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

The superior vena cava (SVC) syndrome occurs when obstruction of this vessel interrupts venous return of blood from the head, upper extremities and thorax to the right atrium. Most cases of SVC syndrome result from neoplasia, especially from lung cancer, but other non-cancer-associated causes may include fibrosis caused by radiotherapy, collagen-vascular diseases, arteriovenous shunts or thrombosis as a complication of use of central venous catheters or devices. We report here the case of a 60-year-old woman with non-small cell lung cancer who was treated, after three lines of chemotherapy, with the epidermal growth factor receptor inhibitor erlotinib and subsequently presented to the hospital with abrupt onset of syncope, shortness of breath and cyanosis (face, neck and trunk). A CT scan of the chest demonstrated a massive thrombosis of both brachiocephalic veins and the SVC. The patient was treated with the systemic thrombolytic agent urokinase, with resolution of the clinical picture and no bleeding complications. The possible pathogenetic causes of thrombosis of the brachiocephalic veins and SVC syndrome in this case are discussed. It is possible that acute thrombosis may be associated with erlotinib use, even if it is likely that cancer may be the main cause of the thrombotic complication.
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PMID:Massive thrombosis of brachiocephalic veins and superior vena cava syndrome in a patient with non-small cell lung cancer treated with the epidermal growth factor receptor inhibitor erlotinib. 1756 30

A five year experience in 21 patients with superior vena caval obstruction (SVCO) was reviwed. SVCO was due to benign conditions in four patients (19%) and malignant tumors in 17 patients (81%). Lymphoma and lung cancer were the most common causes encountered. The most common symptoms and signs were facial swelling, shortness of breath, jugular venous distention, swelling of face and arms, and engorgement of thoracic veins. Benign disorders had a longer duration of symptoms before presentation and required longer time to make the diagnosis than in malignant disorders. No serious complications resulted from the superior vena cava obstruction itself or the investigate procedures leading to the diagnosis. Prognosis and response to treatment were dependent on the underlying cause of SVCO. Chemotherapy was effective in induction of complete regression of SVCO in the majority of patients with underlying malignant disorders. We conclude that SVCO should be approached invasively for diagnosis and tissue diagnosis of the underlying disorder should dictate the appropriate therapy.
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PMID:Superior vena caval obstrution: King Khalid University Hospital experience. 1758 29

A case of a 30-year-old man is presented. He had a past medical history of asthma and presented with cough, shortness of breath, fever and chest pain. The chest X-ray showed cardiomegaly and a interstitial pattern. The echocardiogram revealed a severe pericardial effusion that required performing a pericardiocentesis. A CT scan showed mediastinal adenopathies and reticulonodular interstitial pattern. A bronchoscopy could not be completed because of non-tolerance. Finally a lung biopsy allowed us to reach a final diagnosis of lung adenocarcinoma. Following, some aspects of lung cancer in young people are commented, especially its incidence, histology, symptoms and a prognosis. A few aspects of the interstitial lung disease are also addressed and the differential diagnosis with lymphangitic carcinomatosis.
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PMID:[Lung adenocarcinoma feigning an interstitial lung disease in a 30-year-old man]. 1790 1

The number one cause of cancer death in Taiwan is lung cancer. Of the few studies describing the experience of patients living with lung cancer, most use bivariate analyses to test associations between individual symptoms. Few have systematically investigated multiple symptoms. This prospective study was undertaken to explore the phenomenon of symptom distress, to investigate the presence of symptom clusters, and to examine the relationship of symptom clusters to symptom interference with daily life in Taiwanese lung cancer patients. A sample of 108 lung cancer patients was recruited using the Taiwanese version of the M. D. Anderson Symptom Inventory. Data were analyzed by hierarchical cluster analysis, factor analysis, Pearson correlation, t-test, and regression analysis. The top five most-severe symptoms were fatigue, sleep disturbance, lack of appetite, shortness of breath, and general distress. Factor analysis generated a two-factor solution (general and gastrointestinal symptoms) for symptom severity items. Consistent with the result from factor analysis, cluster analysis also indicated the same two cluster groups (general and gastrointestinal symptoms). Both clusters were significantly correlated with symptom interference items; however, the general symptom cluster presented higher correlation coefficients than did the gastrointestinal symptom cluster. These results provide an important basis for developing novel strategies to manage multiple symptoms in lung cancer patients and thereby improve their well-being.
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PMID:Symptom clusters and relationships to symptom interference with daily life in Taiwanese lung cancer patients. 1820 65

The purpose of this study was to describe (1) the aggressiveness of care in a population of patients who die of lung cancer and (2) differences in care between a sample of lung cancer patients who died in an acute care hospital (DH) and a sample of lung cancer patients who were admitted to hospital during the last six months of life but were discharged and died elsewhere (DO). All lung cancer deaths in 2002 were identified in the provincial registry. Cases were linked to administrative sources of health care data to describe the population as a whole and the aggressiveness of the care that they received. Primary data were collected from a province-wide sample of patients' hospital charts focusing on reasons for admission, care in hospital, advanced planning, pain, and disposition. In total, 5,855 patients who died of lung cancer in 2002 were eligible for inclusion in the cohort. Rates of in-hospital death, emergency room visits, intensive care unit admissions, and chemotherapy use near the end of life were 59.5%, 32.2%, 5.5%, and 4.6%, respectively. The records of 491 patients were abstracted for this study. The DH and DO groups were similar with respect to age, gender, neighborhood income level, and extent of metastatic disease. The most common chief complaints were shortness of breath, pain, inability to cope at home, and altered level of consciousness. Compared to patients in the DO group, those in the DH group presented with pain more often (19% vs. 10%, P<0.005) and were more likely to be admitted with progressive chest malignancy (30% vs. 21%, P<0.05). Regardless of reason for admission, pain was commonly documented as a problem during admission: 73.5% in the DH group and 62.4% in the DO group (P<0.05). Lung cancer patients are heavy users of acute care beds and the emergency room at the end of life. Those who do or do not die in hospital are similar in many respects but our results suggest those dying in hospital have more problems with pain and burden from local chest malignancy.
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PMID:End-of-life care in lung cancer patients in Ontario: aggressiveness of care in the population and a description of hospital admissions. 1824 49

A 53-year-old man was admitted to our hospital because of an abnormal lung shadow on his chest X-ray film. His symptoms were cough and shortness of breath. Chest X-ray and computed tomography showed a large mass lesion in the right lower lobe of the lung. We diagnosed primary non-small cell lung cancer; cT3N1M1 stage IV. Systemic chemotherapy using carboplatin and paclitaxcel was performed. However, the treatment had no effect and he died two months after admission. An autopsy showed pulmonary spindle cell carcinoma, with multiple metastases to the brain, pancreas, etc. Pulmonary spindle cell carcinoma had been recognized as a variant of the squamous cell carcinoma for years, however, in the recent WHO and Japanese classification of lung tumors, it was redefined as an independent histological type. It is a rare form of lung cancer, representing 0.2 to 0.3% of all primary pulmonary malignancies and seems to have poor prognosis. We need to pay more attention to this type of lung cancer.
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PMID:[Autopsy case of rapidly progressive pulmonary spindle cell carcinoma with multiple metastases to the brain and pancreas]. 1982 89

A 45-year-old female presented to the rheumatology clinic with complaint of pain and swelling of multiple small joints of the hands and feet. She also complained of cough and shortness of breath onset around the same time. Since her cyclic citrullinated peptide antibody (anti-CCP) and rheumatoid factor tests were positive, rheumatoid arthritis (RA) was diagnosed and she was started on prednisone with plans for additional disease modifying therapy. Chest X-ray showed a small right pleural effusion. While additional pulmonary evaluation was being planned, a few weeks later she presented with dyspnea, fever and tachycardia. Spiral CT showed pulmonary emboli and increased pleural effusion and patient was started on anticoagulation. A chest tube was placed and exudative pleural effusion was drained. Cytology sample from bronchoscopy raised concerns for adenocarcinoma. Open lung biopsy confirmed moderately differentiated adenocarcinoma. The patient died of lung cancer in the hospital 8 weeks from her diagnosis of RA. We describe a case of paraneoplastic polyarthritis with positive anti-CCP antibody test which has not been reported before. We also review the literature on paraneoplastic arthritis which has been described in association with various other malignancies besides lung cancer.
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PMID:Report of anti-CCP antibody positive paraneoplastic polyarthritis and review of the literature. 2001 60

Organizing pneumonia (formerly known as bronchiolitis obliterans organizing pneumonia, BOOP) is an inflammatory process of the bronchioles that can lead to the destruction of small airways and surrounding lung tissue. Although the majority of cases are idiopathic, certain chemicals and drugs can induce OP. Here, we report a 54-year-old male patient with advanced non-small cell lung cancer (NSCLC) who developed therapy-associated OP. He had undergone several other chemotherapies before being switched to docetaxel as monotherapy (75 mg/m(2)). Treatment was initially well tolerated, but after the second cycle the patient developed increasing shortness of breath. Computed tomography (CT) for staging after the second cycle showed bilateral predominantly interstitial infiltration highly suggestive of acute lung fibrosis. Bronchoscopy revealed signs of chronic bronchitis and watery discharge from both lungs. Bronchoalveolar lavage and transbronchial needle biopsy was performed. Based on histopathologic examination, diagnosis of OP was made. After cessation of docetaxel and initial high dose steroids, the infiltration ameliorated rapidly. This is the second case in the literature that associates docetaxel with rapid onset of bronchiolitis obliterans. Therefore, patients with lung cancer receiving docetaxel who develop respiratory symptoms should be suspected to develop OP.
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PMID:Severe Organizing Pneumonia after Two Cycles of Docetaxel as Fourth-Line Chemotherapy for Advanced Non-Small Cell Carcinoma of the Lung. 2074 Jan 39

A 69-year-old man presented shortness of breath and acute renal failure. He had undergone pulmonary partial resection for lung cancer 5 months prior. On examination, severe hypertension, skin sclerosis of his forearms, and anticentromere antibody were observed. A renal biopsy specimen showed characteristic findings for scleroderma renal crisis, and a right heart catheterization revealed severe pulmonary arterial hypertension. Re-examination of the resected lung specimen revealed sclerodermatous vascular involvement was present.
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PMID:Pulmonary hypertension confirmed histologically five months prior to scleroderma renal crisis onset. 2117 43

Disseminated microvascular pulmonary tumor embolism (DMPTE) is extremely rare and invariably fatal. Typical symptoms and signs of DMPTE include shortness of breath and inadequate oxygenation. Here we demonstrate a patient with unexplained progressive pulmonary hypertension followed by sudden cardiac arrest, who finally diagnosed of DMPTE pathologically under veno-arterial extracorporeal membrane oxygenation (VA-ECMO) system support. A 59-year-old gentleman was diagnosed of advanced non-small cell lung cancer with clinical stage of T3N2M1 in February 2008. His disease had been controlled well for two years under first-line clinical trial and salvage pemetrexed treatment. In early January 2010, he suffered from dyspnea on exertion gradually, although cancer progression was not proven by computed tomography (CT) scan. Transthoracic echocardiography also revealed normal heart size and function. However, he was sent to emergency room (ER) one month later due to dyspnea where pulmonary hypertension was discovered by repeated echocardiography. Follow-up CT scan was shown neither evidences of tumor progression nor pulmonary thromboembolic event in all major pulmonary vessels. Unfortunately, he was found to be unconscious suddenly at ER during urination and diagnosed as pulse-less electrical activity. Cardiopulmonary resuscitation (CPR) was initiated immediately and he was sent to intensive care unit with VA-ECMO system under the impression of cardiovascular system dysfunction. He passed away 10 days after intensive treatment. A necropsy was performed after we received the inform consent from his family. DMPTE was confirmed by pathologists. Currently, diagnosis of DMPTE is challenging and treatment is limited although advances of modern medicine. DMPTE should be kept in mind if cancer patients have dyspnea, inadequate oxygen saturation and unexplained pulmonary hypertension during their disease courses that unexpected serious consequences, like sudden cardiac arrest, may happen.
Lung Cancer 2011 Apr
PMID:Disseminated microvascular pulmonary tumor embolism from non-small cell lung cancer leading to pulmonary hypertension followed by sudden cardiac arrest. 2133 71


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