RESUMO
We report a case of ganglioneuroma in a 67-year-old woman who presented with an abnormal shadow at a medical examination. She was admitted and chest radiography disclosed a mass in the upper right mediastinum. We suspected a mediastinal tumor after chest CT, chest MRI and bronchofiberscopic examination, and so surgical treatment was performed. The histopathological diagnosis was ganglioneuroma. Ganglioneuroma is thought of as a children's disease and adult onset is rare. We reasoned that ganglioneuroma should be included among the mediastinal tumors in patients over 60.
Assuntos
Ganglioneuroma/diagnóstico , Neoplasias do Mediastino/diagnóstico , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Radiografia Torácica , Tomografia Computadorizada por Raios XRESUMO
To investigate patient attitudes towards open disclosure of malignant disease, we conducted a questionnaire survey of 17 patients with malignant lung tumors, to whom the nature of their disease was revealed. The questionnaire used a 100 mm analog scale. Ten of the patients were treated by chemotherapy and their questionnaire results before and after treatment were compared. It was found that they were mostly satisfied about being truthfully informed and that, indeed, they were anxious to know their true diagnoses. They were also keen to have their true prognosis revealed, but not as much as the diagnosis. They also wished to be informed about treatment and its effects. These attitudes showed no marked changes resulting from the administration of chemotherapy, and we therefore concluded that chemotherapy itself had no influence on patients' feelings about disclosure. The questionnaire was well accepted and was useful in judging attitudes to open disclosure.
Assuntos
Consentimento Livre e Esclarecido , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/psicologia , Inquéritos e Questionários , Revelação da Verdade , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We report a case of acute eosinophilic pneumonia (AEP) apparently caused by the resumption of smoking. A 38-year-old woman was admitted to our hospital because of dry cough, high fever and chest pain. Arterial blood gas analysis revealed pronounced hypoxemia and chest X-ray film disclosed diffuse bilateral infiltrate throughout all lung fields. Eosinophils (43.7%) were significantly increased in bronchoalveolar lavage fluid (BALF). The patient was treated with pulse therapy consisting of methylprednisolone and improved quickly. AEP was diagnosed on the basis of BALF findings and the patient's clinical course. Prior to and after her illness, the only noteworthy change in the patient's environmental setting or habits was the resumption of smoking, 3 days after which the symptoms had appeared. We reasoned that the onset of AEP in this patient was strongly related to the resumption of smoking.