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Biomedical subjects

M A Luna

Publications and source records attributed to M A Luna.

13 recordsLinked to original sources
PubMed1979

Methotrexate-induced diffuse interstitial pulmonary fibrosis.

Three patients received respectively 190 mg, 175 mg, and 196 mg of methotrexate and developed bilateral pulmonary infiltrates without evidence of peripheral blood eosinophilia. Sputum in the three cases failed to reveal acid-fast bacilli, pathogenic fungi, or opportunistic organisms by cultures and appropriate stains. Despite discontinuance of the drug and/or institution of corticosteroid therapy, progressive respiratory failure led to death. In all three cases, autopsy revealed gross and microscopic features indistinguishable from those seen in the Hamman-Rich syndrome, and methotrexate hepatotoxicity was present in one. Pulmonary eosinophilia or granulomas, classically seen in previously reported cases of methotrexate pneumonitis, were not observed. It is suggested therefore that methotrexate be added to the list of agents capable of inducing diffuse interstitial pulmonary fibrosis. Conversely, diffuse interstitial pulmonary fibrosis should be considered in the differential diagnosis of patients receiving methotrexate who develop bilateral pulmonary infiltrates seen on chest roentgenograms.

Aged↗
PubMed1978

Calcinosis in nonparathyroid malignant disease: an unusual case report and clinicopathologic review of 17 cases.

An unusual finding of systemic calcinosis in a patient with a nonparathyroid malignant neoplasm stimulated us to do a sclinicopathologic review of similar cases at our institution in the past seven years. Of 3,268 autopsies performed from 1968 to 1975, a total of 17 cases of calcinosis were found, 11 with solid tumors and 6 with hematopoietic neoplasms. Calcinosis was most prominent in the lung, kidney, heart, and stomach and was rarely discovered prior to death. Eighty-two percent of the patients had hypercalcemia and 53% had associated bony metastatic disease. Corticosteroid or phosphate treatment for the hypercalcemia may have contributed to the tissue deposition of calcium. Significant hepatic, renal, metabolic, and pulmonary dysfunctions were also associated with this disorder. Thirty-six percent of the patients had hypercalcemia without skeletal involvement; tumor-produced parathormone-like substances may be responsible for these calcium abnormalities. Calcinosis was a significant complication of neoplastic disease in these patients and contributed to morbidity and mortality.

Adolescent↗
PubMed1978

Bleomycin hypersensitivity pneumonitis.

Three patients developed radiologic and functional pulmonary changes after bleomycin therapy similar to ones previously associated with administration of this drug. However, biopsy specimens showed a pattern consistent with hypersensitivity pneumonitis rather than the interstitial pneumonia usually reported in bleomycin pulmonary toxicity. There was a patchy eosinophilic infiltrate surrounding small airways and distal air spaces, but no immune deposits were noted by ultrastructure or immunofluorescence using conventional techniques and a specific antibody against bleomycin. Two of the patients had peripheral eosinophilia of 12% and 16%. All three patients showed considerable improvement on chest roentgenogram after corticosteroid treatment. Our findings are consistant with the view that bleomycin hypersensitivity pneumonitis has a different pathogenesis than bleomycin interstitial pneumonitis. Its recognition as a separate entity seems warrnated because of the favorable response to steroid therapy.

Adolescent↗
PubMed1978

Adriamycin and mitomycin C: possible synergistic cardiotoxicity.

Ninety-one patients with advanced breast cancer failing adriamycin (ADR)-containing combination chemotherapy were treated with a combination of mitomycin C (MMC) and megestrol acetate. Congestive heart failure (CHF) occurred in 14 (15.3%) of 91 MMC-treated patients compared to three (3.4%) of 89 patients treated with similar ADR-containing combination chemotherapy without MMC (P = 0.01). The median time from the last dose of ADR to evidence of CHF was 8.5 months for the MMC group compared to 1.5 months for the other group. A significantly higher incidence of late onset of CHF implicates MMC as a possible cardiotoxic agent.

Adult↗
PubMed1977

Malignant salivary gland neoplasms of the lip.

The charts of fourteen patients with malignant salivary gland tumors of the lip were reviewed. These patients represented 1 per cent of all patients seen during this same period of time with malignant salivary gland tumors. No specific etiologic factors were implicated except that the tumors occurred predominantly in white males. The overall results of treatment were poor, perhaps secondary to delay in diagnosis, very biologically aggressive tumors, or inadequate or improper treatment. Hopefully, the 20 per cent survival can be improved with planned combined sequential surgery and radiation in those selected high risk patients.

Adenocarcinoma↗
PubMed1977

Desquamative interstitial pneumonia-like reaction accompanying pulmonary lesions.

Six patients with specific pulmonary diseases had pulmonary tissue surgically resected for diagnostic purposes. All six cases were characterized by space-occupying lesions surrounded by a peculiar reaction of the pulmonary parenchyma indistinguishable from desquamative interstitial pneumonia. If small biopsies from these areas had been taken, a diagnosis of desquamative interstitial pneumonia would have been made, and the underlying process would have gone undetected. These cases corroborate even further the concept that desquamative interstitial pneumonia is a pattern of pulmonary reaction, rather than a well-defined disease entity. Furthermore, it seems advisable to make the dianosis of desquamative interstitial pneumonia only when other conditions have been carefully ruled out by thorough clinical and pathologic investigations.

Adult↗
PubMed1976

Germ-cell tumors of the mediastinum, postmortem findings.

Autopsy findings in 20 cases of clinical extragonadal germ-cell tumors arising in the anterior mediastinum are presented. The histologic types were: 2 choriocarcinomas, 3 seminomas, 3 malignant teratomas, 3 embryonal carcinomas, and 9 mixed germ-cell tumors. All of the patients were men, and the ages ranged from 14 to 45 years, with a mean of 32.5 years. The mean survival for these patients after diagnosis was 10.9 months. Local recurrence was characteristic of non-seminomatous tumors. In patients with seminoma, local control of the disease was good, but distant metastases were the cause of death. The most frequent sites of metastases were lungs, bones and liver. In all 20 cases, the testes were carefully step-sectioned. Occult tumor was found in only one case of embryonal carcinoma and a well-defined testicular scar with calcification in a patient with choriocarcinoma. Both patients had lower retroperitoneal metastases. These findings support the premise that, in the majority of cases, these tumors had a primary extragonadal origin.

Adolescent↗
PubMed1975

Aggressive surgery in treatment for parotid cancer: the role of adjunctive postoperative radiotherapy.

A 7 year follow-up of 120 patients with malignant parotid cancers revealed parotidectomy to be an adequate procedure for low-grade, nonaggressive lesions. The addition of radiation therapy postoperatively will improve local and regional control of high-grade, aggressive lesions. Postoperative radiation therapy may also make the removal of the facial nerve unnecessary in certain clinical presentations.

Adenocarcinoma↗