Endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in non-small cell lung carcinoma.

INTRODUCTION: Lung cancer staging has recently evolved to include endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for nodal assessment. AIM: Evaluate the performance and safety of EBUS-TBNA as a key component of a staging algorithm for non-small cell lung carcinoma (NSCLC) and as a single investigation technique for diagnosis and staging of NSCLC. METHODS: Patients undergoing EBUS-TBNA for NSCLC staging at our institution between April 1, 2010 and December 31, 2014 were consecutively included with prospective data collection. EBUS-TBNA was performed under general anesthesia through a rigid scope. RESULTS: A total of 122 patients, 84.4% males, mean age 64.2 years. Histological type: 78 (63.9%) adenocarcinoma, 33 (27.0%) squamous cell carcinoma, 11 (8.9%) undifferentiated/other NSCLC. A total of 435 lymph node stations were punctured. Median number of nodes per patient was 4. EBUS-TBNA nodal staging: 63 (51.6%) N0; 8 (6.5%) N1; 34 (27.9%) N2, and 17 (13.9%) N3. EBUS-TBNA was the primary diagnostic procedure in 27 (22.1%) patients. EBUS-TBNA NSCLC staging had a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rate of 83.3, 100, 100, 86.1, and 91.8%, respectively. No complications were attributable to the procedure. CONCLUSION: A comprehensive lung cancer staging strategy that includes EBUS-TBNA seems to be safe and effective. Our EBUS-TBNA performance and safety in this particular setting was in line with previously published reports. Additionally, our study showed that, in selected patients, lung cancer diagnosis and staging are achievable with a single endoscopic technique.

Benign or malignant? Case report.

INTRODUCTION: Necrotizing sialometoplasia (NS) is a disease in which the clinical and sometimes even histological features can be confused with those of a malignant tumor, but which is in fact a self-limited inflammatory lesion of the salivary glands. CASE REPORT: The authors present a case study of a 43-year-old female patient who came to the ENT Emergency Department with a painful ulcerated lesion of the hard palate. The lesion was 8 days old and had appeared after an abdominoplasty. Given the clinical need to rule out a malignant neoplasm, a biopsy was performed: the histological result was NS. DISCUSSION/CONCLUSION: The authors make a literature review and stress the importance of differentiating between NS and salivary gland neoplasia. Histology is essential in case of ulcerated neoformation of the oral cavity, to adapt treatment, avoiding unsuitable approaches.

Sarcoma de Kaposi em doente com leucemia mielomonocítica crónica / Kaposi’s sarcoma arising in a patient with chronic myelomonocytic leukaemia

Apresenta-se o caso de um doente com leucemia mielomonocítica crónica diagnosticada há cerca de 2 anos, actualmente medicado com hidroxiureiae eritropoietina, enviado a nossa consulta por máculas, pápulas e placas de cor vinosa localizadas aos membros inferiores. Algumas das lesões eramhiperqueratóticas. O diagnóstico de sarcoma de Kaposi foi histologicamente confirmado. O estudo analítico não detectou qualquer imunodeficiência associada. A morte do doente impediu a instituição de qualquer tratamento (AU)

A 84 year-old man from north Portugal with chronic myelomonocytic leukaemia (diagnosed 2 years ago), under treatment with erythropoiet in and hydroxyurea and Kaposi´s sarcoma is reported. The patient was referred to our department with brown macules, papules and patches with a smooth surface and whitish scale, located to the lower limbs that had appeared 2 month ago. The diagnosis of Kaposi’s sarcoma was histologically confirmed. He was HIV-1/HIV-2 negative and had no analytic detectable immussupression. The patient died short time after the diagnosis without specif any treatment (AU)