1/11. High amylase activity in pleural fluid and primary bronchogenic adenocarcinoma.We report a case of primary bronchogenic adenocarcinoma, complicated by pleural effusion, in which very high pleural amylase activity was found, whilst serum amylase was normal. isoamylase determination showed a salivary-type amylase. Concerning the origin of this enzyme, ultrastructural study of the malignant cells obtained from the pleural fluid suggested a local amylase synthesis. The pathophysiological significance of electron-dense granules found in these cells is also discussed.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
2/11. Isolation of legionella pneumophila serogroup 3 from pericardial fluid in a case of pericarditis.A 43-year-old woman was hospitalized for fulminant pericarditis. During diagnostic work-up, an as yet unknown bronchial carcinoma was detected. In the pericardial exudate legionella pneumophila serogroup 3 was demonstrated by direct fluorescent antibody technique and by culture. In a lung biopsy L. pneumophila serogroup 3 was found, too. Using an antigen-ELISA for L. pneumophila serogroup 1, antigenuria was demonstrated. In cases of pericarditis negative for common bacterial pathogens, all diagnostic tests for legionellae, e.g. culture, antigen detection in pericardial, pleural effusion and urine and antibody detection should be included in the diagnostic programme.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
3/11. cardiac tamponade as a presentation of mucoepidermoid bronchogenic carcinoma.We report a young patient who had massive pericardial effusion and tamponade diagnosed clinically and by echocardiography as the presenting manifestation of underlying malignancy. Pericardial and lymphnode biopsy revealed features of mucoepidermoid carcinoma and bronchoscopy localised the primary to be in the left main bronchus.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
4/11. Critical evaluation of results of extension of indication for surgery for primary bronchogenic carcinoma.Among 3,120 surgically resected cases (1957-1983) in Shanghai Chest Hospital, 1,476 resections (47.3%) were performed under extended indication. Six categories--(1) aged 70-87 years (102), (2) associated with severe impairment of pulmonary function (25), (3) small-cell anaplastic type (143), (4) stage III lesion (1,145), (5) invading carina (29), (6) with disseminated pleural metastasis and effusion (32)--were critically evaluated. For the first four categories, long-term survival rates were very encouraging, whereas only technical advancement and short-term results were discussed for the last two. The authors present strategic points significant in availing higher overall operability and hence the overall survival rate, shedding light on the increase of curative potential for lung cancer.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
5/11. Pseudo-pseudo-pseudotumor of the lung.Benign lesions may simulate bronchogenic carcinoma by virtue of radiologic appearance or false-positive cytologic studies. A lung opacity initially suspected to be malignant was, on review, considered to be a loculated effusion. Needle biopsy yielded cells which appeared malignant. The resected lesion was a benign infarct.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
6/11. High amylase content of neoplastic pleural and pericardial effusion probably secondary to amylase producing tumor cells: report of 2 cases.We report two cases of malignant pleural and pericardial effusion respectively secondary to bronchogenic carcinomas. In both effusions, a significant elevation of the Salivary-type-amylase fraction was found, while the corresponding values were normal in serum and urine. Electronmicroscopy of the malignant tumor cells from the pleural effusion showed typical electron-dense granules, suggesting zymogen granules. It is concluded that the high amylase content of the effusions was due to secretion of S-type-isoamylase by the tumor cells.- - - - - - - - - - ranking = 8keywords = effusion (Clic here for more details about this article) |
7/11. pericardial effusion as first evidence of malignancy in bronchogenic carcinoma.Two patients in whom the development of a malignant pericardial effusion lead to the diagnosis of an unsuspected bronchogenic carcinoma are presented. Pericardial involvement has rarely been described as the first manifestation of an underlying lung tumor. Histologic type in both cases was adenocarcinoma, the most commonly described pattern in this situation. In concurrence with previous reports, prognosis of patients with malignant pericardial effusion remains poor.- - - - - - - - - - ranking = 6keywords = effusion (Clic here for more details about this article) |
8/11. Pleural mesotheliomas--an analysis of 18 cases and review of the literature.Eighteen cases of mesothelioma, 7 benign and 11 malignant, were analyzed retrospectively. There were 5 females with benign tumors and 10 males with the malignant variety. The mean age was 59 years in the benign group and 55 years in those with malignant tumors. Exposure to asbestos was documented in one benign and five malignant mesotheliomas. Three patients with benign lesions were asymptomatic on presentation while all 11 with malignant tumors had symptoms, chest pain and dyspnea being the most frequent. Abnormal physical findings were rarely noted in the benign group while all the malignant tumors had abnormal findings on presentation. Signs of a pleural effusion were the most common abnormal physical findings, occurring in 8 of 11 patients. pleural effusion was the most common roentgenologic finding in malignant mesotheliomas, while a mass lesion was the presenting finding in six of seven of the benign group. pleural effusion was a usual accompaniment of malignant tumors and was an exudate, usually hemorrhagic with leukocyte counts up to 20,000/mm3. thoracotomy established the diagnosis in each of the five benign and seven malignant cases in which it was attempted. Pleural biopsy was diagnostic in three of six with malignant and one of two with benign tumors. Pleural fluid cytology did not yield a diagnosis in the seven instances in which it was studied. Excisional surgery was performed in five of the benign cases and all have survived one to six years. No treatment was curative of malignant mesotheliomas. Ten of the 11 with malignant tumors died from 3 to 24 months after onset of symptoms (mean 9.9 months). The clinical features of 82 benign and 160 malignant mesotheliomas from selected series in the literature are reviewed and compared with the present series. The roentgenographic features of 51 benign and 87 malignant tumors are also presented. The clinical and diagnostic features which help differentiate mesotheliomas from bronchogenic carcinomas are discussed. A careful approach to the diagnosis of malignant mesotheliomas may help avoid an unnecessary thoracotomy.- - - - - - - - - - ranking = 3keywords = effusion (Clic here for more details about this article) |
9/11. Bronchogenic carcinoma mimicking metastatic thyroid carcinoma.We present a case of a false-positive 131I scan in the follow-up of a patient with papillary thyroid carcinoma, which developed 24 yr after radiation therapy for Hodgkin's disease. In the primary evaluation of a neck mass, histology was typical for a papillary thyroid carcinoma and thyroglobulin staining was positive. After total thyroidectomy, 131I uptake was seen in the hilum and right lung. The initial interpretation of these foci as metastatic disease was not supported by the progressive clinical course despite radioiodine treatment. Hence, repeated bronchial brushings and cytology of the pleural effusion were obtained. These specimens were negative in thyroglobulin staining and positive for synoptophysin, a marker for small-cell bronchial carcinoma. Thereby a small to medium cell undifferentiated bronchial carcinoma was demonstrated, which apparently was actively taking up iodine. In conclusion, an atypical clinical course of a suspected metastatic thyroid carcinoma should lead to a reevaluation of the initial diagnosis to prevent an inappropriate therapeutic regimen.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
10/11. A malignant pleural effusion infected with salmonella enteritidis.A patient is described with a unilateral pleural effusion persistently infected with salmonella enteritidis. The infection was eventually eradicated with ciprofloxacin. A computed tomographic scan and mediastinal lymph node biopsy demonstrated an underlying small cell bronchogenic carcinoma.- - - - - - - - - - ranking = 5keywords = effusion (Clic here for more details about this article) |
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