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

To determine the presence of chest wall and mediastinal invasion by lung cancer and to establish the origin of chest tumors, we studied 12 patients with intrathoracic tumors by using chest CT combined with artificial pneumothorax. Six patients had primary lung cancer, two had metastases, and one each had neurofibroma, pericardial cyst, chondroma of the rib, and malignant mesothelioma. All 12 tumors abutted the chest wall or mediastinum and could not be separated by conventional CT. Between 400 and 800 ml of air was injected into the pleural space before a second CT scan was obtained. No invasion was found at surgery in cancers that were separated from chest wall or mediastinum on CT scans. Surgery revealed chest wall invasion in three patients in whom the CT scans showed that the tumor was not separated from the chest wall. Only one patient with a tumor that was not separated from the mediastinum on CT did not have mediastinal invasion: in this case, only adhesions were found at surgery. Thus, in the eight patients with primary lung cancer and metastasis, sensitivity, specificity, and accuracy were 100%, 80%, and 88%, respectively. In four patients with mediastinal or pleural tumor, CT combined with pneumothorax was useful for establishing the origin of tumors. In all, 11 of the 12 patients were correctly evaluated by using this method. No complications occurred, except for mild chest discomfort in one patient. This study suggests that chest CT combined with artificial pneumothorax is useful for the evaluation of the extension of lung cancer into the chest wall and mediastinum and for the diagnosis of the site of origin of intrathoracic tumors.
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PMID:Chest CT combined with artificial pneumothorax: value in determining origin and extent of tumor. 200 29

The results of 102 cases of diffuse or peripheral lung lesions examined by transbronchial lung biopsy (TBLB), bronchial brushing (BB), and bronchial alveolar lavage (BAL) via fiberoptic bronchoscope, were reported. The positive diagnostic rate was 74.5% (76 cases). In lung cancer, the positive rate by means of BB was 77.1%, which was higher than that by TBLB (58.1%). In pulmonary tuberculosis, the positive rate by TBLB was 76.9%, higher than that by BAL fluid for identification of tubercle bacillus by culture (44.4%). If TBLB was combined with BB and BAL, the positive diagnostic rate would be further elevated. The data showed that if the size of the masses greater than or equal to 3cm in peripheral lung field on chest film, the possibility of lung cancer was greater than that of those less than 3cm. Most cases of localized infiltration in the lungs were caused by tuberculosis. But the diffuse lesions of the lungs were often caused by bronchiolo-alveolar carcinoma, adenocarcinoma, diffuse interstitial fibrosis of the lungs, silicosis, sarcoidosis, etc. By the careful study of the chest film and ascertainment of the exact locations of the pulmonary lesions there, we can carry out the TBLB and obtain a satisfactory specimen without any X-ray monitoring. In the present group of patients who underwent TBLB, one was complicated by haemorrhage (greater than 50ml) and two by pneumothorax, but all of them recovered promptly after proper management. By strick adherence to indication, adequate preoperative preparations and very careful performance of the procedure, the complications of TBLB could be reduced to minimum.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnostic value of transbronchial lung biopsy in diffuse or peripheral lung lesions]. 209 76

The majority of lung cancers present as either a solitary parenchymal nodule or mass or as a hilar mass that demonstrates progressive growth with time. Unusual parenchymal manifestations of lung cancer include a nodule or mass that may decrease in size without therapy; intrinsic calcification; thin-walled cavitation; a meniscus sign; unifocal or multifocal alveolar infiltrates; satellite nodules; and multiple well-defined pulmonary nodules or masses. Unusual bronchial manifestations of lung cancer include widely separated areas of segmental or lobar atelectasis, mucoid impaction of bronchi, and obstructive hyperinflation. In the pleural space, bronchogenic carcinoma may occasionally be manifested as spontaneous pneumothorax, diffuse nodular tumor spread, and isolated effusion. Unusual mediastinal manifestations of lung cancer include primary mediastinal bronchogenic carcinoma, "downhill" esophageal varices, pulmonary artery invasion and infarction, pericardial and cardiac invasion, and esophageal obstruction. In addition, lung cancer may arise as a complication of bullous lung disease and a number of conditions that cause focal or diffuse lung scarring. Through increased familiarity with these varied manifestations of lung cancer, and a high index of suspicion, it is hoped that the radiographic detection of lung cancer will be improved.
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PMID:Unusual radiographic manifestations of lung cancer. 218 65

A 71-year-old male underwent therapeutic pneumothorax for left pulmonary tuberculosis 42 years ago. He visited our hospital in February 1988 with a complaint of hemosputum. In October, cytology of sputum revealed malignant cells, and the patient was admitted to our hospital for further examination. Because malignant cells were found by the left bronchial lavage, pan-pleuropneumonectomy was performed on January 12, 1989 under the diagnosis of left lung cancer. The tumor was partially left unremoved. Histological diagnosis was diffuse large cell type, B cell non-Hodgkin's lymphoma. Postoperatively, 2 courses of cyclophosphamide, adriamycin, vincristine, prednisone, etoposide (CHOP and VP-16) therapy were performed. However, the patient died of respiratory insufficiency on the 125th postoperative day. Recently, cases of malignant lymphoma involving the pleura after the old tuberculous empyema and therapeutic pneumothorax have been increased. Therefore, prompt diagnosis and treatment are recommended when tumor shadow is suspected as a result of imaging examination.
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PMID:[Non-Hodgkin's lymphoma arising from the wall of old tuberculous empyema--a surgical case report]. 224 44

Seven cases (1.9%) of simultaneous bilateral pneumothoraces were found in a retrospective study of 377 patients with spontaneous pneumothorax during the period from July, 1977 to June, 1989. Their symptoms were essentially those of unilateral pneumothorax, but with more severe dyspnea. All but two cases, both young, had underlying pulmonary diseases. Three (two lung cancers and one metastatic lung disease) had malignant pulmonary disease. During this period, five lung cancer patients were complicated with pneumothorax, and two of them had simultaneous bilateral pneumothoraces. Therefore the frequency of bilateral pneumothoraces in the lung cancer patients associated with pneumothorax is high. In these three patients with malignant disease, tube drainage was carried out but all died of respiratory failure. Two senile patients had small bilateral pneumothoraces. Bed rest without invasive treatment led to successful cure. Two younger patients without underlying pathology initially underwent tube drainage, followed by operation. We conclude that many patients with simultaneous bilateral spontaneous pneumothoraces have underlying pulmonary disease, the frequency of lung cancer being particularly high. Young patients without underlying disease should be operated on following alleviation of symptoms by tube drainage. Older patients and patients with malignancy should be treated with great care and individually.
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PMID:[Simultaneous bilateral spontaneous pneumothoraces]. 227 60

The use of pleuroscopy or thoracoscopy in preoperative staging and resectability assessment of lung cancer is uncommon. Diagnostic and exploratory thoracoscopy could be helpful in three circumstances: when malignant pleural effusion is suspected with a lung cancer, while all the initial investigations remain negative: (cytology, needle-biopsy); in cases with radiological images (using CTs-can or MRI) of small metastatic pleural masses without effusion: thoracoscopy is performed after creating a pneumothorax; when mediastinal or hilar extension of the tumor and lymph-nodes (especially in the left superior mediastinum) cannot be reached for biopsy by mediastinoscopy or parasternal mediastinotomy. The investigation is performed under general anesthesia using double-lumen selective intubation and lung exclusion. This procedure provides a better view of the pleural space and mediastinal and hilar areas; macroscopic involvement of vital structures, organs or vessels can be easily seen and large biopsy specimens safely taken, without any postoperative morbidity. Talc insufflation for pleurodesis is added in patients with massive pleural effusion. Failures of the method or false-negative biopsies are related to previous pleurodesis, pleural partition, or adhesions. The contribution of CT scan and MRI imaging is mandatory to determine indications and to select the best endoscopic approach.
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PMID:[Pleuroscopy in the preoperative staging of bronchial cancer]. 234 76

Spontaneous pneumothorax due to primary lung cancers are increasingly reported as of lung cancer incidence increased. We experienced one lung cancer case with pneumothorax as a primary symptom and two who developed pneumothorax after chemotherapy, among 238 cases of primary lung cancer. In the literature, 76 cases of pneumothorax due to primary lung cancers are described. The mechanism of pneumothorax is discussed.
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PMID:[Three cases of pneumothorax due to lung cancer]. 235 1

Direct current therapy (DC therapy), consisting of the application of electric current directly to the lesion, with chemotherapy using BLM was performed in 4 advanced inoperable lung cancer patients in whom chemotherapy and radiotherapy were not effective or could not be performed. Fluoroscopically two electrodes were inserted percutaneously into the tumor under local anesthesia. The distance between the two electrodes was about 3-4 cm. About 10 volts of direct current for 1 hour (totally over 40 coulombs) was passed between them using a DC treatment processor model 85 (Inter Nova Co., Ltd.), and simultaneously 15-30 mg of BLM was administered intravenously according to the general condition of the patient. The histologic type was adenocarcinoma in 3 cases and there was 1 large cell carcinoma. This treatment was performed once in 3 cases and twice in another. A reduction of tumor size was recognized in 3 cases (2 adenocarcinomas and 1 large cell carcinoma). In another adenocarcinoma case it was not measurable in size because of infiltrative shadow but histologically tumor destruction was recognized within a short period after DC therapy. The complications were mainly slight fever and light pain during the procedure. There was one small amount of hemoptysis and one pneumothorax but it was not necessary to perform special treatment for these complications. DC therapy with chemotherapy is based on our basic experimental experience that some anticancer agents accumulate around the electrodes in lung tissue when direct current is passed. In addition, current itself has cytocidal effects in some cases. Our clinical experience suggested the usefulness of this therapy to treat lung cancer lesions locally.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Direct current therapy with chemotherapy for the local control of lung cancer]. 248 18

We have retrospectively reviewed 100 mediastinoscopies that were carried out in our hospital from 1985 to 1988. 12% the of patients had relative contraindications for that examination technique. There was no intraoperative mortality and 5% of the patients presented complications including severe hemorrhage in three patients, bilateral pneumothorax in one patient and loss of radial pulse in another patient who presented left hemiparesis during the immediate postoperative period. We conclude that mediastinoscopy provides essential information for classification and treatment of lung cancer despite its high potential morbidity; a proper anesthetic technique, correct monitoring and the close cooperation with the surgical team render mediastinoscopy a safe procedure.
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PMID:[Mediastinoscopy: apropos of 100 cases]. 262 90

The results of fine needle transthoracic aspiration biopsy in diagnosing lung diseases in given. Out of 192 biopsies performed in 169 patients with lung tumors, lung cancer was diagnosed in 125 patients (73%), in two hilar cysts, in one an intercostal neurinoma were diagnosed. Side effects were seen in 17 patients (10%) most often pneumothorax in one requiring chest tube drainage. Diagnosis was made during the first 28 days of hospitalisation. This biopsy decreases hospitalization and shortens considerably the diagnosing time. It is a safe and uncomplicated procedure requiring only fluoroscopy.
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PMID:[The significance of fine needle transthoracic aspiration biopsy in diagnosing lung diseases]. 263 46


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