RESUMEN
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Asunto(s)
Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Procedimientos Quirúrgicos Torácicos/métodos , Enfermedades Torácicas/cirugía , Cirugía Torácica Asistida por Video/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Procedimientos Quirúrgicos Torácicos/instrumentación , Cirugía Torácica Asistida por VideoRESUMEN
Until recently, adenoid cystic carcinoma (ACC) has been considered to be a borderline disease between benign and malignant because of its low level of malignancy, slow growth and scarce aggressivity. ACC is now a histologically well defined tumor and is currently classified as malignant; it has a prolonged natural history, is infiltrative, and tends to recur locally and give rise to local-regional metastases or, more rarely, remote metastases. Its incidence in the lower airways is low (0.1% of all broncho-pulmonary neoplasms). Eight patients (6 women and 2 men) have undergone surgery for ACC since 1969. The initial clinical picture included long-term evolution and symptoms were usually produced by large caliber obstruction of the airways, mainly affecting the trachea and large bronchi. Three cases involved the trachea resection with end-to-end anastomosis in two cases, right pneumonectomy in two others (one of which also involved tracheal carina resection), and two lobectomies. After thoracotomy, resection of the tumor was deemed impossible in two cases. Postoperative mortality was 12% (1 patient). Complementary radiotherapy was provided in the two non-resectable cases, or when there was invasion of resected edges or regional metastasis involving ganglia. Total survival was 71.4% after two years, 57.1% after five years and 38% after ten years, after excluding postoperative exitus. When the trachea was involved, survival was 33.3% after two and five years and nil after ten years, with the longest survival 108 months. When bronchi were involved, survival was 75% at five and ten years. We conclude that ACC is a rare, locally invasive tumor that tends to local recurrence, but that survival after surgery is prolonged with or without adjuvant radiotherapy.
Asunto(s)
Neoplasias de los Bronquios , Carcinoma Adenoide Quístico , Neoplasias Pulmonares , Neoplasias de la Tráquea , Adulto , Anciano , Neoplasias de los Bronquios/mortalidad , Neoplasias de los Bronquios/terapia , Carcinoma Adenoide Quístico/mortalidad , Carcinoma Adenoide Quístico/terapia , Terapia Combinada , Femenino , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/terapia , Metástasis Linfática , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Neumonectomía , Factores de Tiempo , Neoplasias de la Tráquea/mortalidad , Neoplasias de la Tráquea/terapiaRESUMEN
We describe a woman with lymphoid interstitial pneumonia diagnosed by open lung biopsy following a profile of unproductive cough, weakness and bilateral lung infiltrates. The patient was also diagnosed as having common variable immunodeficiency based on hypogammaglobulinemia, repeated sinusitis and persistent diarrhea. Exfoliative cytology of pleural effusion revealed the development of non-Hodgkin's lymphoma. We review the associations among these processes and consider the suggestion made by other authors that lymphoid interstitial pneumonia be considered a prelymphomatous process.