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D Szymańska

Publications and source records attributed to D Szymańska.

At least 19 recordsLinked to original sources
PubMed1996

[Pulmonary embolism in malignancy of the lung: a retrospective clinical evaluation and pathomorphologic personal material].

The incidence and clinical significance of pulmonary embolism (PE) in pulmonary malignancy were analysed among 111 autopsy cases including: 65 primary and 24 metastatic lung cancer, 8 hematological malignancies and 14-malignant pleural mesothelioma. In 34 (31%) cases PE was found, in 4 (12%) patients cancer tissue emboli was documented. In nonsmall cell lung cancer the frequency of PE was 40%, compared to 24% in small cell, 25% in metastatic lung cancer and 14% in mesothelioma. Deep venous thrombosis of lower extremities was the source of thrombotic material in 35% cases. In remaining cases the sources of thrombotic material were different (caval vein inferior, superior, and their main branches, right heart cavities, pulmonary artery). In 8 patients with PE the acute form of DIC was observed. In 15 (44%) patients the clinical ante mortem diagnosis of PE was done. In 26% of all analysed cases PE was the direct cause of death. We concluded that PE is a frequent and dangerous complication of lung neoplasms. Clinical diagnosis can be extremely difficult.

Adenocarcinoma↗
PubMed1995

Tuberculosis in the autopsy material: analysis of 1500 autopsies performed between 1972 and 1991 in the Institute of Tuberculosis and Chest Diseases, Warsaw, Poland.

SETTING: The present study is based on 1500 autopsies done in the Institute of Tuberculosis and Chest Diseases Warsaw, Poland during the years 1972-81 and 1982-91. OBJECTIVE: To assess the correctness of tuberculosis diagnosis before death in the above mentioned time periods. DESIGN: The autopsy reports were examined for the diagnosis of active tuberculosis proved by microscopy. The form and localisation of tuberculosis was assessed. The postmortem diagnosis was compared with clinical diagnosis. In those cases in which tuberculosis was not recognised before death the possible causes of this failure were analyzed. RESULTS: Active tuberculosis was found in 119 cases, 7.9% of all autopsies. It was localised in the lungs exclusively in 72 cases, in lungs and in extrapulmonary sites in 45 and in extrapulmonary sites only in 2. The frequency of active tuberculosis was the same for the two periods under evaluation. Tuberculosis was however not recognised before death in a much higher proportion of cases in 1982-92 (54%) than in 1972-81 (24%). The main cause of diagnostic failure was connected with atypical localisation of lesions on chest X-ray and with dissemination outside the lungs. Previous tuberculosis was a factor which facilitated the diagnosis of tuberculosis. CONCLUSIONS: In parallel with the decline of tuberculosis incidence in Poland, many doctors lack experience in diagnosing this disease, especially in cases with atypical X-ray presentation and with extrapulmonary localisation. This may lead to late or even very late diagnosis and have a significant impact on the epidemiological situation.

Adolescent↗
PubMed1995

[Langerhans Cell Histiocytosis in adults].

Five cases of Langerhans' cell histiocytosis in adult patients were reviewed. Signs, symptoms, the course of the disease and methods of treatment were presented. Results of tests, including results of organ biopsies that provided definitive diagnosis in most cases, were also analysed.

Adult↗
PubMed1994

Risk of late recurrence and/or second lung cancer after treatment of patients with small cell lung cancer (SCLC).

The aim of this study was to illustrate some difficulties in distinguishing late recurrence of small cell lung cancer (SCLC), from second primary lung cancer. Three-hundred fourteen SCLC patients were observed at the Institute of Tuberculosis and Chest Diseases in Warsaw, during the period 1976-1985. All patients were treated with chemotherapy and 125 were also treated with radiotherapy on the tumour and mediastinum. Nineteen patients (6%) survived 3 years. This group consisted of eight females (9%) and 11 males (5%). In all of them a complete remission was obtained. In six patients from this group no progression of lung cancer was observed. Four of them are still living, 7.9-16.2 years after the start of treatment. Two patients died of heart infarct. In the remaining 13 patients, progression of SCLC or development of new cancer was noted in the course of observation. In seven of them, histological proof of the character of progression was obtained. In four cases non-small cell lung cancer (NSCLC) was diagnosed after 3-11 years of observation. In one of them SCLC metastases in the liver were unexpectedly found in the autopsy, although adenocarcinoma in the lung diagnosed during bronchoscopy was also confirmed in the autopsy. In three cases SCLC was diagnosed. In one case, 2.7 years from the beginning of treatment, only SCLC metastases were found during laparoscopy. SCLC was found in two other cases after a 7-year cancer-free period. In one of those patients, a new lesion was found in the other lung while the second patient developed a new lesion exactly in the place of the former cancer. In six other patients no histological proof of the character of progression was obtained. Two of the six are still living, 8.2 and 15.1 years later. In the first of these two, a new lesion developed very early in the course of treatment in the same place as the primary tumour and it was regarded as the progression of SCLC. In the second patient, who probably had NSCLC the lesion developed in the contralateral lung after 12.5 years of remission and disappeared after radiotherapy. Four patients died of cancer after 3.2-6.4 years of observation. The cumulative risk of a second primary lung cancer after a 3-year survival period oscillated in our SCLC patients between 4% and 6% for every patient/year of observation. It was concluded that prognosis in SCLC patients is still doubtful, nevertheless, some patients made a complete recovery.

Adult↗
PubMed1994

[The role of pleural needle biopsy and determination of Carcinoembryonic antigen in pleural fluid for diagnosing the etiology of pleural effusion].

Results of histopathological and bacteriological examinations of specimens taken in 213 patients with pleurisy by Abrams' needle biopsy of parietal pleura were presented. Malignant cells were found in histological survey of excisions from pleura in 48/128 patients with final diagnosis of cancer (37.5%). The same examination accompanied by bacteriological survey led to establish proper diagnosis in 41/60 patients with pulmonary tuberculosis (68.3%). In 31 patients with cancer pleural fluid was searched for concentration of the carcinoembryonic antigen (CEA). In this group, in 7/19 patients with negative histological results of pleural biopsy CEA concentrations were markedly increased. This finding strongly supported further searching for malignancy in those cases. Finally, the diagnosis was established due to the pleural needle biopsy in 89/213 patients (41.8%).

Adolescent↗
PubMed1993

[Significance of bronchoscopy in the early phase of chemotherapy in patients with small cell lung carcinoma for assessment of tumor regression and prognosis].

70 SCLC patients (pts): 25 women and 45 men aged 34 to 76 with limited disease were treated with chemotherapy in Institute of Tuberculosis in the period 1.01.1987-31.12.1992. After 3-5 courses of chemotherapy restaging was done using chest X-ray examination, bronchoscopy with cytological examination of bronchial material, abdomen ultrasound examination and other methods according to clinical indications. Complete regression (CR) of the tumor in chest X-ray examination was found in 17 cases, partial regression (PR) in 37 cases and no response (NR)-in 16 pts. The degree of tumor regression on chest X-ray had significant prognostic value. The median survival time in this group was 20 months while median was 13.5 months in PR patients group and 11.5 in NR patients. Bronchoscopy revealed macroscopic or microscopic signs of cancer in 5 of 17 pts with CR on chest X-ray examination, in 23 of 37 cases with PR on X-ray and in 12 of 16 with NR on X-ray. The persistence of tumor signs in bronchoscopic examination seemed to worsen the prognosis in pts with CR on chest X-ray. Complete regression of tumor revealed during bronchoscopy did not have any prognostic significance if CR on the chest X-ray was not obtained. It was concluded that bronchoscopic examinations in early phase of chemotherapy is useful to further treatment planning only in these pts in whom CR of tumor on chest X-ray examination was confirmed.

Adult↗
PubMed1993

[Correlation between chest examination with radiography, bronchoscopy and cytology of bronchial alveolar lavage in patients treated for small cell lung cancer].

In 129 SCLC patients (pts) 250 control fibrobronchoscopic (FOB) procedures were performed during chemotherapy. 71 pts had extensive disease and 58 limited disease. The evident correlation between radiologic and bronchoscopic assessment of tumor regression was confirmed in 60% of examinations. Tumor was visible during 16 bronchoscopic examinations in spite of complete regression on X-ray picture and on 53 chest X-ray examinations despite complete regression in the bronchi. Cancer cells found in 74 out of 250 bronchial washings samples were present significantly more often in these situations in which no regression of tumor in the bronchi was confirmed. Nevertheless tumor cells were also found in 3 out 57 cases in which complete regression on X-ray and in the bronchi was found. It was concluded that complete tumor regression on X-ray picture ought to be confirmed by bronchoscopy with cytologic examination of bronchial washing.

Adult↗
PubMed1993

[Tuberculosis as a cause of death in patients treated in the institute of tuberculosis in 1976-1991].

This study aimed at assessing the reasons why tuberculosis-which can be successfully treated today-is still the cause of death in some patients treated at the Institute of Tuberculosis in the last 15 years. The material consisted of clinical documentation and the results of autopsy of 30 patients who died of tuberculosis between 1976-1991. It was found that 19 out of 30 patients were not treated with antituberculous drugs or were treated only during few days because tuberculosis was diagnosed too late (in 15 patients after death). In 6 patients the treatment failed due to side effects of drugs and in 5 immunosuppressed patients, disease progressed despite the treatment. Difficulties in tuberculosis diagnosis were caused by atypical appearance of the disease in the chest X-ray (localization in the middle and lower lobes in 15 cases, absence of cavities in 22 cases) and in the extrapulmonary regions (11 cases). The main obstacle was the failure to cultivate tubercle bacilli from numerous specimens of the sputum in 10 out of 23 patients in whom the cultures were done.

Adult↗
PubMed1993

[Tuberculosis found in autopsies done in the Institute of Tuberculosis and Lung Diseases 1972-1991].

Between years 1972 and 1991 1500 autopsies were done in the Institute of Tuberculosis and Lung Diseases in Warsaw. Active tuberculosis was found in 119 cases (7.9%). 56 patients died of tuberculosis. Tuberculosis was not diagnosed during life in 37% of all cases and in 39% of that in whom it was the cause of death. Tuberculosis was undiagnosed significantly more often in the years 1982-1991 than in years 1972-1981. Tuberculosis was restricted to the lungs in 60.5% of cases, was found in the lungs and in the extrapulmonary sites in 37.8% and only outside lungs in 1.7%. This is in contrast with official polish statistics. The extrapulmonary tuberculosis was registered in only 4% of cases.

Adolescent↗
PubMed1993

[Pulmonary lymphangiomyomatosis and tuberous sclerosis--similarities and differences].

Two cases pulmonary lymphangioleiomyomatosis and tuberous sclerosis with pulmonary involvement were presented. Clinical picture of both diseases was similar. Breathlessness was the main symptom of lymphangioleiomyomatosis and there were signs of chylothorax. Chest x-ray interstitial changes disseminated in both lungs. High resolution computer tomography showed numerous cysts in both lungs. Proliferation of smooth muscle bundles was found in lung biopsy. Main symptoms of tuberous sclerosis were breathlessness on exertion and recurrent pneumothorax. Changes in chest x-ray, CT and lung biopsy were similar to found in lymphangioleiomyomatosis. Diagnosis of tuberous sclerosis was based on typical extrapulmonary signs and symptoms.

Adult↗
PubMed1993

[Usefulness of microscopic examination of bronchial cellular material for lung cancer diagnosis and determination of cell type].

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.

Adenocarcinoma↗
PubMed1992

[Pulmonary lymphangiomyomatosis].

A case of pulmonary lymphangiomyomatosis in a female during menopause is presented. Difficulties in correct histopathological assessment of lung biopsies were met. The diagnosis was made after diagnosis lymph seeping into the pleural cavity. The patient was initially treated with prednisolone, tamoxifen followed by methyl progesterone and after characterizing the patient's hormone profile with danazol. Lymph seeping to the right pleural cavity was treated with pleural drainage and diet limitations. Lymph exudate to the left pleural cavity was controlled with local cytotoxic therapy. After 7 years of therapy and 8 years since the initial symptoms the state of the patient has deteriorated although she can perform every day chores and does not require oxygen therapy. High resolution CT scan disclosed extensive pulmonary changes implying extensive progression of the disease.

Combined Modality Therapy↗
PubMed1991

[Incidence of pleural mesotheliomas in Poland (preliminary report)].

Mesothelioma is a rare malignancy, difficult to diagnose and rarely found in a population not exposed to asbestos. In the immediate past incidence rates of this disease have increased due to extensive use of this mineral in the industry of the 1950's. The aim of this study was to assess the incidence of mesotheliomas basing on results of a questionnaire posted in 1987 to all pneumonology clinics, oncological departments in Poland, and data from the Central Oncological Register from the years 1970-1985. Incidence of this malignant disease was 1-2 cases per 1,000,000 of general population during the years 1970-1985 and did not rise in 1986. Regional differences were observed, in some areas the incidence rate was 5-6 per 1,000,000. Data from the Occupational Medicine Institute disclosed in these regions more extensive industrial use of this mineral. The authors have also concluded that "at-life" diagnosis of mesothelioma rises, mainly due to the use of open pleural biopsy.

Adolescent↗
PubMed1991

["Blind" trans-bronchial biopsy of the lung in the diagnosis of interstitial lung diseases].

The aim of the study was to assess the diagnostic effectiveness and safety of "blind" transbronchial lung biopsy (B-TBLB) in interstitial lung diseases (ILD). The diagnostic yield of B-TBLB performed in 44 patients was compared with similar yield of classical TBLB carried out in 25 patients. A diagnosis was made by B-TBLB in 29 patients (65.9%) and 14 (56%) by classical TBLB. Most often sarcoidosis, allergic alveolitis, pneumoconioses were found. Side effects were seen in both groups: in the B-TBLB group in 11.4%, in patients that underwent classical TBLB in 32%. It seems that blind transbronchial lung biopsy is a safe, effective and acceptable diagnostical method of interstitial lung disorders.

Adult↗
PubMed1990

[Value of transthoracic needle biopsy of the pleura in the diagnosis of diseases of the respiratory tract].

Pleural biopsy with Abram's needle was made in 160 consecutive patients with undiagnosed pleural effusions. The sampled fluid and pleural bioptates were examined histologically, cytologically and bacteriologically. In 40 cases malignant changes were found, out of 87 with confirmed malignancy. Neoplastic cells were found in 26 patients, ovreall the diagnosis was made in 65% of lung cancer cases. Out of 41 cases of tuberculosis, pleural biopsy provided this diagnosis in 24 patients (59%). Bacteriological examination and pathological of the biopsy specimen allowed to increase the diagnostic field to 63%. Pleural biopsy did not yield any diagnosis in 9 cases of circulatory insufficiency, nor in ten patients with the following diagnoses -- pleuropneumonia, reumathoid arthritis, pulmonary thromboembolism and thoracic trauma. In 13 cases the diagnosis was not made. The diagnostic yield of pleural biopsy was similar to that reported by others. It is most valuable in cases suspected of malignancy and tuberculosis.

Adolescent↗
PubMed1990

[Lymphoid interstitial pneumonia].

Interstitial lymphoid pneumonia is a rare disease characterized by diffuse infiltration of lung tissue by lymphocytes and plasmocytes. The diagnosis can be only achieved by histopathological examination of the biopsied pulmonary tissue. It should be differentiated from malignant processes of the lymphatic system. Immunosuppression is the main line therapy, with prednisone, azatioprine and cyclophosphamide.

Aged↗