[Program of early detection of pulmonary neoplasms by the computed tomography - preliminary Szczecin experience]. / Program wczesnego wykrywania nowotworów pluc za pomoca tomografii komputerowej-- wstepne doswiadczenia Szczecina.

INTRODUCTION: Lung cancer (LC) remains one of the most serious epidemiological and clinical challenges both in the world and Poland. Results of LC therapy are far from satisfaction. One of the reasons of high LC mortality is its late detection. Currently, few centers in the world conduct LC screening programs based on low-dose spiral computed tomography (CT) of the chest. There have been no such programs in Poland up to date. MATERIAL AND METHODS: The program of LC early detection based on CT for citizens of Szczecin aged 55-65, who smoked at least 20 pack/years, was introduced on May 1st 2008 and was planned for 3 years. There were 3647 subjects examined till December 31st 2008. Algorithm of further action for detected lesions was based on the IELCAP and NELSON trial protocols. RESULTS: There were 25 malignancies detected, including 21 LC (17 females and 4 males) up to date (70% were in stage I TNM). In contrast - there was only 16.8% stage IA LC detected in the comparable group diagnosed on the symptoms basis. Fifty seven patients were treated surgically, of whom 16 underwent lobectomy or pneumonectomy coupled with radical mediastinal lymphadenectomy. There were 3 wedge resections and 2 segmentectomies performed, too. Perioperative mortality was 0%. There were 32 benign lesions of different clinical importance resected as well (tuberculoma, hamartoma, inflammatory, mycotic and sarcoidal lesions). In our group 1365 lesions were detected in 996 persons - they are followed up in accordance with the IELCAP algorithm. CONCLUSIONS: Early LC detection program initiated in Szczecin resulted in significant increase of stage IA TNM detected patients subsequently treated radically. There was also a large number of small non malignant lesions detected.

[Langerhans cell sarcoma with pulmonary manifestation, mediastinum involvement and bronchoesophageal fistula. A rare location and difficulties in histopathological diagnosis]. / Miesak z komórek Langerhansa przebiegajacy z zajeciem miazszu pluca, naciekaniem sródpiersia i przetoka oskrzelowo-przelykowa. Rzadka lokalizacja i trudnosci w rozpoznaniu histopatologicznym.

Langerhans cell sarcoma, a neoplastic proliferation of Langerhans cells with malignant cytologic features, is a very rare disease. Only a few cases have been documented in the English-language literature. Special methods, like immunohistochemistry and/or ultrastructural examination, are indispensable for appropriate diagnosis. Correct diagnosis is difficult. In fact, the disease is often misdiagnosed. We present the case of a 47 year-old man with a large mass in the middle lobe of the lung, infiltrating anterior mediastinum, with multiple pulmonary round lesions and enlargement of local lymph nodes, and with bronchoesophageal fistula. Clinical examination indicated the possibility of advanced primary lung cancer. However, the first histological diagnosis was Langerhans cell histiocytosis. In spite of treatment, the progression of pulmonary lesions was observed. Therefore, upper- and middle-lobectomy was performed. The diagnosis of Langerhans histiocytosis was confirmed microscopically again. Nevertheless, the patient's condition deteriorated progressively and he was admitted to the National Tuberculosis and Lung Diseases Research Institute in order to establish a final diagnosis. Revision of earlier resected specimens, as well as an immunohistochemical and ultrastructural examination of samples, taken once again from a bronchial tumor, led to the establishment of a diagnosis of a unique form of Langerhans cell sarcoma with rare pulmonary manifestation.

[The role of the ultrasonography in pulmonary diagnostics]. / Miejsce ultrasonografii w diagnostyce pulmonologicznej.

This article presents a review of ultrasonographic methods and their usefulness in pulmonary diagnostics. Because of its advantages ultrasonography offers a quick, cheap, and safe diagnostics of variety of pulmonary diseases. The role of ultrasound in diagnostics of lung neoplasms, pleural, diaphragma, pericardium and vessels pathology was described. Some restrictions of this tool were mentioned. The newest methods of endobronchial ultrasound were also discussed.

[Pulmonary tuberculosis after 11 years of observation in a patient suffering from advanced squamous lung cancer cured by radical radiotherapy--a case report]. / Przypadek gruzlicy pluc po 11 latach obserwacji u chorego na zaawansowanego raka plaskonablonkowego pluca wyleczonego radykalna radioterapia.

Advanced lung cancer is a neoplasm of a poor prognosis. The treatment may improve it to a certain degree but not satisfactory. A case of squamous- cell lung cancer, in a stage III B of TNM classification, which was by cured completely radiotherapy is described. The 11 years post-treatment observation was performed without any symptoms of recurrence. Actually patient is hospitalised due to active tuberculosis. No evidence for lung cancer was found until now.