Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.559
Filtrar
1.
J Cardiothorac Surg ; 15(1): 37, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32085787

RESUMO

BACKGROUND: Rosai-Dorfman disease is a histiocytic lesion that affects lung rarely. CASE PRESENTATION: We present a 52-year-old female diagnosed with right intrabronchial mass invading the bronchial wall and the extrabronchial tissues with lymphadenopathy. Multiple bronchoscopic biopsies were not diagnostic. Pneumonectomy was performed and postoperative histology revealed marked mucin impaction and bronchial dilatation. The pulmonary tissue showed areas of hemorrhage and chronic inflammation. The mass exhibited an excessive number of lymphocytes, plasma cells, and numerous histiocytes engulfing them (lymphocytophagocytosis). These histiocytes were S100 protein and CD68 positive. These features are consistent with Rosai-Dorfman disease. CONCLUSION: Rosai-Dorfman Disease with pulmonary affection can be misdiagnosed as malignancy. Careful histological examination of the specimen for emperipolesis or lymphocytophagocytosis together with S100 protein and CD68 positivity are the clue for proper diagnosis.


Assuntos
Carcinoma Broncogênico/diagnóstico , Histiocitose Sinusal/diagnóstico , Histiocitose Sinusal/patologia , Neoplasias Pulmonares/diagnóstico , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Diagnóstico Diferencial , Feminino , Histiocitose Sinusal/cirurgia , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Proteínas S100/metabolismo
2.
BMJ Case Rep ; 12(12)2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31822531

RESUMO

Superior vena cava (SVC) syndrome is a group of symptoms caused by complete or partial obstruction of the flow of blood through the SVC. The obstruction is, in most cases, caused by the formation of thrombus or infiltration of a tumour through the vessel wall. The result is venous congestion that creates a clinical situation relating to increase in the venous pressure in the upper part of the body. Symptoms commonly associated with vena cava syndrome include cough, dyspnoea, swelling of the neck, face and the upper extremities and dilation of the chest vein collaterals. In this paper, we examine the case of a 50-year-old man who presented to the emergency department with 'sore throat' which can be easily misdiagnosed as a case of uncomplicated acute pharyngitis. It was a real challenge to diagnose our patient as SVC syndrome caused by bronchogenic carcinoma.


Assuntos
Carcinoma Broncogênico/diagnóstico , Neoplasias Pulmonares/diagnóstico , Faringite/patologia , Síndrome da Veia Cava Superior/diagnóstico , Tórax/patologia , Veia Cava Superior/patologia , Carcinoma Broncogênico/complicações , Humanos , Perda de Seguimento , Neoplasias Pulmonares/complicações , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Faringite/etiologia , Radiografia Torácica , Síndrome da Veia Cava Superior/complicações
3.
Monaldi Arch Chest Dis ; 89(3)2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31850698

RESUMO

Ulceration in the bronchial mucosa is noted rarely in bronchoscopy. In the past, it was frequently encountered in endobronchial tuberculosis. Deep necrotic bronchial ulcers are seen very rarely in clinical practice. Here we are reporting a first-ever case report of malignant bronchial ulcer presenting as necrotic deep bronchial ulcer, in a 70-year-old male, chronic smoker, who complained of breathlessness for 3 months, cough for 3 months, loss of weight and of appetite for 1 month. Bronchoscopy showed a large necrotic ulcer with dense anthracotic pigmentation which bleeds in touch with forceps. Bronchial washings, brushings, endobronchial biopsy were taken from the ulcer which was suggestive of poorly differentiated bronchogenic carcinoma. TBNA from the mediastinal nodes showed the features of caseous necrosis with granulomatous inflammation. Consequently, with the diagnosis of poorly differentiated carcinoma with pulmonary tuberculosis and COPD, the patient was started on anti-tuberculosis drugs, inhaled bronchodilators and referred to an oncologist for chemotherapy.


Assuntos
Broncopatias/complicações , Carcinoma Broncogênico/complicações , Neoplasias Pulmonares/complicações , Tuberculose Pulmonar/complicações , Úlcera/complicações , Idoso , Broncopatias/diagnóstico , Broncopatias/etiologia , Broncoscopia , Carcinoma Broncogênico/diagnóstico , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Membrana Mucosa/patologia , Necrose , Tuberculose Pulmonar/diagnóstico , Úlcera/diagnóstico , Úlcera/etiologia
4.
BMC Pulm Med ; 19(1): 204, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703576

RESUMO

BACKGROUND: Myeloid sarcoma (MS) rarely involves the bronchus, and primary bronchial MS has almost never been reported in mainland China. CASE PRESENTATION: A 65-year-old female patient was admitted with a 3-month history of cough. She was initially diagnosed with bronchogenic carcinoma according to chest computed tomography (CT). However, after a biopsy was taken from the endobronchial lesion by bronchoscopy and further immunohistochemical analysis was performed, the diagnosis of MS was made. Because her bone marrow was normal and she had no history of haematologic diseases, we further considered the diagnosis of primary bronchial MS. The patient received chemotherapy with HAG regimens, and the original mass completely resolved, as confirmed by chest CT scan after 3 cycles of treatment. Meanwhile, no abnormalities were found on re-examination via bronchoscopy. CONCLUSIONS: MS should be considered in the differential diagnosis in the presence of a suspicious pulmonary mass. Immunohistochemical analysis is necessary to confirm the diagnosis. Chemotherapy can lengthen the survival time for patients.


Assuntos
Carcinoma Broncogênico/diagnóstico , Neoplasias Pulmonares/diagnóstico , Sarcoma Mieloide/diagnóstico , Idoso , Antineoplásicos/uso terapêutico , Biópsia , Broncoscopia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Pulmonares/terapia , Sarcoma Mieloide/terapia , Tomografia Computadorizada por Raios X
5.
Phys Med Biol ; 64(24): 245005, 2019 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-31698346

RESUMO

Accurately predicting treatment outcome is crucial for creating personalized treatment plans and follow-up schedules. Electronic health records (EHRs) contain valuable patient-specific information that can be leveraged to improve outcome prediction. We propose a reliable multi-objective ensemble deep learning (MoEDL) method that uses features extracted from EHRs to predict high risk of treatment failure after radiotherapy in patients with lung cancer. The dataset used in this study contains EHRs of 814 patients who had not achieved disease-free status and 193 patients who were disease-free with at least one year follow-up time after lung cancer radiation therapy. The proposed MoEDL consists of three phases: (1) training with dynamic ensemble deep learning; (2) model selection with adaptive multi-objective optimization; and (3) testing with evidential reasoning (ER) fusion. Specifically, in the training phase, we employ deep perceptron networks as base learners to handle various issues with EHR data. The architecture and key hyper-parameters of each base learner are dynamically adjusted to increase the diversity of learners while reducing the time spent tuning hyper-parameters. Furthermore, we integrate the snapshot ensembles (SE) restarting strategy, multi-objective optimization, and ER fusion to improve the prediction robustness and accuracy of individual networks. The SE restarting strategy can yield multiple candidate models at no additional training cost in the training stage. The multi-objective model simultaneously considers sensitivity, specificity, and AUC as objective functions, overcoming the limitations of single-objective-based model selection. For the testing stage, we utilized an analytic ER rule to fuse the output scores from each optimal model to obtain reliable and robust predictive results. Our experimental results demonstrate that MoEDL can perform better than other conventional methods.


Assuntos
Carcinoma Broncogênico/radioterapia , Aprendizado Profundo , Registros Eletrônicos de Saúde , Neoplasias Pulmonares/radioterapia , Carcinoma Broncogênico/diagnóstico , Humanos , Neoplasias Pulmonares/diagnóstico , Resultado do Tratamento
6.
PLoS One ; 14(9): e0223230, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31568496

RESUMO

BACKGROUND: Pulmonary embolism (PE) is correlated with increased mortality among patients with lung cancer (LC). The characteristics of patients with LC presenting with PE have not been fully established, and our meta-analysis aims to comprehensively investigate the clinical characteristics associated with PE in patients with LC to help physicians identify PE earlier in these patients. METHODS: Multiple databases were searched, including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and Wanfang. Odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were used as effect measures for dichotomous and continuous variables, respectively. Moreover, Egger's test, Begg's test and a sensitivity analysis were performed to assess the publication bias and reliability of the articles. RESULTS: In total, 16 studies were included in our meta-analysis. The results indicated that history of chronic obstructive pulmonary disease (OR = 2.59, 95% CI: 1.09, 6.15; P = 0.03), adenocarcinoma (OR = 2.28, 95% CI: 1.88, 2.77; P < 0.01), advanced tumour stage (TNM III-IV vs. I-II, OR = 2.38, 95% CI: 1.99, 2.86; P < 0.01), history of central venous catheter (OR = 1.95, 95% CI: 1.36, 2.78; P < 0.01), history of chemotherapy (OR = 2.32, 95% CI: 1.80, 2.99, P < 0.01), high levels of D-dimer (WMD = 4.31, 95% CI: 2.53, 6.10; P < 0.01) and carcinoembryonic antigen (WMD = 10.30, 95% CI: 9.95, 10.64; P < 0.01) and a low level of partial pressure of oxygen (WMD = -25.97, 95% CI: -31.31, -20.62; P < 0.01) were clinical features of LC patients with PE compared to those without PE. CONCLUSIONS: These results reveal that LC patients with PE have specific clinical features, including but not limited to several cancer- and treatment-related factors, that may help their early identification.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico , Carcinoma Broncogênico/diagnóstico , Neoplasias Pulmonares/diagnóstico , Embolia Pulmonar/diagnóstico , Adenocarcinoma de Pulmão/complicações , Adenocarcinoma de Pulmão/patologia , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antígeno Carcinoembrionário/sangue , Carcinoma Broncogênico/complicações , Carcinoma Broncogênico/patologia , Cateteres Venosos Centrais/efeitos adversos , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Estadiamento de Neoplasias , Razão de Chances , Oxigênio/metabolismo , Pressão Parcial , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/patologia , Embolia Pulmonar/etiologia , Embolia Pulmonar/patologia , Fatores de Risco
7.
Med. clín (Ed. impr.) ; 153(3): 115-121, ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183434

RESUMO

El carcinoma broncogénico es la causa más frecuente de muerte por cáncer en el mundo. Cerca del 75% de los pacientes presentan enfermedad diseminada en el momento del diagnóstico. Hasta un 50% de los pacientes con enfermedad localizada al inicio desarrollarán metástasis. Sin embargo, la evidencia científica actual ha demostrado que, cuando la enfermedad metastásica es limitada y sobre todo en determinadas localizaciones como la cerebral y la suprarrenal, su abordaje multidisciplinar con intención radical puede prolongar la supervivencia. El presente artículo revisa la evidencia clínica bibliográfica existente que apoya el tratamiento, no solo de la enfermedad primaria sino de la metastásica, además del estudio preoperatorio y las indicaciones más aceptadas


Bronchogenic carcinoma is the leading cause of death due to cancer worldwide. Nearly 75% of patients have a disseminated carcinoma at diagnosis. Up to 50% of patients with a localized disease will develop metastasis. Nevertheless, the current scientific evidence has demonstrated that when the metastatic disease is limited, particularly in specific locations such as the brain and the adrenal glands, a multidisciplinary approach with radical intent could achieve a longer survival. This review analyses the clinical evidence available in the literature that supports the treatment of both the primary and the metastatic disease, as well as the preoperative study and the most widely accepted indications


Assuntos
Humanos , Carcinoma Broncogênico/diagnóstico , Carcinoma Broncogênico/cirurgia , Metástase Neoplásica/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Córtex Suprarrenal/patologia , Neoplasias do Córtex Suprarrenal , Neoplasias Encefálicas/complicações
8.
Lung Cancer ; 129: 48-54, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30797491

RESUMO

BACKGROUND: The rate of detection of pulmonary nodules on computed radiography (CR) is approximately 0.09-0.2%, so rapid identification of the nature of solitary pulmonary nodules (SPNs) with a likelihood of malignancy is a critical challenge in the early diagnosis of lung cancer. OBJECTIVE: We conducted this study to compare the diagnostic yield and safety of endobronchial ultrasonography with a guide sheath (EBUS-GS), and the combination of EBUS-GS and virtual bronchoscopic navigation (VBN). METHODS: This was a prospective, multicenter, multi-arm, randomized controlled trial involving a total of 1010 subjects. All the patients recruited underwent a chest CT scan which found SPNs that needed to be diagnosed. The subjects were randomly divided into one of three groups: a traditional, non-guided, bronchoscopy biopsy group (NGB group), an EBUS-GS guided bronchoscopy biopsy group (EBUS group), and a guided bronchoscopy biopsy group that combined EBUS-GS with VBN (combined group). The primary endpoint was to investigate the differences between the diagnostic yields of the three groups. RESULTS: There was no significant difference in the diagnostic yield between the EBUS group (72.3%) and the combined group (74.3%), but the diagnostic yield for the NGB group was 41.2%. The time required to reach biopsy position was significantly less in the combined group (7.96 ± 1.18 min in the combined group versus 11.92 ± 5.37 min in the EBUS group, p < 0.05). However, the bronchoscope operation time was the same in the EBUS-GS and combined groups. The diagnostic yield for peripheral pulmonary lesions (PPLs) >20 mm in diameter was significantly higher than for those <20 mm in diameter. CONCLUSION: The results of our study suggest that guided bronchoscopy could increase the diagnostic yield in the context of peripheral lesions. There was no significant difference in the diagnostic yield between the EBUS and combined groups, but use of EBUS-GS with VBN could significantly shorten the bronchoscope arrival time.


Assuntos
Broncoscopia/métodos , Carcinoma Broncogênico/diagnóstico , Neoplasias Pulmonares/diagnóstico , Nódulos Pulmonares Múltiplos/diagnóstico , Nódulo Pulmonar Solitário/diagnóstico , Adolescente , Adulto , Idoso , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
9.
Lung Cancer ; 127: 6-11, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30642553

RESUMO

INTRODUCTION: RNA isolation from tumor tissue is used for biomarker analyses and validation. Limited diagnostic material from small volume biopsies combined with an increasing demand for standard histologic, molecular characterization, and next generation sequencing applications often leads to limited material for research. We sought to evaluate small volume sampling of lung cancer tissue collected from a single needle pass during a diagnostic procedure and determine if it can provide RNA of acceptable quantity and quality. METHODS: We enrolled 140 patients with probable primary bronchogenic carcinoma and collected RNA from a dedicated FNA aspiration. Total RNA (ηg), RNA integrity number (RIN), and %Mass in base pairs were evaluated from each patient sample. A customized nanoString nCounter® 95-gene panel was used to profile the expression patterns of feature NSCLC genes. We compared gene expression patterns that distinguish lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) in our cohort with a corresponding Cancer Genome Atlas (TCGA) NSCLC datasets. RESULTS: Of the 149 patients consented. RNA-extraction was performed in 101 eligible patients. A satisfactory total RNA mass and RIN was quantified for all samples with a similar distribution among cellular subtypes. Mean %-Mass over 300 base pairs was noted for all specimens and 96% of samples met criteria to perform genetic evaluation with our commercialized gene expression assay. The FNA-derived transcriptomic results showed excellent consistency with the TCGA counterparts, and the differential expression pattern of LUAD vs LUSC subtypes were highly similar. DISCUSSION: In this study, RNA retrieval from a single-pass FNA regardless of procedural approach showed equivalence and suitability for gene expression assessments. RNA extraction from small volume samples has the potential to provide valuable material for genetic profiling.


Assuntos
Biomarcadores Tumorais/análise , Biópsia por Agulha Fina/métodos , Carcinoma Broncogênico/diagnóstico , Neoplasias Pulmonares/diagnóstico , RNA Neoplásico/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos de Viabilidade , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Transcriptoma
11.
Sci Rep ; 8(1): 10766, 2018 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-30018308

RESUMO

Soluble Triggering Receptor Expressed on Myeloid Cells 1 (sTREM-1) can be found in the sera of patients with infectious, autoimmune and malignant diseases. The primary objective of this study was to investigate the prognostic significance of sTREM-1 in lung cancer patients. We analyzed the sera of 164 patients with lung cancer of all histologies and all stages at the time of diagnosis. We employed an ELISA using the anti-TREM-1 clone 6B1.1G12 mAb and recombinant human TREM-1. Patient data was collected retrospectively by chart review. In ROC-analysis, a sTREM-1 serum level of 163.1 pg/ml showed the highest Youden-Index. At this cut-off value sTREM-1 was a marker of short survival in patients with NSCLC (median survival 8.5 vs. 13.3 months, p = 0.04). A Cox regression model showed stage (p < 0.001) and sTREM-1 (p = 0.011) to indicate short survival. There were no differences in sTREM-1 serum values among patients with or without infection, pleural effusion or COPD. sTREM-1 was not associated with metastasis at the time of diagnosis and was not a predictor of subsequent metastasis. In SCLC patients sTREM-1 levels were lower than in NSCLC patients (p = 0.001) and did not predict survival. sTREM-1 did not correlate with CRP or the number of neutrophils. In non-small cell lung cancer patients, sTREM-1 in serum has prognostic significance.


Assuntos
Carcinoma Broncogênico/metabolismo , Neoplasias Pulmonares/metabolismo , Receptor Gatilho 1 Expresso em Células Mieloides/sangue , Idoso , Biomarcadores/sangue , Carcinoma Broncogênico/diagnóstico , Carcinoma Broncogênico/tratamento farmacológico , Carcinoma Broncogênico/epidemiologia , Comorbidade , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Derrame Pleural Maligno/diagnóstico , Prognóstico , Modelos de Riscos Proporcionais , Análise de Regressão , Análise de Sobrevida , Resultado do Tratamento
12.
Folia Med (Plovdiv) ; 60(1): 164-169, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29668447

RESUMO

As part of a retrospective study on bronchoscopies performed at the Clinic of Pneumonology and Phthisiatry of the University Hospital - Pleven by autofluorescence bronchoscopy we found 3 cases diagnosed with carcinoma in situ. They were treated in different ways - endobronchial electrocoagulation, extraction by forceps biopsy and open surgery, but the result was the same - clinical healing. The paper presents the three clinical cases and the analysis of the treatment.


Assuntos
Carcinoma Broncogênico , Neoplasias Pulmonares , Idoso , Carcinoma Broncogênico/diagnóstico , Carcinoma Broncogênico/patologia , Carcinoma Broncogênico/cirurgia , Eletrocoagulação , Humanos , Pulmão/patologia , Pulmão/cirurgia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Pneumonectomia
14.
Arch Bronconeumol ; 53(8): 437-442, 2017 Aug.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28279517

RESUMO

Asbestos is the term used for a set of mineral silicates that tend to break up into fibers. Its use has been associated with numerous diseases affecting the lung and pleura in particular, all of which are characterized by their long period of latency. Asbestos, moreover, has been recognized by the WHO as a Group IA carcinogen since 1987 and its use was banned in Spain in 2002. The publication in 2013 of the 3rd edition of the specific asbestos health monitoring protocol, together with the development of new diagnostic techniques, prompted the SEPAR EROM group to sponsor publication of guidelines, which review the clinical, radiological and functional aspects of the different asbestos-related diseases. Recommendations have also been made for the diagnosis and follow-up of exposed patients. These recommendations were drawn up in accordance with the GRADE classification system.


Assuntos
Asbestose/diagnóstico , Asbestose/terapia , Asbestos/classificação , Asbestos/toxicidade , Asbestose/diagnóstico por imagem , Asbestose/prevenção & controle , Biomarcadores Tumorais , Carcinoma Broncogênico/diagnóstico , Carcinoma Broncogênico/etiologia , Carcinoma Broncogênico/terapia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/terapia , Programas de Rastreamento , Mesotelioma/diagnóstico , Mesotelioma/etiologia , Mesotelioma/terapia , Fibras Minerais/análise , Fibras Minerais/toxicidade , Exposição Ocupacional , Saúde do Trabalhador/legislação & jurisprudência , Doenças Pleurais/diagnóstico , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/terapia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/etiologia , Neoplasias Pleurais/terapia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Testes de Função Respiratória , Fumar/epidemiologia , Espanha
15.
Pan Afr Med J ; 28: 302, 2017.
Artigo em Francês | MEDLINE | ID: mdl-29721133

RESUMO

Endobronchial aspergilloma and intracavitary pulmonary aspergilloma may clinically and radiologically mimic a bronchial neoplasia, hence the importance of systematically searching for an association. A confirmed association completely changes the prognosis as well as the therapeutic approach. We here report two cases with two different forms of pulmonary aspergilloma associated with bronchial carcinoma.


Assuntos
Carcinoma Broncogênico/diagnóstico , Neoplasias Pulmonares/diagnóstico , Aspergilose Pulmonar/diagnóstico , Carcinoma Broncogênico/patologia , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Aspergilose Pulmonar/patologia
16.
J Assoc Physicians India ; 65(9): 98-99, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29313588

RESUMO

Tumours may produce growth factors and cytokines responsible for signs and symptoms distant to the primary or metastatic site. This may be the first sign of a malignancy and its recognition may be critical for early cancer detection. Moreover, proper diagnosis spares the patient of extensive and expensive search for an alternate cause of the neurological dysfunction. In neurological paraneoplastic syndromes like Lambert Eaton Myasthenic syndrome associated with small cell lung cancer, evidence of autoimmunity against presynaptic neuro-muscular junction by anti voltage gated calcium channel anti bodies is well documented. 60% of patients with LEMS are associated with an underlying cancer, usually SCLC. We report a 49 year old male, with over thirty pack years of smoking, who presented with dysautonomia, constitutional symptoms and weakness of all four limbs. Investigations confirmed axonal motor neuropathy with limited stage SCLC with fibro nodular lesions right upper lobe and mediastinal lymphadenopathy. He improved dramatically following chemotherapy and radiotherapy.


Assuntos
Carcinoma Broncogênico/diagnóstico , Síndrome Miastênica de Lambert-Eaton/etiologia , Neoplasias Pulmonares/diagnóstico , Síndromes Paraneoplásicas/etiologia , Humanos , Masculino , Pessoa de Meia-Idade
17.
Quintessence Int ; 47(9): 785-90, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27284583

RESUMO

Intraosseous metastatic tumors (IOM) in maxilla are less frequent than the soft tissue metastatic tumors. Lung and bronchogenic metastatic tumors are uncommon in the maxilla. We present a maxillary bronchogenic metastasis with a rare clinical appearance. IOM was misdiagnosed as a dentoalveolar abscess and treated with antibiotics for 3 weeks. After not responding to antibiotics, the patient's general dental practitioner forwarded the patient to the Department of Oral and Maxillofacial Surgery. The associated tooth was extracted and the patient was recalled 1 week later. No signs of improvement were observed, and cytology, biopsy, and radiology diagnostics were performed. Cytologic results and biopsy could not differentiate a metastatic tumor from a salivary duct carcinoma. Ultimately, negative androgen receptors immunohistochemistry supported the diagnosis of bronchogenic metastatic adenocarcinoma. This case report stresses the importance of taking a thorough medical history. To our knowledge, this is the third bronchogenic IOM to the maxilla reported, mimicking a dentoalveolar abscess. General dental practitioners are among the first in contact with oral metastatic tumors and it is therefore important to report unusual clinical cases, as they present a diagnostic challenge for both the clinician and the pathologist.


Assuntos
Carcinoma Broncogênico/diagnóstico , Neoplasias Maxilares/diagnóstico , Neoplasias das Glândulas Suprarrenais/secundário , Biópsia , Carcinoma Broncogênico/patologia , Diagnóstico Diferencial , Evolução Fatal , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , Neoplasias Maxilares/patologia , Pessoa de Meia-Idade , Abscesso Periapical/diagnóstico , Tomografia Computadorizada por Raios X
18.
Asian Cardiovasc Thorac Ann ; 24(6): 601-3, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27273232

RESUMO

Foreign body aspiration can occur in any age group, but it is more commonly seen in children. In adults, there is usually a predisposing condition that poses a risk of aspiration. If aspiration occurs, prompt diagnosis and extraction of the foreign body is needed to prevent early and late complications. We report a rare case of neglected foreign body aspiration in a 45-year-old schizophrenic opium addicted patient, which resulted in an occlusive lesion in the bronchus, mimicking bronchial carcinoma.


Assuntos
Osso e Ossos , Carcinoma Broncogênico/diagnóstico , Corpos Estranhos/diagnóstico , Granuloma de Corpo Estranho/diagnóstico , Neoplasias Pulmonares/diagnóstico , Animais , Biópsia , Broncoscopia , Galinhas , Diagnóstico Diferencial , Ingestão de Alimentos , Corpos Estranhos/etiologia , Corpos Estranhos/cirurgia , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/complicações , Ópio , Pneumonectomia , Aves Domésticas , Valor Preditivo dos Testes , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Tomografia Computadorizada por Raios X , Resultado do Tratamento
19.
PLoS One ; 11(4): e0153793, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27083009

RESUMO

BACKGROUND: There is sparse literature on whether training in endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) improves the diagnostic yield of conventional TBNA (cTBNA). OBJECTIVES: The aim of this study was to evaluate the diagnostic yield of cTBNA before and after the introduction of EBUS. METHODS: This was a retrospective analysis of patients who underwent cTBNA at our center. The study was divided into two periods, before and after the introduction of EBUS at our facility. The diagnostic yield of cTBNA was compared between the study periods. Rapid on-site cytological examination was not available. RESULTS: A total of 1,050 patients (61.6% men; mean age 45.6 years) underwent cTBNA during the study period (849 before EBUS; 201 after EBUS). Sarcoidosis (n = 527) followed by bronchogenic carcinoma (n = 222) formed the most common indications for performing cTBNA. There was a significant increase in both the success of obtaining a representative sample (from 71% to 85%), and the diagnostic yield (from 33% to 49.5%) of cTBNA, after the introduction of EBUS. The increase in the diagnostic yield of cTBNA after introduction of EBUS remained significant even after adjusting for years of performing cTBNA and the type of anesthesia (topical vs. sedation and topical) on a multivariate analysis. CONCLUSION: The diagnostic yield of cTBNA at our facility increased after the introduction of EBUS-TBNA. However, given the retrospective nature of the study, prospective studies are required to confirm our findings.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Linfonodos/patologia , Adulto , Anestesia , Broncoscopia/métodos , Carcinoma Broncogênico/diagnóstico , Carcinoma Broncogênico/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Sarcoidose/diagnóstico , Sarcoidose/diagnóstico por imagem
20.
Clin Respir J ; 10(6): 740-745, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25689088

RESUMO

BACKGROUND AND AIMS: Organising pneumonia (OP) is not a well-known cause of increased 18 F-FDG uptake, and the relationship of the increased 18 F-FDG uptake to clinical parameters has not been clearly identified. This study aims to assess the role of positron emission tomography-computed tomography (PET-CT) for the diagnosis of focal organised pneumonia that may mimic malignity because of mass-like lesions on the radiological images it causes. METHODS: Among 40 patients of whom histopathological exams were consistent with OP, medical records of 14 focal OP patients diagnosed with surgical biopsy were evaluated retrospectively. RESULTS: There were 10 male (71.4%) and 4 female (28.6%) patients. The mean age at the time of diagnosis was 57.2 ± 11.7 years, ranging from 38 to 85 years. Nine subjects (64.3%) were smokers. Eleven patients (78.5%) had symptoms, the remaining 3 patients (21.5%) were asymptomatic. Three patients (21.3%) had a history of malignancy. Focal lung lesion was initially detected by chest radiography in 10 patients (71.4%) and by computed tomography (CT) scan in all patients. CT scan showed a single lesion in 12 (85.7%) patients. The lesions were located in the right lung of the half of patients (50%) and in the left lung of the other half. The median diameter of the lesions was 3.4 cm (range, 1.8-6.0 cm). PET with 18 F-FDG was performed in all patients, and hypermetabolic activity of the focal lung lesion was demonstrated in all cases. The median values of maximum standardized uptake value was 3.5 ± 2.7 (min 2.1-max 13.1). CONCLUSION: Focal OP is a discrete form of OP that is associated with unifocal lesions on radiological images, and it can easily mimic lung cancer because of positivity on PET scans. There are no specific findings of PET scan for the diagnosis of OP.


Assuntos
Carcinoma Broncogênico/diagnóstico , Fluordesoxiglucose F18/farmacocinética , Pneumonia/metabolismo , Compostos Radiofarmacêuticos/farmacocinética , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Broncogênico/diagnóstico por imagem , Carcinoma Broncogênico/patologia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pneumonia/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA