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

Autopsy studies have shown that lung cancer is often not detected during life and that a correct antemortem diagnosis is made preferentially in patients with pulmonary symptoms, in smokers, and in men. The current research was done as a case-control study to determine whether the autopsy suggestions of detection bias in diagnostic pursuit of lung cancer were confirmed by the way that sputum Papanicolaou smears (Pap smears) were ordered in an inpatient setting. The cases were 385 hospitalized patients in whom sputum Pap tests had been newly performed from October 1977 to September 1980. Each case was matched by age, admission date, and admission diagnosis to a control patient who had not received a Pap test. Excluded from the study were patients in whom sputum Pap tests were obligatory (e.g., those with manifestations of hemoptysis) or unnecessary (e.g., those with a previous diagnosis of lung cancer or multiple previous sputum Pap tests). Demographic data, amount and duration of cigarette smoking, and details of clinical manifestations were extracted from the patients' medical records by research assistants blind to the study hypothesis. Compared with controls, the cases had distinctive elevations in odds ratios for chronic cough, recent cough, male sex, and cigarette smoking, which also showed a distinctive dose-response relation. In multivariate analyses, all four of these "risk factors" for selective ordering of a sputum Pap smear remained independently highly significant. In the extreme category, men who smoked and coughed were 22 times more likely to have a sputum Pap test ordered than were nonsmoking women who did not cough. Clinically, the results suggest that women and nonsmokers may be deprived of appropriate diagnosis and therapy unless a diagnostic workup for lung cancer is guided mainly by radiographic findings and presenting manifestations. Statistically, detection bias has probably led to an excessively elevated magnitude for the cigarette smoking-lung cancer association and to a falsely low estimate of incidence rates in women.
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PMID:Detection bias in the diagnostic pursuit of lung cancer. 318 78

Mass screening for early detection of lung cancer has been in practice from 1982. Up to 1985, 583,549 persons-years have been screened. Screening was done by examining miniature X-rays taken of the chest for all those tested, and by sputum cytology for those thought to be high-risk, 34,044 persons-years. Heavy smokers over 50 years of age comprised much of the high-risk cases and persons evidencing hemoptysis. In a total of 207 detected cases of lung cancer, 120 cases were found by chest X-ray only, 69 cases were uncovered by sputum cytology only, and 18 cases were discovered by both X-ray and cytology. In one hundred and forty-four cases the cancers were resected and in 69 cases the cancers were determined to be in an early stage.
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PMID:[Mass screening for early lung cancer by the Miyagi method]. 335 50

A group of 306 patients with acute pulmonary hemorrhage were evaluated by means of bronchial arteriography and treated with transcatheter embolization. Specific causes for bleeding included lung abscess, chronic pneumonia, tuberculosis, lung cancer, and bronchiectasis. In 120 patients the hemoptysis was massive, with volumes exceeding 500 ml/day. The majority (n = 225) were treated during peak hemorrhage. Embolization was performed with one of three methods: particulate embolization with polyurethane or velour, obturation with the angiographic catheter combined with peripheral embolization by means of infused albumin macroaggregates, and regional infusion of sclerosing agents. Effective hemostasis was obtained initially in 278 patients (90.8%), including 87.5% of those treated during peak hemorrhage. In 26 of 28 cases without initial response, the pulmonary artery was the source of bleeding. Recurrent bleeding, within 1-4 days, requiring surgery was observed in 39 patients with initially successful hemostasis. Of 158 patients who were treated without surgery, subsequent episodes of hemoptysis occurred in 36. Combined methods of embolization may improve the efficacy of treatment of operable and inoperable patients with lung disease complicated by hemorrhage.
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PMID:Transcatheter embolization in the management of pulmonary hemorrhage. 356 15

Plastic double-lumen endobronchial tube was used to maintain the airway in a patient with massive hemoptysis and nonresectable lung cancer. This tube is superior to the previously used Carlens tube, as it can be inserted in emergency situations and does not require surgical setting. In addition, the larger internal diameter of these tubes allows better airway clearance and passage of a flexible bronchoscope. The double-lumen tube may be considered as an alternative to selective main-stem intubation.
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PMID:Plastic endobronchial tubes in the management of life-threatening hemoptysis. 367 22

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

During the treatment of pulmonary tuberculosis, the radiologist is often asked the following questions: 1) is it really TB?; 2) is there any improvement?; 3) when is the X-ray check-up required?. In our opinion, the radiologist is in a position: 1) to confirm the diagnosis of TB; 2) to give a radiological diagnosis of "abnormality" but without a prognostic opinion; 3) to suggest, case by case, when the X-ray check-up is required. After some month or years, when radiological-clinical sequelae are present, the radiologist is often asked equally difficult questions: 1) is it still TB?; 2) is it still active?; 3) could it have caused the hemoptysis?. Again, in our opinion, the radiologist must bear in mind: 1) the not infrequent possibility of reinfections; 2) that the fine, smooth contour of the cavity, whose shape remains unchanged, does not necessarily signify absence of activity; 3) that, at the present time, other illnesses (bronchitis, bronchiectasis, lung cancer) are more frequently the cause of hemoptysis.
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PMID:[Evolution and radiologic sequelae of pulmonary tuberculosis]. 400 May 30

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

Twenty-eight therapeutic bronchoscopic procedures with laser were carried out on 20 patients with primary lung cancer. Indications for laser bronchoscopic study were nonresectable, endoscopically visible tumor in patients who had any of the following complications after chemotherapy and/or radiation therapy: increasing dyspnea, postobstructive pneumonia, atelectasis, or hemoptysis from an endoscopically visible site. Symptomatic benefit was noted by 15 of 20 patients after laser therapy. There were two procedure-related deaths. Our conclusions regarding selection of patients for laser therapy of endotracheal and endobronchial lesions are given.
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PMID:Laser therapy in patients with primary lung cancer. 620 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.
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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.
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PMID:Hemorrhage from carcinoma of the lung. 624 89


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