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

To evaluate the combination of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS) and positron emission tomography with fluorodeoxyglucose (FDG-PET) for the diagnosis of small peripheral pulmonary lesions (PPLs) < or = 30 mm in mean diameter. A total of 74 PPLs (69.2%) were diagnosed by TBB using EBUS-GS with X-ray fluoroscopy. Diagnostic yield by FDG-PET was 78.5% for the 107 PPLs examined. Diagnostic yield with the combination of TBB using EBUS-GS and FDG-PET (90.7%) was significantly higher compared with that for each procedure alone. A significant increment in diagnostic yield with this combination was seen for PPLs >20mm and < or = 30 mm and for malignant lesions. Combination of TBB using EBUS-GS and FDG-PET is useful for the diagnosis of small PPLs.
Lung Cancer 2010 May
PMID:Combining transbronchial biopsy using endobronchial ultrasonography with a guide sheath and positron emission tomography for the diagnosis of small peripheral pulmonary lesions. 1959 71

The aim of the present study was to investigate the relationship between FDG uptake and clinical stage for non-small cell lung cancer. The patients who were histologically or cytologically proven to be adenocarcinoma (AC) or squamous cell carcinoma (SCC) lung cancer and conducted FDG PET/CT staging were retrospectively reviewed. The FDG uptake was quantified as the maximum standardized uptake value (SUVmax). And the T-N-M status was determined mainly by FDG PET-CT imaging according to the 1997 update of the international staging system for lung cancer. From December 2003 to November 2007, 266 cases (194 men and 72 women; age range 31-90 years, median 62 years) were analyzed, which included 161 AC and 105 SCC patients. The present study showed that both size (3.23+/-1.68cm vs 2.63+/-1.33cm, P=0.004) and SUVmax (9.82+/-5.08 vs 8.43+/-4.21, P=0.016) were significantly greater for SCC compared to AC. There was positive correlation between the SUVmax and size for both SCC and AC (r=0.651, 0.632, respectively; both P=0.000). Significant difference is found among different stages in SUVmax for AC (F=11.693, P=0.000) but not for SCC (F=1.514, P=0.216). After controlling the size factor, a significant correlation was found between tumor stage and FDG uptake value for AC (r=0.323, P=0.000), but not for SCC (r=0.113, P=0.252). In conclusion, this observation showed that tumor size and histologic subtype had influences upon FDG uptake in non-small cell lung cancer. It demonstrated significant correlation between clinical stage and SUVmax for AC, but not for SCC.
Lung Cancer 2010 Jun
PMID:Relationship between primary lesion FDG uptake and clinical stage at PET-CT for non-small cell lung cancer patients: An observation. 1968 58

Fluorine-18 fluorodeoxyglycose -position emission tomography ((18)F-FDG-PET) as an efficient staging tool for lung carcinoma; allows description and characterization of the primary tumor and of local and distant metastases in a single examination. One of the important limiting factors in quantification of metabolic parameters with PET is the partial volume effect. Our aim for this study was to delineate tumor (size) both in the primary and metastatic lesions in patients with lung cancer by using partial volume correction techniques. Thirty two patients with proven lung cancer who had (18)F-FDG-PET and computerized tomography (CT) within the last 80 days were involved in this study. They were 18 women and 14 men, with age range 43-83 years. Maximum standardized uptake values (SUVmax) in primary and metastatic lesions for all patients were measured. The lesions were categorized into 4 different Groups according to their site. Partial volume corrections were applied using the CT sizes of lesions to obtain corrected SUVmax values. Average corrected SUVmax in each lesion site was calculated and compared between the 4 Groups. A total of 81 primary and metastatic lesions were included in this analysis. They were 28 mediastinal-hilar lymph node lesions, 26 lung lesions, 11 solid organ lesions, and 16 bone marrow lesions. The average uncorrected SUVmax for the primary lung lesions, mediastinal-hilar lymph node lesions, solid organ lesions, and the bone marrow lesions before application of partial volume correction formula were 7.2+/-3.2; 7.0+/-2.7; 6.3+/-3.4 and 7.0+/-3.4, respectively. The average corrected SUVmax for the lesions in the above mentioned regions were 11+/-6, 10+/-4, 13+/-7, and 18+/-13, respectively. A statistically significant difference was observed in the average SUVmax values between lung lesions and nodal lesions compared to the bone marrow lesions. In conclusion, our findings indicate that metabolic activities of lung cancer lesions vary depending on the sites of metastatic disease.
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PMID:Tumor metabolism measured by partial volume corrected standardized uptake value varies considerably in primary and metastatic sites in patients with lung cancer. A new observation. 1993 31

Even if the prognostic role of SUVmax of 18-FDG-PET has been largely investigated, many issues regarding its relationship with pathologic staging and histological subtypes still remain controversial. This retrospective study investigated the prognostic significance of SUVmax in 119 completely resected, pathologically proven NSCLC. The SUVmax values resulted significantly related to histological subtypes (p<0.001), histological grading (p<0.001), and pathologic stage (p<0.001). The optimal cut-off value of SUVmax to predict prognosis in the whole series was 6.7 (p=0.029). 2-Year disease-specific survival (DSS) was 91% for SUVmax < or =6.7 and 55% for SUVmax >6.7 (p<0.001). SUVmax still remain a significant predictor of survival in Stage IB (2-year DSS of 100% for SUVmax < or =6.7; 51% for SUVmax >6.7, p=0.016). The optimal cut-off values of SUVmax to predict prognosis were 5 for adenocarcinoma (p=0.027) and 10.7 for other non-adenocarcinoma NSCLC subtypes (p=0.010). These histologic-specific cut-offs resulted significantly related to survival when stratified for stage: 2-year DSS for Stage IB adenocarcinoma were 100% for SUV< or =5 and 40% for SUVmax >5 (p=0.051); 2-year DSS for Stage IB non-adenocarcinoma were 83% for SUVmax < or =10.7 and 26% for SUVmax >10.7 (p=0.018). Adenocarcinomas showed significantly lower survival results respect to other NSCLC for intermediate SUVmax level (range 5.5-11.3) (p=0.021). High SUVmax resulted an independent negative prognostic factor at multivariate analysis (HR of 15.7, 95% CI of 2.50-98.44, p=0.003). In conclusion, SUVmax represents a significant prognostic factor in surgically resected NSCLC but a great variability between different histological subtypes, even when adjusted for stage, is present and could be considered when planning future trials on prognostic role of FDG uptake.
Lung Cancer 2010 Aug
PMID:The variation of prognostic significance of Maximum Standardized Uptake Value of [18F]-fluoro-2-deoxy-glucose positron emission tomography in different histological subtypes and pathological stages of surgically resected Non-Small Cell Lung Carcinoma. 1994 13

We report a case of the coexistence of pulmonary tuberculosis and lung cancer maked a wrong diagnosis of lung cancer and metastatic lung carcinoma. The patient was a 80-years-old woman who had ascites and anorexia and decreased weight. Chest CT film showed a mass shadow in the right S, and infiltrative shadows on bilateral lung fields. FDG-PET revealed the tumor in the right lower lung field and many infiltrative shadows in all lung fields, and showed that FDG accumulated diffusely along the peritoneum. We made a diagnosis of lung cancer and metastatic lung carcinoma. However we obtained a diagnosis of coexisting of pulmonary tuberclosis and lung cancer autopsy. When the patient has a shadow suggestive of lung tumor shadow with many infiltrative shadows, we tend to make a diagnosis of lung cancer and metastatic lung carcinoma. We saw the importance of a postmortem examination in a new light.
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PMID:[A case of miliary tuberculosis difficult to distinguish from metastatic lung cancer]. 1999 2

We report a case of amyloid pulmonary nodules with positive FDG uptake that mimic multiple lung metastases. A 54-year-old female patient was referred for the evaluation of multiple lung nodules. A PET/CT scan revealed mild FDG uptake in various sized pulmonary nodules. Resected nodules contained amorphous eosinophilic proteineous material with focal calcification, consistent with amyloidosis. Pulmonary amyloidosis should be added to the differential diagnosis for cases of multiple pulmonary nodules that show positive FDG uptake.
Lung Cancer 2010 Mar
PMID:Pulmonary amyloidosis mimicking multiple metastatic lesions on F-18 FDG PET/CT. 2002 34

A 58-year-old man complaining of increasing weakness of muscular leg strength, diplopia and ptosis was admitted to our hospital. An electromyogram (EMG) showed typical waxing phenomenon in response to high-frequency repetitive stimulation. A diagnosis of Lambert-Eaton myasthenic syndrome (LEMS) was made from his symptoms and EMG results. A chest CT showed mediastinal lymph node swelling. No abnormal mass was seen in either lung field. His serum levels of a P/Q-type anti-voltage-gated calcium channel (VGCC) antibody, Pro-GRP, and NSE were high. FDG-PET showed accumulation of FDG to the mediastinal and left inguinal lymph nodes. The left inguinal lymphadenopathy was pathologically diagnosed as metastasis of small cell lung carcinoma. No tumor could be detected by bronchofiberscopy. No other distant metastasis was detected by brain MRI, abdominal CT, or FDG-PET. After 6 courses of chemotherapy for SCLC, a partial response and reduction of symptoms were obtained. For assessment of indistinguishable neuropathic symptoms, the possible diagnosis of paraneoplastic syndrome, such as LEMS, and the fact that early treatment for primary disease was effective, should be considered.
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PMID:[A case of small cell lung carcinoma without apparent primary lesion accompanying Lambert-Eaton myasthenic syndrome]. 2005 96

We report the findings regarding a 70-year-old man with paraneoplastic limbic encephalitis. He presented with a chief complaint of inability to recall any events. He had been well until one month before admission, and then he abruptly began to show progressive amnesia. At admission, the patient's score on the Revised Hasegawa Dementia Scale (HDS-R) showed a decline to 13/30, thus indicating the existence of severe disorientation and an impaired memory. The brain CT and EEG showed no specific abnormalities and an analysis of cerebrospinal fluid showed only a mild increase in the total protein level. A chest X-ray film revealed a mass in the right hilum, while a histological analysis of the biopsied specimen finally established a diagnosis of small cell lung carcinoma. The FDG-PET and the enhanced brain MRI showed a single small metastatic lesion in the cerebellum. After the 1st course of chemotherapy and whole brain radiation, cognitive function, especially the short-term memory, remarkably improved and the HDS-R score increased to 21/30. However, the tumor again increased in size during the 3(rd) and 4(th) courses of chemotherapy. Interestingly, cognitive function also worsened again and the score of HDS-R declined to 15/30, 20 weeks after the start of chemotherapy. Limbic encephalitis can be associated with malignant tumors, such as small cell lung carcinoma, and some reported cases have shown a cognitive improvement after tumor therapy. In our case, we also observed a reworsening of the cognitive function in association with the acquired chemoresistence.
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PMID:[A case of limbic encephalitis with small cell lung carcinoma in which the cognitive function improved and redeteriorated during tumor therapy]. 2033 11

The natural chronologic evolution of a lung cancer manifesting as a pure ground-glass opacity (GGO) nodule on CT scans still remains to be elucidated. Therefore, it is sometimes difficult to determine proper follow-up examinations, particularly in case of GGO nodule growing slowly on serial CT scans. In the current case, we demonstrate serial morphologic (CT) and metabolic ((18)F-FDG PET) imaging findings in a case of adenocarcinoma, where stepwise progression from a focal pure GGO nodule (presumed atypical adenomatous hyperplasia [AAH] or bronchioloalveolar carcinoma [BAC]) eventually to an invasive adenocarcinoma was clearly depicted for more than 10-year follow-up period. This case seems to be useful for the prediction of tumor growth pattern and aggressiveness of malignant pure GGO nodules. In addition, the evolving process of this case may suggest a guideline for planning an appropriate follow-up examination and management in such cases.
Lung Cancer 2010 Jul
PMID:Stepwise evolution from a focal pure pulmonary ground-glass opacity nodule into an invasive lung adenocarcinoma: an observation for more than 10 years. 2047 41

Patients with stage IV metastatic non-small cell lung cancer (NSCLC) are generally believed to have an incurable disease. Patients with oligometastatic disease represent a distinct subset of patients among those with metastatic disease. There is evidence that these patients have synchronous or metachronous satellite nodules in different pulmonary lobes or have solitary extrapulmonary metastases. In these cases, evidence has shown that surgical resection may provide patients with survival benefit. This article discusses the biology of the oligometastatic state in patients with lung cancer and the selection of patients for surgery, as well as the prognostic factors that influence survival of the patient. To properly select patients for an aggressive local treatment regime, accurate clinical staging is of prime importance. The use of FDG-PET should be considered for restaging if oligometastatic disease is suspected based on a patient's CT scan. A limitation of retrospective clinical studies for oligometastatic disease is that it is difficult to summarize and evaluate the available evidence for the effectiveness of surgical resection due to selection bias, and to a high degree of variability among different clinical studies. Nevertheless, we can certainly learn from the clinical experience acquired from retrospective case series to identify prognostic factors. Following surgical resection, the overall 5-year actuarial survival rate is about 28% for patients with satellite nodules and 21% for patients with ipsilateral nodules. Patients with resected brain metastasis achieve 5-year survival rates between 11% and 30%, and those with adrenalectomy for adrenal metastasis achieve 5-year survival rates of 26%.
Lung Cancer 2010 Sep
PMID:Surgical treatment of oligometastatic non-small cell lung cancer. 2053 26


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