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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical and histopathological findings are described in 6 cases of chronchial carcinoma metastatic to the choroid of the eye. These findings show that especially in bronchial carcinoma, metastases of the choroid often are the first symptoms of the disease even before the primary site of the tumor is recognized. As these metastases often grow in a manner quite different from that of other uveal metastases, they are likely to be mistaken for uveal melanomas. Yet the right diagnosis is decisive for the right therapy. While in case of melanoma the eye has to be enucleated, x-ray therapy should be employed in metastatic carcinoma. Thus the patient can be prevented from becoming blind and from enucleation. The effect of x-ray treatment on the carcinoma cells in the choroid is demonstrated histologically in one of the cases.
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PMID:[Metastases of the choroid of the bronchial carcinoma (author's transl)]. 114 94

The gas sterilized bronchofiberscope has been utilized as a pleuroscope for visual exploration of the pleural space and forceps biopsy of abnormal lesions in 16 patients with undiagnosed pleural disease. The instrument was inserted through a small (1-2 cm) incision. Aspiration of pleural fluid and instillation or aspiration of air to produce a controlled pneumothorax are easily accomplished through the instrument's suction channel. In eight patients with undiagnosed pleural effusion, biopsy of visualized nodules established the diagnosis of carcinoma. Three patients with bronchogenic carcinoma and pleural effusion had no pleural metastases at pleuroscopy which was confirmed in two patients who had thoracotomy and lung resection. Parenchymal subpleural nodules of metastatic carcinoma were confirmed by pleuroscopic biopsy in one patient. Biopsy via the pleuroscope was unsuccessful in two patients, one with pleural fibrosis, probably related to asbestosis, and one with mesothelioma. Both required open surgical biopsy of the pleura. There has been minimal patient discomfort and no serious complications.
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PMID:Clinical experience with pleuroscopy utilizing the bronchofiberscope. 119 Jun 69

Thirty patients with an advanced bronchogenic carcinoma were treated with a combination of adriamycin and 5-fluorouracil; in eight the size of the tumour or its metastases was reduced by over 50%, and eight further patients experienced useful relief of symptoms. This drug combination is useful in the magagement of lung cancer.
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PMID:Treatment of advanced bronchogenic carcinoma with adriamycin and 5-fluorouracil. 120 Nov 86

The records of 96 consecutive patients who underwent mediastinoscopy and were ultimately shown to have bronchogenic carcinoma were reviewed. Indirect tests for mediastinal tumor metastases in these patients included bronchoscopy and chest roentgenograms in all 96, mediastinal laminagrams in 65, esophagograms in 27, carinal biopsy in 23, bronchograms in 5, pulmonary angiograms in 5, azygograms in 2, and aortograms in 2 patients. Of the 43 patients in this series in whom all indirect tests revealed no metastases, mediastinoscopy showed nodal involvement in 11 (28%), who were thus spared unnecessary thoracotomy. On the other hand, if negative mediastinoscopy had not cast doubt on the validity of indirect tests that seemed to show metastases, an operation might actuallly have been denied to 14 patients who were ultimately proved to have anatomically resectable disease.
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PMID:Is mediastinoscopy necessary in the evaluation of lung cancer? 121 1

In an attempt to formulate indications for mediastinoscopy, the histologic tumor type and the radiographic manifestations of the tumor were correlated with the occurrence of mediastinal node metastases in 121 patients who had potentially resectable bronchogenic carcinoma. Our results demonstrated that mediastinal metastases occur commonly in patients with central lesions irrespective of cell type, but that the histologic tumor type has a definite influence on the frequency of mediastinal involvement in patients with parenchymal masses or peripheral lesions. Our results also demonstrated that the absence of radiographic evidence of mediastinal involvement cannot be given strong consideration when selecting patients for mediastinoscopy, because almost 50 per cent of patients with mediastinal involvement did not have mediastinal widening on the chest roentgenogram. Our results, in conjunction with currently accepted principles governing the management of patients with bronchogenic carcinoma, have allowed us to propose a logical approach for the use of mediastinoscopy in the prethoracotomy evaluation of patients with potentially resectable lung cancer.
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PMID:Indications for mediastinoscopy in bronchogenic carcinoma. 124 33

A prospective study has been conducted to determine the clinical importance of lung scintigraphy in the work-up of patients thought to have bronchial carcinoma (i.e., accuracy of the scintigraphic diagnosis, data concerning spread of the primary tumor [=T] as well as the possibility of metastases to the lung hilus and mediastinum [=N]). Ninety-four patients, all of whom were hospitalized for suspected bronchial carcinoma, were examined by 133Xenon i.v., 133Xenon gas inhalation,, and 99mTc-MAA i.v. (macroaggregated albumin or microspheres of human albumin). The suspicion was confirmed in 77 patients. Central and peripheral bronchial carcinomas were kept separate in the evaluation. A normal lung scintigram practically rules out a central bronchial carcinoma. Where the scintigraphic finding prompts suspicion of central bronchial carcinoma, this suspicion must be confirmed by other examinations and preferably those which cytologically and histologically directly demonstrate the tumor. The diagnostic reliability of lung scintigraphy is drastically reduced in patients with bilateral ventilation disturbances. Because of its 27% rate of false negative findings, bronchoscopy is a less suitable means of ruling out bronchial carcinoma than scintigraphy. The peripheral bronchial carcinoma displays no characteristic scintigraphic signs; thus, a normal scintigram does not rule out peripheral bronchial carcinoma. Bronchoscopy was negative in all these patients. Spread of the primary tumor was exactly predicted with bronchoscopy in 11% and with scintigraphy in 42% of cases. When the scintigraphic criteria for hilar or mediastinal involvement are ful filled, it is practically certain that the patient is no longer radically operable. This assertion is valid when mediastinoscopy is normal. Lung scintigraphy possesses the same accuracy in the diagnosis of mediastinal involvement both with peripheral lung tumors and with centrally located tumors.
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PMID:[The value of lung scintigraphy in the staging of bronchial carcinoma. Prospective study for the determination of TN stages]. 125 Nov 66

The records of 112 patients treated at the Ochsner Foundation Hospital with the diagnosis of bronchogenic carcinoma were reviewed. A new concept for defining the location of central versus peripheral tumors is presented. Criteria important in selection of patients for whom mediastinoscopy is likely to be helpful are cell type, location (peripheral versus central), and radiographic evidence of mediastinal metastasis. The size of the tumor is not a useful criterion except possibly for squamous cell lesions. A high incidence of mediastinal metasis was found associated with central tumors (63 to 100 per cent) of all cell types and with peripheral lesions (63 per cent) of undifferentiated cell types. A relatively low incidence of mediastinal metasis was associated with peripheral asenocarcinomas or squamous cell tumors. We would, therefore, recommend mediastinoscopy for all patients with central lesions and those patients with peripheral lesions of an undifferentiated cell type. When correlated with radiographic findings, only 4.6 per cent of peripheral carcinomas of a differentiated cell type with a radiographically normal mediastinum were found to produce mediastinal metastases, and mediastinoscopy is not recommended. In patients with peripheral tumors of indeterminate cell type, a decision for mediastinoscopy may be influenced by other factors such as the operative risk of a thoracotomy and location of the primary tumor within the lung.
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PMID:The selection of patients with bronchogenic carcinoma for mediastinoscopy. 126 61

A total of 351 previously untreated patients presented to this department with limited small cell bronchogenic carcinoma between 1974 and 1985. They were treated with either radical or palliative radiotherapy (152), chemotherapy alone (63), or combined chemoradiotherapy (136). Their 5-year survival rates were 2.6%, 0%, and 5.1% with median survival being 25.7, 29.0 and 47.4 weeks, respectively. Forty-seven patients were given radical radiotherapy, 30 of these received chemotherapy as initial treatment (20), as adjuvant (3) or at relapse (7). Their 5-year survival rate was 12.8%, with a median of 58 weeks, compared with 2.1% and 31.5 weeks for 241 patients who had palliative radiotherapy (P < 0.001). Seventeen of the 47 patients (36%) and 135 of the 241 patients (56%) were given radiotherapy alone. Univariate analysis showed that gender and age had no significant influence on survival but lymph node status did. The median survival for patients who had no lymph node metastases was 37 weeks compared with 24.5 for those who had (P < 0.01). The median and long-term survival rates for patients in this report contradict previous reports that radiotherapy has no influence on survival. Only patients who received radiotherapy, either alone, or with chemotherapy, have survived 5 years.
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PMID:An audit of survival in small cell lung cancer. 128 22

52 patients with bronchogenic carcinoma were studied preoperatively by means of conventional tomography and CT. The results were compared with surgical findings to evaluate the accuracy of these methods in detecting mediastinal lymph node involvement. 323 mediastinal lymph nodes were identified by CT and 237 of these were studied histologically. In 25% of lymph nodes with diameter between 0.5 and 1 cm metastases could be identified. On the other hand, 25% of lymph nodes measuring up to 3 cm did not contain metastases. The results varied in different regions (pre- and paratracheal, azygos region, aorto-pulmonary, subcarinal). The probability of involvement of small nodes was doubled if there were in regions neighbouring metastases. In view of the high incidence of false positive and false negative CT findings, conventional methods were sufficient in the presence of definite pathological findings.
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PMID:[Conventional x-ray techniques and computed tomography in the diagnosis of mediastinal lymph node involvement in non-small cell bronchogenic cancer. Which method is reliable?]. 131 69

A 66-year-old pensioner developed distinct, erythematosquamous and keratonic lesions on the hands and feet within 2 months, and also a progressive red-bluish discoloration of the whole integument. Clinical and X-ray exploration revealed a still asymptomatic small-cell bronchial carcinoma, so that the otherwise inexplicable skin lesions made an acrokeratotic paraneoplastic syndrome of the Bazex type seem most likely. This very rare syndrome has hitherto been observed only in patients with carcinomas of either the bronchial or the upper digestive tract, with or without cervical and mediastinal lymph node metastases. We report on our third patient with Bazex-type acrokeratosis, mainly because of the uncommon distribution and severity of his otherwise typical lesions. In addition, recent reports on this syndrome in the literature are reviewed.
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PMID:[A special form of Bazex acrokeratosis in small cell bronchial cancer]. 132 32


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