinal infiltrates diagnosed as tumour metastases by fluorescein angiography. The patient died 10 weeks after the first symptoms. At autopsy large mediastinal embryonal carcinoma was diagnosed, and both eyes revealed choroidal metastases. This rare tumour usually involves young men and is invariably fatal within a few months. Exceptional bilateral choroidal metastases constituted the presenting sign.
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PMID:Mediastinal embryonal carcinoma with bilateral choroidal metastases. Fluorescein angiographic and histopathologic study. 54 44

The cases of 3 patients with advanced metastatic choriocarcinoma and biochemical and clinical evidence of hyperthyroidism are reported. The thyroid-stimulating hormone (TSH) bioassay activity was increased in all 3 patients before chemotherapy. All patients had clinical signs and symptoms of overt thyrotoxicosis although goiter was present in only 1. Sinus tachycardia was present in all. The 1st symptom in all 3 cases was hemoptysis. An X-ray appearance of multiple pulmonary metastases was also present. There was biochemical evidence of improvement in thyrotoxicosis after chemotherapy. This improvement paralleled the fall in urinary human chorionic gonadotropin (HCG). As treatment, intermittent oral 5-day courses of methotrexate and iv actinomycin D were given at 3-week intervals. In 2 of the cases the ratio of bioassayable thyrotropic activity to HCG found in the serum was similar to the ratio in patients with hydatidiform moles. In the other case the ratio was much higher. It appears that the development of biochemical and clinical hyperthyroidism in patients with choriocarcinoma depends on the duration of the choriocarcinoma and the serum level of HCG. Findings suggest that there may be production of another TSH in addition to the thyrotropic activity of high HCG levels.
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PMID:Choriocarcinoma as a cause of thyrotoxicosis. 94 90

Patients with cancer frequently develop pneumonitis for which no cause is documented ante mortem. Noninvasive diagnostic techniques, such as sputum induction, are generally inadequate, especially in myelosuppressed patients. To avoid pulmonary contamination with organisms colonizing the oronasopharynx and to obtain uncontaminated speciemens, 38 patients underwent bronchial brushing utilizing a transtracheal approach after sputum induction and transtracheal aspiration failed to establish the etiology. Patients with thrombocytopenia were brushed after platelet transfusion. Eleven patients were not clinically considered to be infected; seven proved to have pulmonary metastases, of which one case was diagnosed by this technique; and four patients in whom no diagnosis was obtained by brushing subsequently proved to have interstitial fibrosis (three cases) or a collapsed lobe (one case). Twenty-seven patients were clinically presumed to be infected. Ultimately, 17 of these 27 patients were proven to have pulmonary infection, and 14 of these 17 were etiologically documented by brushing. In ten of the 27 patients presumed to be infected, no etiology could be established by any method. Seven of these ten patients were receiving broad-spectrum antibiotic therapy at the time. Significant but nonfatal complications, including hemoptysis, pneumothorax, and cervical cellulitis, occurred in seven patients; however, this procedure is a relatively safe and useful method to include in the orderly evaluation of myelosuppressed cancer patients with suspected pulmonary infections.
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PMID:Transtracheal selective bronchial brushing for pulmonary infiltrates in patients with cancer. 97 5

A 55-years old patient is reported who became ill with recurrent attacks of coughing and haemoptysis some 3 weeks before death. An extensive mediastinal tumor was demonstrated radiologically. Pathoanatomical examination showed a pleomorphic rhabdomyosarcoma of the lower left pulmonary lobe with metastases in the right lung and regional lymph nodes.
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PMID:[Pulmonary rhabdomyosarcoma (author's transl)]. 108 60

A retrospective study was undertaken in 1990 of 188 patients with the diagnosis of non small cell carcinoma of the lung referred to the Department of Radiation Oncology in 1984. Most patients (178/188) received a course of radiotherapy. This was definitive in 23, palliative in 148 (primary site in 113, metastases in 16, primary plus metastases in 19) and postoperative in 7. This report is a 5 year followup of the 171 patients treated by radiation alone, to assess factors that influence survival. Tumour histology was 50% squamous, 23% adenocarcinoma, 16% large cell and 4% unspecified, non small cell carcinoma. In 8% no histological diagnosis was obtained. The most common symptoms were cough (44%), dyspnoea (43%), chest pain (37%), haemoptysis (33%) and systemic symptoms (36%). Tumour stage (TNM) was assessed retrospectively as I(5%), II(8%), IIIA(18%), IIIB(22%) and IV(28%). A subgroup of 31 cases (18%) of uncertain staging (I-III) was analysed separately and in 2 cases (1%) no staging information was available. Palliative intent of treatment and poorer performance status were related significantly to increasing stage of disease. The effects of palliative treatment were recorded in 79 cases; in 71 there was a reduction in symptoms. The median survival from diagnosis was 8 months (range < 1-72). Using univariate and multivariate analyses, significant and independent prognostic factors for improved survival were good performance status, absence of systemic symptoms, lower tumour stage and curative intent of treatment (higher radiation dose). However the 5-year survival was only 2%. Long-term survival was associated predominantly with early stage disease but not with the type or intent of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Non small cell carcinoma of the lung. A retrospective study. Presented at the 41st annual meeting of the Royal Australasian College of Radiologists, September 1990, Perth. 128 99

A 61-year-old male was admitted because of hemoptysis. He had a 9 year history of liver cirrhosis associated with HB viral chronic hepatitis. Physical examination revealed no abnormalities. Laboratory investigations revealed positive HBs antigen with normal alpha-fetoprotein. Chest X-ray film showed large mediastinal lymph nodes and an endobronchial polypoid mass in the distal end of the right main bronchus. The right main PA was narrowed due to compression by the mediastinal mass. Bronchoscopic examination revealed a polypoid mass in the right main bronchus. The biopsy specimen was histologically diagnosed as undifferentiated large cell carcinoma. The patient developed respiratory failure, and died 3 weeks after admission. Autopsy revealed a small liver cancer of 1.3 cm diameter within the cirrhotic liver, associated with a small abdominal lymph node metastasis and large mediastinal lymph node swellings. Thromboembolism in the bilateral main pulmonary arteries was concluded to be the cause of death. The mediastinal mass which directly invaded into the right main bronchus had a close histological similarity with the liver cancer, showing undifferentiated carcinoma cells with bizarre nuclei and abundant cytoplasm. An immunohistological study revealed cells positive for alpha-fetoprotein in the mediastinal lymph nodes. The patient was diagnosed as having small liver cancer with mediastinal lymph node metastases. A survey of the literature revealed only a few cases of advanced hepatoma associated with prominent mediastinal metastases. This is the first reported case of small liver cancer presenting with large mediastinal lymph node metastases.
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PMID:[A case of small liver cancer presenting as a huge mediastinal mass]. 132 37

Two policies of palliative thoracic radiotherapy for NSCLC have been compared in a randomised multicentre controlled trial aimed at simplifying the palliative treatment of patients with poor performance status. A total of 235 patients were entered. They had inoperable, microscopically confirmed disease, too advanced for 'curative' radiotherapy. Their main symptoms were related to the primary intrathoracic tumour even if metastases were present, and they had a poor performance status. Patients were allocated at random to regimens of either 17 Gy given in two fractions of 8.5 Gy 1 week apart (F2 regimen, 117 patients), or a single fraction of 10 Gy (F1 regimen, 118 patients). Two patients (one in each group) were excluded from all analyses because they were found to have had previously treated malignant disease and had been admitted in error. On admission, 95% of the 233 eligible patients had cough, 47% haemoptysis, 59% chest pain, 64% anorexia, and 16% dysphagia. As assessed by the clinicians, these symptoms were palliated in high proportions of patients, ranging in the F2 group from 48% for cough to 75% for haemoptysis, and in the F1 group from 55% for anorexia to 72% for haemoptysis and chest pain. For all five symptoms the median duration of palliation was 50% or more of survival. All these results were similar in the two treatment groups. In contrast, on daily assessment by the patients using a diary card, those treated with the F2 regimen experienced substantially more dysphagia, which was recorded in 56% of the patients compared with 23% in the F1 group (difference 33%: 95% confidence interval 17-48%). The median survival from randomisation was 100 days in the F2 group and 122 days in the F1 group. The F1 regimen, as it requires only a single attendance for treatment, is recommended as a palliative regimen for patients with inoperable NSCLC and a poor performance status.
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PMID:A Medical Research Council (MRC) randomised trial of palliative radiotherapy with two fractions or a single fraction in patients with inoperable non-small-cell lung cancer (NSCLC) and poor performance status. Medical Research Council Lung Cancer Working Party. 137 84

The imaging investigations in six patients with alveolar soft part sarcoma (ASPS) are reviewed. Five patients presented with a pelvic or lower limb mass and one with haemoptysis from pulmonary metastases. Magnetic resonance imaging (MRI), CT, Doppler US and angiography studies demonstrated the highly vascular nature of this rare tumour and the frequent occurrence of pulmonary and intracranial metastases. Previously unreported Doppler US and MR evidence of multiple enlarged vessels and high blood flow within primary and secondary ASPS tumours is emphasized. Imaging is of considerable importance both for pre-operative localization and long term surveillance of this slow growing but invariably disseminating tumour.
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PMID:Imaging of alveolar soft part sarcoma. 142 47


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