RESUMEN
AIM: The prognosis of patients with lung cancer depends on early diagnosis and accurate staging. The present staging system for lung cancer is tumor (T), node (N), and metastasis (M) staging (TNM). We compared the accuracy of preoperative (clinical) and postoperative (pathological) TNM staging of lung cancer in this study and emphasized the preoperative mediastinoscopy is useful in selected patients. METHODS: We performed a retrospective comparison of the clinical and pathological TNM staging of 530 patients with lung cancer treated surgically. The preoperative clinical TNM staging of all patients was based on physical examination, radiological investigations and bronchoscopy. Mediastinoscopy was used routinely for all patients with an indication since 2000. RESULTS: We found the agreement between clinical and pathological TNM staging to be only 46.4%. The comparison between clinical and pathological TNM staging was 6.2-5.3% at stage Ia, 37.9%-36% at stage Ib, 0.7-0.9% at stage IIa, 23-25% at stage IIb, 27.1-16.2% at stage IIIa, and 3.2-14% at stage IIIb respectively. The frequency rates of the different clinical and pathologic stages were 6.2% and 5.3%, for stage Ia, 37.9% and 36% for stage Ib, 0.7% and 0.9% for stage IIa, 23% and 25% for stage IIb, 27.1% and 16.2% for stage IIIa, 3.2% and 14% for stage IIIb respectively. CONCLUSION: We compared the clinical and pathological staging in patients with non small cell lung cancer submitted to surgical treatment to identify the causes of any discordance. The clinical TNM and staging based on computerized tomography was found to be inaccurate.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/patología , Neoplasias Pulmonares/patología , Ganglios Linfáticos/patología , Cuidados Posoperatorios , Cuidados Preoperatorios , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Broncoscopía , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Detección Precoz del Cáncer , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirugía , Metástasis Linfática , Masculino , Mediastinoscopía , Persona de Mediana Edad , Estadificación de Neoplasias , Selección de Paciente , Neumonectomía , Cuidados Posoperatorios/métodos , Cuidados Preoperatorios/métodos , Pronóstico , Estudios Retrospectivos , Resultado del TratamientoAsunto(s)
Bronquios , Cuerpos Extraños/etiología , Inhalación , Adolescente , Adulto , Niño , Femenino , Humanos , Síndrome , TráqueaRESUMEN
Bronchiectasis due to aspiration of grass inflorescences is described in three children. One patient spontaneously expelled a grass head by coughing and was not operated on. The grass inflorescence was found in the right lobe's medial segment bronchi in the second case and in the pleural cavity of the third. Pulmonary resection was performed in both cases. The clinical manifestations were of both "lodging" and "extrusive" types of aspirated grass inflorescence. This possibility must be considered in the differential diagnosis of chronic pulmonary infections in children.
Asunto(s)
Bronquios , Bronquiectasia/etiología , Reacción a Cuerpo Extraño/complicaciones , Poaceae , Bronquiectasia/diagnóstico por imagen , Bronquiectasia/cirugía , Broncografía , Niño , Diagnóstico Diferencial , Supervivencia sin Enfermedad , Femenino , Reacción a Cuerpo Extraño/diagnóstico , Reacción a Cuerpo Extraño/diagnóstico por imagen , Reacción a Cuerpo Extraño/cirugía , Humanos , Masculino , Infecciones del Sistema Respiratorio/diagnósticoRESUMEN
A 15 x 15 cm mass in the right hemithorax of a 25-year-old woman was incidentally detected at routine chest radiography. Radical excision of the bony chest wall, including right CII-VI, revealed chondrosarcoma. Large, expansile parosteal chondromas were radiographically visualized in the pelvis and bones of the lower leg, representing Ollier's disease. Chondrosarcoma of the chest wall appears to be rare in Ollier's disease.