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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although open lung biopsy (OLB) is frequently employed for diagnosis of pulmonary lesions in patients with Hodgkin's disease, the actual efficacy of the procedure in establishing a diagnosis in these patients, and its effect on their treatment and clinical outcome, have not been evaluated. We reviewed the results of OLB in 41 patients with previously diagnosed Hodgkin's disease (17 with stage II disease, 10 with stage III, and 14 with stage IV) who had pulmonary opacification on chest roentgenogram. Nineteen (46%) diagnoses were specific and 22 nonspecific. The most common specific diagnosis was Hodgkin's disease (12 patients); the others were Pneumocystis carinii pneumonia (3), solitary fungal granuloma (2), cytomegalovirus pneumonia (1), and primary lung adenocarcinoma (1). Specific diagnoses were made in 11 (69%) of 16 patients with discrete nodules or masses but in only eight (32%) of the 25 patients with non-nodular radiographic opacification. Eleven (58%) of 19 patients who were asymptomatic or had had symptoms for longer than 4 wk had specific diagnoses, compared to one of six patients (17%) symptomatic for 1 wk or less. Survival of hospitalization correlated more with stage of Hodgkin's disease than with specific diagnosis. However, treatment was changed after biopsy in 22 (54%) of the patients. The results suggest that OLB can be helpful in the management of patients with Hodgkin's disease and pulmonary infiltrates, both in establishing a diagnosis and in assisting the patients' management. OLB appears to be more helpful in patients with Hodgkin's disease than in patients with acute nonlymphocytic leukemia or the acquired immunodeficiency syndrome and pulmonary infiltrates.
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PMID:Open lung biopsy in patients with Hodgkin's disease and pulmonary infiltrates. 271 53

We reported a rare case of triple cancers with acute lymphoblastic leukemia (ALL) associated with disseminated intravascular coagulopathy (DIC) after the operations of colon cancer and primary lung cancer. A 78-year-old Japanese male, who had been operated upon for colon cancer (adenocarcinoma) on March 1981, metastatic brain tumor (adenocarcinoma) on December 1986, and primary lung cancer (squamous cell carcinoma) on February 1987, was admitted to our hospital because of severe general malaise on December 6 1987. On admission, he had mild hepatosplenomegaly and hemorrhage diathesis such as purpura. Serum LDH increased to 2,515 mU/ml. The white blood cell count was 6,210/microliters with 53% leukemia cells, and the platelet count was 12,000/microliters. A bone marrow was infiltrated with 96.0% leukemia cells. The leukemia cells stained positively for PAS and negatively for peroxidase. Immunological examination of leukemia cells showed that HLA-DR, TdT, B1 and J5 were positive and cytoplasmic Igmu and surface Ig were negative, indicating common ALL. The coagulation studies revealed that the activated partial thromboplastin time was prolonged to 42.0 seconds, FDP increased to 79.9 micrograms/ml, and antithrombin-III decreased to 62%. Chromosome analysis showed a 48, XY, +2, +21q-, t(9;22) karyotype. He was diagnosed as having Ph1 positive ALL associated with DIC. He was treated with vindesine, prednisolone, L-asparaginase, and adriamycin and complete remission (CR) was achieved after two months. But on August 1988, 8 months after CR, ALL and brain tumor relapsed and he died of pneumonia on September 19, 1988.
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PMID:[Ph1 positive acute lymphoblastic leukemia with DIC after operation of colon and lung cancer]. 281 Jul 93

Seventy-three patients with regional, inoperable non-small-cell lung cancer received treatment with initial chemotherapy for two cycles (vinblastine-mitomycin followed in 3 weeks by vinblastine-cisplatin), with planned subsequent neutron irradiation to the primary site and concurrent, elective whole-brain irradiation using photons, followed by two more cycles of identical chemotherapy. Histology was reported as adenocarcinoma or large cell in 75%, and 60% had Radiation Therapy Oncology Group (RTOG) stage 3 disease; the remainder had stage 4. The response rate to chemotherapy induction was 51%. There were 58 patients in a second phase of the study who were potentially eligible for treatment with a medically dedicated cyclotron having more favorable characteristics with regard to treatment planning and dose delivery (neutrons "B"). The overall response rate in this group was 79%. Chemotherapy toxicity included four fatalities (5%), with three related to mitomycin C induced bilateral pneumonitis, and an additional five patients (7%) with life-threatening events that required hospitalization. Two fatalities were attributed to combined effects of chemotherapy and radiation, and six more to chest radiation therapy, for an overall treatment-related death incidence of 12 of 73 (16%). Four of the six deaths related to chest irradiation occurred after treatment with a "physics-based" neutron generator (neutrons "A"). Among the 45 who received neutrons in the B group, two (4%) had radiation-related deaths, and another four (10%) had clinically evident radiation pneumonitis. Pretreatment performance status (PS) and response to chemotherapy, but not RTOG stage or weight loss, were significantly associated with survival. Among patients who actually received chest irradiation, only initial response to chemotherapy remained as a significant predictor of survival in univariate analysis, with a median survival of 20 months in responders v 9 months in chemotherapy nonresponders. The patterns of first relapse observed in B group patients revealed that 28% were distant, while 64% were locoregional. This represents a reversal of the usual pattern in studies of chest irradiation alone. It probably reflects elimination of brain relapse by the use of elective whole-brain irradiation, impact of systemic chemotherapy on micrometastases elsewhere, and conservative treatment volumes employed for the chest irradiation in an attempt to minimize its toxicity. Further exploration of combined modality therapy is indicated for regional non-small-cell disease, with a real potential for survival impact if the therapeutic index can be improved.
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PMID:Combined treatment with chemotherapy and neutron irradiation for limited non-small-cell lung cancer: a Southwest Oncology Group Study. 282 5

X-ray features of 23 cases (25 foci) of non-squamous cell carcinoma and other malignant neoplasms in the trachea and main bronchi were reviewed. They were 15 (17 foci) adenoid cystic carcinomas, 3 carcinoids, 2 mucoepidermoid carcinomas, 1 well-differentiated adenocarcinoma, leiomyosarcoma and extramedullary plasmocytoma each. The symptoms were non-specific leading to a delayed diagnosis more than one year in 52% of cases. The X-ray findings were classified into 3 types: intraluminal polypoid (11 tumors), sessile mass without and with extraluminal invasion (3 and 11 tumors). These tumors were prone to extraluminal invasion and can be demonstrated by X-ray. The air lumen involved appeared as localized expansion in 3 adenoid cystic carcinomas, 1 of which was proved by operation. Routine chest films were of limited value with 30% false negative chest film, 26% mediastinum mass and 30% obstructive pneumonitis/atelectasis. Lesions of posterior tracheal wall and carina were better revealed by lateral tomography. Of the 10 cases with lateral tomography, images were superior to those of AP tomography in 5. Three cases had CT scan, by which intra-tracheal/bronchial lesions, invasions of mediastinum and regional lymph nodes were shown. CT scan is more accurate compared with the other imaging modalities in visualizing these lesions and more helpful in selecting treatment.
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PMID:[X-ray features of primary non-squamous cell carcinoma and other malignant neoplasms in the trachea and main bronchi--analysis of 23 cases]. 283 59

Two hundred and thirty patients, treated by resection for bronchial carcinoma, were analysed. The histological examination showed in 80% a squamous cell carcinoma, in 11.3% an adenocarcinoma, in 5.3% a large cell and in 3.4% a small cell carcinoma. There was a great difference between preoperative and postsurgical TNM-classification: 90% stage I preoperatively and only 68.3% after resection with mediastinal lymph node dissection. Twenty-four patients (10.4%) died during the first 30 days after operation. The main cause of death was cardiac failure or respiratory insufficiency. Forty-four patients (19.1%) had non-fatal complications. Atelectasis and pneumonia predominated. Survival without regard to stage and cell type was 27.6% at 5 years. As expected survival rate in T1N0M0 was best (40%). Therefore early detection of bronchial carcinoma is essential.
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PMID:Operated bronchial carcinoma: a review of 230 cases. 301 20

The study relates to patients with bronchioloalveolar carcinoma who had undergone operation. On reassessment of histological specimens, 92 patients were considered to have been suffering from bronchioloalveolar carcinoma. Bronchioloalveolar carcinoma was further classified according to histological findings as typical or of mixed type. The latter included cases on which there was differentiation towards pulmonary adenocarcinoma. A third group consisted of 32 cases of peripheral pulmonary adenocarcinoma originally diagnosed as bronchioloalveolar carcinoma. Pulmonary tuberculosis was found to have occurred oftener in bronchioloalveolar carcinoma cases than in mixed bronchioloalveolar cases (p less than 0.005). A history of pneumonia was commoner in mixed bronchioloalveolar and adenocarcinoma patients than in bronchioloalveolar patients (p less than 0.05). Lobectomy or more conservative resection had been possible in the majority of cases. There had been no surgical or hospital mortality. No differences existed between the groups as regards surgical treatment, postoperative radiotherapy or chemotherapy. Local recurrence was commoner in bronchioloalveolar patients than in mixed bronchioloalveolar patients (p less than 0.001) or adenocarcinoma patients (p less than 0.025). Mixed bronchioloalveolar and adenocarcinoma patients had distant metastases oftener than bronchioloalveolar patients (p less than 0.025 and p less than 0.001). Adenocarcinoma patients also had more metastases than mixed bronchioloalveolar patients, but the difference was not statistically significant. Most metastases (82%) were discovered within three years of operation. The incidence of local recurrences increased from three years after operation. The five-year survival rate was 57% in the bronchioloalveolar group, 45% in the mixed bronchioloalveolar group and 17% in the adenocarcinoma group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results of surgical treatment in bronchioloalveolar carcinoma. 302 37

One hundred and thirteen patients with early gastric cancer operated on during the period from 1967 to 1982 were followed up until 1985; 24 of them died. The 5- and 10-year cumulative survival rates of 99 patients, excluding 14 (12.4%) who died of diseases unrelated to gastric cancer, were 97.8% and 89.1%, respectively. Of the 24 deaths, seven were due to recurrence of gastric cancer, one to pulmonary metastasis found preoperatively and 16 to diseases unrelated to gastric cancer. Recurrence took the form hepatic metastasis in four cases, bone metastasis in two and recurrence in the gastric remnant in one. The metastases were distant in the majority of cases of recurrence, and recurrence characteristically occurred late, with six patients dying more than 5 years and one dying 10 years after surgery. The recurrences were mostly found in patients with poorly differentiated adenocarcinoma. On the other hand, the causes of death in 16 patients were diseases unrelated to gastric cancer, i.e., primary cancer of other organs in six, operative complications, heart diseases, senility, and pneumonia in two each, and a traffic accident and apoplexy in one each. Thus, Many of the deaths were due to primary cancer of other organs. Four patients underwent non-curative resection. One had lung metastasis found preoperatively and the remaining three had positive margins. The latter three did not undergo a second operation, but the causes of their deaths were not recurrence of gastric cancer. It is necessary to follow up patients from the standpoint not only of recurrence of gastric cancer, but also of diseases other than gastric cancer and multiple gastric cancer in elderly patients.
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PMID:Factors influencing the postoperative course 113 patients with early gastric cancer. 302 77

Transthoracic esophagogastrectomy is a safe operation. Mechanical staplers and a cervical anastomosis have been emphasized to avoid catastrophic consequences of anastomotic leaks in the chest. Transhiatal esophagectomy has been proposed to bring the anastomosis into the neck. It is meant to be a palliative procedure and consequently denies the patient the best chance for surgical cure. The emphasis should be on anastomotic technique and sound principles of surgical oncology. Since 1980, we have performed 104 esophagectomies for carcinoma of the esophagus. We used a left thoracoabdominal incision for distal tumors (64) and the Ivor Lewis technique (40) for more proximal tumors. A two-layer inverting interrupted silk suture technique was used for all anastomoses. More than 90% of the procedures were performed by resident staff. The operative mortality was 2.9% (3 patients). There were no anastomotic leaks. Five patients required between one dilation and three dilations postoperatively. A positive smoking history was present in 83 patients and substantial alcohol use, in 33. Median estimated blood loss was 500 ml, and 60% of patients required no transfusions. Major complications included pneumonia (12 patients) and reexploration for bleeding (2). Minor complications included atelectasis (71 patients), atrial fibrillation (9), ventricular arrhythmias (9), urinary tract infection (3), and wound infection (2). Squamous cancer was present in 31 patients and adenocarcinoma, in 73. Positive lymph node metastases were present in 75%. Anastomotic recurrence was documented in 6 patients. Standard techniques of esophagogastrectomy and a two-layer anastomosis will give excellent results with low mortality and acceptable morbidity.
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PMID:Transthoracic esophagectomy: a safe approach to carcinoma of the esophagus. 327 51

Three fatal cases of listerial endocarditis were studied. The first case occurred in an apparently healthy 58-year-old man, who presented with symptoms of pneumonitis. The second case developed in a 75-year-old woman with adenocarcinoma of the lung and aortic stenosis. In the third patient, an 83-year-old woman, aortic valve vegetations with perforations were found at necropsy. A colonic adenocarcinoma was found in the first and third cases. Ampicillin, alone or with an aminoglycoside, was the antibiotic used. Urgent valve replacement was performed in the first case. Listeria monocytogenes was isolated from blood cultures in all three cases. A review of 41 other patients with listerial endocarditis showed a nonspecific clinical picture, but septic complications occurred in one-half of the cases. Thirty-nine patients had at least one predisposing factor, which was underlying heart disease in 25 cases. The mortality rate was 48%.
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PMID:Fatal endocarditis due to Listeria monocytogenes. 329 64

After 3 days of intestinal obstruction, a proximal jejunojejunal intussusception was resected during surgery in an adult Holstein cow. A transmural adenocarcinoma was found at the proximal margin of the intussusception. The cow recovered well from surgery and produced milk and embryos to expectation. During the seventh month after surgery, the cow developed pneumonia and, therefore, was euthanatized. Disseminated abdominal and thoracic neoplasia was observed at necropsy.
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PMID:Jejunojejunal intussusception associated with a transmural adenocarcinoma in an aged cow. 335 Jul 45


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