Clinical experience of transbronchoscopic laser ablation for central airway stenosis using a high-power diode laser-ten years' experience at a single institute.

BACKGROUND: High-power diode (GaAlAs) laser systems have been used for transbronchoscopic laser ablation for central airway stenosis. Such diode laser systems show a similar clinical effect to a conventional Nd-YAG laser, but the instrument is more compact with easier handling. We use a high-power diode laser system with a non-contact probe for endobronchial ablative therapy. The present study reviewed our experience with transbronchoscopic laser ablation to explore a better clinical approach for managing central airway lesions. METHODS: We retrospectively reviewed the patients who were treated for central airway lesions by transbronchial laser ablation using the non-contact-type probe from January 2005 to December 2015 at Chiba University Hospital. We investigated the cause of stenosis, number of treatments, laser setting, total amount of energy, complications, and simultaneously performed modality. RESULTS: Thirty-three patients underwent treatment a total of 72 times. There were 23 males, with an average age of 60.3 years old (range, 18-80 years old). The primary causes of the central airway stenosis were neoplastic disease in 22 (16 malignant tumors, 6 benign tumors) and non-neoplastic disease in 11. Among malignant tumors, there were eight tracheal cancer and five lung cancer patients as well as three patients with esophageal cancer. Among benign tumors, there were three hamartomas and one patient each with papilloma, smooth muscle tumor, and glomus tumor. The non-neoplastic causes of airway stenosis were intubation or tracheotomy in four patients, tuberculosis and granulation in two each, and trauma, burn, and surgery in one each. The numbers of treatments were 30 times (1.36 times/patient) for neoplastic diseases and 42 times (3.82 times/patient) for non-neoplastic disease. The total amount of energy was 1,936 J on average (1,674 J for neoplastic diseases and 2,098 J for non-neoplastic disease). There were no major complications related to transbronchial laser ablation therapy. CONCLUSIONS: Transbronchoscopic laser ablation using a diode laser system with a non-contact probe can be safely performed and is useful for endobronchial treatment of both neoplastic and non-neoplastic central airway lesions.

Glomus Tumor of the Kidney in a Child With Tuberous Sclerosis.

Primary glomus tumors of the kidney are rare and have never been reported in children under 16 years of age. Tuberous sclerosis complex (TSC) is an extremely variable genetic condition that can affect virtually any organ in the body. Only a single case of glomus tumor associated with TSC was reported in 1964. In this article, we describe the clinical, radiologic, and pathological features of a primary renal glomus tumor in an 8-year-old girl with TSC. This tumor is large, has a deep location, and has infiltrative margins and numerous mitoses. However, there was no disease progression in a 16-month period of follow-up. To our knowledge, this is the second report of primary renal glomus tumor in childhood, the youngest one in the literature.

Synchronous primary glomus tumor in a patient with adenocarcinoma of the ipsilateral lung.

Glomus tumors are rare mesenchymal neoplasms arising from the glomus bodies in the deep dermis of the extremities or derive from the modified smooth muscle cells of the normal glomus body. Primary pulmonary glomus tumors are particularly rare and infrequently reported. We report a case of a primary glomus tumor occurring in the lung with adenocarcinoma in the ipsilateral lung as synchronous lung cancers in a 69-year-old man. He underwent lobectomy for adenocarcinoma and wedge resection for the glomus tumor with mediastinal lymph node dissection and was doing well without recurrence or metastasis at the last follow-up.

[Etiology and pathogenesis of glomus tumours (chemodectomas) of the base of the skull].

The objective of the present work was to describe the poorly known history of the development of the nomenclature of glomus tumours (chemodectomas) of the base of the skull, elucidate etiology and pathogenesis of these neoplasms. The authors present a chronological table illustrating the progress of etiological and pathogenetic studies as well as the surgical treatment of the tumours. The results of analysis and discussion of the controversial issues of the nomenclature are reported.

Tumores glómicos de oído medio / Glomus tumor of the middle ear

Se hace un análisis y revisión bibliográfica de los tumores más frecuentes del oído medio, enfocando fundamentalmente los aspectos etiológicos, clasificación y tratamiento de estos tipos de tumores. En segundo lugar, se esboza el papel que desempeña la radioterapia en los estadíos avanzados, según la clasificación de Alford y Guilford, a pesar de que estos tumores son relativamente radioresistentes. El pronóstico depende de la extensión de la enfermedad. Finalmente, se concluye que la clave del tratamiento, luego de llegar al diagnóstico por la clínica y el estudio imagenológico, es la extirpación quirúrgica. (AU)

Glomuvenous malformation (glomangioma) and venous malformation: distinct clinicopathologic and genetic entities.

OBJECTIVES: To develop clinical criteria that permit clinical distinction between inherited glomuvenous malformation (GVM), known as glomangioma, and inherited cutaneomucosal venous malformation and to test these criteria on sporadic lesions. DESIGN: Clinical data were compiled for 1685 patients with inherited or sporadic cutaneous venous anomalies. Based on a cohort of patients with a mutation in the TIE2 or glomulin gene or a histologic diagnosis, we defined clinical criteria for inherited GVM and cutaneomucosal venous malformation. We then applied these criteria to sporadic cases in a blinded manner and genetically or histologically confirmed this clinical diagnosis whenever possible. RESULTS: Glomuvenous malformations accounted for 5.1% of venous anomalies and were frequently inherited (63.8%), whereas venous malformations were rarely familial (1.2%). Glomuvenous malformations were nodular and scattered, or plaque-like and segmental, with color varying from pink to purplish dark blue, whereas most venous malformations (VMs) were soft, blue, and often localized vascular lesions. Glomuvenous malformations were mainly located on the extremities and involved skin and subcutis, whereas VMs commonly affected muscles and joints (P<.001). Glomuvenous malformations had a distinct raised, often hyperkeratotic cobblestone-like appearance and could not be completely emptied by compression, unlike VMs. Glomuvenous malformations were painful by compression, whereas VMs were painful on awakening, after activity, or with hormonal changes. Elastic compressive garments aggravated pain in GVMs, in contrast to VMs. CONCLUSIONS: This large series of patients with superficial venous anomalies established clinical features that distinguish VMs and GVMs. This differential diagnosis is essential, as the outcome and the treatment for GVMs differ.

Subungual glomus tumor: clinical manifestations and outcome of surgical treatment.

Surgical excision is the treatment of choice for subungual glomus tumor. However, the anatomical location has inherent difficulties. We report the outcomes of surgical treatments for subungual glomus tumor. Sixteen patients, who were seen over an eight-year period (1995-2003) and confirmed as gloums tumor by histopathologic examination were reviewed. The most common subjective symptom was pain induced by contact in 81%. The tumor presented as a discolorated spot or subungual nodule and 38% of tumors were acccompanied with nail dystrophy. All tumors showed discolorated spots or subungual nodules. As shown in the Table 2, the dystrophic nail change was found in 38% of tumors. Differently oriented incisions were made according to the location of tumor, matrix, or bed. The original nail plate was restored in eight patients. Thirteen patients (81%) had cosmetically excellent nail plates, and three patients (19%) had partial distal splits of nail plates. There was no recurrence. Our series suggests that a transungual approach with nail avulsion and an incision selected according to the tumor location can produce an excellent outcome with minimal postoperative complications. Dressing with a trimmed nail plate may also be beneficial in managing the wound and preventing postoperative nail deformity.

[Glomus tumors of the finger: a report on 60 cases]. / Parmak yerlesimli glomus tümörü: 60 olgunun incelenmesi.

OBJECTIVES: We evaluated patients who underwent surgery for glomus tumors of the finger. METHODS: During a 23-year period, 60 patients (48 females, 12 males; mean age 34.6 years; range 5 to 60 years) underwent surgery for glomus tumors of the finger. The patients were evaluated with respect to symptoms on presentation, diagnosis, operation types, and postoperative complications. The mean follow-up was 16 months (range 6 to 72 months). RESULTS: The most common symptom was pain (67%), which intensified when exposed to cold in 42%. Other symptoms included tenderness in 37 patients (62%), swelling in the finger tip in six patients (10%), and nail deformities in 34 patients (57%). The tumors were most frequently encountered in the fourth and fifth decades of age. Localization of the tumor was in the right hand in 32 patients (53.3%), and in the left hand in 28 patients (46.7%). The time to surgery from the onset of symptoms ranged from six months to 30 years (mean 6 years). Fifty-one patients were examined by plain radiographs, 27 of which showed concave-surface erosions in the bone; nine patients underwent magnetic resonance imaging studies besides plain radiography. The tumors were subungual in 49 patients (82%) and in the pulp in 11 patients (18%), for which transungual and midlateral approaches were applied, respectively. Postoperatively, nine patients (15%) developed recurrences, all of whom achieved clinical recovery following a subsequent operation. CONCLUSION: Given the considerably delayed time to diagnosis, glomus tumors should be taken into consideration in the presence of severe finger tip pain of unknown origin.

Estudio evolutivo sobre 15 casos de tumores de la región temporal / Evolutionary study on 15 cases of tumors in th temporary region

Se ha realizado un estudio retrospectivo de 15 casos de tumores glómicos yúgulo-tímpanotemporales con un seguimiento de entre 5 y 23 años. Seis casos fueron tratados exclusivamente con cirugía. Cinco casos sólo con cobaltoterapia. Dos casos con cirugía (uno en dos ocasiones) y cobalto y dos casos no recibieron tratamiento. De los ocho casos tratados con cirugía con o sin cobalto complementario, se obtuvo la curación sin evidencia de recidiva en todos los casos. En los tratados con cobaltoterapia sólo, se han conseguido estabilizaciones o progresiones muy lentas de la enfermedad de hasta veinte años. Se hace énfasis en la conveniencia de establecer criterios individualizados para concretar el tratamiento idóneo en cada caso. (AU)

Glomangioma múltiplo / Multiple glomangioma

Um caso de glomangioma múltiplo é descrito em homem de 61 anos de idade. Os achados clínicos e histopatológicos são discutidos, com revisão da literatura.

A case of multiple glomangioma is described in a 61-year-old man. The clinical and histopathological features are discussed, with the review of the literature.

[Experimental influenza caused by an incomplete form of the agent]. / Eksperimental'naia grippoznaia infektsiia, vyzvannaia nepolnoi formoi vozbuditelia.

Incomplete form of the influenza virus obtained in accordance with Nayak's method was administered intranasally to mice CBA and C57BL. From the lung tissue of the infected mice the causative agent could be isolated for 45 days, and from the other internal organs--the first hours after the infection only. In morphological investigation of the lungs of animals infected with an incomplete form of the influenza virus a prevalence of the proliferative component against the background of inflammatory changes was noted. Three months after the infection limited lymphoid formations consisting of monomorphic cells with hyperchromic nuclei were defined in the lung tissue. Marked proliferation of the alveolar and bronchial epithelium was observed later; considerable anaplasia of the cells was noted in the papillomatous structure of the alveolar and bronchial epithelium. Glomangioma of the mesentery was observed among affections of other internal organs in 18.7% of mice CBA.