1/57. granular cell tumor of the bronchus.Persistent atelectasis and recurrent pneumonia in the same location should raise suspicion of congenital anomalies or obstructing lesions of the bronchus leading to the affected area. We present an 8-year-old black female with a history of recurrent fever, cough, atelectasis of the right middle and lower lobes, and weight loss for several months. Flexible bronchoscopy revealed a polypoid mass obstructing the bronchus intermedius. biopsy of the neoplasm demonstrated a granular cell tumor (GCT). The patient had a lobectomy of the right lower and middle lobes. She had no recurrence of the tumor after several years of follow-up.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/57. Chemotherapy for a patient with advanced non-small-cell lung cancer during pregnancy: a case report and a review of chemotherapy treatment during pregnancy.BACKGROUND: lung cancer is the most common cause of cancer death in women in the USA. lung cancer arising during pregnancy is rare and has been reported only 15 times since the 1950s. However, the use of chemotherapy for lung cancer during pregnancy has not previously been reported. methods: The history, treatment and outcome of a patient with stage IV non-small-cell lung carcinoma (NSCLC) diagnosed during pregnancy is presented. Previous published reports on lung cancer were retrieved by a literature search of medline and Cancerlit. RESULTS: A 31-year-old woman was diagnosed as having stage IV NSCLC with bilateral pulmonary involvement when 26 weeks pregnant. Her shortness of breath progressed to dyspnea at rest on 100% inspired oxygen. Therefore, she was treated with systemic chemotherapy using cisplatin and vinorelbine. Despite this treatment, her oxygenation declined further over the next 4 days and thus the baby was delivered via cesarean section after 27 weeks of gestation. Four cycles of vinorelbine and cisplatin have now been administered. Following this treatment, the patient has experienced a significant clinical improvement and no longer requires supplemental oxygen. No chemotherapy-related adverse effects have been noted in the baby. In the 15 previously reported patients with concurrent lung cancer and pregnancy, chemotherapy administration during pregnancy has not been described. CONCLUSIONS: Treatment of lung cancer with chemotherapy during pregnancy should be considered on an individual basis with regard to the stage of the cancer and the maturity of the fetus. To our knowledge, the case presented here is the first report of a woman receiving chemotherapy for lung cancer while pregnant.- - - - - - - - - - ranking = 391.63666836728keywords = cancer (Clic here for more details about this article) |
3/57. life-threatening hypersensitivity pneumonitis induced by docetaxel (taxotere).4 patients with advanced non-small-cell lung cancer (NSCLC) treated with docetaxel developed life-threatening pneumonitis requiring mechanical ventilation. Docetaxel (30-60 mg x m(-2), according to a different protocol) was infused within one hour with standard premedications. One patient's pneumonitis occurred 5 days after the first dose of docetaxel, and that of the other 3 between the 2nd and 6th cycles. Based on the clinical course, radiological findings of an interstitial pneumonitis, and exclusion of other possible resultant causes, including metastatic cancer, radiation pulmonary injury, infection, or connective tissue disease, hypersensitivity pneumonitis was diagnosed. The patients were treated with hydrocortisone at 1200 mg per day or methylprednisolone at 240 mg per day. Although 3 of the 4 had a partial improvement in lung oxygenation, all patients' conditions of hypersensitivity pneumonitis persisted and were complicated by other events, such as hospital-acquired infection and tension pneumothorax. The presence of this unusual hypersensitivity pneumonitis, which was so severe as to be life-threatening and refractory to high-dose corticosteroid therapy, should be taken into account during docetaxel treatment.- - - - - - - - - - ranking = 60.251795133428keywords = cancer (Clic here for more details about this article) |
4/57. Reasons for the delays in the definitive diagnosis of lung cancer for more than one year from the recognition of abnormal chest shadows.OBJECTIVE: Primary lung cancer generally has a poor prognosis if not diagnosed at an early stage. But some lung cancers grow very slowly. In particular, adenocarcinoma is sometimes observed for years with no change of tumor size. In this study, we examined the reasons for the delays in reaching a definitive diagnosis of lung cancer. methods: We retrospectively reviewed primary lung cancer cases between January 1995 and December 1999 and examined those whose definitive diagnoses were delayed for more than a year. RESULTS: A total of 222 primary lung cancers were diagnosed. Of those, 19 patients (group A, 8.6%) were diagnosed after more than a year, and the other 203 (group B, 91.4%) were diagnosed within one year. The proportion of women in group A was significantly higher than that in group B (p<0.05). The mean age of group A was significantly younger than that of group B (p<0.05). The Brinkman Index of group A was significantly lower than that of group B (p<0.05). The histologic types were significantly different between the two groups (p<0.05). In group A, 18 patients (94.7%) had adenocarcinomas. Five primary reasons for the delays in group A were identified: 1) Four patients were tentatively diagnosed as inflammation or benign tumor on CT and were consequently not followed-up. 2) The chest CT shadows in 6 patients were suspected lung cancers but transbronchial lung biopsy findings did not show malignancy. 3) Four patients were tentatively diagnosed as inflammation or benign tumor on CT, but the tumors showed only very slow growth or no change at all. 4) The chest CT shadows of 2 patients were suspected lung cancer, but the patients refused to undergo video-assisted thoracic surgery (VATS) or closer examination. 5) Three patients did not consult medical facilities for a second examination. CONCLUSIONS: Many of the adenocarcinomas reviewed in our study grew slowly or remained unchanged for years. Doctors are mainly responsible for the delays in the definitive diagnosis and should aggressively perform VATS or closer examinations without hesitation.- - - - - - - - - - ranking = 331.38487323385keywords = cancer (Clic here for more details about this article) |
5/57. Arterial embolization to preoperatively manage pulmonary disease associated with inflammation.Preoperative arterial embolization is used in pulmonary disease to reduce intraoperative blood loss resulting from exposure of extensive adherent pleura due to repeated inflammation. Between January 1996 and February 2001, 5 patients underwent surgery with this procedure. Underlying diseases were 3 cases of aspergilloma and 1 each of chronic expanding hematoma and lung cancer. All embolization was permanent, involving coil insertion. Surgical treatment was successful in all 5 patients without mortality. Such preoperative management proved useful in reducing intraoperative blood loss in hypervascular collateral feeding vessels in the area of resection or decortication.- - - - - - - - - - ranking = 30.125897566714keywords = cancer (Clic here for more details about this article) |
6/57. Bronchial adenoma presenting with chronic asthma and obstructive pneumonia: a case report.A rare case of primary pulmonary neoplasm is reported. The patient was a 38-year-old woman presenting with obstructive pneumonia. Fiberoptic bronchoscopy revealed an endobronchial mass obstructing the left main bronchus: a reddish polypoid mass which bled on contract that was suggestive of bronchial adenoma. The patient also had a long-standing history of bronchial asthma and hemoptysis and the delay in establishing the eventured diagnosis was caused by the minor symptoms mimicking those of asthma. A persistent restrictive lung and the presentation of obstructive pneumonia were important clues which warranted further investigation by computed tomography (CT) scan and bronchoscopy. The patient underwent rigid bronchoscopy with CO2-laser ablation under general anesthesia. Histopathology confirmed a bronchial adenoma. The clinical response was excellent. Bronchial adenoma should be considered in young patients presenting with asthma, hemoptysis and obstructive pneumonia. Bronchoscopic CO2-laser ablation is an effective treatment and provides an alternative to aggressive thoracotomy.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/57. Factitious fungus in two children with cancer receiving liposomal amphotericin.amphotericin b deoxycholate and liposomal formulations of amphotericin are often started and continued empirically, in immunocompromised hosts, based on the computed tomography findings and the patient's clinical picture. The authors describe two patients with presumed fungal pulmonary nodules, which were progressive despite prolonged treatment with liposomal amphotericin b. At subsequent biopsy, neither had evidence of active fungal disease; rather, the nodules revealed reactive changes and lipid-laden macrophages. These cases underscore the importance of establishing a microbiologic diagnosis in cases of presumed fungal infection.- - - - - - - - - - ranking = 120.50359026686keywords = cancer (Clic here for more details about this article) |
8/57. Early detection and successful treatment of drug-induced pneumonitis with corticosteroids.A 69-year-old patient with non-small cell lung cancer developed pneumonitis with the use of the chemotherapeutic drugs gemcitabine, paclitaxel, and vinorelbine. He developed progressively worsening dyspnea, fevers, chills, and night sweats three weeks after initiation of chemotherapy treatment with no improvement with antibiotics. Bronchoscopic lung biopsy and endotracheal cultures were negative. Four weeks after the onset of symptoms, chest computed tomography scan showed a ground glass appearance of the lung parenchyma bilaterally consistent with pneumonitis. Gemcitabine is a nucleoside analog with activity against solid tumors, including breast and non-small cell lung cancers. Pneumonitis is a rare and potentially deadly complication of gemcitabine. Early treatment with corticosteroids leads to a complete resolution of this patients pneumonitis. Gemcitabine was discontinued and his chemotherapeutic regimen was changed to include paclitaxel, vinorelbine, and topotecan with no recurrence of pneumonitis. Pneumonitis should be included in the differential diagnosis of dyspnea in patients undergoing gemcitabine-based chemotherapy.- - - - - - - - - - ranking = 60.251795133428keywords = cancer (Clic here for more details about this article) |
9/57. balantidium coli pneumonia in an immunocompromised patient.A fatal case is reported of balantidium coli pneumonia in a 71-y-old woman suffering from anal cancer. The diagnosis was made by the discovery of motile trophozoites in a wet mount from bronchial secretions. The usual habitat of the parasite is the colon; lung balantidiasis is very rare.- - - - - - - - - - ranking = 30.125897566714keywords = cancer (Clic here for more details about this article) |
10/57. Pneumonitis due to corynebacterium equi.corynebacterium equi, a known cause of pneumonitis in foals, calves, and swine, was isolated from the sputum and bronchial washings of a child with pneumonitis and leukemia. Clinical improvement followed the administration of chloramphenicol, and cultures of sputum specimens were sterile until relapse occurred after antibiotic therapy was terminated. Cure was achieved with a second course of chloramphenicol therapy. corynebacterium equi was not isolated from 1,181 samples of sputum from other immunosuppressed children with cancer.- - - - - - - - - - ranking = 30.125897566714keywords = cancer (Clic here for more details about this article) |
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