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

Radiation pneumonitis usually occurs within 1-3 months after the completion of radiation therapy. A 63-year-old male with primary lung cancer treated by radiation therapy developed radiation pneumonitis 5 months after the completion of radiation therapy. He received 60 Gy to the lung tumor in a conventional fractionation schedule, and then two courses of intravenous chemotherapy using cis-diamine-dichloroplatinum (II) (110-140 mg) and etoposide (140-175 mg). Oral etoposide was initiated for bone metastases on the 104th day after the completion of radiation therapy at a daily dose of 20 mg, to a total dose of 1075 mg. He complained of fever and exertional dyspnea 5 months after the completion of radiation therapy. Chest radiography showed homogeneous infiltrates in the irradiated lung. These clinical signs and symptoms were refractory to antibiotic therapy, but steroid therapy resulted in marked improvement. The development of radiation pneumonitis was suspected to be induced by oral etoposide, which was given before the onset of radiation pneumonitis. These data suggest that etoposide induces a recall phenomenon, as has been demonstrated with such drugs as adriamycin and actinomycin-D.
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PMID:[A case with delayed-onset radiation pneumonitis suspected to be induced by oral etoposide]. 132 65

We reported two cases of idiopathic interstitial pneumonia (IIP) who developed acute exacerbation after bronchoalveolar lavage (BAL). One case was a 67-year-old male who presented with dry cough and exertional dyspnea. He was diagnosed as IIP and transbronchial lung biopsy revealed alveolitis. BAL was performed after administration of prednisolone. He complained of severe dyspnea after BAL and was diagnosed as having an acute exacerbation of IIP. In spite of extensive treatment including pulse therapy with methylprednisolone, he died. The other case was a 57-year-old male noted to have a chest X-ray abnormality who presented with dry cough and dyspnea on exertion. He was diagnosed as having IIP and primary lung cancer. BAL was performed to evaluate the activity of IIP, and respiratory distress subsequently became severe. After BAL, he developed an acute exacerbation of IIP and died in spite of treatment. In both cases, peripheral white blood cell counts were increased just before BAL. It was suggested that this condition might participate in acute exacerbation of IIP. It should be kept in mind that some patients with IIP may develop acute exacerbation after BAL.
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PMID:[Two cases of IIP which developed acute exacerbation after bronchoalveolar lavage]. 816 6

A case illustrating the value of aggressive respiratory training in improving the prognosis of lung cancer complicated by low pulmonary function is reported. Preoperative and postoperative respiratory training enabled the patient with chronic respiratory failure to survive a lengthy operation and eventually breathe without assistance. The patient has survived more than 71 months, and experiences only exertional dyspnea at the time of publication. Aggressive preoperative and postoperative respiratory management may make more of the growing number of lung cancer patients eligible for standard surgical procedures.
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PMID:Effective preoperative and postoperative respiratory training in a lung cancer patient with chronic respiratory failure. 846 May 58

We report herein the case of the 71-year-old man with lung cancer and pulmonary emphysema requiring supplementary oxygen at 21/min by nasal cannula for whom thoracoscopic wedge resection of an adenocarcinoma in his left lower lobe was successfully performed. During the same procedure, thoracoscopic laser ablation of pulmonary bullae was also carried out. There were no postoperative complications, and the patient is currently well 12 months following surgery without any evidence of local or regional recurrence, or distant metastasis. His severe dyspnea on exertion improved, and he no longer requires supplementary oxygen.
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PMID:Combined thoracoscopic lung resection and laser ablation for lung cancer with pulmonary emphysema: report of a case. 903 4

A 68-year-old man who worked as an editor was admitted to Aichi Medical University Hospital due to dyspnea on exertion and emaciation. The patient had noticed rapid weight loss during diet therapy for diabetes mellitus that started in the beginning of July, 1993. Laboratory examinations revealed elevated levels of LDH and amylase in serum. Ultrasonography disclosed minimal ascites. Dyspnea on exertion developed in September, 1993. Chest roentgenography showed diffuse bilateral small nodular or reticular opacities. CT-guided percutaneous needle aspiration was done and cytologic examination of a specimen of lung tissue revealed papillary adenocarcinoma. The diagnosis was bronchiolo-alveolar carcinoma. Serum levels of amylase were elevated. The amylase isozyme pattern was of the salivary type. Serum levels of CA19-9 and CEA were also elevated. The patient died of respiratory failure on December 4, 1993. Postmortem examination revealed diffuse small nodules in both lungs. Examination of the nodules showed bronchiolo-alveolar cell carcinoma. The tumor cells stained positively for amylase (salivary type, not pancreatic type) CA19-9, and CEA by the avidin biotin complex method, but they were immunohistologically negative for AFP. We conclude that this lung cancer produced amylase, CA19-9, and CEA. We know of only a few reports of cases in which lung cancer produced both amylase and CA19-9.
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PMID:[Diffuse bronchiolo-alveolar cell carcinoma that produced both amylase and CA19-9]. 921 68

Lung cancer during pregnancy is rare, although the number of case reports has been increasing in recent years. Herein, we describe two cases of lung carcinoma complicating pregnancy with different presentations and outcomes, and review the relevant literature. The first case involved a 31-year-old patient with squamous cell carcinoma with multiple bone metastases. The initial symptoms were productive cough and dyspnea on exertion during the second trimester of pregnancy, to which the patient paid little attention. Chemoradiation was started 1 month postpartum, soon after the diagnosis was made, but with little response. She died at home several days after palliative radiotherapy. The second case involved a 34-year-old patient with poorly differentiated lung carcinoma with brain metastasis. Left hemiparesis had developed initially during the third trimester. She underwent excision of the metastatic brain tumor and received radiotherapy to the left lung tumor and brain. The patient is still alive after a follow-up period of more than 1 year. Delayed diagnosis may be the main problem in the management of lung cancer during pregnancy, because of misinterpretation of common respiratory symptoms and physicians' reluctance to use radiologic imaging studies owing to concerns over the safety of the fetus. Thus, we suggest chest radiographs with abdominal lead shielding for pregnant patients with protracted cough and hemoptysis. Treatment of unresectable lung cancer during pregnancy generally consisted of radiation therapy with or without chemotherapy in previous reports, but the optimal therapy is still unknown, owing to inadequate case numbers and insufficient follow-up data.
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PMID:Lung cancer in pregnancy: report of two cases. 974 70

Fourteen cases (13 pleural and one intrapulmonary) of solitary fibrous tumors (SFTs) (the so-called fibrous mesothelioma) were studied. The lesions occurred more in females (nine cases) than males (five cases). The age of patients ranged from 44 to 73 years old (median 60 years). The tumors presented as cough with or without blood-tinged sputum, exertional dyspnea, chest pain, nausea, body weight loss, fever, or as asymptomatic masses detected by routine chest radiograph. Two patients with huge (tumor larger than 20 cm) malignant tumors had accompanying pleural effusion and one associated with hypoglycemia. Ten benign tumors measured 2-11 cm (median size 7 cm) while the remaining four histologically malignant ones measured 20-30 cm in size. All of them were well circumscribed and thinly encapsulated. Hemorrhage and necrosis were more frequently seen in the malignant tumors. Histologically, these lesions were characterized by 'patternless pattern' with occasional hemangiopericytic features (three cases). The tumor cells were all immunoreactive for vimentin, CD 34, and focally actin-positive in one case, but not for keratin, desmin, S-100 protein, carcinoembryonic antigen, alpha 1-ACT and F VIII-related antigen, supported a primitive mesenchymal origin. p53 protein was expressed in two of the malignant cases. Proliferating cell nuclear antigen stain was positive with 50 and 80% of the labeling index in the benign and malignant tumors, respectively, but retinoblastoma gene protein was negative in all tumors. This analysis confirmed the relationship between histological malignant SFTs and tumor size, cellularity, mitotic activity, necrosis and tumor suppressor gene expression. However, the clinical behavior was unpredictable. Complete respectability seemed to be the most important indicator of clinical outcome in the less aggressive tumors.
Lung Cancer 1999 Jan
PMID:Thoracic solitary fibrous tumor: clinical and pathological diversity. 1010 Jan 46

The preoperative physiologic assessment of a patient being considered for surgical resection of lung cancer must consider the immediate perioperative risks from comorbid cardiopulmonary disease, the long-term risks of pulmonary disability, and the threat to survival due to inadequately treated lung cancer. As with any planned major operation, especially in a population predisposed to atherosclerotic cardiovascular disease by cigarette smoking, a cardiovascular evaluation is an important component in assessing perioperative risks. Measuring the FEV(1) and the diffusing capacity of the lung for carbon monoxide (DLCO) measurements should be viewed as complementary physiologic tests for assessing risk related to pulmonary function. If there is evidence of interstitial lung disease on radiographic studies or undue dyspnea on exertion, even though the FEV(1) may be adequate, a DLCO should be obtained. In patients with abnormalities in FEV(1) or DLCO identified preoperatively, it is essential to estimate the likely postresection pulmonary reserve. The amount of lung function lost in lung cancer resection can be estimated by using either a perfusion scan or the number of segments removed. A predicted postoperative FEV(1) or DLCO < 40% indicates an increased risk for perioperative complications, including death, from lung cancer resection. Exercise testing should be performed in these patients to further define the perioperative risks prior to surgery. Formal cardiopulmonary exercise testing is a sophisticated physiologic testing technique that includes recording the exercise ECG, heart rate response to exercise, minute ventilation, and oxygen uptake per minute, and allows calculation of maximal oxygen consumption (.VO(2)max). Risk for perioperative complications can generally be stratified by .VO(2)max. Patients with preoperative .VO(2)max > 20 mL/kg/min are not at increased risk of complications or death; .VO(2)max< 15 mL/kg/min indicates an increased risk of perioperative complications; and patients with .VO(2)max < 10 mL/kg/min have a very high risk for postoperative complications. Alternative types of exercise testing include stair climbing, the shuttle walk, and the 6-min walk. Although often not performed in a standardized manner, stair climbing can predict .VO(2)max. In general terms, patients who can climb five flights of stairs have O(2)max > 20 mL/kg/min. Conversely, patients who cannot climb one flight of stairs have .VO(2)max < 10 mL/kg/min. Data on the shuttle walk and 6-min walk are limited, but patients who cannot complete 25 shuttles on two occasions will have .VO(2)max < 10 mL/kg/min. Desaturation during an exercise test has been associated with an increased risk for perioperative complications. Lung volume reduction surgery (LVRS) for patients with severe emphysema is a controversial procedure. Some reports document substantial improvements in lung function, exercise capability, and quality of life in highly selected patients with emphysema following LVRS. Case series of patients referred for LVRS indicate that perhaps 3 to 6% of these patients may have coexisting lung cancer. Anecdotal experience from these case series suggest that patients with extremely poor lung function can tolerate combined LVRS and resection of the lung cancer with an acceptable mortality rate and good postoperative outcomes. Combining LVRS and lung cancer resection should probably be limited to those patients with heterogeneous emphysema, particularly emphysema limited to the lobe containing the tumor.
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PMID:The physiologic evaluation of patients with lung cancer being considered for resectional surgery. 1252 70

We report 2 cases of pulmonary pleomorphic carcinoma. The patient in case 1 was a 44-year-old man who was admitted to our hospital complaining of dry cough and dyspnea on exertion. Chest radiography and CT showed a huge tumor with left pleural effusion. Percutaneous biopsy suggested malignancy. As distant metastasis was not found and as cytological examination of pleural effusion gave a result of class II, we attempted to perform left pneumonectomy. However, we performed partial resection of the tumor because it had invaded the aorta, pulmonary artery, pericardium and pleura. The pathological diagnosis was pleomorphic carcinoma, p-T4 N2 M0. After the operation, we performed systemic chemotherapy, including cisplatin and irinotecanm with little effect (PD). The patient died of progression of the tumor. Case 2 was a 34-year-old man who was admitted to our hospital complaining of fever and general malaise. Chest radiography and CT showed a tumor in the left upper lobe. As no distant metastasis was found, we tried left upper lobectomy. However, we performed left upper segmentectomy and lymph node dissection because of invasion of the aorta and the chest wall, and because of hypersegmentation of the left upper lobe. Pathological diagnosis was pleomorphic carcinoma, p-T4 N0 M0. After the operation, the mediastinum was subjected to radiation therapy. However, a metastatic tumor was found in the pelvis after this radiation was given. We performed systemic chemotherapy with substances including cisplatin, gemcitabine and vinorelbine, but with little effect (PD). The patient died of peritonitis and pleuritis due to the recurrence and progression of the tumor. Both cases had rapidly growing neoplasms showing little sensitivity to chemotherapy or radiotherapy. Pulmonary pleomorphic carcinoma is suggested to be type of lung cancer with a poor prognosis when the tumor is not resected in the early stages.
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PMID:[Two younger male patients with rapidly progressing pulmonary pleomorphic carcinoma]. 1500 17

Botryomycosis is a rare chronic suppurative disease characterized by the presence of eosinophilic granules containing the causative bacteria on histological study of an abscess specimen. The majority of cases involve the skin and visceral involvement is rare. A 54-year-old man with primary pulmonary botryomycosis which involved parietal pleura presented with exertional dyspnea for 2 weeks. Echo-guided aspiration of lung mass yielded viridans streptococci and positive Gram stain of the surgical specimen indicated viridians streptococci was the causative pathogen. There was no recurrence during 2 years of follow-up after surgery and antibiotic treatment. Early differentiation of botryomycosis from lung cancer, pulmonary tuberculosis, and actinomycosis is essential.
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PMID:Primary pulmonary botryomycosis with parietal pleura involvement. 1549 30


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