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At least 55 records · Page 3Linked to original sources
PubMed2002

[Endoscopic ultrasonography guided fine-needle aspiration in diagnosis of lung neoplasm and mediastinal lymph node metastasis].

OBJECTIVE: To access the feasibility, safety and accuracy of endoscopic ultrasonography guided fine-needle aspiration (EUS-FNA) in patients with suspected lung neoplasm and metastatic mediastinal lymph nodes. METHODS: Using a linear array scanning endosonography (Pentax FG32-UA) and a 22-guage GIP (Medi-Globe) needle, we performed EUS-FNA in 10 patients including 6 patients with lung mass and enlarged mediastinal lymph nodes, 1 patient with a mass in the right lung, 1 patient with a mass near the esophagus, and 2 patients with extensive enlarged mediastinal lymph nodes. The data collected included lesions types, complications and diagnostic accuracy. RESULTS: EUS-FNA revealed small cell carcinoma in 5 patients, squamous cell carcinoma in 1, adenocarcinoma in 1, and benign lymph nodes in 2. Malignancy was confirmed by follow-up in 7 patients, and benign tumor was confirmed by mediastinoscopy, thoracoscopy or follow-up in 2 patients. In 1 patient, FNA sample was not diagnosed because of inadequate specimen. None of the patients had complications caused by any procedures. CONCLUSION: EUS-FNA is safe, reliable and accurate in diagnosis of suspicious lung neoplasm and mediastinal lymph node.

Adult↗
PubMed1997

Search for a primary lung neoplasm in patients with brain metastasis: is the chest radiograph sufficient?

OBJECTIVE: We assessed whether chest CT provided an advantage over chest radiography when diagnosing a primary lung neoplasm in a selected group of patients. MATERIALS AND METHODS: From a retrospective evaluation of 925 patients who had a discharge diagnosis of brain metastasis, we identified 32 patients who presented without a known primary tumor site and who were investigated subsequently with both chest radiography and CT. Reports of chest radiographs were classified as showing a primary lung neoplasm (positive), as abnormal but nonspecific, or as negative. Patients were categorized as having negative chest radiograph, negative CT; positive chest radiograph, positive CT; nonspecific chest radiograph, positive CT; or negative chest radiograph, positive CT. Radiographic technique and clinical and lesion characteristics were compared among these categories. RESULTS: We found negative chest radiograph and negative CT in one patient who ultimately proved to have breast cancer. The remaining 31 patients (97%) had primary lung carcinoma. In 19 (59%) of the 32 patients, chest radiographs and CT were positive. Twelve patients (38%) had a nonspecific or negative chest radiograph and positive CT. In the 31 patients with lung carcinoma, the mean diameter of lesions in patients with positive chest radiographs was 4.2 cm, compared with 2.5 cm in patients with normal or nonspecific radiographs (p < .01). CONCLUSION: Lung cancer is by far the most common cause of a de novo presentation with brain metastasis. Chest CT is valuable to supplement chest radiography in patients with metastatic brain disease in whom a primary lesion is sought. Lesion size appears to be the most important determinant of detectability of a primary tumor on chest radiographs.

Brain Neoplasms↗
PubMed1995

Low frequency of alterations in p53, K-ras, and mdm2 in rat lung neoplasms induced by diesel exhaust or carbon black.

Inhalation of diesel exhaust (DE), which contains soot particles with adsorbed mutagenic organic compounds, and its virtually mutagen-free soot particle analog, carbon black (CB), produce similar types and prevalences of pulmonary neoplasms in chronically exposed F344 rats. This result suggests that DE-induced neoplasia develops from the effects of a high lung burden of carbonaceous particles rather than from the genotoxicity of organic constituents. In this investigation, pulmonary carcinomas from rats exposed to DE or CB were analyzed for alterations in K-ras and p53 to determine if mutations caused by these agents are also similar. K-ras and p53 were chosen for this study because mutation patterns of these genes in lung neoplasms have been associated with specific exposures. A low frequency (3/50) and variable pattern of activating mutations were identified in codons 12 and 61 of the K-ras gene. Immunoreactive levels of p53 protein, suggesting gene dysfunction, were present in 7/13 squamous cell or adenosquamous carcinomas, regardless of the associated exposure. However, single-strand conformational polymorphism analysis and direct sequencing of p53 did not detect any mutations in these neoplasms. No immunoreactivity or mutations in p53 were observed in adenocarcinomas. The increased level of p53 protein in the squamous carcinomas is not explained by stabilization by the mdm2 gene product, because this protein was not overexpressed based on immunohistochemical analysis. No pattern of mutation was detected that would suggest a differential mechanism of carcinogenicity between DE and CB; however, inactivation of the p53 pathway may have a role in the development of rat lung neoplasms with a squamous cell carcinoma component.

Adenocarcinoma↗
PubMed2004

Radiofrequency thermal ablation of 69 lung neoplasms.

Radiofrequency thermal ablation (RFA) is a new, minimally invasive technique offered in the treatment of various neoplasms. RFA produces ionic agitation within the area to be treated, resulting in the heating of neoplastic tissue using a radiofrequency generator. Well defined areas of coagulative necrosis are formed, thereby destroying the tumor. Percutaneous CT-guided RFA was performed in 34 patients with 69 lung neoplasms. Six patients were affected by primary Non-Small Cell Lung Cancer (NSCLC), and 28 patients presented with metastatic lung nodules originating in various solid tumors. Patients were considered ineligible for surgery for the following reasons: medical comorbidities; technical reasons; severe respiratory insufficiency; refusal of surgery. Adequacy of treatment was assessed by CT-Scan and Nuclear Magnetic Resonance (NMR) with gadolinium. A median follow-up of 9 months (3-25 months) resulted in 30 patients evaluable for response with a total of 63 nodules to be treated, 58 of which achieved complete necrotic response. Relapse occurred in 5/63 treated nodules. In 2 of these patients, relapse occurred exclusively in the treated nodules, whereas in the other 3 patients, relapse occurred in the treated nodules as well as at distant sites. 9 patients are alive and disease free. Pneumothorax requiring pleural drainage was the main complication, observed in 16% of the treatment sessions. Lung RFA has shown itself to be a safe and feasible option in the treatment of lung neoplasms in patients otherwise ineligible for surgery. The high rate of complete responses obtained in our study (92%) suggests that further investigation of lung RFA, combined with chemotherapy and/or radiation therapy is warranted with the objective of improving local disease control and survival rates.

Adult↗
PubMed1996

Bronchoscopic, photodynamic, and laser diagnosis and therapy of lung neoplasms.

The use of lasers in the diagnosis and treatment of lung neoplasms has just surpassed a 20-year experience. This paper reviews recent developments in the use of lasers in the palliative treatment of advanced tracheobronchial tumors and pleural mesothelioma. The role of bronchoscopic laser therapy relative to other endobronchial treatment modalities such as stent placement and brachytherapy is presented. Finally, the potential use of lasers in photodetection and curative treatment of early lung cancer is discussed.

Brachytherapy↗
PubMed1992

Tumor emboli from lung neoplasms involving the pulmonary vein.

Systemic tumor embolization during pulmonary resection for lung neoplasms is an uncommon but potentially catastrophic complication. In recent months, two patients undergoing pulmonary resection for bronchogenic carcinoma were found at operation to have tumor extending into a pulmonary vein. Both patients had systemic tumor embolization, one with a fatal outcome because of occlusion of the superior mesenteric artery. The possibility of systemic tumor embolization should be considered in patients with large, central tumors and particularly those that abut the pulmonary veins. The implications of such pulmonary vein involvement is reviewed, and an algorithm for postoperative evaluation and management of these patients is presented.

Aged↗
PubMed1996

[Evaluation of the usefulness of palpation and Daniel's biopsy for detection of metastasis to supraclavicular and scalene lymph nodes in patients with lung neoplasms].

In 169 patients with lung cancer the usefulness of physical examination and Daniel's biopsy in detection of metastases to supraclavicular and scalene lymph nodes were evaluated. In 35 patients with palpable lymph nodes and in 25 patients with nonpalpable lymph nodes metastases were confirmed by histological examination. The sensitivity, the specificity and the likelihood ratio of physical examination in detection lymph nodes metastases were respectively: 58%, 86% and 4.1. In 6 patients (5%) among 119 with nonpalpable lymph nodes the positive Daniel's biopsy was the diagnostic procedure. In 5 patients with non-small carcinoma and in 3 patients with malignant mesothelioma positive results of Daniel's biopsy enabled a change of cancer staging and giving up the eventual surgical operation.

Adult↗
PubMed2001

Unusual primary lung neoplasms.

Bronchial carcinoids and hamartomas are, respectively, the most common malignant and benign unusual primary lung neoplasms. These tumors are often asymptomatic but can cause central airway obstruction. Helical computed tomographic and radionuclide scintigraphic advances in their detection and evolution, together with newer interventional bronchoscopy techniques such as neodymium:yttrium-aluminum-garnet laser phototherapy and cryotherapy, represent important improvements in the diagnosis and management of patients with such tumors.

Female↗
PubMed2003

A review of intractable facial pain secondary to underlying lung neoplasms.

We describe a 63-year-old smoker who suffered from intractable facial pain secondary to an underlying lung neoplasm. Data from 30 previously reported and similar cases are also summarized. The clinical triad of a smoker suffering from periauricular pain and an elevated ESR should alert the clinician to the possibility of an occult lung mass. In these cases a computed tomography of the chest should always be obtained. Previously refractory pain typically responds to surgical resection of the mass and/or radiation therapy.

Carcinoma, Non-Small-Cell Lung↗