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

A 63 year old male complained of persistent backache and productive cough. The chest X-ray revealed the fungus ball at the left apical-posterior segment and Aspergillus fumigatus was cultured from the sputum. He was treated on fulconazole and miconazole. Six months later, motor and sensory paralysis below the mamillary level and urinary and stool incontinence developed. A magnetic resonance image disclosed the destruction of the second thoracic spinal vertebra involved by the cavitated fungus ball of the left lung. Continuous peroral administration of antifungal drugs was not successful, and he expired with severe dyspnea. The autopsy revealed an extensive granulomatous and purulent change of the epidural and subdural spaces of the second to fifth thoracic spinal cord. Subdural inflammation extended to the lower thoracic and lower cervical level. Thoracic spinal cord revealed an extensive myelomalacia predominantly involving the left lateral white column, and also anterior and posterior columns. Small areas of the white matter were cystic. The left anterior horn cells revealed severe central chromatolysis. Moderate lymphocytic and plasma cell infiltration was found around the vessels within the cord. A few thrombi were found in the vein near the anterior nerve root. Central nervous system involvement of pulmonary aspergillosis is quite uncommon. However, there are a few reports of patients with paraplegia secondary to the spinal extension by aspergillus infection. Sheth et al. described that epidural and subdural granulomatous change with aspergillus abscesses and spinal cord myelomalacia is comparable to metastatic carcinoma. However, the aspergillus infection in the spinal cord is more extensive and destructive.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Aspergillosis involving the thoracic spinal cord--an autopsy case]. 129 15

Thoracic CT scans were performed preoperatively in 19 patients with carcinoma of the esophagus and one patient with esophageal leiomyoma. CT findings were compared with surgical and pathological findings before and after operation. CT was shown to be inaccurate in the preoperative assessment of the involvement of esophageal carcinoma and of little value in judging potential resectability (69%). Its accuracy was low in staging the tumor, usually understaging (37.5% staging II) or overstaging tumor (45.4% staging III), without information about suitable treatment of esophageal cancer. With low accuracy in visualizing lymph nodes of the mediastinum and periesophagus (30%), it is not helpful in distinguishing benign from malignant tumor of the esophagus.
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PMID:[Preoperative CT scan for esophageal tumor]. 130 34

A 10-year-old Tennessee Walking Horse gelding was admitted to the veterinary teaching hospital for evaluation of intermittent fever, lethargy, and anorexia. Initial laboratory analyses revealed anemia and hyperfibrinogenemia. Abdominocentesis and thoracentesis yielded fluid samples with high nucleated cell counts and total protein concentrations. The tentative diagnosis was nonseptic peritonitis. The horse did not improve after 4 days of antimicrobial treatment, and pitting edema of the ventral midline developed. Thoracic radiography and ultrasonography revealed consolidation of the ventral aspect of the lung fields and pleural effusion. Pleuroscopy of the right hemithorax revealed pleural effusion and a soft-tissue mass in the caudal portion of the mediastinum. Findings on biopsy of the liver and mediastinal mass led to a presumptive diagnosis of metastatic cholangiocellular carcinoma. The horse was euthanatized, and the diagnosis was confirmed at necropsy.
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PMID:Antemortem diagnosis of cholangiocellular carcinoma in a horse. 139 2

The authors studied 8 patients (4 males and 4 females) with Cushing's syndrome due to ectopic ACTH secretion. Chronological age ranged from 15 to 45 years and duration of the disease ranged from 3 to 48 months. All patients presented typical signs of Cushing's syndrome, blood hypertension, and four of them had hyperpigmentation of the skin. Five patients had fasting hyperglycemia and all patients but one had serum hypokalemia (serum K = 2.2 to 3.9mEq/l). The circadian rhythm of cortisol was absent in all patients and basal cortisol levels were elevated in all patients but one. Basal ACTH levels evaluated in 7 patients were elevated in 6 (29 to 1050 pg/ml-MRC). One patient presented normal depression of urinary 17-OH after two days of dexamethasone and normal increase of urinary 17-OH and serum 11-dexycortisol after methyrapone. Four patients had carcinoid tumor (3 thymic and 1 bronchial), two had pancreatic islets cell tumors, one had bilateral pheochromocytoma and medular carcinoma of the thyroid, and one had oat cell carcinoma of the lung and medular carcinoma of the thyroid. Thoracic X-rays identified the ectopic ACTH secretion tumor in four cases, all confirmed by CT scan. Abdominal CT showed a difuse enlargement of the adrenals in seven cases and bilateral nodules in one case (pheochromocytomas). Six patients died within 3 years of the diagnosis. The authors concluded that clinical and hormonal findings could mislead the findings of ACTH ectopic secretion and Cushing's disease, and suggest that thoracic X-rays and CT scans of the skull, thorax, and abdome should be done in all cases of Cushing's syndrome.
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PMID:[Cushing syndrome due to ectopic ACTH secretion]. 255 51

The authors present a series of twenty metachronous lung carcinomas operated upon in the Thoracic Surgery Unit of Nancy between 1975 and 1987. These lesions occur after a first lung tumor resected for stade 1 TNM in 19 cases, with a 59 month's mean free interval and they are surgically treated by 14 controlateral lobectomies and 6 completion pneumonectomies. In spite of 4 post-operative deaths, the survival rates reach 51% at 3 years and 32% at 5 years. This study with a review of the literature emphasize the relatively high incidence of metachronous lung carcinomas in the patient resected for a tumor of good pronostic factors, their occurrence after a prolonged interval, the difficulty to prove their primary nature and the justification of a surgical approach because the long-term results are comparable with that of patients operated upon for a single carcinoma.
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PMID:[Metachronous bronchial neoplasm. 20 cases surgically treated]. 270 Jan 58

Chest wall recurrence following radiation and hormonal therapy is an uncommon but serious and disabling condition. A chest wall ulcer secondary to treatment for recurrence also presents the same dilemma. Over the past 35 years, the Thoracic Service at our institution has treated 35 patients for these problems by surgical resection and reconstruction. Eight patients were seen after the first recurrence, six after the second, ten after the third, and ten after the fourth. One patient had chest wall resection with mastectomy when recurrence followed radiation therapy. Following resection of the tumor, 21 patients had reconstruction using mesh or a mesh "sandwich." There were no operative deaths and no respirator need. Twenty patients are alive from five to 120 months, with a median of 50 months. One of 35 patients had chest wall recurrence. Surgical resection of recurrent mammary carcinoma resistant to all other therapy is a viable alternative for both palliation and cure.
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PMID:Local recurrent mammary carcinoma failing multimodality therapy. A solution. 291 36

Thyroid tumors were diagnosed in 26 dogs between 1977 and 1984. A total of 23 of the 26 tumors were carcinomas, and 3, detected as incidental findings at necropsy, were adenomas. The median patient age was 9.5 years. Dogs of the Beagle breed were affected most commonly (5 dogs). The most common physical abnormalities in carcinoma patients were cervical swelling, dyspnea, and coughing. A total of 25 of 26 dogs were clinically euthyroid. Aspiration cytology provided diagnostic information in 8 of 17 cases. In dogs with thyroid carcinoma, a cervical soft tissue lesion was identified consistently by use of radiography and scintigraphy with sodium pertechnetate. Pulmonary metastases were detected radiographically in 8 of 21 dogs with thyroid carcinoma. Thoracic nuclear imaging confirmed the radiographic findings in 11 of 14 dogs. Surgical excision of the thyroid mass was the primary treatment for 17 dogs with carcinoma. Eight dogs died within 2 years (median, 7 months) of surgery because of primary tumor regrowth or metastases. Four dogs were alive at a range of 3 to 48 months after surgery, and 4 dogs died from unrelated causes. Necropsy of 7 dogs with thyroid carcinoma revealed neoplastic infiltration of the cervical blood vessels and pulmonary metastases in each dog. The most common histologic patterns of thyroid carcinoma were solid or compact cellular (11 dogs) and mixed solid-follicular tumors (8 dogs). Dogs with a solid carcinoma had a median survival time of 10.5 months (6 dogs), and dogs with a mixed solid-follicular tumor had a median survival time of 8 months (3 dogs).
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PMID:Clinical and pathologic features of thyroid tumors in 26 dogs. 301 18

The rapid and widespread development of imaging techniques during the last decade has markedly modified the previous algorithms used in the staging of pulmonary carcinoma, particularly M0/M1 in the TNM classification and the directives of the American Thoracic Society. Sensitivity and specificity of each method are reviewed according to the most frequent metastatic sites of bronchopulmonary carcinoma. Presently, CT is the most efficient technique for detection and display of metastases of the contralateral lung, brain, adrenal glands and retroperitoneal lymph nodes. Ultrasound is equal or even slightly superior to CT for the detection of liver metastases. The superiority of magnetic resonance imaging (MRI) over CT in the detection of brain metastases has already been demonstrated. The results of MRI using fast sequences have recently been demonstrated for imaging of thoracic, abdominal and bone metastases, but confirmation of these first results by prospective studies is needed. Skeletal survey is still obtained by radioisotope scanning.
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PMID:[Staging of pulmonary cancer, establishment of M1]. 367 84

Between 1979 and 1984, mediastinoscopy was performed on 1,000 of the 1,500 patients admitted to the Thoracic Surgical Service of the Toronto General Hospital with the diagnosis of carcinoma of the lung. In 144 cases, concomitant anterior mediastinoscopy was also performed. Abnormal mediastinal nodes were found in 296 (29.6%). The overall complication rate was 2.3%, with no deaths. Mediastinoscopy revealed diseased nodes in 24% of patients with squamous cell carcinoma, 29% with adenocarcinoma, 54% with small cell undifferentiated carcinoma, 31% with large cell undifferentiated carcinoma, and 12% with bronchoalveolar carcinoma. Abnormal mediastinal nodes were found with equal frequency in right- and left-sided tumors and occurred in 31% of tumors in the main bronchus, 25% of upper lobe tumors, and 17% of lower lobe tumors. Of the 704 patients having negative results of mediastinoscopy, 590 were subjected to thoracotomy. Ninety-three percent underwent resection (85% curative, 7% palliative) and 7% had unresectable tumors. Of the resections, 20% were pneumonectomies. At thoracotomy, 52 of the 590 patients with negative mediastinoscopic results were found to have abnormal mediastinal nodes. Sixty-two of the 296 patients with positive results of mediastinoscopy were selected for thoracotomy. Eighty-six percent had resectable lesions (67% curative, 18% palliative) and 14% unresectable. The pneumonectomy rate in this group was 35%. These current data support our previous opinion that routine mediastinoscopy can be done with negligible morbidity and provides essential information for the classification and management of cancer of the lung.
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PMID:Prospective evaluation of mediastinoscopy for assessment of carcinoma of the lung. 394 59

A 59-years old woman showed 5 years after the diagnosis of a sarcoidosis of stage II--III according to Wurm and Reindell an abdominal symptomatology in the sense of an ulcerous disease. Radiological, endoscopical and bioptical examinations revealed a small contraction of the antrum, an ulcus at first diagnosed as benign and an adenocarcinoma. In the resected part of the stomach were found noncaseating granulomas with Epithelioid cells and Giant cells as well as the adenocarcinoma. 1 1/2 years after partial resection of the stomach (B II) a recurrence of the carcinoma near the anastomosis and metastases in the lymphonoduli of the abdomen were found by autopsy. Thoracic of abdominal manifestations of the sarcoidosis could no longer be demonstrated.
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PMID:[Sarcoidosis involvement and adenocarcinoma of the stomach]. 409 50


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