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Postgraduate Medical Journal Apr 1956
Topics: Carcinoma, Bronchogenic; Humans; Lung Neoplasms; Tuberculosis; Tuberculosis, Pulmonary
PubMed: 13388978
DOI: 10.1136/pgmj.32.366.213 -
Modern Pathology : An Official Journal... Mar 2006Pulmonary epithelium is known to undergo a preneoplastic process prior to the development of lung carcinoma. Squamous dysplasia and atypical adenomatous hyperplasia have...
Pulmonary epithelium is known to undergo a preneoplastic process prior to the development of lung carcinoma. Squamous dysplasia and atypical adenomatous hyperplasia have been identified and classified as preinvasive lesions of squamous cell carcinoma and peripheral pulmonary adenocarcinoma, respectively. However, these commonly recognized preinvasive lesions do not completely explain the development of all histological types of lung carcinoma. By examining 114 resection lung specimens, we concluded that there are four histological patterns of bronchial epithelial dysplasia based on morphological features (basal cell dysplasia, columnar cell dysplasia, bronchial epithelial dysplasia with transitional differentiation, and squamous dysplasia). The histological patterns were further characterized by immunohistochemistry. Basal cell dysplasia was focally positive for cytokeratin (CK) 17 and 10/13; columnar cell dysplasia was generally positive for CK7, 8, and 18; bronchial epithelial dysplasia with transitional differentiation had a heterogeneous immunoprofile, while squamous dysplasia was positive for CK10/13 and focally positive for CK17. Various degrees of abnormal expression of p53 and Ki-67 were found in the different types of bronchial epithelial dysplasia. The cases were divided into three groups based on degree and extent of bronchial epithelial dysplasia. By Crosstabs McNemar test, the Mann-Whitney U-test (for two independent groups), the Kruskal-Wallis one-way nonparametric ANOVA (for >2 independent groups) and Spearman correlation analysis, the degree and extent of bronchial epithelial dysplasia was shown to be positively correlated with the incidence of bronchogenic carcinoma and multifocal primary lung carcinoma (P<0.05). These findings indicated the following: (1) bronchial epithelium can develop various patterns of dysplasia with abnormal/ambiguous cell differentiation and abnormal expressions of p53 and Ki-67. Thus, these bronchial epithelial dysplastic lesions may represent a preneoplastic process. (2) The degree of bronchial epithelial dysplasia may significantly predispose individuals to bronchogenic carcinoma and multifocal primary lung carcinoma.
Topics: Adult; Aged; Bronchial Neoplasms; Carcinoma, Bronchogenic; Cell Differentiation; Epithelial Cells; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Lung Neoplasms; Male; Middle Aged; Precancerous Conditions; Respiratory Mucosa; Tumor Suppressor Protein p53
PubMed: 16415791
DOI: 10.1038/modpathol.3800553 -
Sao Paulo Medical Journal = Revista... Jul 2008Round pneumonia is a condition usually described in children, with few reports addressing adult patients. It is an oval-shaped consolidation that, due to its... (Review)
Review
CONTEXT
Round pneumonia is a condition usually described in children, with few reports addressing adult patients. It is an oval-shaped consolidation that, due to its radiological appearance, simulates bronchogenic carcinoma. Its evolution tends to be benign, although diagnostic dilemmas have sometimes required exploratory thoracotomy. Deaths caused by this condition have even been reported. To the best of our knowledge, there have been 31 previous cases of round pneumonia in adults reported in the English and Portuguese-language literature, of which only one was completely asymptomatic.
CASE REPORT
The case of a 54-year-old female patient presenting a lung mass found on routine imaging evaluation is reported. Respiratory symptoms and signs were absent, but the patient had a significant history of smoking. Her physical examination gave normal results. On chest radiographs, a mass located in the middle third of the right lung was observed. Three weeks after the initial evaluation, the patient was admitted for a complete evaluation and for staging of a pulmonary malignancy, but repeated chest radiographs showed complete resolution.
Topics: Carcinoma, Bronchogenic; Diagnosis, Differential; Female; Humans; Lung Neoplasms; Middle Aged; Pneumonia; Radiography
PubMed: 18853036
DOI: 10.1590/s1516-31802008000400010 -
The European Respiratory Journal Mar 2000Since the authors' initial experience in the surgical management of bronchogenic carcinoma in 1956, more than 40 years have passed. The purpose of this report was to... (Comparative Study)
Comparative Study Review
Since the authors' initial experience in the surgical management of bronchogenic carcinoma in 1956, more than 40 years have passed. The purpose of this report was to review the authors' data and compare the results by decade (1956-1966; 1967-1976; 1977-1986; and 1987-1996) in order to assess the changing patterns in bronchogenic carcinoma. A total of 1,597 thoracotomies have been performed. Between the first and last decades of the study, patients' mean age increased from 57 to 63 yrs, the ratio of males to females decreased from 19:1 to 3:1 and the proportion of adenocarcinoma cases increased from 10 to 34%. The operative mortality decreased from 10% in 1967- 1976 to 4% in 1987-1996 and the overall 5-yr survival improved from 27 to 36% during the same period. The rate of lobectomy progressively increased from 32% in 1956-1966 to 61% in 1987-1996, whereas that of pneumonectomy and exploratory thoracotomy decreased from 42 to 28% and from 20 to 4%, respectively. Changing patterns of patient characteristics, histology and type of surgery were associated with a constant improvement in the overall 5-yr survival. This improvement was particularly evident among patients with advanced-stage carcinoma.
Topics: Carcinoma, Bronchogenic; Female; Humans; Lung Neoplasms; Male; Middle Aged; Survival Rate; Time Factors
PubMed: 10759450
DOI: 10.1034/j.1399-3003.2000.15.19.x -
The Journal of Thoracic and... Apr 2002Lung cancer invading the chest wall without lymph node metastasis has recently been downstaged to stage IIb. To validate this reclassification, we reviewed our...
OBJECTIVE
Lung cancer invading the chest wall without lymph node metastasis has recently been downstaged to stage IIb. To validate this reclassification, we reviewed our experience with en bloc lung and chest wall resection for bronchogenic carcinoma.
METHODS
From February 1985 to November 1999, 95 en bloc lung and chest wall resections were performed on 94 patients (62 men and 32 women). The median age was 66 years (range, 38-93 years). Pancoast tumors were excluded. Factors that may affect survival were analyzed with univariate analysis, and factors found to be significant univariately were analyzed multivariately to determine whether the significant association remained after adjusting for other significant factors.
RESULTS
Presenting symptoms included chest wall pain in 42 patients, cough in 17 patients, and "other" in 16 patients. Twenty patients were asymptomatic. Ninety-two patients were current or former smokers (median pack-years, 50; range, 8-150 pack-years). Seventy-five lobectomies, 12 pneumonectomies, 5 bilobectomies, 2 wedge excisions, and 1 segmentectomy were performed. The number of ribs resected ranged from 1 to 5 (median, 3). Sixty-one patients required chest wall reconstruction (prostheses in 60 and bovine pericardium in 1). Operative morbidity and mortality were 44.2% and 6.3%, respectively. Sixty-five cancers were classified as T3 N0 M0, 16 as T3 N1 M0, and 14 as T3 N2 M0. Squamous cell carcinoma was present in 56 tumors, adenocarcinoma in 25, large cell carcinoma in 11, and "other" in 3. Follow-up was complete in 86 (96.6%) of 89 operative survivors and ranged from 1 month to 15 years (median, 19 months). Overall 5-year actuarial survival was 38.7%. Five-year survival for patients with stage IIb disease (T3 N0 M0) was 44.3% compared with only 26.3% for those with stage IIIa disease (T3 N1 M0 or T3 N2 M0, P =.0082). Women had a better 5-year survival than men (52.9% vs 31.0%, P =.0122). The best 5-year survival was observed in women with stage IIb disease (61.2%). All other variables (age, tumor size, histopathology, forced expiratory volume in 1 second, extent of operation, depth of invasion, and adjuvant therapy) did not significantly affect survival.
CONCLUSIONS
En bloc resection of lung cancer invading the chest wall is safe but associated with significant morbidity. Long-term survival is stage and sex dependent. The best survival is observed in women who have T3 N0 M0 disease (stage IIb).
Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Bronchogenic; Carcinoma, Large Cell; Carcinoma, Squamous Cell; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Lung Neoplasms; Male; Middle Aged; Minnesota; Neoplasm Staging; Predictive Value of Tests; Pulmonary Surgical Procedures; Respiratory Function Tests; Sex Factors; Survival Analysis; Thorax; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 11986594
DOI: 10.1067/mtc.2002.121159 -
The Tohoku Journal of Experimental... Oct 1982Out of 11,247 cases undergoing resectional therapy for bronchogenic carcinoma at 39 institutions, 6,348 were operated before July 1976 and the remaining 4,899...
Out of 11,247 cases undergoing resectional therapy for bronchogenic carcinoma at 39 institutions, 6,348 were operated before July 1976 and the remaining 4,899 thereafter. Analyzing both series, the following results were obtained: 1) The rate of pneumonectomies to lobectomies was 1:2.3 in the former and 1:3.9 in the latter. Pneumonectomies were more on the left side, whereas the right lobectomies were about twice as many as the left ones. 2) Postoperative empyema occurred in 180 cases (2.8%) in the former and 79 cases (1.6%) in the latter. The incidence was significantly higher in the cases of right pneumonectomy than in the cases of left pneumonectomy, and in the cases of pneumonectomy than in the cases of lobectomy. Although the incidence of postpneumonectomic empyema decreased only slightly, overall incidence decreased significantly because of marked increase of lobectomy cases. 3) Out of 180 cases of empyema in the former series, 17 died within 30 days. 4) The 5-year survival rate of the patients with empyema was 28 per cent. 5) The 5-year survival rate was 30 per cent in 93 cases of squamous cell carcinoma, 30 per cent in 50 cases of adenocarcinoma and 15 per cent in 13 cases of large cell carcinoma. There was no survivor among 7 cases of small cell carcinoma. 6) Out of 259 cases of empyema, micro-organisms were cultured in 161 cases, were negative in 20, and unknown in 78. Although various organisms were found, gram-negative bacteria and Pseudomonas were most frequently isolated, i.e. 37 per cent and 36 per cent, respectively. 7) As for the treatment of 5-year survival cases of empyema, thoracoplasty and bronchial closure were frequent as compared with open thoracic window technics such as Eloesser's and Symbas' operation. And, more than half of the cases of empyema seem to have been complicated with bronchial fistulae.
Topics: Adenocarcinoma; Bacteria; Carcinoma, Bronchogenic; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Empyema; Humans; Lung Neoplasms; Methods; Pneumonectomy; Postoperative Complications; Time Factors
PubMed: 6294915
DOI: 10.1620/tjem.138.177 -
The Tohoku Journal of Experimental... Nov 1987The present article describes the results of observations of 11 lesions in 8 cases of roentgenographically occult in situ or microinvasive squamous cell carcinoma with a...
The present article describes the results of observations of 11 lesions in 8 cases of roentgenographically occult in situ or microinvasive squamous cell carcinoma with a size of 4 X 4 mm or less which were detected by detailed histologic investigations of 59 cases of occult bronchogenic carcinoma. The 59 cases were discovered mainly by mass screening for the detection of early lung cancers using chest x-ray combining sputum cytology for heavy smokers. The resected specimens were processed with the method of serial block sectioning. All the serial blocks of these minimal carcinomas were observed in detail to confirm the presence or absence of carcinoma and of morphological changes of the bronchial epithelium contiguous to carcinoma. Adjacent to carcinoma, there were normal bronchial epithelium in three lesions, squamous metaplasia with marked atypia in four, basal cell hyperplasia in two, and markedly atypical basal cells without hyperplasia in two. An inference on histogenesis of bronchogenic squamous cell carcinoma was drawn from the detailed observations as follows: (1) A carcinoma develops in the area of squamous metaplasia with marked atypia; (2) A carcinoma arises from markedly atypical basal cells with or without prior hyperplasia. Even in such small-sized carcinomas, there is a difference in type of invasion within the bronchial wall. One is the creeping type which shows a marked horizontal growth and the other is the penetrating type which shows a marked downward growth.
Topics: Aged; Bronchi; Carcinoma in Situ; Carcinoma, Bronchogenic; Carcinoma, Squamous Cell; Epithelium; Humans; Hyperplasia; Lung Neoplasms; Metaplasia; Middle Aged; Smoking
PubMed: 3433284
DOI: 10.1620/tjem.153.265 -
Zhongguo Fei Ai Za Zhi = Chinese... Apr 2010Because radical resection for lung cancer invading the initial borderline of different lobes and carina is difficult, we tried to analyse the variables of successful...
BACKGROUND AND OBJECTIVE
Because radical resection for lung cancer invading the initial borderline of different lobes and carina is difficult, we tried to analyse the variables of successful tracheal carinoplasty and bronchovasculoplasty to discover a proper approach for appropriate early and long-term results.
METHODS
Of 1 399 lung resections for primary lung cancer performed in our hospital from April 1985 to December 2006, 133 underwent bronchoplastic surgeries, including 15 carinoplasty cases and 118 sleeve lobectomy (SL) cases, and 118 pneumoectomy (PN) cases were compared at the same time.
RESULTS
Complications occurred in 18 cases, with no operative related mortality. For all patients, the 1 year, 3 year, and 5 year survival rates were 79.8%, 56.7% and 31.2%, respectively. The 5 year survival rate by cancer stage was 69.2% for Ib, 40.6% for IIb, 19.6% for IIIa, and 16.6% for IIIa (N2).
CONCLUSION
Selection of cases, clearance of lymph nodes, disposal of the bronchus and pulmonary vessel and replacement or restoration of the superior vena cava are the main factors influencing prognosis.
Topics: Adult; Aged; Carcinoma, Bronchogenic; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Survival Rate; Trachea; Treatment Outcome
PubMed: 20677564
DOI: 10.3779/j.issn.1009-3419.2010.04.16 -
Journal of Clinical Pathology Jun 1978Ten out of 164 cases of bronchogenic carcinoma showed pathological evidence at necropsy of the ectopic ACTH syndrome. All occurred in association with oat-cell...
Ten out of 164 cases of bronchogenic carcinoma showed pathological evidence at necropsy of the ectopic ACTH syndrome. All occurred in association with oat-cell carcinoma, constituting 19% of that group. The pathological features consisted of adrenocortical hyperplasia confined to the zona fasciculata and Crooke's hyaline change in the pituitary. Immunoperoxidase stainable ACTH was detected in the pituitary but not in the carcinoma tissue, a surprising finding, which may be due to the different nature of ACTH present in tumour tissue. The ectopic ACTH syndrome was diagnosed ante mortem in only four out of 10 patients on the basis of hypokalaemia and metabolic alkalosis. The lack of clinical pointers in all but terminal cases is discussed as well as possible measures for earlier diagnosis.
Topics: Adrenal Glands; Adrenocorticotropic Hormone; Aged; Carcinoma, Bronchogenic; Carcinoma, Small Cell; Female; Humans; Lung Neoplasms; Male; Middle Aged; Paraneoplastic Endocrine Syndromes; Pituitary Gland
PubMed: 209063
DOI: 10.1136/jcp.31.6.591 -
The European Respiratory Journal May 2004Multidetector computed tomography-generated virtual bronchoscopy (VB) is a recent technical development that allows visualisation of the lumen and wall of the trachea... (Review)
Review
Multidetector computed tomography-generated virtual bronchoscopy (VB) is a recent technical development that allows visualisation of the lumen and wall of the trachea and proximal part of the bronchial tree. A dynamic image is produced that resembles what is seen with fibreoptic bronchoscopy (FB). Although the technique has not yet reached daily clinical practice and it can never replace FB, performing VB can be useful in well-defined clinical situations. In this paper, the value and limitations of virtual bronchoscopy will be reviewed, to illustrate the potential role of virtual bronchoscopy in the evaluation of trachea and bronchial tree pathology.
Topics: Biopsy; Bronchi; Bronchial Diseases; Bronchography; Carcinoma, Bronchogenic; Constriction, Pathologic; Humans; Lung Neoplasms; Surgery, Computer-Assisted; Tomography, X-Ray Computed; Trachea; User-Computer Interface
PubMed: 15176696
DOI: 10.1183/09031936.04.00099804