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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patterns of failure after treatment for carcinoma of the lung were analyzed by the major WHO cell types. Only diagnoses of the review panel of the Veterans Administration Lung Group were used. First sites of progression were analyzed for 185 patients in a clinical trial, and cause of death was evaluated in 300 consecutive autopsies from VALG studies. Clinical progression was similar for all cell types--20% failed locally and 30% developed metastases. Carcinomatosis or brain metastasis caused death in only 27% of patients with squamous, in over half with large cell and adenocarcinoma, and in 70% of patients with small cell carcinoma. Complications of the local tumor (infection, hemorrhage, and respiratory failure) caused death in 50% of patients with squamous, in 1/3 with large cell and adenocacrinoma, and in 21% of those with small cell carcinoma. These clinical and autopsy data suggest the need for aggressive treatment of the local tumor in all cell types, and systemic therapy for small cell carcinoma. Both local and systemic approaches are needed for large cell and adenocarcinoma.
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PMID:Influence of cell type on failure pattern after irradiation for locally advanced carcinoma of the lung. 22 35

The patient was an 82-year-old male who consulted us over a lymph node enlargement in the right side of his neck. The WBC was 23,700/microliters (lymphocytes 80%), and a diagnosis of chronic lymphocytic leukemia (CLL) was given based on the findings of a bone marrow puncture and lymph node biopsy. During the observation period, abnormal shadows accompanied by cavitation appeared in the right lower lung field, and CT-guided percutaneous biopsy findings indicated a squamous cell carcinoma of the lung. No metastatic lesions were noted. No aggressive surgical or internal treatments were performed in consideration of the patient's age. The patient was admitted again and died of respiratory failure due to lung carcinoma. Reports of CLL and other malignant tumors arising in one patient are rare in Japan, and those of their occurring concurrently are even rarer. In the present report, a case of synchronous cancer of squamous cell carcinoma of the lung and CLL is described, together with a review of the literature.
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PMID:Synchronous cancer of squamous cell carcinoma of the lung and lymphocytic leukemia (B-cell type): a case report. 151 71

A 76-year-old man with spindle cell (squamous) carcinoma of the lung developed fatal respiratory failure after limited thoracic irradiation at a total dose of 18 Gy. He developed severe pulmonary toxicity, which presented as dry cough, dyspnea, and pulmonary infiltrates extending beyond the radiation field. Microscopically, a transitional form of squamous to spindle-shaped cells was observed in the primary tumor, located at right S8. Immunohistochemical examination showed positive staining of spindle cells for keratin, vimentin, and EMA, but not for desmin. These results indicate that the spindle cells had characteristics of squamous epithelial cells, and differed from carcinosarcoma. Distant metastatic lesions were composed of only the spindle cell component.
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PMID:[A case of spindle cell (squamous) carcinoma (WHO) of the lung]. 180 85

Eaton-Lambert myasthenic syndrome is a rare disorder of neuromuscular transmission. We are unaware of previous New Zealand reports and present two patients. Characteristic abnormalities in compound muscle action potential amplitude following repetitive nerve stimulation and on single fibre electromyography were present. Both patients also showed mild patchy abnormalities in peripheral nerve conduction. The clinical picture resembled Guillain-Barre syndrome in one patient who developed severe generalised weakness and respiratory failure. In both patients the neurological presentation lead to the recognition of a previously asymptomatic small cell lung carcinoma.
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PMID:Eaton-Lambert myasthenic syndrome: two cases with typical and atypical features. 216 Jun 29

A 63-year-old man with Eaton-Lambert syndrome manifested by marked respiratory failure was reported. He began to notice blepharoptosis and diplopia in September, 1987, followed by weakness and easy fatigability in bulbar, neck and limb muscles in association with impotence by February, 1988. On admission in August, 1988, Gowers' sign, decreased tendon reflexes and muscle weakness improved by the injection of edrophonium were found. Anti-acetylcholine receptor antibody was negative. Single muscle action potential evoked in the thenar muscle was abnormally low in amplitude with the stimulation of the median nerve: repetitive nerve stimulation study revealed the waning at the low rates, but the waxing at the high rate (30 Hz), suggesting the diagnosis of Eaton-Lambert syndrome. Early gastric cancer (adenocarcinoma) was diagnosed from needle biopsy specimens in August, 1988, but no other neoplasm including thymoma or lung cancer was found. After subtotal gastric resection in September, 1988, he failed into respiratory failure, requiring artificial ventilation for seven months. Plasmapheresis and drugs such as anticholinesterase, guanidine hydrochloride, and corticosteroid were ineffective for the recovery from weakness in respiratory muscle. Lung cancer was suspected, based on a chest X-ray in March, 1989, and one month later he died of pneumonia. At autopsy, small cell carcinoma of the lung was observed, but there was neither recurrence nor metastasis of the gastric cancer. Emphasis was placed on the respiratory failure in Eaton-Lambert syndrome which has rarely been reported.
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PMID:[Eaton-Lambert syndrome manifested by respiratory failure associated with small cell carcinoma of the lung]. 217 52

Patients presenting with inoperable non-small cell carcinoma of the lung and major symptomatic bronchial obstruction were treated initially with debulking of the airways by YAG laser, followed by conventional external-beam radiotherapy. The former method was used to minimize postobstructive pneumonitis or respiratory failure (or both) that often complicates major brochial obstruction and also to lessen the burden of tumor to be treated by radiotherapy. The preliminary results of 19 patients treated in this manner are reported, emphasizing the impact of this combined method on morbidity and mortality.
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PMID:Initial combination therapy with YAG laser photoresection and irradiation for inoperable non-small cell carcinoma of the lung. A preliminary report. 370 43

Four patients with limited disease small cell carcinoma of the lung were treated with high-dose cyclophosphamide (120 mg/kg over days 1 and 2), BCNU (400 mg/m2 over days 1 and 2) and VP-16 (200 mg days 1-5) used as intensification treatment after conventional chemotherapy. To ameliorate hematopoietic toxicity, autologous bone marrow cells collected and cryopreserved prior to treatment were reinfused on day 8. In three patients clinical response was evaluable. Two achieved a complete remission: one died without evidence of tumor after 3 months; the other had a regional relapse after 6 months. One patient who had progression of disease on conventional chemotherapy was refractory to high-dose treatment. Three patients developed diffuse interstitial pneumonitis 3 weeks after treatment and two died of respiratory failure. High-dose intensification chemotherapy with autologous marrow reinfusion may complement the effects of standard combination chemotherapy in small cell carcinoma of the lung. The current status of this approach is reviewed.
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PMID:Autologous bone marrow transplantation following high-dose chemotherapy with cyclophosphamide, BCNU and VP-16 in small cell carcinoma of the lung and a review of current literature. 609 92

A ten-year experience (1970-1979) with 164 anterior mediastinotomies at a VA hospital to diagnose pulmonary or mediastinal lesions or to assess the resectability of carcinoma of the lung is reported. of 135 attempts to obtain diagnosis, 130 (96%) were successful. Of 19 patients who had a subsequent thoracotomy because the anterior mediastinotomy suggested that a curative resection was possible, 17 (90%) had successful resections. Two (1.7%) patients died-one of a paraneoplastic syndrome and one from progressive respiratory failure. Eleven complications in the 162 survivors included eight minor wound infections, an initially unrecognized pneumothorax, persistent bleeding from a lymph node biopsy site, and an air leak necessitating reoperation in another. Anterior mediastinotomy is a relatively safe procedure, even in patients with advanced carcinoma or lung disease. it has much less risks than a formal thoracotomy and provides much better exposure and diagnostic possibilities than a mediastinoscopy.
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PMID:The use of anterior mediastinotomy to assess intrathoracic lesions. 626 23

Central to risk assessment for lung resection is the fact that surgery offers the only chance of long-term survival and cure in non-small carcinoma of the lung. The challenge is, therefore, to offer surgery to as many patients as possible, whilst avoiding the risk of death from postoperative respiratory failure. Risk assessment is based on careful evaluation of the patient's existing cardiac and respiratory disease. The use of a cardiac risk index, such as that described by Detsky, will ensure that cardiac risk factors are recognised and, where possible, ameliorated prior to surgery. Pre-existing respiratory disease may be assessed by arterial blood gas analysis, exercise testing, whole and regional lung function tests. Criteria based on these tests have been proposed to aid patient selection prior to lung resection. However, these criteria take no account of the beneficial influence on outcome of modern anaesthesia and postoperative care. The elimination of postoperative pain, along with techniques such as minitracheostomy and incentive spirometry have allowed surgery to be offered to many patients who would have been deemed unsuitable by standard criteria. Patients with potentially resectable lung cancer must never be arbitrarily excluded from surgery on the basis of any single criteria or test. Referral for assessment by an experienced team consisting of a thoracic physician, surgeon and anaesthetist will maximise the number of patients offered surgery for this otherwise incurable disease.
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PMID:Is this patient fit for thoracotomy and resection of lung tissue? 764 93

It is well established that patients with compromised pulmonary function have a greater incidence of morbidity and mortality following lung resection. The prognosis of 36 (9.7%) patients with poor respiratory function (forced expiratory volume in ls (FEV1) and FEV1/FVC (forced vital capacity) ratio were equal to or less than 50% of the predicted value) of a total of 369 patients who underwent pneumonectomy due to non-small cell lung carcinoma over 10 years were reviewed. All but three patients were male with a median age of 62.5 years. Right pneumonectomy was carried out in 12 (33%) and left in 24 (67%) patients. Median FEV1 and FEV1/FVC were 1.51 (46%) and 46.5% respectively. Three (8%) patients died within 30 days of surgery. The postoperative complication rate in patients with poor respiratory function was 44%. Nine (27%) of the hospital survivors died due to non-malignant causes (recurrent chest infection/respiratory failure) and 12 (36%) due to recurrent tumour. The cause of death in one patient was second primary lung tumour and it was unknown in three (9%) patients. Eight (24%) long-term surviving patients did not have severe respiratory symptoms; their FEV1 and FEV1/FVC were remeasured and revealed a median 1.05 l (38%) and 50%, respectively of the predicted value. Actuarial 5-year survival was 29%. Poor respiratory function is associated with postoperative complications and non-malignant deaths arising secondary to respiratory failure. The survival profile demonstrates that patients were successfully treated with pneumonectomy and suggests that surgery should not be withheld from those with limited lung function if detailed investigations predict adequate residual lung function.
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PMID:Results of pneumonectomy for cancer in patients with limited ventilatory function. 851 13


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