RESUMEN
The clinical significance of lung nodules in patients with esophageal carcinoma has received little attention. Therefore, we carried out a retrospective detailed review of 116 consecutive cases of esophageal carcinoma, including 98 squamous cell cancers, seen at the Philadelphia Veterans Affairs Medical Center between 1984 and 1997. Seventy-four percent of our patients were black; it was not surprising therefore that 84% of our patients in this series had squamous cell cancers. Initially, chest radiographs, computed tomography (CT) scans, or thoracotomy showed solitary pulmonary nodules in 22 (19%) patients. A definitive diagnosis was established in 19 patients, including 15 (68%) benign nodules and 4 (18%) new primary lung carcinomas. Three (14%) nodules were indeterminate, but in no case could a solitary lung metastasis be identified. Radiographic evidence of multiple lung metastases was present, however, in 4 (3%) of 116 patients at diagnosis. Autopsies of six patients were later performed, and three showed multiple lung metastases; two of these patients had negative chest radiographs shortly before death. Our experience suggests that for a cohort of mostly squamous cell esophageal cancers, a solitary lung metastasis is rare at diagnosis; a solitary pulmonary nodule at this time likely represents a benign abnormality or primary lung cancer. Multiple pulmonary metastases are also very unusual at diagnosis, probably become increasingly common during the terminal phases of disease, and may be radiographically occult.
Asunto(s)
Carcinoma de Células Escamosas/secundario , Neoplasias Esofágicas/patología , Nódulo Pulmonar Solitario/secundario , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiología , Estudios de Cohortes , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Nódulo Pulmonar Solitario/diagnóstico , Nódulo Pulmonar Solitario/epidemiología , Tomografía Computarizada por Rayos XRESUMEN
Extramedullary plasmacytoma is a rare form of plasma cell dyscrasia, in which malignant plasma cell tumors arise outside the bone marrow. The tumor may arise in any part of the body but the vast majority occur in the head and neck, primarily in the nasal cavity, paranasal sinuses, or upper airway. Six patients with extramedullary plasmacytoma are presented and the clinical and radiographic findings are reviewed.