RESUMO
AIM: The aim of this article was to determine sentinel lymph node (SLN) identification rate (IR) using Patent Blue V in patients with non-small cell lung cancer (NSCLC) and to evaluate the accuracy of SLN for the presence of mediastinal metastasis. METHODS: Between 2004 and 2006 the data from 32 patients with clinical stage IA to IIB, who underwent lung resection for NSCLC, were prospectively analyzed. Patent blue V dye was injected in the peritumoral tissue, and the first lymph node to stain was identified as a sentinel node. RESULTS: SLN was identified in fifteen patients (IR=46.9%). SLN with metastatic involvement was observed in four patients. Accuracy, sensitivity and specificity of the sentinel lymph node in predicting the status of other mediastinal lymph node stations were respectively 86.7%, 100%, and 84.6%. In 63.1% patients, the SLNs corresponded to the lymph node stations 10 and 11. In seven patients (36.9%), the SLNs were located in the N2 stations. CONCLUSION: Although the use of Patent Blue V for SLN identification is feasible, this technique presents relatively low identification rate. The major difficulty on the detection of SLNs was the black coloration of the lymph node, which interfered with the visualization of the dye.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/cirurgia , Corantes , Cuidados Intraoperatórios , Neoplasias Pulmonares/cirurgia , Metástase Linfática/diagnóstico , Biópsia de Linfonodo Sentinela , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/secundário , Estudos de Viabilidade , Feminino , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/secundário , Masculino , Mediastino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Seleção de Pacientes , Estudos Prospectivos , Sensibilidade e EspecificidadeRESUMO
Peripheral bronchial carcinoids are uncommon. Their presentation as synchronous tumors is rare and limited to anecdotal cases.We report the case of a 62-year-old female with the radiological finding of multiple bilateral nodular lesions. Bilateral sequential thoracotomies were performed and all three nodules were treated by sublobar resections. Pathological examination revealed all specimens to be carcinoid tumors and subsequent investigation confirmed the lung as the primary site. A review of previous cases of multiple carcinoids is presented and the particularities of their management are discussed.
Assuntos
Neoplasias Brônquicas/patologia , Tumor Carcinoide/patologia , Neoplasias Primárias Múltiplas , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/cirurgia , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Pessoa de Meia-Idade , Toracotomia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We reviewed the frequency and type of fungal infections in patients undergoing lung transplantation at Pavilhäo Pereira Filho Hospital between may 1989 and january 1995. Among the 42 lung transplant recipients studies, 17 ( 40 por cento ) had histologic diagnosis of fungal infection: aspergillosis 8 casos, candidosis 6 cases, and aspergillosis combined with candidosis 3 cases. Among all fungal infections, 47 por cento ( 8 of 17 cases ) occurred in the first month after transplantation, and 82 por cento occurred within the first six months after the transplant. The diagnosis was done during life in candidosis in 77 por cento of patients by transbronchial biopsy. However, aspergillosis was revealed in autopsy material in 82 por cento of cases. Most of the patients with candidosis had a local infection in the transplanted lung. On the contrary, in aspergillosis patients 88 por cento had the mycosis in the native lung