The response of atelectasis from lung cancer to radiation therapy.

Between January 1981 and June 1983, 33 newly diagnosed patients with lung cancer presented with radiological findings of atelectasis. These patients were treated by primary radiation therapy, with doses ranging from 1200 to 6000 cGy. The response of atelectasis to radiation therapy was established on the basis of follow-up chest roentgenograms. Of the 28 patients with non-small cell carcinoma of lung, there were 17 (61%) who had improvement of the atelectasis. Among these, 13 patients were treated with doses ranging from 5000 to 6000 cGy in 5 to 8 weeks; 9 of these (70%) responded. By histological subtype, the numbers, though small, show that three of eight patients with adenocarcinoma responded, as compared to 2 out of 4 with large cell undifferentiated carcinoma and 12 of 16 patients with squamous cell carcinoma. In patients treated by more than 5000 cGy, four of eight (50%) patients with squamous cell carcinoma had a complete response and three (37.5%) had a partial relief of atelectasis, for a total response of 87.5%. The study indicates the importance of radiation therapy in the management of atelectasis caused by primary lung cancer.

Fate of tricuspid regurgitation after closed valvotomy for mitral stenosis.

Rheumatic mitral valve disease is not infrequently associated with tricuspid regurgitation (TR). To determine the fate of TR following closed mitral valvotomy (CMV), we examined the records of 23 patients with variable degrees of TR and significant mitral stenosis (MS). Based on angiocardiographic assessment of TR, patients were divided into two groups: group 1 (15 patients) had mild-to-moderate TR, while group 2 (eight patients) had severe TR. After valvotomy, dyspnea lessened in all patients. Right ventricular (RV) failure signs (jugular venous distension and hepatomegaly) and the amounts of diuretics used diminished in 12 of 15 patients in group 1. Group 2 patients showed insignificant improvement at one-year follow-up period. Cardiac recatheterization was performed in four of group 2 patients three to five years later primarily for persistence of RV failure signs. The mitral valve areas varied from 1.4 to 2.7 cm2. There was mild mitral regurgitation in two patients. There was no deterioration of the left ventricular ejection fraction, but TR was at least moderate in all cases.

Pulmonary blastoma.

Pulmonary blastoma is a rare tumor containing both mesenchymal and/or epithelial elements that mimics the embryonal tissues of the developing lungs. We are presenting two cases of pulmonary blastoma for its rarity and reviewed the literature for clinical features, investigative findings, classification, management and prognosis.