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2.
Medicine (Baltimore) ; 99(2): e18678, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914061

RESUMO

To investigate the correlation between the proliferating cell nuclear antigen Ki-67 and the multislice computed tomography (MSCT) signs in different subtypes of lung adenocarcinoma.Ninety-five patients with lung adenocarcinoma confirmed by surgical pathology and treated between January 2017 and December 2017 were included. MSCT was performed before the operation, and the characteristics of the high-resolution CT (HRCT) signs of the lesions were compared with the Ki-67 immunohistochemistry results.The levels of Ki-67 in the 95 lung adenocarcinoma specimens were positively correlated with the malignancy of lung adenocarcinoma. Spearman correlation coefficient was 0.615. The expression of Ki-67 was positively correlated with the nodules' diameter, density, and lobulated sign, with Spearman correlation coefficients of 0.58, 0.554, and 0.436. There was no significant correlation with spiculation and pleural retraction, with correlation coefficients of 0.319/0.381.These findings suggest that the MSCT signs of different types of lung adenocarcinoma might be associated with the expression of Ki-67. Without replacing biopsy, the imaging features of pulmonary nodules could be comprehensively analyzed to evaluate the proliferation potential of preoperative nodules, but additional studies are needed for confirmation.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Antígeno Ki-67/biossíntese , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Tomografia Computadorizada Multidetectores/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/patologia , Pleura/patologia , Estudos Retrospectivos
3.
Neurosurg Clin N Am ; 31(1): 43-48, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739928

RESUMO

The lateral retropleural thoracic approach offers minimally invasive access for the treatment of thoracic spine pathology, specifically thoracic herniated discs. Alternatives to the retropleural approach traditionally included posterolateral or anterior approaches, which carry increased morbidity. The retropleural approach affords lateral access to the thoracic spine that allows for addressing pathology such as herniated discs, corpectomy, tumor, or trauma. This article outlines preoperative workup and planning, intraoperative steps, tips, and postoperative care.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Neurocirúrgicos/métodos , Pleura/anatomia & histologia , Pleura/cirurgia , Coluna Vertebral/cirurgia , Procedimentos Cirúrgicos Torácicos/métodos , Vértebras Torácicas/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Resultado do Tratamento
5.
Sud Med Ekspert ; 62(6): 58-62, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825335

RESUMO

A rare case of a lethal outcome due to iatrogenic damage to the intercostal vessel, a collateral branch of the posterior intercostal artery, is described. The little-known features of the topography of this vessel (location on the upper edge of the underlying rib), which requires further study in the context of variable anatomy, are given. The risks associated with deviations from the traditionally recommended sites of pleural puncture (below the eighth intercostal space to the scapular line) are substantiated. An analysis of the characteristics of bleeding arising from the intercostal vessels (from two ends, under high pressure, etc.) is given, which implies the extreme importance of a timely diagnosis. Differing points of view on the legal assessment of malpractice when care is delivered by a series of doctors, and the legal necessity of determining the 'point of no return' (the latest moment after the onset of bleeding, in which medical aid can still prevent an unfavorable outcome), are considered. An opinion is expressed on the need for the active participation (initiative) of an expert in the provision of expertise.


Assuntos
Doença Iatrogênica , Pleura , Punções , Humanos , Pleura/lesões
6.
Artigo em Inglês | MEDLINE | ID: mdl-31751008

RESUMO

Malignant pleural mesothelioma is a cancer of the mesothelial cells lining the pleural sac. Surgery for malignant pleural mesothelioma should be part of a multimodality treatment approach and the aim of surgery should be macroscopic complete tumor resection. Lung-sparing operations, such as extended pleurectomy decortication, have gained increasing popularity in the past decade.  This video tutorial illustrates the main steps of extended pleurectomy decortication for the treatment of malignant pleural mesothelioma.


Assuntos
Neoplasias Pulmonares , Pulmão , Mesotelioma , Pleura/cirurgia , Neoplasias Pleurais , Procedimentos Cirúrgicos Torácicos/métodos , Idoso , Dissecação/métodos , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Mesotelioma/patologia , Mesotelioma/cirurgia , Tratamentos com Preservação do Órgão/métodos , Pleura/patologia , Neoplasias Pleurais/patologia , Neoplasias Pleurais/cirurgia , Resultado do Tratamento
7.
Medicine (Baltimore) ; 98(48): e18142, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770250

RESUMO

RATIONALE: Mucormycosis is a rare opportunistic fungal infection with poor prognosis. The incidence of mucormycosis has been increasing, and it is a threat to immunocompromised hosts. We present a case of gastric mucormycosis complicated by a gastropleural fistula during immunosuppressive treatment for adult-onset Still disease (AOSD). PATIENT CONCERNS: An 82-year-old woman diagnosed with AOSD who developed gastric ulcers during the administration of an immunosuppressive therapy with corticosteroids, cyclosporine, and tocilizumab complained of melena and epigastralgia. Esophagogastroduodenoscopy showed multiple ulcers covered with grayish or greenish exudates. DIAGNOSES: The patient diagnosed with mucormycosis based on culture and biopsy of the ulcers, which showed nonseptate hyphae branching at wide angles. Mucor indicus was identified using polymerase chain reaction. INTERVENTIONS AND OUTCOMES: Although liposomal amphotericin B was administered, gastric mucormycosis was found to be complicated by a gastropleural fistula. The patient died because of pneumonia due to cytomegalovirus infection, and autopsy revealed the presence of Mucorales around the fistula connecting the stomach and diaphragm. LESSONS: Gastric mucormycosis is refractory to treatment and fatal. Surgical resection, if possible, along with antifungal drugs can result in better outcomes.


Assuntos
Fístula Gástrica/microbiologia , Mucormicose/complicações , Infecções Oportunistas/complicações , Fístula do Sistema Respiratório/microbiologia , Úlcera Gástrica/microbiologia , Idoso de 80 Anos ou mais , Feminino , Fístula Gástrica/induzido quimicamente , Humanos , Imunossupressores/efeitos adversos , Mucormicose/induzido quimicamente , Mucormicose/microbiologia , Infecções Oportunistas/induzido quimicamente , Infecções Oportunistas/microbiologia , Pleura/microbiologia , Fístula do Sistema Respiratório/induzido quimicamente , Doença de Still de Início Tardio/tratamento farmacológico , Úlcera Gástrica/induzido quimicamente
8.
Medicine (Baltimore) ; 98(48): e18251, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770288

RESUMO

RATIONALE: Small cell carcinoma (SCC) occurs mostly in the lung, and small cell lung cancer accounts for 13% of newly diagnosed lung cancers. Only 2.5% of SCC occurs in extrapulmonary sites, and SCC of pleural origin is especially very uncommon. PATIENT CONCERNS: An 85-year-old man presenting with progressive dyspnea for more than 7 days. DIAGNOSES: Computed tomography scan of the chest showed massive pleural effusion and diffuse nodular thickening of the pleura on the right chest. Sonography-guided needle biopsy of the pleural mass was performed and histologic and immunohistochemical findings revealed SCC. Since no parenchymal lung lesion was observed, the patient was finally diagnosed with SCC of the pleura (SCCP). INTERVENTIONS: Due to the patient's old age and poor performance status, chemotherapy was not performed and only drainage of pleural effusion was conducted for symptom relief. OUTCOMES: Dyspnea improved after pleural effusion drainage. The patient was discharged and transferred to a local medical center for hospice care. LESSONS: Although primary SCCP is extremely rare, SCCP should also be considered as well as mesothelioma in case of presence of a pleural-based mass with massive pleural effusion.


Assuntos
Carcinoma de Células Pequenas , Dispneia , Derrame Pleural Maligno , Neoplasias Pleurais , Toracentese/métodos , Idoso de 80 Anos ou mais , Carcinoma de Células Pequenas/complicações , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Pequenas/fisiopatologia , Dispneia/diagnóstico , Dispneia/etiologia , Cuidados Paliativos na Terminalidade da Vida , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Pleura/diagnóstico por imagem , Pleura/patologia , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/etiologia , Derrame Pleural Maligno/fisiopatologia , Derrame Pleural Maligno/terapia , Neoplasias Pleurais/complicações , Neoplasias Pleurais/patologia , Neoplasias Pleurais/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia de Intervenção/métodos
9.
Kyobu Geka ; 72(12): 997-1000, 2019 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-31701910

RESUMO

We report a case of giant solitary fibrous tumor( SFT) of the pleura postoperatively complicated with probable reexpansion pulmonary edema and atrial fibrillation. An 85-year-old woman was diagnosed to have a 13 cm sized intrathoracic neoplasm. Upon thoracotomy, the tumor was found to pedunculate from the right lung with no direct invasion to the surrounding structures. Complete resection of the tumor and expansion of the right lung was obtained. Histopathology revealed the tumor was a benign SFT arising from the visceral pleura. An infiltrative shadow in the right lower lung field soon after the surgery suggested a reexpansion pulmonary edema, which eventually recovered within a week. The patient suffered from a refractory atrial fibrillation that led to a congestive heart failure requiring an intensive medical treatment. It is emphasized that thoracic surgeons should be aware of these postoperative complications in treating such a case like this.


Assuntos
Fibrilação Atrial , Neoplasias Pleurais , Edema Pulmonar , Tumor Fibroso Solitário Pleural , Idoso de 80 Anos ou mais , Feminino , Humanos , Pleura , Tumor Fibroso Solitário Pleural/cirurgia , Tomografia Computadorizada por Raios X
10.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(11): 852-857, 2019 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-31694096

RESUMO

Objective: To analyze the clinical,imaging and pathological features of Pleuroparenehymal fibroelastosis (PPFE). Methods: The clinieal data of a patient diagnosed as PPFE admitted in department of Respiratory and Critical Care Medicine,Beijing Hospital in April 2017 were reported and the related literatures were reviewed.With "pleuroparenehymal fibroelastosis" as the search terms, and the search time before October 1st 2017 for Wanfangdata, China National Knowledge Infrastructure(CNKI), and PubMed. Results: The patient was a 46-year-old male presented with cough, shortness of breath after exercise.A CT scan of the chest revealed bilateral, irregular pleural thickening with upper lobe predominance.After 3 years of antituberculosis treatment,the disease progressed. A diagnosis of pleuroparenehymal fibroelastosis (PPFE) was confirmed by CT guided lung biopsy. A total of 132 cases were reported (including 1 case in Chinese). 88 of them were confirmed by pathology with detailed data.Clinical data of 89 reported cases with PPFE including 48 males and 41 females aged 13 to 85 years were enrolled and analyzed in the study.The common symptoms were dyspnea(62%, 55 cases),cough(58%, 52 cases),recurrent respiratory tract infection(17%, 15 cases).The main CT features are reported:pleural thickening(87%,77 cases), recurrent pneumothorax(52%,46 cases), traction bronchiectasis(30%, 27 cases),subpleural comsolidation(20%, 18 cases). All patients were proven PPFE by biopsy.34 cases received corticosteroid, 5 cases received lung transplant operation.40 cases died during the follow-up from 4 month to 84 month. Conclusions: Pleuroparenehymal fibroelastosis is a rare disease.The imaging findings were dominated by both upper lobes. Lung biopsy might be necessary. PPFE is often misdiagnosed as pulmonary tuberculosis/obsolete pulmonary tuberculosis,asbestosis,connective tissues disease and Drug-induced pneumonitis.There was no consensus on the treatment.


Assuntos
Pulmão/diagnóstico por imagem , Tecido Parenquimatoso/patologia , Pleura/patologia , Doenças Pleurais/patologia , Fibrose Pulmonar/patologia , Biópsia , China , Tosse/etiologia , Dispneia/etiologia , Feminino , Humanos , Pulmão/patologia , Pulmão/cirurgia , Transplante de Pulmão , Masculino , Pessoa de Meia-Idade , Tecido Parenquimatoso/diagnóstico por imagem , Pleura/diagnóstico por imagem , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/cirurgia , Fibrose Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento
12.
Int J Mol Sci ; 20(20)2019 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-31614900

RESUMO

Thrombin is an essential procoagulant and profibrotic mediator. However, its implication in tuberculous pleural effusion (TBPE) remains unknown. The effusion thrombin and plasminogen activator inhibitor-1 (PAI-1) levels were measured among transudative pleural effusion (TPE, n = 22) and TBPE (n = 24) patients. Pleural fibrosis, identified as radiological residual pleural thickening (RPT) and shadowing, was measured at 12-month follow-up. Moreover, in vivo and in vitro effects of thrombin on PAI-1 expression and mesothelial-mesenchymal transition (MMT) were assessed. We demonstrated the effusion thrombin levels were significantly higher in TBPE than TPE, especially greater in TBPE patients with RPT > 10mm than those without, and correlated positively with PAI-1 and pleural fibrosis area. In carbon black/bleomycin-treated mice, knockdown of protease-activated receptor-1 (PAR-1) markedly downregulated α-smooth muscle actin (α-SMA) and fibronectin, and attenuated pleural fibrosis. In pleural mesothelial cells (PMCs), thrombin concentration-dependently increased PAI-1, α-SMA, and collagen I expression. Specifically, Mycobacterium tuberculosis H37Ra (MTBRa) induced thrombin production by PMCs via upregulating tissue factor and prothrombin, and PAR-1 silencing considerably abrogated MTBRa-stimulated PAI-1 expression and MMT. Consistently, prothrombin/PAR-1 expression was evident in the pleural mesothelium of TBPE patients. Conclusively, thrombin upregulates PAI-1 and MMT and may contribute to tuberculous pleural fibrosis. Thrombin/PAR-1 inhibition may confer potential therapy for pleural fibrosis.


Assuntos
Inibidor 1 de Ativador de Plasminogênio/metabolismo , Pleura/patologia , Receptor PAR-1/metabolismo , Trombina/metabolismo , Tuberculose/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Modelos Animais de Doenças , Exsudatos e Transudatos/metabolismo , Feminino , Fibrose , Seguimentos , Humanos , Masculino , Mesoderma/efeitos dos fármacos , Mesoderma/crescimento & desenvolvimento , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Mycobacterium tuberculosis/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Derrame Pleural/metabolismo , Derrame Pleural/patologia , Transdução de Sinais , Tuberculose/patologia , Adulto Jovem
14.
Part Fibre Toxicol ; 16(1): 34, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477126

RESUMO

BACKGROUND: Potassium octatitanate fibers (K2O•8TiO2, POT fibers) are used as an asbestos substitute. Their physical characteristics suggest that respirable POT fibers are likely to be carcinogenic in the lung and pleura. However, previous 2-year inhalation studies reported that respired POT fibers had little or no carcinogenic potential. In the present study ten-week old male F344 rats were left untreated or were administered vehicle, 0.25 or 0.5 mg rutile-type nano TiO2 (r-nTiO2), 0.25 or 0.5 mg POT fibers, or 0.5 mg MWCNT-7 by intra-tracheal intra-pulmonary spraying (TIPS), and then observed for 2 years. RESULTS: There were no differences between the r-nTiO2 and control groups. The incidence of bronchiolo-alveolar cell hyperplasia was significantly increased in the groups treated with 0.50 mg POT and 0.50 mg MWCNT-7. The overall incidence of lung tumors, however, was not increased in either the POT or MWCNT-7 treated groups. Notably, the carcinomas that developed in the POT and MWCNT-7 treated rats were accompanied by proliferative fibrous connective tissue while the carcinomas that developed in the untreated rats and the r-nTiO2 treated rats were not (carcinomas did not develop in the vehicle control rats). In addition, the carcinoma that developed in the rat treated with 0.25 mg POT was a squamous cell carcinoma, a tumor that develops spontaneously in about 1 per 1700 rats. The incidence of mesothelial cell hyperplasia was 4/17, 7/16, and 10/14 and the incidence of malignant mesothelioma was 3/17, 1/16, and 2/14 in the 0.25 mg POT, 0.5 mg POT, and MWCNT-7 treated groups, respectively. Neither mesothelial cell hyperplasia nor mesothelioma developed in control rats or the rats treated with r-nTiO2. Since the incidence of spontaneously occurring malignant mesothelioma in rats is extremely low, approximately 1 per 1000 animals (Japan Bioassay Research Center [JBRC] historical control data), the development of multiple malignant mesotheliomas in the POT and MWCNT-7 treated groups was biologically significant. CONCLUSION: The incidence of pleural mesotheliomas in male F344 rats administered POT fibers and MWCNT-7 was significantly higher than the JBRC historical control data, indicating that the incidence of pleural mesothelioma in the groups administered POT fibers and MWCNT-7 fibers via the airway using TIPS was biologically significant. The incidence of type II epithelial cell hyperplasia and the histology of the carcinomas that developed in the POT treated rats also indicates that respirable POT fibers are highly likely to be carcinogenic in the lungs of male F344 rats.


Assuntos
Carcinógenos/toxicidade , Neoplasias Pulmonares/induzido quimicamente , Pulmão/efeitos dos fármacos , Mesotelioma/induzido quimicamente , Pleura/efeitos dos fármacos , Titânio/toxicidade , Animais , Carcinógenos/química , Carcinógenos/farmacocinética , Exposição por Inalação , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/patologia , Fibras Minerais , Pleura/patologia , Ratos Endogâmicos F344 , Propriedades de Superfície , Distribuição Tecidual , Titânio/química , Titânio/farmacocinética
15.
Khirurgiia (Mosk) ; (9): 52-57, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31532167

RESUMO

Advanced multiple organ parasitic invasion is reported in the article. A thorough assessment of pathological process, surgical anatomy and preoperative examination resulted radical surgery despite multiple organ disease. Surgical procedure included extended left-sided hemihepatectomy, atypical resection of S6liver segment and pancreas, removal of themediastinal parasite with partial excision of parietal pleura and pericardium.


Assuntos
Equinococose/cirurgia , Hepatectomia/métodos , Humanos , Fígado/anatomia & histologia , Fígado/parasitologia , Fígado/cirurgia , Pâncreas/parasitologia , Pâncreas/cirurgia , Pancreatectomia/métodos , Pericardiectomia/métodos , Pericárdio/parasitologia , Pericárdio/cirurgia , Pleura/parasitologia , Pleura/cirurgia
16.
World J Surg Oncol ; 17(1): 158, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31506081

RESUMO

BACKGROUND: The diagnosis of peripheral pulmonary lesions (PPLs) is a challenging task for pulmonologists, especially for small PPLs. Conventional localization of these small PPLs, which are > 1 cm away from the visceral pleura in operation, is quite difficult. Currently used methods inevitably damage the visceral pleura and may cause a series of complications, such as pneumothorax and hemothorax. Hence, the present study aimed to find out an intraoperative localization method with no damage to the visceral pleura. METHODS: We retrospectively reviewed 21 patients with PLLs who underwent electromagnetic navigation bronchoscopy (ENB)-guided biopsy plus a new methylene blue staining with the help of massage (Massage Staining) in our department between August 2017 and December 2018. RESULTS: The median age of these 21 patients was 51.3 ± 2.1 years. The diameter of the PPLs was 8.2 ± 2.3 mm. The rate of successful biopsy was 76.2%, and the rate of excellent or satisfactory of Massage Staining was 81.0%, while all lesions of these 21 cases were included in the range of staining, and the median distance from the edge of the stained site to the edge of the lesion was 29 ± 18 mm. The duration of ENB-guided biopsy plus Massage Staining was 26.7 ± 5.3 min, and the intraoperative blood loss was 3.3 ± 1.5 ml. No pneumothorax, hemorrhage, and tracheal injury occurred intraoperatively. CONCLUSIONS: The ENB-guided biopsy combined with Massage Staining is an innovative one-stop strategy designed to enhance the precision of thoracic surgery. The Massage Staining avoids damage to the visceral pleura, causes the low incidence of complications, but yields precise localization of PPLs.


Assuntos
Broncoscopia/métodos , Campos Eletromagnéticos , Biópsia Guiada por Imagem/métodos , Neoplasias Pulmonares/cirurgia , Pleura/cirurgia , Coloração e Rotulagem/métodos , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Pleura/patologia , Pneumonectomia , Pneumotórax/prevenção & controle , Prognóstico , Estudos Retrospectivos
17.
Urology ; 134: 66-71, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31487511

RESUMO

OBJECTIVE: To analyze the outcomes of upper pole access during percutaneous nephrolithotomy (PCNL), an option pole often avoided due to the concern for pleural injury. METHODS: We retrospectively collected data on patients undergoing PCNL at our institution. Patients were divided into 3 groups according to access: supracostal upper calyx (group 1), subcostal upper calyx (group 2), and nonupper calyx (group 3). Preoperative imaging was reviewed to assess stone burden, Hounsfield units (HU), location, and Guy's Stone Score. Patients were considered stone-free if residual fragments were 3 mm or smaller on CT scan. RESULTS: We analyzed 329 PCNLs (left: 174; right: 155). Stones had a median size of 32 mm, 800 HU, and Guy's Stone Score of 2. Groups 1, 2, and 3 had 119, 108, and 102 patients, respectively. The 90-day complication rate was 20.4% (7.9% Clavien 3-4). Group 1 patients, with higher BMI and larger stones, had higher SFR than group 3 (89.9% vs 79.4%, P = .038), but with a significantly higher risk of complications (P = .001). Within group 1, left PCNL (7.0% vs 24.2%, P = .016) and BMI ≥30 (6.9% vs 25.0%, P = .013) carried a lower risk of chest tube insertion. There was no difference in complications between groups 2 and 3 (1.9% vs 2.9%). CONCLUSION: Upper pole access is safe and effective, particularly if done below the ribs. Supracostal access is an effective option to achieve higher stone-free rates in complex stones, while carrying a risk of significant hydrothorax, particularly on the right side and in nonobese patients.


Assuntos
Hidrotórax , Complicações Intraoperatórias , Cálculos Renais , Nefrolitotomia Percutânea , Pleura/lesões , Cuidados Pré-Operatórios/métodos , Adulto , Índice de Massa Corporal , Feminino , Humanos , Hidrotórax/etiologia , Hidrotórax/prevenção & controle , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrolitotomia Percutânea/efeitos adversos , Nefrolitotomia Percutânea/métodos , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos , Estados Unidos
18.
Adv Respir Med ; 87(4): 247-251, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476014

RESUMO

Solitary fibrous tumors of the pleura (SFTP) represent less than 5% of all pleural tumors with a higher susceptibility for men in the sixth and seventh decades of life. Imaging and histopathological analyses indicate that these tumors have an unpredictable clinical course since larger tumors are often associated with malignancy; however, this assumption is not universal. In addition, there are no systematic descriptions of lung function in either the basal or post-surgical scenarios of SFTP patients. We describe a series of 3 patients between 4th and 5th decade of life with a benign histopathological SFTP without local recurrence in their follow-up. We also analyzed changes in lung function, emphasizing possible associations with clinical recovery.


Assuntos
Tumor Fibroso Solitário Pleural/patologia , Tumor Fibroso Solitário Pleural/cirurgia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Pleura/patologia , Pleura/cirurgia , Tomografia Computadorizada por Raios X
20.
Clin Lab ; 65(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31414757

RESUMO

BACKGROUND: Detection of carcinoembryonic Antigen (CEA) in pleural effusion has good clinical application value in differentiating benign and malignant pleural effusion, but sometimes CEA provides limited help. We report a case of a patient with left lung neoplasms combined with bilateral pleural effusion with increased CEA in the pleural effusion whose thoracoscopy pleural biopsy pathology was negative, mimicking lung carcinoma and ultimately confirmed as pulmonary sarcomatoid carcinoma by CT-guided percutaneous lung biopsy. METHODS: The chest computed tomography (CT) scan, thoracoscopy pleural biopsy, and CT-guided percutaneous lung biopsy were arranged to explore the etiology of pleural effusion. RESULTS: The chest CT scan showed bilateral pleural effusion with left lung neoplasms, pulmonary atelectasis, and left hilar enlargement. Pathology of thoracoscopy biopsy showed pleural inflammation with infiltration of inflammatory cells. Pathology of CT-guided percutaneous lung biopsy confirmed pulmonary sarcomatoid carcinoma. CONCLUSIONS: Elevated pleural effusion CEA is not a specific index of lung cancer. CT-guided percutaneous lung biopsy is appropriate for patients presenting with pleural diseases with lung neoplasms, especially when thoracoscopy pleural biopsy result was negative.


Assuntos
Antígeno Carcinoembrionário/metabolismo , Carcinoma/diagnóstico , Erros de Diagnóstico , Neoplasias Pulmonares/diagnóstico , Pleura/metabolismo , Derrame Pleural/diagnóstico , Idoso , Biópsia , Carcinoma/diagnóstico por imagem , Carcinoma/metabolismo , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pleura/diagnóstico por imagem , Pleura/patologia , Derrame Pleural/metabolismo , Derrame Pleural/patologia , Toracoscopia/métodos , Tomógrafos Computadorizados
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