The value of the new scoring system for predicting neoplastic pericarditis in the patients with large pericardial effusion.

PURPOSE: Early recognition of neoplastic pericarditis (npe) is crucial for the planning of subsequent therapy. The aim of the present study was to construct the scoring system assessing the probability of npe, in the patients requiring pericardial fluid (pf) drainage due to large pericardial effusion. METHODS: One hundred forty-six patients, 74 males and 72 females, entered the study. Npe based on positive pf cytology and/or pericardial biopsy specimen was recognised in 66 patients, non-npe in 80. Original scoring system was constructed based on parameters with the highest diagnostic value: mediastinal lymphadenopathy on chest CT scan, increased concentration of tumour markers (cytokeratin 19 fragments-Cyfra 21-1 and carcinoembryonic antigen-CEA) in pf, bloody character of pf, signs of imminent cardiac tamponade on echocardiography and tachycardia exceeding 90 beats/min on ECG. Each parameter was scored with positive or negative points depending on the positive and negative predictive values (PPV, NPV). RESULTS: The area under curve (AUC) for the scoring system was 0.926 (95%CI 0.852-0.963) and it was higher than AUC for Cyfra 21-1 0.789 (95%CI 0.684-0.893) or CEA 0.758 (95%CI 0.652-0.864). The score optimally discriminating between npe and non-npe was 0 points (sensitivity 0.84, specificity 0.91, PPV 0.9, NPV 0.85). CONCLUSION: Despite chest CT and tumour marker evaluation in pericardial fluid were good discriminators between npe and non-npe, the applied scoring system further improved the predicting of neoplastic disease in the studied population.

Screening of angiogenesis inhibitors by modified tumor-induced angiogenesis (TIA) test in lung cancer.

Aberrant angiogenesis-the new vessels formation is a mandatory event in the process of tumor growth and expansion. Studies on mechanisms involved in tumor-induced angiogenesis (TIA) and on its possible inhibitors are needed in order to introduce in future new methods of tumor treatment. The aim of our study was to determine the usefulness of the modified cutaneous TIA (mice without immunosuppression) test for screening in vivo of the angiogenesis modifiers. In both models (classical and modified TIA) we demonstrated comparable angiogenesis activity following human lung cells inoculation and similar degree of neovascularization response inhibition caused by theobromine. We reported that in modified TIA model preincubation with theobromine significantly suppressed angiogenic potential of human lung cancer cells as well as the ability of those cells to produce proangiogenic cytokine-bFGF.

[Use of video-thoracoscopy for diagnostic and small surgical procedures in the chest]. / Zastosowanie videotorakoskopii do zabiegów diagnostycznych i malych operacji w klatce piersiowej.

The report introduces videothoracoscopy as a new diagnostic and therapeutical method in chest surgery. The main indications for thoracoscopic procedures were described. Also, 37 videothoracoscopic procedures performed on 35 patients were presented. In 5 cases procedure was therapeutical, in the rest of them diagnostic. In all diagnostic cases, thoracoscopic procedures allowed to determine accurate diagnosis. No significant complications were observed.

[A case of bronchial carcinoid diagnosed after 21 years of recurrent lung infections]. / Przypadek rakowiaka pluca rozpoznany po 21 latach nawracajacych zakazen pluc.

A case of 59 year old woman with a 21 year history of recurrent pneumonias of the upper left lobe is presented. When she at last agreed for the diagnosis her chest X-rays revealed atelectasis and cirrhosis with bronchiectases of the left lung. Tumor of the left main bronchus and severe inflammation of the surrounding mucosa with purulent secretion were found during bronchofiberoscopy. The patient underwent left pneumonectomy. Histological examination of the specimen revealed presence of carcinoid in the main left bronchus without involvement of the regional lymphnodes, with signs of irreversible damage of other bronchi and pulmonary tissue. The very long period of observation since the first symptoms, no metastases in the bronchopulmonary lymphonodes and no distant metastases indicate the low-grade malignancy of the carcinoid in the presented case.

[A case of bronchial mucoepidermoid carcinoma in an 18-year old man]. / Przypadek raka sluzowo-naskórkowego oskrzela u 18-letniego mezczyzny.

18 years old man with mucoepidermoid carcinoma of the left main bronchus was treated in Cardiothoracic Department of Institute of Tuberculosis and Lung Diseases in Warsaw. Diagnosis was established by microscopic examination of the samples taken during bronchofiberoscopy. Sleeve resection of the left main bronchus was performed. Microscopic examination of the resected tumor confirmed previous diagnosis and showed also that wall of the bronchus was not infiltrated by neoplasm and tumor was of low-grade malignancy. After the operation granulosis slightly narrowing bronchial anastomosis was observed. It was easily removed using the laser. Patient was discharged from hospital in good condition. Prognosis in this case is optimistic.