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

We present a retrospective study of twenty patients in whom bronchial carcinoids, and five, peripheric. One case met the criteria of atypical carcinoid. The mean age of presentation was 46.66 +/- 17.07 years (15-76), with predominance of the female gender (3:2). Twenty per cent of patients were asymptomatic and in the remainder, the diagnosis suffered an average delay of 19 months since the appearance of symptoms. Such symptoms were cough (50%), recurrent pneumonias (40%), fever (35%), hemoptysis (35%), thoracal pain (30%), carcinoid syndrome (10%) and consumptive syndrome (5%). The radiology showed lobular or segmentary atelectasis (40%), nodule/mass (30%), lobular or segmentary consolidation (20%), obstructive pneumonitis (5%) and atypical pleural effusion (5%). Direct endoscopic vision offered a sensitivity of 84.6%, while transbronchial biopsy, just 69.2%. Metastasis in mediastinal, suprarenal, thyroid and brain gangliar chains were detected.
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PMID:[Clinical study of 20 cases of bronchial carcinoid]. 155 22

We reviewed 69 patients with documented carcinoid tumors, 67 of whom had resectable disease. Operations included nine pneumonectomies, 31 lobectomies, 12 bilobectomies, five segmental resections, and 10 sleeve resections. Follow-up on 65 patients reveals 40 surviving beyond 5 years and 13 beyond 20 years since resection. There were no operative deaths and only one recurrence (local) that was subsequently successfully resected. Twenty patients had had recurrent unifocal pneumonitis or hemoptysis for up to 5 years prior to diagnosis. Two patients had the carcinoid syndrome. Biopsy was performed on 23 tumors and resulted in "moderate-to-severe" hemorrhage in six cases. Lymphatic spread was present in seven cases. All seven are alive and free of disease, six of whom have been followed from 5 to 24 years. Diseased resection margins were present in two cases, with both surviving 20 years after resection. All 10 sleeve resections were performed more than 5 years ago. We conclude that carcinoid tumors carry a favorable prognosis upon resection, even when intrathoracic lymphatic metastases are present and are resected. Lung-sparing resections including sleeve resections should be utilized. Recurrent pneumonia or hemoptysis or both requires diligent investigation. Biopsy of the tumors may be performed with care.
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PMID:Bronchial carcinoid tumors: twenty years' experience. 735 32

Bronchial carcinoid tumors are usually indolent, slow-growing tumors with an excellent prognosis. However, even typical carcinoids can metastasize to regional lymph nodes or to distant sites. Atypical carcinoids tend to behave more invasively with more frequent nodal and distant metastases. Despite this, long-term survival can be expected as many tumors grow and spread slowly. At the end of the spectrum are the highly aggressive small cell carcinomas which have a very poor prognosis despite aggressive chemotherapy. Clinically, carcinoid tumors are frequently asymptomatic. Symptoms are most frequently due to obstruction (pneumonia, 'asthma', coughing) or bleeding. Carcinoid syndrome is seen infrequently and usually signifies metastatic disease. Cushing's syndrome is occasionally seen in association with these tumors. The treatment of carcinoid tumors is surgical. Resection should be complete and encompass the regional lymph nodes.
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PMID:Bronchial and thymic carcinoid tumors: a review. 769 41

We would like to describe the characteristics of affection by carcinoid tumor in our surroundings. In so doing, we have reviewed the clinical histories of the 131 cases of carcinoid tumor diagnosed in our center between 1972 and 1990. The incidence has been 0.7 cases per 100,000 inhabitants per year. The age at diagnosis is from 8 to 88 years, and the proportion of men to women is practically 1. The most common locale affected the appendix (54 cases) followed by the bronchials (46 cases). The most common clinical presentation has been casual discovery and in the bronchials, in addition to hemoptysis and pneumonia. Carcinoid syndrome was found in only 4 cases, and of 17 determinations of indole acetic 5-hydoxi acid, only 2 resulted pathological. There were four cases of hepatic metastasis and two deaths related with the tumor.
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PMID:[Carcinoid tumor. An analysis of 131 cases]. 802 94

During the period 1977-95, 20 patients underwent surgery for carcinoid tumour in the bronchus at the University Hospital of Trondheim (n = 16) and Innherred County Hospital (n = 4). All the tumours were typical carcinoid tumours. Median age of the patients was 41 years (range 16-78 years). The observation period averaged 7.5 years (0.5-18 years). The most common symptoms were cough, dyspnoea, wheezing and pneumonia. One patient had carcinoid syndrome. Chest X-ray were negative in three of the patients. Bronchoscopy was carried out in all the patients. Biopsies were taken in ten of them, and the diagnosis was conclusive in five cases. Lateral thoracotomy was performed in all the patients. The surgical procedures were lobectomy (15), segmental/wedge resection (3), bronchotomy with tumour resection (1) and sleeve resection (1). 19 patients were still alive at the time of follow-up, with no tumour recurrence. One patient died from cerebral stroke eight years after surgery. Good long-term results were found, and the study supports the use of limited lung resection or bronchoplasty operations to treat carcinoid tumour in the bronchus if the primary tumour is localised and there are no metastases.
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PMID:[Surgical treatment of carcinoid bronchial tumor]. 923 5

A case of a 7-year-old boy admitted to the clinic with severe symptoms of 1-month lasting pneumonia not responding to antibiotics is presented. The chest X-ray confirmed inflammatory process in left lung parenchyma. Due to unsuccessful further preservative treatment, bronchoscopy and CT of the thorax were performed. They showed the presence of a tumor narrowing the left main bronchus. Histopathologic examination of the tissue taken during bronchoscopy revealed carcinoid. Through the left-sided thoracotomy, the resection of a 5 cm large oval-shaped tumor, as well as the distal part of the left main bronchus was done. During clinical observation the child did not present any symptoms of the carcinoid syndrome. Urine levels of acids: homovanillic, vanillylmandelic and 5-hydroxyindolylacetic were normal. Bronchoscopy and X-ray of the chest directly, two weeks after and six months after resection were normal. Childhood primary pulmonary neoplasms are rare and the most frequent malignant tumors are bronchial adenomas. About 80-90% of them are carcinoids. The period from initial symptoms to clinical diagnosis and the institution of treatment, usually lasts several months. In our case it was a seven-week-long period. When cough, weezing, hemoptysis and inflammation of lung parenchyma are prolonged, carcinoid should always be considered in differential diagnosis. Radiological changes are usually nonspecific in cases of bronchial adenomas. Bronchoscopy with biopsy and CT scan are investigations that are decisive. Because of relatively low malignancy of carcinoid, results of the surgical treatment are good even in presence of metastases in regional lymphatic nodules.
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PMID:[Bronchial carcinoid in a 7-year-old boy]. 1186 52

Carcinoids are neuroendocrine neoplasms. Bronchial carcinoids are unusual, malignant primary neoplasms that characteristically involve the central airways and typically exhibit well-defined margins and bronchial-related growth. Bronchial carcinoids include low-grade typical carcinoids and the more aggressive atypical ones. They usually affect patients in the 3rd through the 7th decade of life who are often symptomatic with cough, hemoptysis or obstructive pneumonia. Rarely, the initial symptoms are related to the secretion of hormones causing carcinoid or other endocrine syndromes. Bronchial carcinoids radiologically manifest as hilar or perihilar masses, with or without associated atelectasis, pneumonia or bronchiectasis. At CT-scan the relationship of these tumors with the bronchial tree is usually seen, and they show contrast enhancement or calcification. Even if the radiological signs may be suggestive for bronchial carcinoid, the definitive diagnosis is reached only by the tissue sampling. Bronchoscopic biopsy is the more effective way to identify the nature of carcinoid tumors because of their frequent central location. The treatment of choice is the surgical resection which should be carried out with maximum respect for the residual lung and bronchial tissues. Endoscopic ablations in well defined cases, bronchotomy and lung resections with or without bronchoplastic procedures have been described. Hilar and mediastinal lymph node sampling and examination should be ever performed during open procedures. Positivity of the nodal tissues could influence the resection procedure and is related with the prognosis, specially for the atypical carcinoids. Chemo- and radiation therapy are not effective in improving the long-term outcome in those patients with advanced disease. The long-term outcome is strictly related with the histological subtype and the lymph node status. Local recurrences and distant metastases are more frequent in the atypical carcinoids which manifest a more aggressive behavior. During the last decade, the importance of the use of somatostatine analogues (octreotide) in the staging, early detection of the recurrent disease and its management such as that of the associated carcinoid syndrome became clear.
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PMID:[Bronchopulmonary carcinoid tumours]. 1214 71

Bronchopulmonary neuroendocrine tumors (BP-NETs) comprise approximately 20% of all lung cancers and represent a spectrum of tumors arising from neuroendocrine cells of the BP-epithelium. Although they share structural, morphological, immunohistochemical, and ultrastructural features, they are separated into 4 subgroups: typical carcinoid tumor (TC), atypical carcinoid tumor (AC), large-cell neuroendocrine carcinoma (LCNEC), and small-cell lung carcinoma (SCLC), which exhibit considerably different biological characteristics. The clinical presentation includes cough, hemoptysis, and obstructive pneumonia but varies depending on site, size, and growth pattern. Less than 5% of BP-NETs exhibit hormonally related symptoms such as carcinoid syndrome, Cushing, acromegaly, and SIADH. SCLC is the most common BP-NET, while LCNEC is rare, approximately 10% and < or =1%, respectively, of all lung cancers. Both SCLC and LCNEC progress rapidly, are aggressively metastatic, and exhibit a poor prognosis. The incidence of BP-carcinoids (TC and AC) in the US was 1.57 of 100,000 in 2003 (an unexplained and substantial increase over the last 30 years, approximately 6% per year). No curative treatment except for radical surgery (almost never feasible) exists. The slow-growing TC exhibit a fairly good prognosis ( approximately 88%, 5-year survival), whereas AC demonstrate a 5-year survival of approximately 50%, and the highly malignant LCNEC and SCLC5-year survival of 15% to 57% and <5%, respectively. This review provides a broad overview on BP-NETs and focuses on the evolution of the disease, general features, and current diagnostic and therapeutic options.
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PMID:Bronchopulmonary neuroendocrine tumors. 1847 55

Serotonin syndrome is a potentially life-threatening condition that results from excessive serotonin agonism of the central and peripheral nervous system. Though serotonin syndrome is most often associated with ingestion of more than one serotonergic drug, many other mechanisms have been associated with serotonergic excess. This case study presents a 79-year-old African-American female, an assisted living resident, who presented to the emergency department with altered mental status, acute onset of "chills," reduced appetite, urinary incontinence, and an elevated temperature of 103 degrees F (39.4 degrees C). Extensive initial diagnostic findings were negative for urinary tract infection, systemic infection, pneumonia, myocardial infarction, and stroke. Despite aggressive medical management, including intravenous hydration and broad-spectrum antibiotics, the patient continued to become more confused, agitated, and despondent over the subsequent 24 hours. The initial working diagnosis did not include serotonin syndrome, but once other studies did not reveal an etiology of the symptoms and the patient continued to be delirious, paroxetine was discontinued and all symptoms resolved within 48 hours of last dose. Voluntary reporting, postmarketing surveillance, and implementation of well-designed randomized clinical trials are all mechanisms to gather data on serotonin syndrome. These practices will provide future researchers with needed information to solidify diagnostic criteria, educate health care professionals, and safeguard the public against this preventable and potentially lethal drug-drug interaction.
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PMID:A case study of delayed serotonin syndrome: lessons learned. 1969 9

Pulmonary neuroendocrine tumors comprise 20% of all lung cancers. They are separated into 4 subgroups: typical carcinoid tumor, atypical carcinoid tumor, large-cell neuroendocrine carcinoma, and small-cell lung carcinoma. The major symptoms present in 60% of patients are cough, hemoptysis, and obstructive pneumonia. They may also exhibit hormonally related symptoms e.g. carcinoid syndrome. Small cell lung cancer is the most common subgroup, with rapid progression, aggressive metastatic potential and the worst prognosis. Large cell neuroendocrine carcinoma is rare but also has a poor prognosis. Typical carcinoid may be accompanied with hormone related symptoms and has the best prognosis; atypical one on the contrary may cause lymph node and distant metastases in half of the cases. Elevated plasma levels of chromogranin-A are present in majority of pulmonary neuroendocrine tumors and act as tumor marker. The mainstay of treatment is radical surgery if possible. In locally advanced or metastatic disease combination chemotherapy and somatostatin-analogues may have beneficial effect. This review focuses on the general features, and current diagnostic options of pulmonary neuroendocrine tumors.
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PMID:[Symptoms and diagnostics of lung neuroendocrine tumors]. 2135 52


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