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Biomedical subjects

W N Sinner

Publications and source records attributed to W N Sinner.

At least 19 recordsLinked to original sources
PubMed1988

Triple fine-needle biopsy of Kulchitsky cell carcinomas I, II (bronchial adenomas).

All bronchial adenomas (BA) or Kulchitsky cell tumours I, II, are classified by WHO as low-grade malignomas. In some cases with an established benign clinical course and stability over a period of years, the pre-operative diagnosis of a typical carcinoid (KCCI) may justify a wait-and-see approach. If surgery is indicated, local resection is feasible in place of lobectomy or pneumonectomy. In a consecutive series of thirty-two patients KCCI, II or BA were diagnosed pre-operatively by fine-needle biopsies (FNB). Samples from three different sites were obtained, permitting appropriate diagnostic management and treatment. The thirty-two BA comprised 22 typical carcinoids, five atypical carcinoids, and five cylindromas. Twenty-eight patients presented with a "benign" cytohistological and/or clinical appearance. In four out of thirty-two patients, signs of malignancy with or without metastases were present. No major complication occurred. In a five-year follow-up, 25 out of 32 patients remained alive. One patient was alive but had metastases. Three out of 32 patients with cytohistologic malignant features had died of their disease. In four out of 32 patients the cause of death was not attributed to neoplastic disease.

Adenoma↗
PubMed1985

Directed fine needle biopsy of anterior and middle mediastinal masses.

Mediastinal masses are seldom detected early by conventional radiography since density differences between mediastinal tissues often are inconspicuous. With CT mediastinal masses may be recognized more easily and their localization and relationship to other organs as well as their site of origin and extension is revealed. Sometimes clues to the type of tissue, of which they consist, may be obtained, but their specific histology often remains unclear. Definitive therapy depends on accurate tissue diagnosis of both benign and malignant masses. Fine needle biopsy (FNB) satisfies all the requests for accurate patient management and therapy. A presentation of 76 cases of a wide variety of anterior and middle mediastinal masses diagnosed by FNB, using different approaches, is given. The technique, results and complications are discussed.

Biopsy, Needle↗
PubMed1985

The direct approach to posterior mediastinal masses by fine-needle biopsy.

Fine-needle biopsy (FNB) is helpful in establishing an accurate cyto-histopathologic diagnosis of posterior mediastinal masses, which, on conventional radiography and with other imaging methods, may remain unclear. By doing so it initiates adequate patient management and therapy in the interest of improved prospects of cure. FNB was carried out in 55 patients with a wide variety of posterior mediastinal masses. The technique included percutaneous transthoracic FNB by a direct approach as well as FNB by the paravertebral approach with or without previous mediastinography. In 28 of 55 patients a neurogenic tumor could be diagnosed; 8 of these tumors (30%) proved to be malignant. In 14 patients, cystic lesions were detected, and in 13 patients a spectrum of other changes was found. Complications were minor and not essentially different as compared to the total material of 2,726 patients with 5,300 FNBs, with the exception that fewer pneumothoraces occurred (10 vs. 27%). In 2 patients, treatment was necessary (one suction by needle and one chest drainage). In the rest of the patients, observation during the post-biopsy period was utilized and the clinical follow-up was unremarkable.

Adult↗
PubMed1985

Importance and value of a preoperative diagnosis in oat cell carcinoma by radiography and its verification by fine needle biopsy (FNB).

Surgical resection currently offers the best hope of cure in Non Small Cell Lung Cancer (NSCLC), while chemotherapy and/or radiotherapy is the primary choice for Small Cell Lung Cancer (SCLC). The preoperative diagnosis of small cell anaplastic carcinoma (oat cell carcinoma) therefore is extremely important for adequate patient management treatment and prognosis. The patients history, clinical findings and radiographic patterns are all important for the differential diagnosis of SCLC (oat cell cancer) constituting a clinical, radiological and histopathological entity. FNB is a minor, fast, safe, inexpensive procedure, which is easy to perform, not uncomfortable for the patient and which, due to high accuracy may confirm or exclude SCLC (oat cell cancer). Major surgery with its inherent risk of morbidity/mortality may such be avoided allowing to choose the optimal and most appropriate form of alternative treatment permitting a high quality of life during the course of the disease. In a series of 2726 patients with 5300 FNB, of which 1264 (46%) showed evidence of malignancy SCLC (oat cell carcinoma) was cytologically diagnosed in 54 cases (6%). No serious complication occurred.

Adult↗
PubMed1984

Fine needle biopsy of solitary pulmonary metastasis.

When a nodule which is increasing in size is detected on a chest radiograph the question arises whether it is a primary or metastatic tumour. Experience has shown that the removal of a singular metastasis of an extrapulmonary tumour has a 5-year survival of about 25-30%, if the primary tumour is removed as well. The cytologic results of fine needle biopsy may give clues for the possible localization of the primary tumour. A selective search is then justified and may be rewarding. In 30 cases of 48 pulmonary lesions the cytological and histological results of the operative specimen were compatible with solitary lung metastasis of an extrapulmonary primary tumour. In 18 of 48 cases there was strong evidence for a second primary lung tumour. Fine needle biopsy helps clarify the nature of the lesion and may also give information regarding the site of the extrapulmonary primary tumour. This is important for patient management, therapy and prognosis.

Adenocarcinoma↗
PubMed1983

Fine needle biopsy of tuberculosis coexistent with carcinoma of the lung.

In 62 cases (out of 2726 cases with 613 inflammatory lesions of which 303 showed evidence for specific infection) pulmonary tuberculosis coexistent with lung cancer has been diagnosed by radiography and fine needle biopsy. There was a considerable sex predominance of elderly men. In cases with lung cancer superimposed on pulmonary tuberculosis, there is frequently a delay in the diagnosis of the carcinoma, especially with active tuberculosis. A known diagnosis of tuberculosis dominates the clinical findings to such a degree, that signs of a coexisting carcinoma are overlooked, since all symptoms may be explained by the inflammatory process alone. When the diagnosis is finally made it is too late for a curative therapy. Fine needle biopsy may be helpful in clarifying the dual nature of this process earlier, such making higher prospects for curative treatment possible.

Adult↗
PubMed1983

Fine needle biopsy of double or multiple primary carcinomas of the lung.

Any pulmonary mass discovered after obvious successful surgery for bronchogenic carcinoma has to be suspected of potentially being a second primary cancer of the lung. "Recurrent" carcinoma in a bronchial stump may not be a continuation of the original tumor, but a new primary. Early recognition is important for patient management, therapy and prognosis, since curative resection of the second primary may still be feasible. Fine needle biopsy may be helpful in obtaining an early cytological and histological diagnosis and be decisive for specific treatment with improved prospects of cure. Fourty-eight patients, who underwent thoracotomy for a synchronous or successive mass in a patient with successfully removed bronchogenic carcinoma diagnosed by fine needle biopsy, showed a second primary carcinoma of the lung in 18 cases, while 30 cases showed evidence of metastatic disease.

Aged↗
PubMed1982

Needle biopsy and tumor staging (TNM-system).

Needle biopsy is helpful in classifying pulmonary neoplasms according to the TNM-system. A population of 2726 patients is described in which needle biopsy differentiated between neoplasm and inflammatory disease. In the subgroup of patients with neoplasms (46%) TNM-staging was established by needle biopsy. Extrapolation of these results aided in deciding whether the diagnosed lesions were operable or inoperable. Needle biopsy is also helpful in establishing the diagnosis of oat cell carcinoma. For all practical purposes this is an inoperable lesion. The patient may such be saved unnecessary thoracotomy; an alternative treatment of surgery i.e. radiotherapy and/or chemotherapy is then available. Finally, the combination of needle biopsy with subsequent TNM-staging is useful as a prognostic device.

Actinomycosis↗
PubMed1982

Fine-needle biopsy of hamartomas of the lung.

Hamartomas are unexpectedly detected in asymptomatic patients, in mass surveys, general health examinations, and chest radiographs for other reasons. They often present a difficult problem both for the radiologist and the referring clinician, as their differentiation from lung carcinoma or a metastasis may be impossible by radiography. Although the typical radiographic appearance of a well circumscribed, solitary, lobulated nodule smaller than 4 cm in diameter with popcorn calcification permits confident recognition, most hamartomas present as noncharacteristic nodules. Some authors, therefore, recommend thoracotomy for a definitive diagnosis. Needle biopsy was helpful in this study for diagnosis in 61 cases. In 42 cases, one procedure requiring two or three punctures was sufficient to obtain the diagnosis; in 17, two procedures (one to three punctures) were required; and in two, three procedures were necessary. Of 61 cases, surgery was performed in 20. The histology of the surgical specimen confirmed the diagnosis except in two cases, in which a benign fibroma and a benign chemodectoma were found. The 5 year follow-up of the 41 cases not operated on showed no evidence of malignancy.

Adult↗
PubMed1982

Computed tomography of pulmonary thromboembolism.

Twenty-one consecutive cases of clinically suspected pulmonary thromboembolism were investigated by radiographic studies, isotopic lung scans and computed tomography. As early as 1976 in 17 of 21 cases morphological details were found not recognizable on lung radiographs but visualized on CT scans. This included peripheral changes (e.g. wedge-shaped densities with its broad base against a peripheral pleural surface and with its tip pointing to the parahilar area) suggesting pulmonary infarction and central defects consistent with central embolic masses or thrombi in pulmonary arteries of 1st through 3d order. This material is unique since it-to our best knowledge-represents the first indirect and direct visualization of pulmonary thromboembolism and infarction made by CT.

Adult↗
PubMed1981

The gastrointestinal tract as a vehicle for drug smuggling.

Four cases of attempts to smuggle narcotics (marijuana, heroin, and cocaine) by swallowing a large number of drug-filled foreign bodies (condoms and capsules) and hiding them from customs authorities in the gastrointestinal canal during transit are described. This is compared with a psychiatric patient who swallowed 48 Vicks Inhalers. Drug smuggling by swallowing condoms or capsules containing narcotics is now a worldwide ethical-legal problem. It also is of therapeutic and prognostic importance as this may lead to such emergencies as mechanical obstruction, rupture of the drug-containing foreign bodies, and life-threatening intoxication of the carrier.

Adult↗
PubMed1981

Computed tomography of "pleuroma"--a cancer mimicking atelectatic pseudotumor of the lung.

Characteristic radiographic features of "pleuroma"--an atelectatic pseudotumor of the lung, have previously been described. Knowledge of the existence of this lesion and its appearance is necessary if confusion with lung carcinoma is to be avoided. In a remarkable case these factors are demonstrated. In addition to conventional chest x-rays linear tomography and computed tomography was used to confirm the diagnosis of a "pleuroma" and to exclude a suspected carcinoma of the lung. It is thought that the combination of radiographic findings and CT patterns may enhance the possibilities of identifying and confirming the lesion and be helpful in preventing morbidity and mortality by preventing unnecessary invasive tests and/or surgery.

Aged↗