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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of pulmonary atypical mycobacteriosis (AM) were reported. Two cases were associated with lung cancer in which the diagnosis of malignancy was difficult and delayed by the coexistence of AM. The third was a case of adult T-cell leukemia (ATL) which manifested during the course of AM. In case 1 (73 years, male) and case 2 (86 years, male), chest roentgenogram abnormalities as well as clinical symptoms were considered to be caused by mycobacteriosis because of positive smear of acid-fast bacilli in sputa on admission. Therefore it took four months and three months respectively for final diagnosis of lung cancer. The autopsy of case 1 revealed a poorly differentiated adenocarcinoma with coexisting foci of squamous cell carcinoma in right lower lung, and granulomatous inflammations with caseating necroses in right mid and lower lungs. M. avium complex was cultured from sputum on admission, and also a high titer of HTLV-I antibody was demonstrated. In case 2 malignant cells were detected in sputa (class V), however his general condition did not allow an aggressive anticancer chemotherapy and he died of malignancy with complication of thromboangiitis obliterans on right lower leg. Case 3 was a 76-year-old male who had been diagnosed as lung AM for more than two years. His chest radiography showed bilateral infiltrative shadows with frequent positive cultures of M. avium complex (more than 100 colonies) from sputum. A generalized lymphadenopathy including right hilar lymph node on chest X-ray film was followed by the presence of atypical lymphocytes in peripheral blood and the elevation of HTLV-I antibody in serum. Four months later he died with hypercalcemia and renal failure in spite of chemotherapy (CPM + VCR + ADR + PLS). The above cases suggest that AM as well as tuberculosis should be considered when pulmonary infiltrates were observed in malignant patients, especially in patients with retrovirus infections.
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PMID:[Three cases of pulmonary atypical mycobacteriosis associated with lung cancer and adult T-cell leukemia]. 237 33

Resection of contralateral lung cancer (6 cases of pulmonary metastasis from the first lung cancer and one case of second primary lung cancer) were evaluated retrospectively in terms of postoperative complication, pulmonary function and survival rate. Out of 691 cases with resected non small cell lung cancer, 7 cases (1.0%) had contralateral lung cancer which were resected as the second operation. Six cases were squamous cell carcinoma and one case was adenocarcinoma. The interval between the first and the second operation was 12 months to 10 years (average 46 months). The post-operative stage of first lung cancer were stage I in 5 cases and stage IIIB in 2 cases, but no case had lymphadenopathy at the first operation. Operative procedures for contralateral lung were as follows; one case of lobectomy----lobectomy, one case of lobectomy----segmentectomy, two cases of lobectomy----partial resection, two cases of pneumonectomy----partial resection. For a metachronous lung cancer, right upper sleeve lobectomy was done as the first operation followed by left lower sleeve lobectomy as the second cancer five years later. Contralateral lung resection impaired pulmonary function, but all cases well tolerated the second operation. The five-years survival rate after second operation was 40.0%.
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PMID:[Second surgical intervention for contralateral recurrence or second primary lung cancer]. 261 16

We examined interlobar (between upper and middle lobes) lymph node enlargement by compensating filter hilar tomography in cases of central vein type right upper lobe vein. The control group consisted of 100 randomly selected specimens, in which hilar lymphadenopathy such as malignant lymphoma or sarcoidosis, and displacement of interlobar fissure due to atelectasis or tuberculosis were excluded. Eighty-four of the control cases were central vein type. As a lung cancer group, 18 cases were analyzed. These cases consisted of central vein type, and interlobar lymph node enlargement was noted on operation, in the course of therapy or on enhanced CT study. The right hilum bordered by the upper lobe bronchus (medial to the orifice of B1) and segmental bronchus (B2 or B3) above, central vein lateral and intermedial arterial trunk on the mediastinal side were evaluated. The shadows that obscured the inner margin of the central vein and lower margin of the upper-lobe and segmental bronchi were analyzed. The inner margin of the central vein was visible in 75 cases (89.3%) in the control group, compared to 1 (5.6%) of 18 cases in the lung cancer group. Decreased radiolucency beneath the upper lobe bronchus and segmental bronchus was found in 10 cases (11.9%) in the control, compared to 16 cases (88.9%) in the lung cancer group. In conclusion, obliteration of the inner margin of the central vein and the opacity that decreased the radiolucency extending to the peripheral side of the upper lobe bronchus are strongly suggestive of interlobar lymph node enlargement. Recognition of interlobar lymph node enlargement is useful for the staging of lung cancer and diagnosis of the disease that accompanies systemic hilar lymphadenopathy.
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PMID:[Analysis of interlobar (between upper and middle lobes) lymph node enlargement on hilar tomography]. 279 66

Magnetic resonance imaging and computed tomography were compared in a prospective study of 137 lung cancer patients proved by surgery or autopsy for determining the staging, evaluation of therapeutic effect and diagnosis of recurrent tumor. 1. Lung cancer staging In peripheral lung cancer, T1 and T2 relaxation times of the tumors before operation have some correlation with those of operated specimens. These relaxation times, however, are of limited nodule characterization. Hilar mass and adjacent pulmonary consolidation (obstructive pneumonia or collapse) can be distinguished on T2-weighted image (77%) and Gd-DTPA enhanced image (80%). Therefore these images help in distinguishing tumor from peripheral lung disease. In the diagnosis of tumor invasion to the heart and great vessels, MRI is superior to CT because MRI can be helpful in distinguishing true mass from heart and great vessels. As for the chest wall, MRI is more useful than CT in detecting tumor invasion especially to the thoracic inlet and superior regions. In the diagnosis of mediastinal and hilar lymphadenopathy, MRI is equivalent or slightly inferior to CT, but MRI can easily demonstrate the lymphadenopathy at subcarinal region on coronal image. 2. Evaluation of therapeutic effect in lung cancer patients treated by radiation and chemotherapy MRI patterns of therapeutic effect was divided into 3 types. It is suggested that there is some correlation between these patterns and histologic types. MRI can easily demonstrate necrotic area on T2-weighted and Gd-DTPA enhanced images. 3. Diagnosis of recurrent tumor in treated lung cancer Concerning detecting recurrent tumor after surgery or irradiation, and delineating tumor from radiation pneumonitis, T2-weighted and Gd-DTPA enhanced images are of clinical value.
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PMID:[MR imaging in the assessment of lung cancer patients: primary lung cancer staging, evaluation of therapeutic effect and diagnosis of recurrent tumor]. 279 69

Subcarinal lymph nodes are commonly involved by metastases from cancers of both the right and left lungs. No data exist on the relative accuracy of radiologic methods for evaluating subcarinal nodes. We prospectively studied lung cancer patients who were surgical candidates with CT, MR imaging (0.35 T), esophagography, and anteroposterior tomography. Forty-six patients who subsequently underwent thoracotomy had excision or sampling of subcarinal nodes at mediastinoscopy. All 46 had CT scans, 27 had MR imaging, 23 had esophagography, and 21 had anteroposterior tomography. Receiver-operating characteristic curves were constructed for each technique, and the area under each curve was calculated. MR and CT were nearly identical in subcarinal evaluation, with areas under the receiver-operating characteristic curves of 0.90 and 0.86, respectively; both were superior to esophagography (0.55) and anteroposterior tomography (0.61). The size threshold at which subcarinal nodes were considered abnormally enlarged in this lung cancer population was 11 mm in short axis for CT, agreeing with the size threshold previously reported for a normal population. The size threshold for abnormal nodal enlargement with MR imaging was 18 mm in short axis. We conclude that CT and MR imaging are comparable in the detection of subcarinal lymphadenopathy and are superior to both tomography and esophagography. Different size thresholds for metastatic subcarinal nodes are needed for CT and MR imaging to be comparable in overall performance.
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PMID:Radiologic evaluation of the subcarinal lymph nodes: a comparative study. 283 67

Although computed tomography (CT) is widely used in the evaluation of lung cancer, its use in the evaluation of clinical stage T1N0M0 lung cancer remains controversial. To evaluate the utility of CT, the authors studied 35 patients with clinical stage T1N0M0 lung cancer who underwent CT. Thoracotomy, mediastinoscopy, or fine-needle aspiration biopsy were performed in 26 of the patients. Metastases were proved in six of these patients, with CT demonstrating adenopathy in four of the six and a contralateral mass in one. Chest wall invasion was not demonstrated with CT in one patient. The overall prevalence of metastatic lesions in this group of 26 patients was 23.1%, with 15.4% of the 26 having unresectable lesions. CT demonstrated all metastatic lesions that precluded curative surgery. The results suggest that CT is clinically useful in the evaluation of clinical stage T1N0M0 lung cancer.
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PMID:T1N0M0 lung cancer: evaluation with CT. 291 15

In order to assess the potential of computed tomography (CT) of the mediastinum and mediastinoscopy in the staging of lung cancer, 125 patients were examined. Of these, 104 underwent thoracotomy, at which there was no evidence of mediastinal tumour involvement in 79 while 25 patients had signs of tumour spread. The sensitivity and specificity of CT were 87.0 per cent and 95.8 per cent, respectively, in the detection of direct tumour extension with a mediastinal mass. When lymph node enlargement was the sole finding, CT did not provide any differentiation between benign and malignant lymphadenopathy. The mediastinal involvement was inaccessible on mediastinoscopy in 18 cases (72%). Despite the surperior sensitivity of CT it was often difficult to determine whether direct tumour infiltration of mediastinal structures had occurred. It was concluded that CT is necessary for screening the entire mediastinum and, when it reveals no evidence of mediastinal tumour spread, mediastinoscopy will yield no further information. Mediastinoscopy will help to correctly identify accessible mediastinal lymph node involvement of the superior mediastinum and to define the mediastinal tumour invasion in doubtful cases.
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PMID:Computed tomography and mediastinoscopy in the assessment of resectability of lung cancer. 292 40

A 53-year-old man complained of anorexia and abdominal distention of one month's duration. The chest X-ray demonstrated a mass in the left lung with hilar and mediastinal adenopathy and a lytic lesion in the right fourth rib. A transbronchoscopic biopsy of the mass revealed oat cell carcinoma (WHO classification). The endoscopic evaluation also revealed a gastric lesion (IIc type). Biopsy of this lesion indicated signet ring cell gastric cancer. An abdominal CT scan demonstrated multiple liver metastases. Based on these findings, the patient was diagnosed as having synchronous lung and gastric primaries, with liver and bone metastasis from lung cancer. Carboplatin (CBDCA) was administered by intravenous drip infusion of 450 mg/m2. After a second treatment with CBDCA about 3 weeks later, the patient achieved a partial response at the primary site of lung cancer as well as at the liver and bone metastases. In addition, repeat endoscopy of the stomach demonstrated a complete regression. A biopsy specimen taken by gastroscopy was negative for cancer cells. Subsequent chemotherapy for small cell lung cancer was administered with cyclophosphamide, adriamycin, and vincristine, and to date there is no evidence of recurrence. Further studies on CBDCA treatment of small cell lung cancer and gastric cancer are needed to establish the efficacy of this drug against these two histologically different cancers.
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PMID:A case report of synchronous small cell lung cancer and gastric cancer successfully treated with carboplatin. 301 77

In summary, carcinoma is the most frequent cancer that metastasizes to the skin; lung cancer in men and breast cancer in women. Clinically distinctive patterns of cutaneous metastasis of epithelial origin include alopecia neoplastica, pulsatile nodules, Sister Mary Joseph's nodules, morpheaform, and cellulitis-like lesions. Biopsying these lesions reveals adenocarcinoma, squamous cell carcinoma, or anaplastic carcinoma. The type of histologic pattern seen can be a clue to the organ of origin giving rise to the cutaneous metastasis. Skin that is damaged allows for circulating malignant cells, often of epithelial or leukemic origin, to lodge and proliferate locally (inflammatory oncotaxis). The commonest form of leukemia to affect the skin of elderly males is chronic lymphocytic leukemia. However, when leukemia involves the mucous membranes, acute myeloid leukemia (acute monocytic and acute myelomonocytic leukemia) is the most likely diagnosis. When papules, nodules, or plaques develop on the head, neck, or torso in a middle-aged male accompanied by lymphadenopathy, there must be a high index of suspicion that these lesions are metastatic lymphomatous deposits. Definitive histologic diagnosis on a skin biopsy specimen is difficult. In this situation, it is best to rely on histologic patterns seen in lymphoid tissue along with cellular marker studies. An elderly patient having bone pain, anemia, elevated blood calcium level, and renal failure along with purplish or skin-colored nodules and plaques on the trunk has a good chance of having multiple myeloma. Biopsying these lesions is most certain to reveal atypical plasma cells, and blood immunoelectrophoresis will demonstrate characteristic monoclonal gammopathy. There are two malignancies seen in children under 3 years of age that often times affect the skin in a characteristic fashion. Letterer-Siwe disease, which is distinguished from other histocytic disorders by its cell of origin, the Langerhans cell, clinically shows maculopapular and erosive lesions distributed in a seborrheic pattern. Neuroblastoma derived from cells of the neural crest demonstrates clinically widespread bluish papulonodules. Kaposi's sarcoma, a multifocal vascular malignancy, has a wide spectrum of clinical expression. Those patients who are immunocompromised secondary to concomitant disease or immunosuppressive therapy are more susceptible to a disseminated fulminant course accompanied by opportunistic infection. In conclusion, although specific signs of internal malignancy are less common than nonspecific ones, they are just as important; if the clinician managing the cancer patient is familiar with these clues to internal disease, proper patient management will ensue.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Specific cutaneous manifestations of internal malignancy. 307 47

A total of 474 histologically proved Lung Cancers (LC) were evaluated by Conventional Radiology (CR) and Computed Tomography (CT) in order to assess the role of these two diagnostic modalities in the staging of LC. In 196/474 LC it was possible also to refer, for the evaluation of the diagnostic reliability, to the surgical control. The CR features of LC both at stage III (13% of the global series) and at stage I-peripheral T1 (16% of the global series) presented very high positive and negative predictive values (90% and 95%, retrospectively); in these cases it was considered useless to perform CT. The CT grading showed a high negative predictive value in excluding stage III caused respectively by grade T3 (91.5%) and grade N2 (93.5%). As to the staging, the CT assessment of the stage I and II showed a high predictive value (91.5%). On the other hand, the CT assessment of stage III presented an unsatisfactory predictive value (71%), due to the low predictive value in grade T3 (71.5%), poor in grade N2 (57.5%). The increase of the value threshold mediastinal adenopathies from 1 to 2 cm, leads to a great improvement of this predictive value (92%). The CT reliability was matched with the two different surgical "philosophies" (non aggressive or aggressive); surgery was excluded or performed according to the presence of omo-lateral mediastinal adenopathy. A correct advice to perform surgery was achieved in 33.5% (non aggressive "philosophy") and 43.8% (aggressive "philosophy") of cases; surgery was correctly excluded respectively in 49.6% and 45.9%. The resort to mediastinoscopy was advised in 7.8% and 1.3% of the cases respectively. In both "philosophies" the error of under-staging was lower (2.5%), than that of over-staging (6.6%).
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PMID:[Role and limits of diagnostic imaging in the staging of lung cancer]. 371 85


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