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

A 77-year-old man was in good health until he complained of fatigue 3 weeks before presentation. Two weeks before admission, he developed gradually worsening shortness of breath. One week before admission, he developed a cough that initially was nonproductive but later was associated with hemoptysis.His past medical history was remarkable for a history of colon cancer (Dukes' stage III), for which he underwent a hemicolectomy and treatment with adjuvant chemotherapy in 1993. He had a myocardial infarction in 1986 and underwent coronary artery bypass surgery in 1999. He also had a history of hypertension, type 2 diabetes, and gout. He smoked in the past but had stopped more than 30 years ago.He was initially evaluated by his primary care physician, who noted that he complained of diaphoresis but denied fevers, chills, or contact with others who were ill. His physical examination was remarkable for bilateral crackles that were more pronounced on the right. A chest radiograph demonstrated bilateral pulmonary infiltrates (Figure 1). He was treated with amoxicillin. The next day, however, his physician noted that his dyspnea had worsened and that his oxygen saturation on room air was poor. He was therefore admitted for further evaluation. The amoxicillin was discontinued, and he was treated with levofloxacin, followed by ceftriaxone and azithromycin as his pulmonary status continued to deteriorate. He received intravenous diuretic agents, which failed to improve his respiratory status. During the initial phase of hospitalization, he was anemic, with a hematocrit of 21.3%. His serum creatinine level, which had been 1.0 mg/dL in 1999, was now 2.5 mg/dL. Urinalysis was remarkable for the presence of numerous red blood cells. His oxygen requirement increased, and he eventually required a 100% nonrebreather mask. A computed tomographic scan of the chest demonstrated prominent alveolar opacities throughout the right upper, middle, and lower lobes, with similar opacities in the left upper and left lower lobes (Figure 2). An echocardiogram showed an ejection fraction of 50%, as well as mild mitral regurgitation. Serologies were remarkable for an antinuclear antibody titer of 1:320 and a P-antineutrophil cytoplasmic antibody (P-ANCA) titer of greater than 1:320. C-ANCA was negative. Anti-glomerular basement membrane and anti-human immunodeficiency virus antibodies were undetectable.
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PMID:Cases from the medical grand rounds of the Osler Medical Service at Johns Hopkins University. 1207 15

Case 1: A 60-year-old woman with sigmoid colon cancer and multiple lung metastases developed dyspnea 34 months after sigmoidectomy and following systemic chemotherapy. Chest X-ray revealed left atelectasis and obstruction of the left main bronchus by lung metastasis, and stenosis of the right main bronchus was also suspected. Bronchial arterial infusion of CDDP, 5-FU and MMC relieved the atelectasis and dyspnea. The left bronchus remained patent for 12 months. Case 2: A 70-year-old man who had a pulmonary recurrence of rectal cancer suffered from hemoptysis and dyspnea, which had improved with systemic chemotherapy but then become exacerbated again. Bronchoscopic examination revealed intraluminal bleeding from a metastatic tumor. The symptoms were relieved after bronchial arterial infusion of CDDP, 5-FU and MMC. The diameter of the treated tumor was reduced by 15%. Hemoptysis was negligible until he died 8 months later. Bronchial arterial infusion chemotherapy for pulmonary metastasis from colorectal cancer is clinically beneficial, especially for patients with life-threatening respiratory symptoms like airway obstruction or intraluminal bleeding.
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PMID:[Clinical benefit of bronchial arterial infusion chemotherapy to pulmonary metastasis from colorectal cancer--report of two cases]. 1471 76

Pulmonary capillary hemangiomatosis is a rare vascular proliferative disease of unknown etiology. The common clinical features are slowly progressive and finally fatal pulmonary hypertension. The clinical diagnosis is usually difficult. Because most reported cases are of autopsy, little is known about its incipient lesion and natural history. Presented herein is a case of pulmonary capillary hemangiomatosis incidentally detected in a surgically resected lung for a metastatic colon cancer. The patient was a 60-year-old Japanese woman with a history of sigmoid colon cancer 3 years previously. The patient had undergone a right lower lobectomy for a metastatic tumor in the hilar region and a thoracoscopic tumorectomy of the peripheral area of the left upper lobe. Except for an episode of hemoptysis 2 weeks prior to the lung surgery, there were no other clinical symptoms characteristic of pulmonary capillary hemangiomatosis. The non-tumor area of right lower lobe showed multiple foci of capillary proliferation affecting alveolar walls, interlobular septa and pleura associated with patchy hemorrhage. There was a minor degree of vascular and bronchial involvement by capillary proliferation. It is suggested this particular case is an incidentally detected clinically incipient stage of pulmonary capillary hemangiomatosis. Passive congestion secondary to metastatic colon cancer in the hilar region may have contributed to the pathogenesis of this lesion.
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PMID:Pulmonary capillary hemangiomatosis incidentally detected in a lobectomy specimen for a metastatic colon cancer. 1670 1

In June 1997, the patient underwent an operation for cecal colon cancer pStage II .I n May 1999, a liver metastasis at S6 was detected and the patient received a partial liver resection.In April 2004, a liver metastasis in S4 was detected and another partial liver resection was performed.In November 2008, he complained of hemoptysis and cough.The chest CT examination showed lymph node metastases in the mediastinum that invaded the left main bronchus.We performed chemo-radiotherapy for local control from January 2009. Because the lymph nodes were reduced remarkably and clinical complaints disappeared, we administrated a mFOLFOX6 regimen from June.We recognized the effect of treatment to be a complete response.In February 2014, we detected a lymph nodes recurrence around a right pulmonary artery.We performed chemo-radiotherapy again because the patient declined surgery.However, lymph node metastases did not completely respond.We then performed chemotherapy 30 times using a FOLFIRI plus panitumumab regimen.On PET-CT, the recurrent lesion did not show a hot spot.We experienced a case that responded to chemo-radiotherapy for long-term control of lymph node recurrence.
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PMID:[Long-Term Survival of a Patient with Mediastinal Lymph Node Metastasis Treated with Chemo-Radiotherapy after Surgery for Cecal Cancer]. 2939 47