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

Frozen-section (FS) analysis of mediastinal lymph nodes is commonly used in the staging of lung cancer and the evaluation of diagnostic tissue at mediastinoscopy. This approach facilitates definitive surgical intervention in a single operation and reduces costs. However, FS analysis can be labor intensive for the pathology department and time-consuming while the patient is anesthetized. Imprint cytology is more rapid than the FS procedure (average, 2 minutes versus 11 minutes per node) and allows more extensive sampling of the specimen. In this prospective study, we compared the diagnostic accuracy of imprint cytology and permanent sections on 121 mediastinal lymph nodes from 38 patients. There were no false-positive results and one false-negative result, although that patient was correctly classified based on positive cytology from another node. The sensitivity was 96.6%, the specificity was 100%, and the predictive value of a positive result was 100%, as no false-positives results were observed. The predictive value of a negative result was 98.9%, and the overall efficiency was 99.2%. These results compare favorably with those in other studies comparing the diagnostic accuracy of imprint cytology with that of FS analysis and with reported accuracy rates of FS technique. Our findings confirm the usefulness of this technique as an adjunct or substitute for FS analysis in the intraoperative pathologic evaluation of mediastinal lymphadenopathy.
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PMID:Intraoperative imprint cytology for evaluation of mediastinal lymphadenopathy. 817 86

We presented a case of metastatic iris tumor from lung cancer first presenting as decreased vision. A 47-year-old male was referred to our hospital, complaining of decreased vision. At his first visit, a yellowish mass was found on the right iris, and chest X-ray revealed paratracheal, subcarina, and right hilar lymphadenopathy. Bronchoscopy was performed, and small cell carcinoma was detected in a transbronchial biopsy specimen. Sixteen cases of metastatic iris tumor from lung cancer have been reported of such rare occurrences in Japan. The clinical features are briefly reviewed.
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PMID:[A case of metastatic iris tumor from lung cancer presenting as decreased vision]. 823 Aug 84

A 85-year-old female was admitted with general fatigue and chest discomfort in July 1991. Her chest X-ray film showed several pulmonary nodules in the bilateral lung fields without hilar lymphadenopathy. Metastatic lung cancer was suspected, but primary cancer was not detected in spite of cancer screening. Hemoglobin was 8.7 g/dl. The patient also had various immunological abnormalities including increased serum cold agglutinin titer, decreased serum complement, positive anti-nuclear antigen and IgM-kappa monoclonal gammopathy detected by immunoelectrophoresis. She was diagnosed as having autoimmune hemolytic anemia with cold agglutinin disease and M-protein. With the administration of corticosteroids, hemolytic anemia improved temporarily, but the patient died of hemorrhagic gastritis. At autopsy, a lung tumor was detected in the left upper lobe, mainly without hilar lymphadenopathy. The autopsy specimens showed Non-Hodgkin's lymphoma (diffuse medium-sized cell type), differentiated from macroglobulinemia by immunohistochemical studies. In elderly patients, with various immunological abnormalities, B-cell lymphoproliferative disorders such as malignant lymphoma should be suspected.
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PMID:[Non-Hodgkin's lymphoma with pulmonary involvement and various immunological abnormalities in an elderly patient]. 836 Oct 68

Metastatic spread to subcarinal lymph nodes in patients with bronchogenic carcinoma generally indicates unresectability. Transcarinal needle aspiration of the main carina (TCNA) has been used to obviate the need for more invasive procedures, particularly thoracic surgery. Of 510 transbronchial needle aspirations performed at our institution from 1983 to 1991, 88 (17 percent) were from the main carina in patients with bronchogenic carcinoma. We reviewed these 88 TCNA procedures to assess our experience with TCNA in the staging of lung cancer. The TCNA results were positive in 32 of 88 (36 percent) patients (20 non-small-cell cancers, 12 small-cell lung cancers). Following bronchoscopy, TCNA was the only evidence of unresectability in all 20 patients with non-small-cell lung cancer and was the only mode of diagnosis in 5 of 12 (42 percent) patients with small-cell lung cancer. Thirteen patients with non-small-cell lung cancer and positive TCNA also had positive bronchial secretion cytologic studies. Five of these patients had further subcarinal sampling and in all cases metastatic involvement was confirmed. TCNA was positive in 29 of 67 (43 percent) patients with radiographic evidence of mediastinal adenopathy. Of the remaining 38 patients with radiographic evidence of mediastinal adenopathy and negative TCNA results, 23 patients had further mediastinal sampling with mediastinoscopy or thoracotomy and in all cases mediastinal spread of cancer was established. Nineteen of 58 (33 percent) patients with an endoscopically normal-appearing main carina had a positive TCNA, while 13 of 30 (43 percent) patients with broadening or widening of the main carina had positive TCNA results. There were no complications. We conclude that TCNA is often a safe and useful staging modality in patients with bronchogenic carcinoma.
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PMID:The role of transcarinal needle aspiration in the staging of bronchogenic carcinoma. 840 56

Magnetic resonance (MR) imaging has both advantages and disadvantages in its application in lung cancer staging. Because of its ability to provide superior contrast resolution and to display structures in many planes, MR imaging is better than computed tomography (CT) for the detection of mediastinal and chest wall invasion. MR imaging also is more sensitive than CT for detection of hilar and mediastinal lymph node enlargement. Multiplanar T1- and T2-weighted images are optimal for differentiating lymph nodes from large vessels without the need for contrast enhancement; in these cases administration of Gd-DTPA provides no more information than plain MR images. MR studies should be used for examining patients with suspected mediastinal or chest wall invasion and those who have equivocal hilar or mediastinal adenopathy. The shortening effect of Gd-DTPA on the T1 value results in a high signal. This effect is dependent upon both the perfusion and diffusion of the contrast agent and the amount of extracellular fluid. The distribution of Gd-DTPA is similar to that of iodinated water-soluble contrast media. Gd-DTPA examination should be tailored to provide information regarding blood flow, vascularity, and permeability, none of which is easily appreciated on CT or plain MR images. Applications for which Gd-DTPA enhancement may be helpful include differentiating between malignant and benign pulmonary masses, differentiating between hilar lung cancer and peripheral postobstructive atlectasis or pneumonia, determining therapeutic effect after radiation therapy, and differentiating between recurrent or residual tumor and radiation pneumonitis.
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PMID:Clinical utility of Gd-DTPA-enhanced magnetic resonance imaging in lung cancer. 841 16

Transbronchial needle aspiration (TBNA) offers the unique opportunity to pathologically stage patients with lung cancer at the time of diagnostic bronchoscopy. The purpose of this study was to compare the staging sensitivities of the Wang 22-gauge and 19-gauge needles. We studied 64 patients with bronchogenic carcinoma and mediastinal adenopathy. Before bronchoscopy each patient underwent chest CT. Three to four aspirates were obtained with each needle from endotracheal sites adjacent to paratracheal lymphadenopathy. In 47 patients malignant mediastinal adenopathy was confirmed by the 19-gauge needle. A total of 29 patients had malignant 22-gauge needle aspirates. Of the 64 patients, 9 had benign, reactive mediastinal lymph nodes. There were 20 patients in whom only the 19-gauge needle demonstrated malignancy and 2 patients with malignant 22-gauge needle aspirates as the sole identifier of paratracheal malignancy. As a staging tool, the 19-gauge needle was significantly more sensitive than the 22-gauge needle, 85.5 versus 52.7% (p = 0.0001). Overall, in 49 of 55 patients (89.1%) with malignant mediastinal lymphadenopathy paratracheal tumor was confirmed by TBNA. The 19-gauge TBNA staging of the mediastinum is an effective, safe, and cost-saving alternative to surgical mediastinal exploration that can be performed during initial diagnostic bronchoscopy.
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PMID:Comparison of the Wang 19-gauge and 22-gauge needles in the mediastinal staging of lung cancer. 848 39

A case of double primary lung cancer was reported, one of which was peripheral type of adenocarcinoma of the right lung and the other was central type of squamous cell carcinoma of the left. A 66-year-old male was referred to our hospital on Nov. 2 1991, because a coin lesion at the right S1 was pointed out on chest X-ray. On bronchoscopy, a nodular tumor at the orifice of the left B3 was unexpectedly found. Biopsy of the left B3 tumor and washing cytology of the right B1 led to a diagnosis of left moderately differentiated squamous cell carcinoma (clinical T1N0 M0) and right adenocarcinoma (clinical T1N0M0). A right upper lobectomy was first performed with R2 lymph node dissection on Nov. 25 1991. Post-operatively, it was confirmed that the lesion was histologically poorly differentiated adenocarcinoma of the right S1, and the pathological stage was T2N0M0. Two weeks after the operation, chemotherapy of CDDP, VDS and MMC was given because of suspicion of rapid metastasis to the left hilar lymph nodes. Left upper lobectomy with R2 dissection was performed 7 weeks after the initial operation. Pathological findings showed squamous cell carcinoma originating from B3 with inflammatory lymphadenopathy and pathological evaluation was T1N0M0. He was discharged after an uneventful course of 3 weeks after the second operation. There are many reports that limited operations are recommended for each lesion in double primary lung cancer to reserve the pulmonary function. However, limited interventions cause frequently local metastasis, especially in peripheral type adenocarcinoma more than 3 cm in diameter and central type squamous cell carcinoma with lymph node metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Staged bilateral upper lobectomy of pathologically different synchronous double primary cancer]. 852 74

Glycolysis is increased in tumor tissues. [18F]fluoro-2-deoxy-D-glucose (FDG) is a glucose analogue radiopharmaceutical used in positron emission tomography (PET) to trace glucose metabolism. We investigated the sensitivity and specificity of FDG-PET imaging in the diagnosis and staging of lung cancer. One hundred and seven patients who had abnormal chest roentgenograms underwent whole-body PET imaging using FDG. PET scan results were classified as positive or negative based on the presence or absence of increased FDG uptake in the lung and/or in the mediastinum. All 82 patients with lung cancer had increased FDG uptake in the lungs, whereas only 12 of 25 patients with nonmalignant diseases had increased FDG uptake. Sixteen lung cancer patients with mediastinal metastases had increased FDG uptake in the mediastinum, of whom three had no lymphadenopathy on computed tomography of the chest. Sixteen lung cancer patients without mediastinal nodal involvement had no FDG uptake in the mediastinum. Seven of these patients had lymphadenopathy on computed tomography. FDG-PET imaging is 100% accurate in predicting mediastinal involvement in patients with lung cancer. It is 100% sensitive and 52% specific in predicting the malignant nature of a chest radiographic abnormality.
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PMID:Fluorodeoxyglucose-positron emission tomography in the detection and staging of lung cancer. 854 52

In 232 patients predominantly with the central type of lung cancer underwent echotomography (ET) (n = 16), CT (n = 142) and MRT (n = 55) in order to evaluate their possibilities in the diagnosis of the spread of a tumor process to the mediastinum and their impact on disease staging. The results of the techniques and the data of surgical interventions were compared: CT in 55 patients, CT in 70 and MRT in 22. The sensitivity of each method was determined by 3 parameters: 1) detection of intrathoracic lymphadenopathy; 2) diseased mediastinal large vessels; and 3) cancer spread to the pleura, pericardium, heart, and chest. Routine tomography is of informative value in the diagnosis of metastases into a peritracheo-bronchial group of lymph nodes (its sensitivity, 66%), ET, for paravasal (91%), CT and MRT for any groups of mediastinal lymph nodes (89-100%). MRT and ET (with sensitivities of 80 and 100%, respectively) were the methods of choice in the assessment of vascular lesions. MRT and CT are the most potent in evaluating the pleura, pericardium, and chest. The application of new techniques allows the clinical disease stage to be changed in 520 patients. Only X-ray and bronchological studies of patients with suspected lung cancer are not sufficient. ET either CT or MPR should be supplemented.
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PMID:[Significance of computerized, magnetic resonance and ultrasound tomography in the diagnosis of spreading of pulmonary cancer to the mediastinum]. 864 66

A case of unilateral hilar lymphadenopathy due to mycoplasmal pneumonia in an adult patient is presented. A 54-year-old female was admitted to our hospital because of high grade fever and abnormal shadows on chest roentgenograms. She did not have any respiratory symptoms before admission. Chest roentgenograms on admission revealed a tumor-like shadow in the right hilus resembling lung cancer. On the seventh day after admission, abnormal shadows on chest roentgenograms spontaneously improved without therapy. The patient was diagnosed as having mycoplasmal infection based on the serological tests.
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PMID:[A case of unilateral hilar lymphadenopathy resembling lung cancer due to mycoplasmal pneumonia in an adult]. 879 11


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