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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The paper deals with the important problem of pulmonary surgery--the capacities of surgical treatment in concomitance of pulmonary tuberculosis and lung cancer. In 1990 to 2002, the Santarishkes Republican Tuberculosis and Lung Diseases Hospital and the Department of Thoracic Surgery and Oncology, Vilnius University Cancer Institute operated on 2218 patients with lung cancer, of them 46 (2.1%) were diagnosed as having concomitance of lung cancer and tuberculosis. The diagnosis of central and peripheral lung cancer was established in 37 (80.4%) and 9 (19.6%) patients, respectively. Histology revealed squamous-cell tumors in 24 (52.2%) patients, adenocarcinoma in 10 (21.7%), and adenosquamous-cell carcinomas in 12 (26.1%) patients. Stages I, II, and III were established in 12 (26.1%), 11 (23.9%), and 23 (50%) patients, respectively. Pulmonectomy was performed in 18 (39.2%) patients; 10 (21.7%), 10 (21.7%), and 8 (17.4%) patients underwent lobectomy, bilobectomy, and segmentectomy, respectively. Postoperative complications were observed in 28 (60.8%) patients. There were 6 (13%) cases of death. Twenty-three (50%) patients received complex treatment. Surgery is the method of choice in the treatment of concomitance of pulmonary tuberculosis and lung cancer. In such patients, survival averaged 28 +/- 2 months.
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PMID:[Potentialities of surgical treatment for concomitance of pulmonary tuberculosis and lung cancer]. 1759 60

Lung cancer is responsible for 40% mortalities from malignant diseases in man and exhibits an extremely infiltrating way of growing. It does not respect the lobes' or the organs' borders and spreads by blood system, lymph system and per continuitatem. According to its biological characteristics and response to treatments it may be divided in to small cell lung cancer (SCLC) and non small cell lung cancer (NSCLC), which also includes other histological types. Lung cancer treatment includes surgical treatment, chemotherapy, radiotherapy, the combination of the former three as well as symptomatic treatment. In this study, we analyzed 125 patients with lung cancer, that were hospitalized at the Clinic for Thoracic Surgery in KCU Sarajevo. The difference according to gender is statistically significant because we had 111 (88,8%) male patients in comparison with 14 (11,2%) female patients. The average age of male patients was 60,3 years while female patients were 61,9 years old on average. Thus, the difference in average age is not statistically significant. In diagnostic procedures: chest radiography was the most significant in peripheral lesions (60, 8%). CT of the thoracic organs has a statistical significance because the tumor changes were confirmed in 123 patients (98,4%). In bronchoscopy, we had 120 patients (96,0%). The number of patients with preformed lobectomy (63) is statistically significantly greater in the observed group (125) then the number of patients with other operative procedures preformed. From the postoperative complications we had exitus letalis 2 (1,6%), wound infection 19 (15,2%), and 104 without complications (83,2%). The results of testing the significance of differences according to the cancer types in non small cell lung cancer were planocellular, adenocarcinoma, and macrocellular. Comparing the preoperative staging and operative findings through stages we obtained to the following results: in stage ST0 the deviation was 16,7%, STIA the deviation was 40,1%, STIB the deviation was 16,1%, STIIA the deviation was 11,1%, STIIB the deviation was 12,5%, STIIIA the deviation was 33,33%, STIIIB the deviation was 33, 3%. From the overall number of patients, who were in preoperatively graded stage STIA, operative findings confirmed STIA, which makes the most important statistically significant difference. In 36 patients or 28,8% the status was changed in operative finding. In 89 patients preoperative status or 72,2% remained unchanged following the operation.
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PMID:Evaluation of the preoperative stage and operative findings in patients with non-small cell lung cancer. 1784 50

A 62-year-old man presented in June 2006 with right thoracic pain, cough, and weight loss, which had persisted for 3 months. Chest X-ray showed a mass-like shadow in the right pulmonary apex, suggesting a stage IIIb adenocarcinoma which was confirmed by biopsy. We gave a total radiation dose of 60 Gy, after this which general malaise and weakness were noted. The results of endocrinological examinations suggested syndrome of inappropriate antidiuretic hormone secretion (SIADH). Thoracic CT showed ground-glass opacity (GGO) in both lungs, and we could not rule out pulmonary tuberculosis. A sputum was positive for acid-fast stain and PCR-Tb, suggesting that SIADH was associated with pulmonary tuberculosis. Water restriction, i.v. physiological saline, and antituberculosis therapy relieved hyponatremia and the symptoms.
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PMID:[A patient who sufferred pulmonary tuberculosis with syndrome of inappropriate secretion of antidiuretic hormone, after radiotherapy for pulmonary adenocarcinoma]. 1818 40

Small-cell carcinoma (SCC) of neuroendocrine type is an uncommon tumor of the endometrium. No previous report has documented Cushing's syndrome due to ectopic ACTH production by SCC of the endometrium. We describe a 56-year-old Japanese woman with SCC of the endometrium and multiple lung metastases presenting as Cushing's syndrome. The patient was referred to our hospital because of general fatigue with facial and leg edema, and multiple nodular lesions in the bilateral lungs on chest X-ray examination. A physical examination revealed that the patient had moon face, buffalo hump, and truncal obesity. Endocrinological examinations confirmed ACTH-dependent Cushing's syndrome. Thoracic computed tomography imaging showed multiple nodular lesions in the bilateral lungs. Abdominal magnetic resonance imaging suggested a malignant tumor of the uterus. The patient received a lung tumor biopsy and surgical hysterectomy. The endometrial carcinoma was histologically a SCC admixed with endometrioid adenocarcinoma. The SCC of the endometrium showed immunoreactivity for pro-opiomelanocortin, ACTH, and vimentin, but not for thyroid transcription factor-1. The lung biopsy specimen had the same features. These findings indicated that the SCC originated from the endometrium, and the ectopic ACTH-producing tumor caused Cushing's syndrome. This study provides the evidence that SCC of endometrial origin was an ectopic ACTH-producing tumor causing Cushing's syndrome.
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PMID:Small-cell carcinoma of the endometrium presenting as Cushing's syndrome. 1983 52

Platinum-based chemotherapy is the standard first-line treatment for patients with advanced non-small-cell lung cancer (NSCLC). However, randomized trials have recently demonstrated the efficacy of several new drugs (pemetrexed, bevacizumab, cetuximab, erlotinib, gefitinib) in this setting. Hence, the choice of optimal treatment is no longer limited to the different platinum-based doublets. In order to guide clinical management of patients with advanced NSCLC, assess the strengths and limitations of available evidence, and to suggest priorities for clinical research, the Italian Association of Thoracic Oncology organized an International Expert Panel Meeting on the first-line treatment of advanced NSCLC, which took place in Sperlonga (Italy) in May 2009. Experts recommended that every effort should be made to obtain adequate tumor tissue before initiating treatment. Tumor histology/cytology subtyping is now important for the correct choice of treatment. In particular, considering efficacy data obtained with pemetrexed and safety concerns with bevacizumab, a division between squamous and non-squamous tumors is necessary. Epidermal growth factor receptor (EGFR) mutation analysis, at present, is not recommended in all patients, but should be performed in subgroups of patients characterized by higher prevalence of sensitizing mutations (Asians, never smokers, women, adenocarcinoma). When a mutation is present, first-line treatment with single-agent EGFR tyrosine-kinase inhibitor may be considered. Finally, the potential benefit of maintenance treatment for patients without progression at the end of first-line should be carefully discussed with each patient. Although the number of treatment options for patients with advanced NSCLC has increased recently, their results remain modest and further research is mandatory.
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PMID:Recent issues in first-line treatment of advanced non-small-cell lung cancer: Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology. 2003 27

Some skin lesions may accompany malignancies. Acanthosis nigricans, one such lesion, is a paraneoplastic dermatosis characterized by hyperpigmented and velvety verrucose plaques observed as symetric eruptions. With this report, we aim to present a rare case of concomitant lung cancer and acanthosis nigricans. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. A 65-year-old patient who had hyperpigmented, hypertrophic and symmetric verrucose lesions at the flexor surfaces of the lower and upper extremities, face, palms and the axillary region. Thoracic computed tomography demonstrated a hypodense mass lesion with a dimension of 5 x 5.5 cm at the center of basal segment bronchi of the left pulmonary lobe. Fiberoptic bronchoscopy showed that the access to the lower left lobe was almost completely obstructed by the endobronchial lesion. The result of the histopathologic examination of the endobronchial tissue biopsy was reported as non-small cell (adenocarcinoma) lung cancer. Result of the histopathologic analysis of the punch biopsy of the skin lesions was reported as acanthosis nigricans .There are no pathognomonic dermatological findings for lung cancer. In conclusion, there are skin lesions that accompany lung cancer and we believe that these should be considered for differential diagnosis.
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PMID:Acanthosis nigricans in a patient with lung cancer: a case report. 2081 63

A new lung adenocarcinoma classification is being proposed by the International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society (IASLC/ATS/ERS). This proposal has not yet been tested in clinical datasets to determine whether it defines prognostically significant subgroups of lung adenocarcinoma. In all, 514 patients who had pathological stage I adenocarcinoma of the lung classified according to the Union for International Cancer Control/American Joint Committee on Cancer 7th Edition, and who had undergone a lobectomy with mediastinal lymph node dissection were retrospectively reviewed. Comprehensive histological subtyping was used to estimate the percentage of each histological subtype and to identify the predominant subtype. Tumors were classified according to the proposed new IASLC/ATS/ERS adenocarcinoma classification. Statistical analyses were made including Kaplan-Meier and Cox regression analyses. There were 323 females (63%) and 191 males (37%) with a median age of 69 years (33-89 years) and 298 stage IA and 216 stage IB patients. Three overall prognostic groups were identified: low grade: adenocarcinoma in situ (n=1) and minimally invasive adenocarcinoma (n=8) had 100% 5-year disease-free survival; intermediate grade: non-mucinous lepidic predominant (n=29), papillary predominant (n=143) and acinar predominant (n=232) with 90, 83 and 84% 5-year disease-free survival, respectively; and high grade: invasive mucinous adenocarcinoma (n=13), colloid predominant (n=9), solid predominant (n=67) and micropapillary predominant (n=12), with 75, 7170 and 67%, 5-year disease-free survival, respectively (P<0.001). Among the clinicopathological factors, stage 1B versus 1A (P<0.001), male sex (P<0.008), high histological grade (P<0.001), vascular invasion (P=0.002) and necrosis (P<0.001) were poorer prognostic factors on univariate analysis. Both gross tumor size (P=0.04) and invasive tumor size adjusted by the percentage of lepidic growth (P<0.001) were significantly associated with disease-free survival with a slightly stronger association for the latter. Multivariate analysis showed the prognostic groups of the IASLC/ATS/ERS histological classification (P=0.038), male gender (P=0.007), tumor invasive size (P=0.026) and necrosis (P=0.002) were significant poor prognostic factors. In summary, the proposed IASLC/ATS/ERS classification of lung adenocarcinoma identifies histological categories with prognostic differences that may be helpful in identifying candidates for adjunctive therapy. The slightly stronger association with survival for invasive size versus gross size raises the need for further studies to determine whether this adjustment in measuring tumor size could impact TNM staging for small adenocarcinomas.
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PMID:Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. 2125 58

The patient of 52-year-old smoker was admitted in emergency with headaches, dyspnea, oedema and cyanosis of the cephalic extremity and of the superior members. This signs and symptoms suggest a superior vena cava sindrom. Thoracic CT scan shows the thrombosis of the superior vena cava and a tumor localized in the Bariety's Lodge of about 30/40 mm witch is around the right lateral wall of the traheea.This tumor is also tangent to the superior the superior vena cava. The patient was operated by total median sternotomy. By this approach we performed a complete excision of the mediastinal tumor mass. After that we effected a longitudinal cavotomy, we took out the endoluminal clot and we sutured the superior vena cava. The histological diagnosis of the mediastinal tumor was adenocarcinoma tubular-papillary moderately differentiated. The evolution post operative period was favorable the superior vena cava sindrom was a complet remission. The thoracic CT scan control after 9 months later didn't show a local relapse and blood flow was normally throw the superior vena cava.
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PMID:[Superior vena cava syndrome--surgical solution--case report]. 2135 82

Standardized lung cancer classifications by the World Health Organization have traditionally been based on the histological characteristics of resected tumors with little guidance about diagnosis based on small biopsies and cytology. The focus has mainly been on the separation of small-cell lung carcinoma (SCLC) and non-small-cell lung carcinoma (NSCLC). Until recently there have been no therapeutic implications to further classification of NSCLC, so little attention has historically been given to the distinction of adenocarcinoma and squamous cell carcinoma in these small tissue samples. This situation has changed dramatically in recent years with the discovery of several therapeutic options that are only available to patients with adenocarcinoma or NSCLC, not otherwise specified (NSCLC-NOS), rather than squamous cell carcinoma. Therefore this article reviews new criteria and terminology recently proposed by the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) lung adenocarcinoma classification. This includes recommendation for use of special stains as an aid to diagnosis, particularly in the setting of poorly differentiated tumors that do not show clear differentiation by light microscopy. The need for every institution to develop a multidisciplinary strategy to obtain these small specimens and process them not only for diagnosis but also for molecular testing is emphasized.
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PMID:Pathological diagnosis and classification of lung cancer in small biopsies and cytology: strategic management of tissue for molecular testing. 2150 Jan 21

Pulmonary mucinous adenocarcinoma (PMA) is the terminology recently proposed in the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) International Multidisciplinary Classification of Lung Adenocarcinoma Guidelines for most tumors previously classified as mucinous bronchioloalveolar carcinomas (mBACs). PMA is histologically characterized by lepidic growth and at least some degree of invasive growth of goblet or columnar neoplastic cells with abundant intracytoplasmic mucin. We report here the cytologic features of PMA in a bronchial brushing specimen. The patient is an 84-year-old woman with a persistent dense consolidation in the right middle lobe of the lung found on non-contrast computed tomography (CT) scan. Bronchial brushing smears showed a monotonous population of columnar neoplastic cells forming "drunken honeycomb"-like cell clusters. The neoplastic cells displayed inconspicuous cytologic atypia. The concurrent transbronchial tissue biopsy and the resection specimen confirmed the diagnosis of PMA. Due to the bland nuclear features, the neoplastic cells in the bronchial brushing specimen were interpreted as benign at the time of the initial diagnosis, demonstrating a diagnostic pitfall of bronchial brushing cytology. A high index of suspicion is recommended when a lung lesion with "drunken honeycomb"-like cell clusters is encountered in bronchial brushing specimens. The review of the literature regarding the recently designated PMA is presented.
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PMID:The "drunken honeycomb" feature of pulmonary mucinous adenocarcinoma: a diagnostic pitfall of bronchial brushing cytology. 2156 23


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