RESUMO
AIM: The prognosis of patients with lung cancer depends on early diagnosis and accurate staging. The present staging system for lung cancer is tumor (T), node (N), and metastasis (M) staging (TNM). We compared the accuracy of preoperative (clinical) and postoperative (pathological) TNM staging of lung cancer in this study and emphasized the preoperative mediastinoscopy is useful in selected patients. METHODS: We performed a retrospective comparison of the clinical and pathological TNM staging of 530 patients with lung cancer treated surgically. The preoperative clinical TNM staging of all patients was based on physical examination, radiological investigations and bronchoscopy. Mediastinoscopy was used routinely for all patients with an indication since 2000. RESULTS: We found the agreement between clinical and pathological TNM staging to be only 46.4%. The comparison between clinical and pathological TNM staging was 6.2-5.3% at stage Ia, 37.9%-36% at stage Ib, 0.7-0.9% at stage IIa, 23-25% at stage IIb, 27.1-16.2% at stage IIIa, and 3.2-14% at stage IIIb respectively. The frequency rates of the different clinical and pathologic stages were 6.2% and 5.3%, for stage Ia, 37.9% and 36% for stage Ib, 0.7% and 0.9% for stage IIa, 23% and 25% for stage IIb, 27.1% and 16.2% for stage IIIa, 3.2% and 14% for stage IIIb respectively. CONCLUSION: We compared the clinical and pathological staging in patients with non small cell lung cancer submitted to surgical treatment to identify the causes of any discordance. The clinical TNM and staging based on computerized tomography was found to be inaccurate.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/patologia , Linfonodos/patologia , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Broncoscopia , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Detecção Precoce de Câncer , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Metástase Linfática , Masculino , Mediastinoscopia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Seleção de Pacientes , Pneumonectomia , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/métodos , Prognóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A 60-year-old man had noted exertional dyspnea and left anterior chest pain. A chest roentgenogram showed the presence of a giant mass and computed tomography (CT) of the chest confirmed the mass with an inhomogeneous density in the left hemithorax. A transthoracic TruCut needle biopsy of the mass showed benign fibrous tissue. The patient underwent a thoracotomy. A tumor arose from the visceral pleura of left lower lobe and pedinculated. Size of the tumor was 19 x 18 x 7 cm and weighed 1500 g. It was successfully resected. The pathological diagnosis of the tumor was benign localized fibrous tumor of the pleura.
Assuntos
Mesotelioma/cirurgia , Neoplasias Pleurais/cirurgia , Humanos , Masculino , Mesotelioma/diagnóstico por imagem , Mesotelioma/patologia , Pessoa de Meia-Idade , Pleura/patologia , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/patologia , Radiografia , ToracotomiaRESUMO
Bronchiectasis due to aspiration of grass inflorescences is described in three children. One patient spontaneously expelled a grass head by coughing and was not operated on. The grass inflorescence was found in the right lobe's medial segment bronchi in the second case and in the pleural cavity of the third. Pulmonary resection was performed in both cases. The clinical manifestations were of both "lodging" and "extrusive" types of aspirated grass inflorescence. This possibility must be considered in the differential diagnosis of chronic pulmonary infections in children.
Assuntos
Brônquios , Bronquiectasia/etiologia , Reação a Corpo Estranho/complicações , Poaceae , Bronquiectasia/diagnóstico por imagem , Bronquiectasia/cirurgia , Broncografia , Criança , Diagnóstico Diferencial , Intervalo Livre de Doença , Feminino , Reação a Corpo Estranho/diagnóstico , Reação a Corpo Estranho/diagnóstico por imagem , Reação a Corpo Estranho/cirurgia , Humanos , Masculino , Infecções Respiratórias/diagnósticoRESUMO
Pulmonary laceration is an uncommon complication of tube thoracostomy technique that is expected vigorous clinically and may be fatal. In this study, we report a case of pulmonary laceration owing to a tube thoracostomy, with no clinical signs, and detected incidentally on thorax computed tomography.
Assuntos
Tubos Torácicos/efeitos adversos , Lesão Pulmonar , Ferimentos Penetrantes/etiologia , Adulto , Humanos , Pulmão/diagnóstico por imagem , Masculino , Toracostomia/efeitos adversos , Tomografia Computadorizada por Raios X , Ferimentos Penetrantes/diagnóstico por imagemRESUMO
A 3 x 4 cm homogeneous opacity was incidentally detected over the first rib at routine chest radiography. Radionuclide bone scan identified a hot spot, not excluding malignancy and excision of the rib revealed fibro-osseous lesion. A review of the literature showed 12 cases of this extremely rare lesion.
Assuntos
Doenças Ósseas/diagnóstico por imagem , Costelas/diagnóstico por imagem , Doenças Ósseas/patologia , Neoplasias Ósseas/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Radiografia , Costelas/patologiaRESUMO
A 15 x 15 cm mass in the right hemithorax of a 25-year-old woman was incidentally detected at routine chest radiography. Radical excision of the bony chest wall, including right CII-VI, revealed chondrosarcoma. Large, expansile parosteal chondromas were radiographically visualized in the pelvis and bones of the lower leg, representing Ollier's disease. Chondrosarcoma of the chest wall appears to be rare in Ollier's disease.