RESUMO
A case of an adenoid cystic carcinoma of trachea is presented. A 30-year-old non-smoking woman with strong inspiratory dyspnea at rest was admitted to the Dept. of Pulmonary Diseases. At auscultation a respiratory murmur was more silent at right lung and stridor over trachea was heard. CT scan revealed tumor at the bifurcation of the trachea. Bronchoscopy was made and biopsy established the diagnosis: adenoid cystic carcinoma. The tumor was partially removed with rigid bronchoscope and radiotherapy was started. Clinical improvement occurred; in control CT scan tumor vanished. The trachea cancers are rare. Symptoms often mimic asthma or chronic bronchitis. Thus in every patient with chronic cough and dyspnea bronchoscopy should be made. A treatment of choice is primary resection and postoperative radiotherapy.
Assuntos
Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/cirurgia , Neoplasias da Traqueia/diagnóstico , Neoplasias da Traqueia/cirurgia , Adulto , Biópsia , Broncoscopia , Carcinoma Adenoide Cístico/radioterapia , Feminino , Humanos , Radioterapia Adjuvante , Indução de Remissão , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/radioterapiaRESUMO
INTRODUCTION: Tumors arising in the lungs are in over 90% bronchogenic carcinomas that have been attributed predominantly to tobacco smoking, asbestos or air pollution but little is known about endogenous factors that could facilitate their development and invasiveness. The lungs originate embryologically from the same endoderm cells which form the epithelia lining the digestive tract, where gastrin is the major proliferative stimulus. AIMS: Since lung cancer patients were recruited mostly among smokers, who also have been found to exhibit significantly higher infection rate of Helicobacter pylori (HP) infection than non-smokers and, as since the HP-infected subjects show enhanced plasma levels of gastrin, we decided 1) to compare the seroprevalence of HP and the expression of its cytotoxin, CagA, in lung cancer patients with those in the age- and gender-matched controls without cancer: 2) to determine the gene expression for gastrin and its receptors (CCKB-R) in lung cancer, 3) to assess the gastrin levels in plasma bronchial lavage and in tumor tissue and 4) to examine the expression of cyclooxygenase (COX)-1 and COX-2 in cancer tissue resection margin and intact bronchial mucosa. MATERIAL AND METHODS: The trial material included 50 patients with lung carcinoma and 100 age- and gender-matched controls. Anti-HP and anti-CagA IgG seroprevalence was estimated by specific antisera using ELISA tests. Gene expression of gastrin, CCKB-R, COX-1 and COX-2 was examined using RT-PCR, while gastrin was measured by specific RIA. RESULTS: The seroprevalence of HP, especially that expressing CagA, is significantly higher in lung cancers than in healthy controls. Both gastrin and CCKB-R mRNA were detected in the cancer tissue and at the resection margin and similarly COX-2 mRNA was expressed in most cancers and resection margin but not in bronchial mucosa where only COX-1 was found. The lung cancer tissue and resection margin contained many folds larger amounts of immunoreactive gastrin than intact bronchial mucosa.
Assuntos
Antígenos de Bactérias , Gastrinas/genética , Infecções por Helicobacter/complicações , Helicobacter pylori , Isoenzimas/genética , Neoplasias Pulmonares/etiologia , Prostaglandina-Endoperóxido Sintases/genética , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/sangue , Proteínas de Bactérias/metabolismo , Sequência de Bases , Estudos de Casos e Controles , Ciclo-Oxigenase 1 , Ciclo-Oxigenase 2 , Primers do DNA/genética , Feminino , Expressão Gênica , Infecções por Helicobacter/imunologia , Helicobacter pylori/imunologia , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Masculino , Proteínas de Membrana , Pessoa de Meia-IdadeRESUMO
The authors presented 4 cases of patients with a foreign body in the esophagus, which has been tried to remove by means of fiberoscopy and rigid esophagoscopy. The fiberoptic endoscopy has failed either as a diagnostic method or as a therapeutic one. The classical esophagoscopy has turned out to be much better in both cases. The fiberoscopy is a valuable diagnostic and therapeutic procedure in a lot of diseases of digestive tract. Especially it is useful in order to remove some foreign bodies from the esophagus, but at the same time it fails when removing big foreign bodies (e.g. parts of false teeth, large bones). In these cases rigid esophagoscopy is the only effective method when performed under endotracheal anesthesia and with esophageal muscles relaxation.
Assuntos
Esofagoscopia/métodos , Tecnologia de Fibra Óptica/métodos , Corpos Estranhos/diagnóstico , Adulto , Idoso , Feminino , Corpos Estranhos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Ópticas , SegurançaRESUMO
A case of a primary synchronous bilateral lung cancer is presented. Tumor of the left lung was treated with lobectomy, tumor of the right lung with radiotherapy. Patient survived 5-years without evidence of disease recurrence.
Assuntos
Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia , Neoplasias Primárias Múltiplas/radioterapia , Neoplasias Primárias Múltiplas/cirurgia , Terapia Combinada , Intervalo Livre de Doença , Humanos , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Indução de RemissãoRESUMO
A case of a primary synchronous lung cancer is presented. Both tumors were removed via a simultaneous both sided posterior lateral thoracotomy. The radical surgical procedure produced respiratory insufficiency resulting in grave adaptation problems and the need to put the patient on a respirator. Rehabilitation allowed the patient to overcome the initial problems allowing light physical work without dyspnea.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Pulmonares/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Toracotomia/métodos , Carcinoma de Células Escamosas/reabilitação , Humanos , Neoplasias Pulmonares/reabilitação , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/reabilitaçãoRESUMO
A case of a 51 year old male with multiple primary lung cancer is presented. Inspite of various gross diagnostical problems small cell lung cancer of the right lung and adenocarcinoma of the left lung were diagnosed. The patient responded favorably to the chemotherapy. Adenocarcinoma was treated surgically. The patient died due to progression of the SCLC.
Assuntos
Adenocarcinoma , Carcinoma de Células Pequenas , Neoplasias Pulmonares , Neoplasias Primárias Múltiplas , Adenocarcinoma/diagnóstico , Adenocarcinoma/terapia , Carcinoma de Células Pequenas/diagnóstico , Carcinoma de Células Pequenas/terapia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/terapiaRESUMO
In the ENT Clinic, Medical Academy, Cracow a joint ENT team accompanied by thoracic surgeon performed the segmentary resection of trachea in three patients with stenosis of the subglottal area and of the upper section of trachea. The connecting surgery of trachea and thyroid cartilage was successful in two patients, but failed in one. Advantages of this method and reason of failure were thoroughly discussed.
Assuntos
Laringoestenose/cirurgia , Estenose Traqueal/cirurgia , Idoso , Anastomose Cirúrgica/métodos , Criança , Feminino , Humanos , Laringoestenose/complicações , Pessoa de Meia-Idade , Estenose Traqueal/complicaçõesRESUMO
In the years 1980-1985 sutures were removed endoscopically from stumps and anastomoses in 52 patients operated in the years 1969-1985. The total number of bronchoscopies was 154, in 88 protruding threads into the airway lumen were removed. Interval between removal of first suture and date of surgery ranged from 0.5 to 192 months. Mycotic infection was diagnosed in 5 cases (9.6%). The causative agents being Aspergillus fumigatus and Candida albicans. In all cases removal of protruding threads lead to a complete cure. It was found that incidence of such mycotic infections decreased from 20.2% observed during the years 1962-1979 to 9.6% in the years 1980-1985.
Assuntos
Aspergilose/epidemiologia , Broncopatias/cirurgia , Candidíase/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Doenças da Traqueia/cirurgia , Adulto , Idoso , Aspergillus fumigatus/isolamento & purificação , Broncopatias/microbiologia , Broncoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecção da Ferida Cirúrgica/microbiologia , Técnicas de Sutura , Doenças da Traqueia/microbiologiaRESUMO
A comparison of serum, pulmonary tissue and bronchial secretory levels of erythromycin and cyclic--11,12 carbonate of erythromycin (Davercin--Polfa) was carried out in 55 patients with lung cancer. All patients received erythromycin and Davercin 80 hours prior surgery, during which a small fragment of pulmonary tissue was removed for further evaluation. Concentration of both antibiotics was determined microbiologically. Better penetration of Davercin to the pulmonary tissue was found, as well as higher tissue concentration. The study demonstrates the advantage of Davercin over erythromycin in treating bacterial infections of the respiratory system.