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

Existing cytological and radiological services enabled the introduction of transthoracic fine-needle aspiration (FNA) in Johannesburg in 1983. The results achieved in the first 500 patients subjected to this procedure are presented, together with histological and clinical correlation. Of a total of 330 malignant tumours in this series, 306 were successfully sampled by FNA. Sensitivity of the technique in malignant disease was 92.7%, with 98.8% specificity. Positive and negative predictive values were 99.4% and 85% respectively. FNA was less accurate in the assessment of 24 benign thoracic tumours, only 75% of which were adequately sampled. Similarly, definitive cytological diagnosis of specific non-neoplastic pulmonary lesions, including granulomatous disease, was possible in only 78.6% of cases. The problem of aspirates in which no cellular abnormality (benign or malignant) was observed is discussed in relation to accuracy of needle placement. The special advantages of this technique included non-surgical verification of malignancy in radiologically or clinically inoperable cases; documentation of metastases; and detection of those tumour types (small-cell undifferentiated carcinoma and lymphoma) more appropriately treated by chemotherapy than by surgery. Pneumothorax requiring intercostal drain insertion occurred in 24 patients (4.8%). The advantages of rapid, accurate, inexpensive, non-operative diagnosis of thoracic masses was felt to outweight this single major complication.
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PMID:Transthoracic fine-needle aspiration cytology. An analysis of 500 cases. 267 39

This paper reports the results of 42 CT-aided fine needle biopsies of adrenal masses in 40 patients (26 were smaller than 3 cm., six smaller than 1 cm.). There were 25 adenomas, seven metastases, one primary carcinoma, one case of tuberculosis, two phaeochromocytomas and four post-inflammatory lesions. Diagnostic material was obtained in 88%. There was one incorrect diagnosis and on five occasions the result was indefinite, leading to an accuracy of 73%. Exclusion or demonstration of malignancy was, however, correct in 85%. There were no complications except for one unimportant pneumothorax.
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PMID:[Results of the diagnosis of adrenal masses using percutaneous CT-guided fine needle biopsy]. 300 65

We compared samples obtained using a fine-needle with those made using a screw-needle (Rotex) of equal diameter in 28 patients. The biopsies were performed with the aid of computed tomography. All patients had lesions suggesting primary lung neoplasia or metastatic disease located in the lung parenchyma, pleura and in the ribs (17, 9 and 2 patients, respectively). Diagnostic material was obtained from 25 patients. There was no statistically significant difference in the yield of diagnostic material produced by the two procedures. Malignancy was found in 12 patients. Pneumothorax was the most common complication, occurring in 7 patients. CT-guided diagnostic needle biopsies have high diagnostic accuracy and a low complication rate. The diagnostic yield of the fine-needle and the screw-needle is equal.
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PMID:Fine-needle and screw-needle samples in CT-assisted biopsies of chest lesions. 304 Apr 54

Ninety-two fine-needle aspiration biopsies (FNAB) were performed in 79 patients, yielding a sensitivity of 90 percent and specificity of 100 percent for malignancy. Seven different malignant cell types were identified: squamous cell, adenocarcinoma, large cell, small cell, carcinoid, embryonal cell, and malignant fibrous histiocytoma. A 94 percent correct correlation between the cytologic and histologic specimens was achieved. Pneumothorax requiring tube thoracostomy complicated 11 percent of the biopsies. Thoracotomy was avoided in 35 percent of patients considered for operation because FNAB documented benign disease, metastatic disease, or small-cell carcinoma. FNAB was able to provide a pathologic diagnosis for chemotherapy and radiotherapy in patients with metastatic disease. A diagnosis was obtained prior to operation in 98 percent of thoracotomies. Only one diagnostic thoracotomy and one thoracotomy for unresectable pulmonary malignancy were required in a 4-year period. We concluded that FNAB, a highly sensitive and specific procedure with a low morbidity rate and a high correlation with histologic findings, reduces the need for diagnostic thoracotomy.
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PMID:Diagnosis of pulmonary masses by fine-needle aspiration. 305 34

Two cases of angiosarcoma of the scalp were reported. The patients were elderly men and died from pulmonary complications, including pneumothorax, pulmonary haemorrhage and pneumonia, associated with metastatic tumours in the lungs. The data recorded from 95 autopsies of patients with angiosarcoma in Japan during 1980-1984 were analyzed. According to the anatomical distribution of the primary tumour, the patients could be subdivided into a scalp group and non-scalp group. In both groups, the most common metastatic site was the lung. The patients of the scalp group had more frequent pulmonary complications such as pneumonia, haemothorax, atelectasis and pneumothorax, when compared with the patients of the non-scalp group. In particular, pneumothorax was observed only in the patients of angiosarcoma of the scalp. The results indicate that angiosarcoma of the scalp tends to metastasize to the lung, especially to the subpleural or surface pleural area and these metastatic tumours are prone to necrosis, causing characteristic pulmonary complications.
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PMID:Angiosarcoma of the scalp: report of two cases with fatal pulmonary complications and a review of Japanese autopsy registry data. 312 Apr 5

Bilateral spontaneous pneumothorax is a rare complication of pulmonary metastases. We report a 44 year old woman who developed this complication a few months after undergoing mastectomy and postoperative radiotherapy for primary angiosarcoma of the breast.
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PMID:Bilateral pneumothorax secondary to metastatic angiosarcoma of the breast. 356 54

The association of spontaneous pneumothorax with metastatic osteosarcoma is well known. Small blebs and bullous change can be easily detected in the lungs by computed tomography. In patients with known sarcomas, blebs and bullae may appear as the first or early manifestation of metastatic disease (or concurrent with the disease) as illustrated by the three patients presented here with three different types of sarcomas. The literature has been reviewed as to the etiology of spontaneous pneumothoraces occurring in metastatic sarcomas and the relationship of bleb and bullae formation to these spontaneous pneumothoraces is discussed.
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PMID:Bullous change by CT heralding metastatic sarcoma. 385 45

A series of 140 patients with malignant pleural mesothelioma is reported. Clinical presentation was delayed in cases without a large effusion, but there was extensive tumour at presentation, shown by thoracoscopy, thoracotomy or computed tomography, in all patients investigated. Thoracoscopy was a useful diagnostic alternative to thoracotomy. With progression of disease, mesothelial extension was more important than distant metastases, which were usually too small and sparse to produce symptoms. Skin deposits of tumour in sites of previous invasive procedures did not cause pain or other clinical problems, and we consider that diagnostic and therapeutic procedures should not be withheld to avoid them. In the management of recurrent pleural effusions, intrapleural bleomycin, preceded by aspiration and followed by suction, was a useful alternative to surgery. Pneumothorax, spontaneous or iatrogenic, required decortication. Adequate pain relief was difficult; radiotherapy and nerve blocking procedures were not effective and opiates were often necessary.
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PMID:Malignant mesothelioma of the pleura: clinical aspects and symptomatic treatment. 620 38

Spontaneous pneumothorax is an unusual consequence of pulmonary metastases. This complication occurs mainly in children and adolescents with primary osseous sarcomas and is extremely rare in patients with pulmonary metastases secondary to carcinomas. Germ cell tumors have a proclivity to metastasize to the lung, but few instances of pneumothorax have been recorded. The authors present 3 cases of pneumothorax secondary to pulmonary metastases from germ cell tumors, both gonadal and extragonadal in type.
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PMID:Germ cell tumors complicated by pneumothorax. 630 92

Spontaneous pneumothorax is a rare complication of metastatic lesions of the lung. Treatment was given to 111 cases of synovial sarcoma at the Center Clinics in 1975-1981, lung metastases being in 53 cases (47.7%). Spontaneous pneumothorax was registered in 4 patients (3.6%) out of the total number of cases and in 7.55% of those with lung metastases. Three cases of spontaneous pneumothorax and lung metastases of synovial sarcoma revealed no symptoms. Therapeutic effect was obtained by conservative treatment. The risk of spontaneous pneumothorax in cases of lung metastases is increased after chemotherapy, which may be associated with the disintegration of subpleural metastases. Pneumothorax did not interfere with repeated courses of chemotherapy.
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PMID:[Spontaneous pneumothorax in patients with lung metastases of synovial sarcoma]. 633 Oct 3


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