Development of eosinophilic granulomatosis with poliangiitis (Churg-Strauss syndrome) and brain tumor in a patient after more than 7 years of omalizumab use: A case report.

Omalizumab is a monoclonal anti-immunoglobulin E antibody used for the treatment of severe perennial allergic asthma. Previous reports have suggested that omalizumab treatment can be associated with the development of eosinophilic granulomatosis with poliangiitis (EGPA) (formerly known as Churg-Strauss syndrome) and an increased risk of malignancy. Long-term risks of omalizumab treatment are not very well defined. Here, we report the case of a 75-year-old woman with concurrent occurrence of EGPA and brain tumor after more than 7 years of omalizumab treatment. The possibility of EGPA should be borne in mind during long-term treatment with omalizumab. Despite the absence of definitive data, an association may also exist between the development of malignancy and omalizumab use.

Transbronchial needle aspiration in the diagnosis and staging of lung cancer.

OBJECTIVES: This study was aimed to determine effects of transbronchial needle aspiration (TBNA) in diagnosis and staging of lung cancer. METHODS: Records of 55 patients who underwent TBNA in our Chest Department from February 2002 to December 2004 were reviewed retrospectively. RESULTS: Out of 55 patients who had undergone TBNA, 30 were diagnosed to have lung cancer after complete work up. Transbronchial needle aspiration was positive for malignant cells in 12 out of 20 lung cancer patients with mediastinal lymphadenopathy on computed tomographic scan (CT scan) of the thorax. Mediastinoscopy was positive for malignancy in three cases and the remaining five had bulky lymph node enlargement which was considered malignant, given the histologic diagnosis established by other methods. Transbronchial needle aspiration was also positive for two other patients who had lymph nodes less than 1 cm size. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TBNA in the diagnosis of lung cancer patients were 58%, 100%, 100%, 37% and 66%, respectively. CONCLUSIONS: The study demonstrates that TBNA is an efficient procedure in the diagnosis and staging of lung cancer. The diagnostic yield is increased when there is lymph node enlargement on CT scan of the thorax and reduces the need for mediastinoscopy.