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)

Metastatic lesions of breast cancer represent rare indications for operation in thoracic surgery. Only in case of persistent malignant pleural effusions or in case of tumour progress despite all other available therapy modalities thoracic surgery can be indicated. Over a period of 5 years between 1993 and 1997 53 patients with metastatic breast cancer were treated in our institution. 36 pts. suffered from persistent pleural effusions, 13 pts. had pulmonary metastases and 4 pts. had metastases involving the chest wall. In all these patients the disease could not be controlled by conservative measures. Our experiences are the following: Thoracoscopy is the diagnostic method of choice for pleural effusions in patients with malignant tumors. If a malignant pleural effusion is confirmed, a talc poudrage represents the most reliable treatment to palliate the dyspnea. The resection of a single solitary pulmonary metastasis can be indicated to confirm the histologic type of the nodule. Resections for centrally localized lesions causing hemoptysis or atelectasis represent rare occasions. Metastatic lesions of breast cancer involving the ribs or the sternum are resected in order to confirm the histologic diagnosis. According to the literature these procedures, with a 5-year survival rate of 50% and without perioperative mortality, can be beneficial.
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PMID:[Thoracic surgery relevant indications for adjuvant and/or palliative measures in breast carcinoma]. 1006 94

A 29 year old white man presented to the emergency room with new onset pleuritic chest pain and shortness of breath. He was initially diagnosed as having viral pericarditis and was treated with non-steroidal anti-inflammatory drugs. A few weeks later he developed recurrent chest pain with cough and haemoptysis. Chest radiography, cardiac examination, transthoracic and transoesophageal echocardiography pointed to a mass that arose from the posterior wall of the right atrium, not attached to the interatrial septum, which protruded into the lumen of the right atrium causing intermittent obstruction of inflow across the tricuspid valve. Contrast computed tomography of the chest showed a right atrial mass extending to the anterior chest wall. The lung fields were studded with numerous pulmonary nodules suggestive of metastases. A fine needle aspiration of the pulmonary nodule revealed histopathology consistent with spindle cell sarcoma thought to originate in the right atrium. Immunohistochemical stains confirmed that this was an angiosarcoma. There was no evidence of extracardiac origin of the tumour. The patient was treated with chemotherapy and radiation. This case highlights the clinical presentation, rapid and aggressive course of cardiac angiosarcomas, and the diagnostic modalities available for accurate diagnosis.
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PMID:Primary right atrial angiosarcoma mimicking acute pericarditis, pulmonary embolism, and tricuspid stenosis. 1021 78

Primary sarcomas of the great vessels are rare, but the most common site is the inferior vena cava. Herein are reported five new cases arising from the pulmonary veins with clinicopathologic correlation and comparison to previously reported cases. All new cases occurred in women ranging in age from 23 to 64 years at diagnosis (mean, 56 years). They had symptoms suggestive of left heart failure, including three patients with dyspnea, one with hemoptysis, and one with cough. Three cases showed tumor extension along the pulmonary veins into the left atrium. Tumors ranged in size from 2.8 to 7 cm in greatest dimension. Histologically, all were leiomyosarcomas. They were highly cellular tumors. Three cases had predominantly spindle cell morphology and two were predominantly epithelioid; one had foci of calcification. Most showed extensive necrosis. All tumors were reactive with antibodies to actin and desmin. Two cases were reactive with antibodies to MIC-2 (dotlike); two cases showed reactivity to keratin antibodies; and two showed reactivity for estrogen, progesterone receptor protein, or both. None were positive for antibodies to S-100 protein. All cases were treated with surgical excision. Follow-up ranged from 2 months to 21 years (mean, 4.8 years). Two patients were alive and well; two were alive with metastases; and one died of disease. Pulmonary vein sarcomas represent intermediate- to high-grade leiomyosarcoma. Although often lethal, complete surgical excision can lead to long-term survival. They occur predominantly in women and may express hormone receptors. Therefore, hormonal manipulation may offer promise as adjuvant therapy.
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PMID:Leiomyosarcoma of the pulmonary veins. 1047 68

The carcinoid tumors of the bronchial are extremely uncommon, with an incidence of 5% of all pulmonary neoplasms. The carcinoid is the more frequent tumor of the lung in paediatric age. The symptoms most often reported were cough, recurring infection, chest pain, hemoptysis, fever, dyspnea, mild dyspnea attacks after physical effort or nervousness. The carcinoid syndrome is uncommon. Neuroendocrine tumors of the lung embrace a spectrum from low-grade typical carcinoid, intermediate-grade atypical carcinoid, and high-grade categories of large cell neuroendocrine carcinoma and small cell carcinoma. Low grade neoplasms may metastasize to adjacent nodes. Atypical carcinoids are considered low grade malignancies. Most malignant end of neuroendocrine neoplasm group is small cell carcinoma. Typical carcinoids carry an excellent prognosis and should be offered conservative lung resection, whilst atypical carcinoids which behave aggressively should be treated by radical lung resection. The authors report a case of the young patients with bronchial typical carcinoid tumor who had suffered from cough and mild dyspnea attacks after physical effort or nervousness in the last year.
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PMID:[A case of recurrent cough in bronchial carcinoid]. 1057 Jul 90

Metastasis to the lung occurs quite commonly from certain types of extrapulmonary primary carcinoma. Spread to the bronchial lumen is relatively rare. When this does occur, symptoms resembling those of primary bronchial carcinoma are often present, in association with partial or complete obstruction of the bronchial lumen. Palliation of such symptoms is possible with the use of intraluminal radiotherapy (ILT). Between 1990 and 1998, 37 patients with endobronchial metastases were treated using this modality; a single fraction of radiation was delivered by the remote afterloading high dose rate microSelectron system. Data regarding these patients' characteristics and outcome are presented, following a retrospective review of case notes. The commonest symptoms were dyspnoea, cough and haemoptysis; the commonest primary tumour sites were breast, colorectum, oesophagus and kidney. Twenty-four (64.9%) patients had some improvement in symptoms following treatment. Mean overall survival was 280 days, range 9-1145 days. No serious adverse effects occurred. ILT is a relatively simple, safe and effective treatment in the palliation of symptoms due to endobronchial metastases.
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PMID:Treatment of endobronchial metastases with intraluminal radiotherapy. 1084 36

Primary cardiac leiomyosarcomas are very rare. A 19-year-old man was admitted to a local hospital with dyspnea and hemoptysis. He was later transferred to our hospital because of his worsening dyspnea. An enhanced chest computed tomography scan demonstrated a large mass in the left atrium. A transthoracic echocardiogram showed a large mobile mass in the left atrium. The tumor was totally resected. The pathohistological examination showed leiomyosarcoma. The tumor rapidly recurred. and a second and third operation were performed. After the third operation, the patient was treated with radiotherapy. There was no local recurrence but multiple distant metastases were found 2 months after completion of radiation therapy.
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PMID:Rapidly growing primary cardiac leiomyosarcoma: report of a case. 1823 85

This prospective study represents our experiences in using fibreoptic bronchoscopy (FOB) in the evaluation of different thoracic lesions. Over a 20-month period, 203 patients (151 males and 52 females) (age range: 15-100 years) underwent bronchoscopies. The patients had a wide range of symptoms and/or radiographic abnormalities. The majority had cough and shortness of breath; haemoptysis was a common symptom. In all, 148 patients had neoplasms and 55 had non-neoplastic lesions. The most common malignancy was bronchogenic carcinoma (91 confirmed, 33 suspected). Other neoplasms included pulmonary metastases and mediastinal tumours. The non-neoplastic chest lesions included pulmonary tuberculosis, pulmonary hydatid cyst, lung abscess and resolving chest infection and chronic bronchitis. FOB was most useful in the diagnosis of bronchogenic carcinoma (positive diagnostic yield of 73%). It was least useful in diagnosing mediastinal tumours.
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PMID:Flexible fibreoptic bronchoscopy in Basra, Iraq: a 20-month experience. 1155 6

Aspiration of oro-pharyngeal secretions and gastric content is the most frequent cause of formation of primary lung abscess. A compromised mental status (e.g. alcoholism, sedatives, stroke) and esophageal dysfunction (e.g. herniation, vomiting) are important risk factors. Aspiration pneumonia presents as a subacute disease and is usually not distinguishable from other causes of pneumonia, until typical radiological signs of cavitation and putrid sputum appear 8 to 14 days after the initial event of aspiration. Anaerobic bacteria play a pivotal role in an almost exclusively mixed spectrum of causative organisms. Aerobic pathogens are also frequently isolated, but whether they are an active part of infection or merely represent colonizers remains unclear in many instances. Differential diagnosis includes bronchial neoplasms, either as necrotizing carcinoma or as the cause of poststenotic cavernous pneumonia, other infectious diseases like tuberculosis, Pneumocystis carinii pneumonia or endocarditis with septic metastases, and lung artery embolism or vasculitis (M. Wegener). Fiberoptic bronchoscopy is extremely helpful in determining cause and etiology of the disease and should be carried out in all patients presenting with cavernous lung lesions. Bacteriological sampling should be performed using protected specimen brushing (PSB) technique. Broncho-alveolar lavage might serve as a less expensive but also less sensitive alternative measure. Since anaerobic bacteria resemble ubiquitous commensals of the oral cavity, sputum is of no use in anaerobic culture. Principal therapeutic strategy is antibiotic therapy for an extended period, usually four weeks to four months, unless radiologic changes and as well laboratory as clinical indicators of infection are completely resolved. Clindamycin, optionally supplemented with a second or third generation cephalosporin and Ampicillin/Sulbactam proved equally effective in treating aspiration pneumonia and primary lung abscess. The role of Moxifloxacin and other new flouroquinolones with their favorable pharmacodynamics is currently evaluated. Provided that antibiotics are prescribed for a sufficient period of time and patients' compliance is ensured, surgical procedures are limited to a negligible number of complications, e.g. recurrent severe hemoptysis, empyema or broncho-pleural fistula.
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PMID:[Diagnosis and therapy of abscess forming pneumonia]. 1169 90

A case of a 7-year-old boy admitted to the clinic with severe symptoms of 1-month lasting pneumonia not responding to antibiotics is presented. The chest X-ray confirmed inflammatory process in left lung parenchyma. Due to unsuccessful further preservative treatment, bronchoscopy and CT of the thorax were performed. They showed the presence of a tumor narrowing the left main bronchus. Histopathologic examination of the tissue taken during bronchoscopy revealed carcinoid. Through the left-sided thoracotomy, the resection of a 5 cm large oval-shaped tumor, as well as the distal part of the left main bronchus was done. During clinical observation the child did not present any symptoms of the carcinoid syndrome. Urine levels of acids: homovanillic, vanillylmandelic and 5-hydroxyindolylacetic were normal. Bronchoscopy and X-ray of the chest directly, two weeks after and six months after resection were normal. Childhood primary pulmonary neoplasms are rare and the most frequent malignant tumors are bronchial adenomas. About 80-90% of them are carcinoids. The period from initial symptoms to clinical diagnosis and the institution of treatment, usually lasts several months. In our case it was a seven-week-long period. When cough, weezing, hemoptysis and inflammation of lung parenchyma are prolonged, carcinoid should always be considered in differential diagnosis. Radiological changes are usually nonspecific in cases of bronchial adenomas. Bronchoscopy with biopsy and CT scan are investigations that are decisive. Because of relatively low malignancy of carcinoid, results of the surgical treatment are good even in presence of metastases in regional lymphatic nodules.
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PMID:[Bronchial carcinoid in a 7-year-old boy]. 1186 52

Carcinoids are neuroendocrine neoplasms. Bronchial carcinoids are unusual, malignant primary neoplasms that characteristically involve the central airways and typically exhibit well-defined margins and bronchial-related growth. Bronchial carcinoids include low-grade typical carcinoids and the more aggressive atypical ones. They usually affect patients in the 3rd through the 7th decade of life who are often symptomatic with cough, hemoptysis or obstructive pneumonia. Rarely, the initial symptoms are related to the secretion of hormones causing carcinoid or other endocrine syndromes. Bronchial carcinoids radiologically manifest as hilar or perihilar masses, with or without associated atelectasis, pneumonia or bronchiectasis. At CT-scan the relationship of these tumors with the bronchial tree is usually seen, and they show contrast enhancement or calcification. Even if the radiological signs may be suggestive for bronchial carcinoid, the definitive diagnosis is reached only by the tissue sampling. Bronchoscopic biopsy is the more effective way to identify the nature of carcinoid tumors because of their frequent central location. The treatment of choice is the surgical resection which should be carried out with maximum respect for the residual lung and bronchial tissues. Endoscopic ablations in well defined cases, bronchotomy and lung resections with or without bronchoplastic procedures have been described. Hilar and mediastinal lymph node sampling and examination should be ever performed during open procedures. Positivity of the nodal tissues could influence the resection procedure and is related with the prognosis, specially for the atypical carcinoids. Chemo- and radiation therapy are not effective in improving the long-term outcome in those patients with advanced disease. The long-term outcome is strictly related with the histological subtype and the lymph node status. Local recurrences and distant metastases are more frequent in the atypical carcinoids which manifest a more aggressive behavior. During the last decade, the importance of the use of somatostatine analogues (octreotide) in the staging, early detection of the recurrent disease and its management such as that of the associated carcinoid syndrome became clear.
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PMID:[Bronchopulmonary carcinoid tumours]. 1214 71


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