Cases reported "Bronchial Neoplasms"

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1/14. granular cell tumor arising metachronously in the bronchus and esophagus.

    We present a case of granular cell tumor (GCT) occurring in the esophagus 7 years after operation for bronchial GCT. A 59-year-old Japanese man complained of epigastralgia, and endoscopic examination of the upper digestive tract disclosed a submucosal tumor in the lower esophagus. Histological examination of the endoscopic mucosal resection of the esophageal tumor showed a proliferation of neoplastic cells with an eosinophilic and granular cytoplasm. The cytoplasm of the neoplastic cells was histochemically positive for PAS stain and immunohistochemically positive for S-100. This tumor did not fulfill any of the diagnostic criteria for malignancy at either the macroscopic or microscopic level. I believe that this is the first case of GCT occurring metachronously in the respiratory and digestive tracts. Clinicians and pathologists should bear in mind that GCT may arise metachronously in the respiratory and digestive tracts.
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2/14. Multicentric tracheobronchial and oesophageal granular cell myoblastoma.

    Two patients with multiple intrathorcic granular cell myoblastomas are described. In one case multiple tumours were present in the major airways and oesophagus. The patient presented with recurrent pulmonary infections and stridor due to airway obstruction. In the other case dysphagia caused by multiple oesophageal granular cell myoblastomas was the major symptom. Granular cell myoblastoma is a rare tumour of neurogenic origin with a characteristic histological appearance. The pattern of multiple tracheobranchial and oesophageal tumours is uncommon and forms the basis of this report.
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3/14. Human papilloma virus type 11 in a fatal case of esophageal and bronchial papillomatosis.

    We report a case of an apparently healthy 27-year-old man with a fatal course of papillomatosis, originating in the distal part of the esophagus and spreading into the main and intermediate bronchus. Human papillomavirus type 11, usually associated with juvenile laryngeal papillomatosis and genital condyloma acuminatum, was detected in the papillomas. In spite of treatment with CO2-laser evaporation of the papillomas, and with systemic as well as topical interferon, VP-16 and bleomycin, the papillomatosis progressed relentlessly during almost 2 years, and finally caused the death of the patient. We have no explanation for the malignant course of wart virus infection in this young man.
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4/14. Laser photocoagulation in obstructing malignant tumours of the respiratory and gastrointestinal tracts.

    The palliation of obstructing malignant tumours of the respiratory tract and the gut is often inadequate. We report the endoscopic use of Nd-YAG laser photocoagulation for the rapid and safe relief of malignant obstruction in airways, colon and oesophagus in three patients.
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5/14. Left pneumonectomy associated with subtotal esophagectomy for carcinoma of the esophagus invading the left main bronchus.

    A case of squamous cell carcinoma of the mid-thoracic esophagus invading the left main bronchus, and synchronous gastric cancer was successfully treated with subtotal esophagectomy, left pneumonectomy, total gastrectomy and reconstruction using the right colon. The indications of this procedure are discussed.
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6/14. Profound xenon-133 trapping in left main bronchus. Obstruction by necrotic tumor.

    Squamous cell carcinoma of the esophagus eroded into the central airway with production of left main bronchus occlusion and aspiration pneumonia of the right lower lobe.
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7/14. Carcinoma of the bronchus with atypical presentation: report of a case.

    A 64-year-old man presented with dysphagia due to obstruction of lower third of the esophagus. esophagoscopy showed narrowing of the esophagus with normal mucosa. Chest X rays were normal, but on lung scan there was no perfusion of the left lung. That patient died of aspiration and on post mortem a carcinoma of the bronchus with abscess formation and perforation into the esophagus was found.
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8/14. Triple endoscopy: a neglected essential in head and neck cancer.

    Surgeons are sometimes embarrassed to discover a second unanticipated cancer while focusing attention on an already evident cancer in the head and neck area, the bronchus, or the esophagus. we began in October, 1976, to do direct laryngoscopy, esophagoscopy, and bronchoscopy on each of the 134 cases admitted to our unit with suspected head and neck cancer. In 10 of the 134 patients in whom triple endoscopy was done, no malignancy was found. Of 24 of 124 (20%) patients with head and neck cancer, 16 patients (13%) had synchronous carcinoma and eight patients (7%) had metachronous carcinoma in this 2-year period. The incidence can be expected to rise steadily with time and mandates "triple endoscopy" on all patients with a suspected cancer in the head and neck area, the bronchus, or the esophagus, as these structures form a closely related unstable field. The discovery of several patients with dysplastic mucosal changes, carcinoma in situ, or very early invasive cancer, not only of the head and neck but also of the esophagus and bronchus, presents new problems of management.
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9/14. Polypoid carcinoma of the esophagus. A unifying term for "carcinosarcoma" and "pseudosarcoma".

    Polypoid carcinomas with spindle-cell sarcomatous features have been designated either as carcinosarcoma or pseudosarcoma. The distinction between these two tumors has depended on the presence of "intermingling" of the carcinomatous and sarcomatous components in so-called carcinosarcoma. But unlike the carcinosarcoma, the sarcomatous component in pseudosarcoma has been considered benign. A polypoid tumor of the esophagus in a 57-year-old male was predominantly composed of spindle cell, sarcomatous cells. The presence of adjacent intraepithelial epidermoid carcinoma with transitional and ultrastructural features confirmed the epithelial origin of this tumor. Because of the absence of "intermingling," the primary tumor was considered to be a pseudosarcoma. However, our postmortem examination showed metastases composed of both carcinomatous and sarcomatous features. A review of the literature on carcinosarcomas and pseudosarcomas shows that only one case of pseudosarcoma reported by Hughes and Cruickshank showed a similar situation and indicates that the sarcomatous component in pseudosarcomas has the same metastatic potentiality as has been reported in carcinosarcomas. We conclude from these studies a basic similarity of the carcinosarcoma and pseudosarcoma. The term polypoid carcinoma is proposed for both these lesions.
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10/14. Hematoporphyrin-derivative and photoradiation therapy of malignant tumors.

    Kodak projectors with #2418 red Corning filters were used as a light source to treat cutaneous and subcutaneous malignancies in five patients who previously had been given hematoporphyrin derivative (HpD). An argon dye laser system was used to treat malignancies in patients who also were given the HpD. These tumors included 11 melanomas of the eye, three carcinomas of the esophagus, one melanoma of the esophagus, four carcinomas of the lung, three basal cell skin cancers, and one retropharyngeal metastatic oral cancer. Clinical results and technical problems of this therapy are discussed.
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