RESUMO
Nine patients (seven men and two women), median age 57 years (range 40-68 years), with large malignant pericardial effusion confirmed by cytological examination, were treated with direct intrapericardial administration of cisplatin. After insertion of a polyurethane catheter, fluid was drained and cisplatin (10 mg in 20 ml normal saline) was instilled over 5 min during 5 consecutive days (total cisplatin dose: 50 mg). If fluid reaccumulation occurred the courses were repeated every 3 weeks. All of the patients achieved a complete therapeutic response (no more fluid reaccumulation). The median time of response was 2.8 months (range 1-24 months). Mild nausea occurred in two patients, supraventricular arrhythmia in one patient and infectious complications in one patient. Eight patients died because of disease progression without evidence of cardiac tamponade or stricture. Autopsy, performed in 7 cases, revealed neoplastic involvement of the pericardium in all of the patients, but pericardial effusion was seen in one patient only.
Assuntos
Cisplatino/administração & dosagem , Neoplasias Cardíacas/secundário , Derrame Pericárdico/tratamento farmacológico , Adulto , Idoso , Cateterismo , Feminino , Neoplasias Cardíacas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/etiologia , PericárdioRESUMO
Two cases of subacute sensory neuronopathy (SSN) associated with small cell lung cancer are reported. In both cases motor disability, attributed to motor neuropathy and neuronopathy, respectively, accompanied SSN. Immunohistochemical studies performed provide further data suggesting the involvement of humoral antibodies and the participation of protease inhibitors in the pathogenesis of SSN.
Assuntos
Encéfalo/patologia , Carcinoma de Células Pequenas/patologia , Neoplasias Pulmonares/patologia , Doenças Neuromusculares/patologia , Síndromes Paraneoplásicas/patologia , Transtornos de Sensação/patologia , Medula Espinal/patologia , Autoanticorpos/análise , Encéfalo/imunologia , Carcinoma de Células Pequenas/imunologia , Complemento C3/análise , Ferritinas/análise , Gânglios Espinais/imunologia , Gânglios Espinais/patologia , Proteína Glial Fibrilar Ácida/análise , Humanos , Doenças do Complexo Imune/imunologia , Doenças do Complexo Imune/patologia , Técnicas Imunoenzimáticas , Imunoglobulina G/análise , Imunoglobulina M/análise , Neoplasias Pulmonares/imunologia , Masculino , Pessoa de Meia-Idade , Degeneração Neural/fisiologia , Doenças Neuromusculares/imunologia , Síndromes Paraneoplásicas/imunologia , Transtornos de Sensação/imunologia , Medula Espinal/imunologia , alfa 1-Antiquimotripsina/análiseRESUMO
16 patients with clinical and radiological symptoms suggesting lung disease were described. Metastatic character of process was documented in 7 of them during life and in 9 after death. The pulmonary symptoms without any signs of primary tumor lasted from few months to 3 years. Two patients revealed primary tumor in ovary, 1-in uterus, 4-in thyroid gland, 2-in prostata, 2-in breast, 2-in pancreas, 1-in bone, one in testicle, and 2-in kidney.
Assuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundário , Adulto , Idoso , Neoplasias Ósseas/patologia , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia , Neoplasias da Glândula Tireoide/patologia , Neoplasias Urogenitais/patologiaRESUMO
Results of microscopical examination of airway material (sputum, bronchoscopy) were analysed in 563 patients with lung cancer. Bronchoscopic material was examined from all patients, while sputum only from 352. Sputum was always analysed prior examination of bronchoscopic material cancer cells were found in material from lower airways in 366 patients (65%), correct cell typing was achieved in 286 (78.1%). Cancer cells were present in the sputum in 28.1% of the analysed patients and in 60% of the material obtained during bronchoscopy. In 178 patients with squamous cell lung cancer, cancer cells were found in 64.9% while correct cell typing was found in 83.4%. In 183 patients with small cell lung cancer, neoplastic cells were found in 72.6% of the cases while correct cell typing was achieved in 88.7%. In 144 patients with adenocarcinoma cancer cells were found in 53.4% while correct typing was present in 64.9%. In 18 cases of large cell lung cancer, cancer cells were present in 50%, and correct cell typing was achieved in 22.2%. Differences were statistically significant between small cell lung cancer and adenocarcinoma. Correct cell typing was statistically more often significant in patients with squamous cell lung cancer or SCLC in comparison with the other types. Significant results of positive cytology was found when analysing localisation of the tumor. In cases of central tumor cytology was positive in 60% of the cases, while in peripheral tumors it was positive only in 43.9% of the cases. The size of the tumor did not affect the sensitivity of the cytological examination.
Assuntos
Neoplasias Pulmonares/patologia , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Broncoscopia , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escarro/citologiaRESUMO
A case is presented of a round coin shadow seen on a routine chest radiogram producing grave diagnostic problems. During hospitalization the patient presented neurological and bone and joint involvement symptoms. Transthoracic needle biopsy of the lesion allowed to diagnose large cell cancer, but autopsy changed this diagnosis to malignant histiocytoma.