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

Delineation of the metastatic spread of lung cancer has been attempted by a variety of means. Controversy as to the indications for organ surveys, mediastinoscopy, scintillation scanning, and biopsy techniques still exists. Since definition of the micrometastatic state is yet unachieved, the staging of disease for therapy continues to be predicted on documented spread beyond the site of the origin. The records of 75 patients in whom the presence or absence of mediastinal metastases was known were retrospectively reviewed to establish the sensitivity, specificity, predictive values, and accuracy of 67Ga scintigrams. Comparisons were made with chest roentgenograms, mediastinal tomograms, and endoscopic findings. Five patients had 67Ga-negative studies. In the 70 patients having 67Ga-positive lung lesions, mediastinal 67Ga uptake had a sensitivity of 88%, a specificity of 86%, predictive values of 93% for a positive test and 76% for a negative test, and a test accuracy of 87%. These studies, plus those of others, permit selectivity of choosing candidates for mediastinoscopy. If the primary is 67Ga positive, a negative mediastinal scan obviates mediastinoscopy. If the mediastinum is 67Ga positive, mediastinal exploration is indicated. The level of involvement dictates whether resection is undertaken in suitable surgical candidates. This approach, employed since 1976, has lowered the costs of staging, and 67Ga has become our scintigram of choice.
J Thorac Cardiovasc Surg 1979 Jan
PMID:Evaluation of the mediastinum by gallium-67 scintigraphy in lung cancer. 75 66

Two hundred forty-two patients who had bronchial carcinoma and who underwent radical surgery were studied in order to determine putative host resistance to the tumor at histologic level, i.e., lymphocytic infiltration in the center and around the tumor, together with sinus histiocytosis and follicular hyperplasia in the regional lymph nodes. These features were evaluated in a semiquantitative way, giving rise to three groups of patients: D- (reaction absent or poor), D+ (reaction present), and D++ (strong reaction present). Five-year survival rates and the incidence of metastases in regional nodes were significantly related to the putative host resistance against the tumor, but no clear-cut correlation between grade of malignancy of the tumor and histologic type was evidenced. The significance of these reactive changes is fully discussed.
J Thorac Cardiovasc Surg 1977 Apr
PMID:Histology of bronchial carcinoma and regional lymph nodes as putative immune response of the host to the tumor. 83 42

One hundred consecutive patients with findings suggestive of resectable bronchogenic carcinoma were studied prospectively to determine if routine liver, brain, and bone scans (multiorgan scans) detected metastases which were not suggested by a history, physical examination, and serum chemistries. Multiorgan scans were compared with clinical evaluations in 52 patients found to have operable bronchogenic carcinoma. There was a discordance between scans and clinical evaluations in 25/153 scans (16 per cent). Two of the 22 negative scans in patients with abnormal clinical findings were false negative. Sixteen of the 17 positive scans in patients with normal clinical findings were false positive. One of the 131 scans done in patients with no evidence of metastases on clinical evaluation was true positive. These data indicate that the routine use of multiorgan scans in the initial staging of potentially resectable bronchogenic carcinoma is not justified.
J Thorac Cardiovasc Surg 1977 May
PMID:Multiorgan scans for staging lung cancer. Correlation with clinical evaluation. 85 Apr 23

This paper presents the unusual case of a patient with a histologically benign giant cell tumor of the femur that resulted in bilateral multiple pulmonary metastases having the appearance of benign giant cell tumor. An aggressive surgical approach was used to eradicate the pulmonary metastases; 25 nodules excised from the left lung and 33 nodules from the right lung were proved histologically to be benign giant cell tumors. Three years after bilateral thoracotomies, he remains well, without evidence of recurrent disease, and his lung function is almost normal.
J Thorac Cardiovasc Surg 1977 Dec
PMID:Benign giant cell tumor of femur with bilateral multiple pulmonary metastases. 92 19

A case is reported in which the patient died during pneumonectomy from endobronchial embolus of a tumour resulting in obstruction of the main bronchus of the normal lung. It is believed that the complication might have been prevented by the use of a double-lumen endobronchial tube. If generally employed, this precaution would also lessen the risk of intra-operative spread of smaller tumour emboli that may cause implantation metastases.
Scand J Thorac Cardiovasc Surg 1976
PMID:Death during pneumonectomy from endobronchial tumour embolus. A case report. 95 90

A 69-year-old patient underwent removal of a left atrial tumor which was diagnosed clinically and pathologically as atrial myxoma. Fourteen, 18 and 22 months later, distant metastases were discovered. Two of the metastases were removed entirely and one partially. The metastatic tumors were also thought to be of myxomatous origin by light and electron microscopy. Only at autopsy was it demonstrated that the patient had a primary chondrosarcoma of the pelvis giving rise to widespread myxoid metastases to the heart and other sites.
J Thorac Cardiovasc Surg 1976 Oct
PMID:Chondrosarcoma simulating malignant atrial myxoma. 96 89

Gallium-67 citrate scanning was prospectively evaluated in 55 patients who had lung lesions suspected to be primary carcinoma on chest x-ray films and in whom subsequent histologic diagnosis was obtained. Of 47 patients with histologically proved carcinoma of the lung, 44 (94 per cent) had a positive 67Ga scan. No patient with a positive scan had a benign lesion, so that the positive scan accuracy rate was 100 per cent. All 8 patients with a benign lesion and 3 patients with a malignant lesion had negative scans, for a negative scan accurary rate of 72 per cent for benign lesions. These results give statistical validity for the usefulness of the 67Ga scan in diagnosing carcinoma of the lung (p less than 0.001). Tumor cell type had little effect on the sensitivity of 67Ga scan. The 67Ga scan was equally useful in the evaluation of peripheral and central lesions. There was little difference amount T1, T2, and T3 classified lesions in their ability to take up 67Ga. The 67Ga scan was competitive with mediastinoscopy in assessing mediastinal lymph node metastases and provides a noninvasive method of assessing hilar lymph node metastases. There was a good correlation between the clinical staging of patients with lung cancer based on a chest x-ray film and 67Ga scanning and the staging after surgical treatment based on the histology of the resected specimens.
J Thorac Cardiovasc Surg 1976 Nov
PMID:Gallium-67 scanning for carcinoma of the lung. 97 11

Two cases of pulmonary blastoma are reported. One occurred in a 29-year-old man 31 months after a cyst had been excised from the same pericardial-pleural area. The cyst appeared to be of mesothelial origin and, although supported by a cellular stroma, was originally considered to be benign. The morphologic features, location, and possible relationship to a mesothelial lesion suggest an embryonal-mesothelial origin of the tumor. The patient died of recurrent and metastatic disease 9 years after the first resection. The second case is that of a now 74-year-old woman who, over a period of 19 years, has had six separate small peripheral lung tumors excised. They originally resembled fibrous hamartomas but included embryonal-type immature areas and became increasingly more cellular and sarcomatous. The fine structure of the recurrent tumors is that of primitive stroma with few fibrils but no other differentiating features.
J Thorac Cardiovasc Surg 1976 Nov
PMID:Pulmonary blastoma. 97 21

The gross rates of growth of pulmonary cancers and pulmonary metastases may be reduced to clinically useful nomograms and graphs. The constructs are feasible because most neoplasms growing in the lung are observed only during a limited segment of their life history, often being observed too few times to permit the identification of the growth curve of best fit. Consequently, the parameter that can be calculated most quickly, namely linear growth rate in mm./day, may be most useful. The linear radial growth rates are plotted against observed survival. The nomograms permit easy approximation of the volume doubling time and the exponential radial growth rate in mm./mm./day. The mean of the log normal frequency distributions of doubling times for common primary and metastatic cancers found growing in the lung is plotted on one nomogram to put the information in perspective. The more widespread reporting and tabulation of such data should lead to a highly useful kinetic staging and treatment evaluation system.
J Thorac Cardiovasc Surg 1976 Feb
PMID:The prognostic value of measuring the gross linear radial growth of pulmonary metastases and primary pulmonary cancers. 124 53

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.
J Thorac Cardiovasc Surg 1976 May
PMID:The selection of patients with bronchogenic carcinoma for mediastinoscopy. 126 61


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