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

To evaluate utility of Gd-DTPA enhanced MRI (Gd-MRI) in lung cancer, Gd-MRI was performed in 69 cases. 1) Viable tumor was strongly enhanced, necrosis in the tumor, however, was not enhanced on Gd-MRI. Enhanced patterns of Gd-MRI were divided into 3 types, however there was little correlation between the enhancement patterns and histologic types. 2) In serial scan studies of 15 cases, the signal intensity of the tumor reached the peak 3 minutes to 10 minutes after Gd-DTPA administration, and after that the signal intensity decreased gradually. 3) In 23 of 27 (85%) hilar lung cancer cases, Gd-MRI could differentiate the tumor from the peripheral obstructive pneumonia or atelectasis. In 18 of these 23 cases, the peripheral lung disease showed higher intensity than the tumor. 4) In Gd-MRI of pulmonary nodules less than 3 cm in diameter, lung cancers (n = 13) were more strongly enhanced than tuberculomas (n = 5) (p less than 0.001). Based on these data, Gd-MRI was helpful for detecting tumor necrosis and tumor extension on hilar lung cancer with peripheral lung disease. Moreover Gd-MRI may become a feasible diagnostic method for pulmonary nodules.
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PMID:[Clinical studies for usefulness of Gd-DTPA enhanced MRI in lung cancer]. 131 52

Preoperative staging in esophageal cancer is usually done by noninvasive tests. Currently, in the staging of lung cancer, when lymph nodes are identified preoperatively by CT or MRI to be greater than 1 cm, surgical staging using mediastinoscopy, Chamberlain procedures, or thoracoscopy are employed. We describe herein the use of thoracoscopy in routine preoperative staging of esophageal cancer. With the advent of newer laparoscopic techniques currently available, thoracoscopy plays an increasing role in the management of intrathoracic disease. Staging thoracoscopy as a routine preoperative invasive staging test appears to be a good diagnostic test.
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PMID:Thoracoscopic lymph node dissection in the staging of esophageal carcinoma. 159 80

An 80-year-old man was admitted to our hospital with a complaint of insidious hearing loss and facial palsy. Chest X-ray film showed an abnormal shadow in the right lower lobe. Adenocarcinoma of the lung was diagnosed by transbronchial brushing cytology. During admission, headache and dysphagia appeared, although no abnormality was detected in the brain CT and MRI. Lumbar puncture yielded adenocarcinoma cells in the cerebrospinal fluid. A diagnosis of leptomeningeal metastasis from the adenocarcinoma of the lung was considered and intrathecal administration of methotrexate was performed. The patient's condition deteriorated gradually and he died of respiratory failure. Autopsy revealed massive invasion of tumor cells in the leptomeninges of the brain and spinal cord. This case illustrates that facial nerve palsy with insidious hearing impairment may appear as the initial symptoms in meningeal carcinomatosis resulting from lung cancer metastasis.
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PMID:[Insidious hearing loss and facial palsy as the presenting symptoms of meningeal carcinomatosis resulting from adenocarcinoma of the lung]. 175 49

Brain metastases are frequent, accounting for 20% of all brain tumours. The most common primary tumours responsible for brain metastases are lung cancer in man and breast cancer in women. Most metastases are located at the grey matter-white matter junction, in junctional vascular territories and in the rolandic region. Although non-specific, MRI is the most sensitive neuroradiological method for the lesions, especially when accompanied by gadolinium injection. MRI must absolutely be performed before surgical treatment, as gadolinium might detect other metastatic lesions or show metastatic tumours so small that they were not visible at computerized tomography (CT).
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PMID:Brain metastases. 191 82

Twenty-two cases of transverse myelopathy associated with malignancy were collected in nationwide survey in Japan. Paraneoplastic necrotizing myelopathy (PNM) was suspected in 9 of them and 8 cases were diagnosed as radiation myelopathy (RM), clinically and pathologically. Other 5 cases had different causes of transverse myelopathy. In comparison with PNM and RM, malignant lymphoma, flaccid paraplegia and sphincter dysfunction were highly associated in the patients with PNM. On the other hand, lung cancer, spastic paraplegia, abnormality in spinal MRI and dysesthesia in legs as an initial symptom were prevalent in the cases of RM. Six cases of them were compared pathologically. Although all cases had no metastasis of malignant cells, five cases of PMN showed acute and chronic necrosis and rarefaction of spinal cord with or without perivascular cuffing. One case of RM had focal spinal cord atrophy and no lymphocytes infiltration. Immunohistochemically, herpes simplex virus type 2 (HSV2) infection in spinal cord was shown in the 2 cases of the necrotizing myelopathy. Virus infection such as HSV2 could be one of causes of PNM and virological study must be done in the cases of necrotizing myelopathy associated with malignancy.
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PMID:[Nationwide survey of necrotizing myelopathy associated with malignancy in Japan]. 193 64

A 61-year-old man was admitted to our hospital because of a left lung cancer. The chest x-ray film showed an irregular mass in the left upper lung field and the ill-defined left upper mediastinal border. A large portion of the aorta seen in the CT section above the aortic arch was understood to be aortic elongation. When a left pneumonectomy was performed, a saccular aneurysm of the distal aortic arch was found and resected under partial aortic clamping. Following the aneurysmectomy mediastinal dissection was performed in the normal way. The patient recovered uneventfully. The pathological specimens showed a pT2N1M0 squamous cell carcinoma with obstructive pneumonia and an arteriosclerotic aneurysm. There was no report of lung cancer associated with aneurysm of the thoracic aorta. In a patient with left lung cancer obliterating the left upper mediastinal border (the "silhouette sign") the aortic arch should be closely examined by MRI and/or angiography.
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PMID:[A case of left lung cancer associated with an aneurysm of the thoracic aorta]. 207 92

Sixty-one patients with primary lung cancer, who had CT and MR imaging before surgery, were studied. MR imaging used spin-echo sequences with T1 weighted image and T2 weighted image (C-MRI), and included STIR technique (Stir-MRI). The accuracy of diagnosis of mediastinal lymphadenopathy (regarding 10 mm or larger in short transverse diameter as positive) was 89% by CT, 84% by C-MRI and 89% by Stir-MRI. The accuracy of diagnosis of hilar lymphadenopathy was 42% by CT, 67% by C-MRI, and 75% by Stir-MRI. The accuracy of diagnosis of mediastinal lymph node metastases was 89% by CT, 94% by C-MRI and 96% by Stir-MRI. The accuracy of diagnosis of hilar lymph node metastases was 78% by CT, 87% by C-MRI and 89% by Stir-MRI. The possibility of enhancement of diagnostic accuracy of lymph node metastases from lung cancer was suggested by combining MR imaging included STIR technique with CT.
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PMID:[Hilar and mediastinal lymph node metastases from lung cancer; detection with CT and MR imaging]. 216 51

Since 1987, 24 patients with inoperable non-small-cell lung cancer (NSCLC), stage T1-3 N0-2 M0, have undergone lymph node dissection and intraoperative radiation therapy (IORT) to the primary with 10-20 Gy. Patient selection criteria were nonresectability based on severe cardiorespiratory impairment, no radiological evidence of distant metastases and a Karnofsky performance status of greater than 80. In 18 patients the IORT procedure was followed by an external beam radiation series (EBR) including the tumor with 46 Gy and the regional lymph nodes with 46/56 Gy. The tumor response was assessed by CAT-scan volumetry before the institution of IORT, 4 weeks later, before the onset of EBR, 8 weeks after the combined treatment course and on a 3 months basis thereafter. Prospectively, MRI of the thorax with/without Gadolinium-DTPA was performed to examine contrast enhancement and signal behavior of the tumor, in an attempt to differentiate residual disease compared to therapy-related collateral damage. So far, 18 patients have completed the combined treatment course with a median follow-up of 11 months (range 4.5 to 25 months). The overall local response rate (CR and PR) was 88.2%. In detail, 11 complete responses, 6 partial responses and one minimal response were observed. The overall and recurrence-free survival at 25 months was 49.6% and 83.3%, respectively.
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PMID:Intraoperative plus external beam irradiation in nonresectable lung cancer: assessment of local response and therapy-related side effects. 217 42

MRI is used most efficaciously in the evaluation of patients with bronchogenic carcinoma when employed as a tailored examination designed to answer specific questions relevant to patient management. CT continues to be used more generally in staging lung cancer when imaging beyond conventional chest radiography is required. Specific areas in which MRI can provide important and unique information (which may supplement a CT study) include the following: (1) evaluation of the local extent of superior sulcus tumors, and (2) distinction between stage IIIA (resectable) and stage IIIB (unresectable) tumors. Confirmation of tumor invasion of major mediastinal structures is necessary before depriving a patient of potential curative resection. MRI may contribute important information when CT findings are indefinite, particularly with regard to invasion of major cardiovascular structures (eg, superior vena cava, pulmonary artery, pericardium, and heart); invasion of the tracheal carina or bilateral involvement of main bronchi; and the presence of contralateral mediastinal or hilar lymphadenopathy. MRI should be considered as a primary imaging modality to evaluate central tumors in patients for whom intravenous contrast agents are contraindicated, and as a problem-solving modality when CT is inconclusive in the detection of a possible hilar or mediastinal mass. Other specific applications of MRI include the identification of tumor recurrence in the presence of radiation fibrosis, assessment of the extent of chest wall invasion of peripheral lung tumors, and the noninvasive characterization of adrenal masses. The scope of these MRI applications in patients with lung cancer may expand in the future with refinements in motion suppression techniques, implementation of ultrafast MRI (using variations of the echoplanar method), and further development of MRI spectroscopy and MRI contrast agents.
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PMID:Magnetic resonance imaging in the evaluation of lung cancer. 218 81

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


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