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Operation of a foetal type lung cancer
S38
Abstracts
admitted in September 1998 for the evaluation of a pathologic chest X-ray finding. It turned out, that the abnormality was already seen on a chest film made in 1985. CT evaluated a mediastinal tumour with multiple mediastinal lymphadenomegaly. According to the oncologistÕs and surgeonÕs opinion the patient went for operation, during which the mediastinal tumour was removed. Because of the unplanned injury of the right arteria pulmonalis, a consequent pulmonectomy was also performed. The tumour proved to be a hyalin vascular type Castelman lymphoma by histologic examination. Castelman lymphoma is a very rare disease, that mainly involves the mediastinum of middle-age patients. It is a benign process of unknown origin, however follicular dentritic cell tumour may evolve from it according to the literature. The treatment is removal of the tumour with follow up. Malignant pleural effusion in elderly patients J. Zdravkovic, Institute for Pulmonary Diseases and TB, Clinical Centre of Serbia, Belgrade, Yugoslavia Pleural effusion is a common clinical problem. Although there are many causes, the most frequent one is cancer, especially in elderly patients. The purpose of the study was to determine the most frequent etiology of pleural effusion in patients over 60 years of age. The second common cause in our group of patients is congestive heath failure (18.6% and TB 16.3%). We separately analyzed the exudation of malignant etiology in patients hospitalized during 1995 at the Institute for Pulmonary Diseases and TB. In more than half of these group of patients (55.8%) malignant pleural effusion was confirmed. The diagnosis was confirmed by pleuroscopy in all patients. The exudation was unilateral and on right side more than half cases. Slower exudate absorption in elderly patients is due to immunodeficiency and the terminal phase of their illness. Drainage of pleural fluid followed by intercavitary therapy offers the potential for long term palliation of respiratory symptoms by reducing or eliminating the formation of fluid. Giant cell carcinoma of the lung with paraneoplastic hypereosinophilia V. Kacÿar, G. Radosavljevi«c, S. Filipovi«c. Institute of Lung Disease and TB, Beograd Yugoslavia The exact incidence of paraneoplastic syndromes is difficult to estimate. We define paraneoplastic syndrome as a symptome complex that cannot be ascribed to local or direct effects of the cancer process and which appears to be mediated by factors released by tumors during their growth and metabolism. Multiple tumor types may be associated with extreme eosinophilia both in the tumor itself and in peripheral blood or within both localizations. Eosinophilia may be found up to l0% in hematological neoplasms and from 1-3% in patients with lung cancer. A male patient, 50 years old, was admitted at the Institute for determining the etiology of sinister pleural exudate and diffuse bilateral pulmonary lesions. Following the laboratory tests, the extreme peripheral leukocytosis(59x10) with eosinophil predominant of 47% was noticed. Aspiration puncture of bone marrow and bone biopsy were performed due to hypereosinophilia.The findings revealed reactive hypercellular bone marrow with marked eosinophil predomination (37% ) and existing secondary deposits being analogous to adenocarcinoma. Lethal outcome with the signs of respiratory insufficiency ensued rather quickly. Autopsy findings showed primary bronchial giant cell carcinoma with multiple organ metastases. Cardiological finding in patients with lung cancer and superior
vena cava syndrome (SVCS) Vasic N., Stevic R., Radosavljevic G., Jovanovic D., Kacar V., Institute of Lung Diseases and TB, Clinical Center of Serbia, Belgrade, Yugoslavia In order to investigate the initial cardiac lesions in patients with lung diseases and SVCS we analyzed 90 patients treated at the Institute of Lung Diseases and TB in Belgrade during the period of three years (1996-1998). The study group consisted of 78 male and 12 female patients, aged 58 yrs, in average. In this period the total number of patients treated for lung cancer was 4404. Two patients were excluded from the study due to previous heart disease. Clinical cardiological examinations with arterial and peripheral venous pressure measurements, PA thoracic radiography and ECG were performed in all patients at the time of diagnosis. ECG was performed in patients with cardiomegaly and ECG signs of pericardial effusion. The incidence of SVCS at the time of lung cancer diagnosis was 2% (90/4404), and in patients with right side tumor localization it was 80% (72/90). According to the histopathological type the findings were the following: microcellular 49% (24), squamous cell carcinoma 37% (18), adenocarcinoma 14% (7). Clinical findings indicated: peripheral venous hypertension in 47% (41) (average 31/49 cm H2), arterial hypertension in 13% (11), arterial hypotension in 10% (9) of patients. Enlargement of cardiac shadow on PA thoracic radiography was observed in 24% (21) of patients. ECG lesions were found in 58% (51) of patients: QRS complex voltage decrease in 32% (38), dysrhythmia in 16% (14), ST-T segment changes in 10% (9) patients. More than half of the patients with lung cancer and SVCS had ECG changes and 1/4 had radiographic enlargement of the cardiac shadow. Cardiac lesions (pericardial effusion, tamponade, lung edema and cardiac rhythm disorders) potentiate the severity of urgency of the underlying disease. This demands adequate and prompt cardiological treatment (pericardial punctures, diuretics, antiarrhythmics) in order to initiate specific oncological treatment as soon as possible. Operation of a foetal type lung cancer M. Juh‡sz, M. Orosz1, K. Ivaskevics2, Zs. MŽsz‡ros, E. Unger, Zs. Dobosi. BajcsyÐZsilinszky Hospital Surgical Department Semmelweis Medical University Pulmonological Clinic1 BajcsyÐZsilinszky Hospital Pathological Department, Budapest, Hungary2 The authors describe the case of a 50 years old female patient who was operated on suspected malignancy of the right lung. On operation a rare malignancy was found: a foetal type adenocarcinoma. The authors give an account on the histological feature of this tumour type, review the symptomatology, diagnosis, differential diagnosis and the survival by literature. Correlation between aerosol deposition patterns and preferential sites of lung cancers in human and rat lungs Imre Bal‡sh‡zy1 and Werner Hofmann2 1KFKI Atomic Energy Research Institute, Radiation and Environmental Physics Department, Budapest, Hungary 2University of Salzburg, Institute of Physics and Biophysics, Salzburg, Austria The documented site selectivity of lung tumors suggests that the preferential sites of tumor occurrence may be correlated with the distribution of inhaled particulate matter throughout the respiratory system. Most of the lung tumors in humans originate in the bronchial airways, while the majority of lung cancers in rats has been observed at the bronchiolar-alveolar level. In the present
Abstracts
admitted in September 1998 for the evaluation of a pathologic chest X-ray finding. It turned out, that the abnormality was already seen on a chest film made in 1985. CT evaluated a mediastinal tumour with multiple mediastinal lymphadenomegaly. According to the oncologistÕs and surgeonÕs opinion the patient went for operation, during which the mediastinal tumour was removed. Because of the unplanned injury of the right arteria pulmonalis, a consequent pulmonectomy was also performed. The tumour proved to be a hyalin vascular type Castelman lymphoma by histologic examination. Castelman lymphoma is a very rare disease, that mainly involves the mediastinum of middle-age patients. It is a benign process of unknown origin, however follicular dentritic cell tumour may evolve from it according to the literature. The treatment is removal of the tumour with follow up. Malignant pleural effusion in elderly patients J. Zdravkovic, Institute for Pulmonary Diseases and TB, Clinical Centre of Serbia, Belgrade, Yugoslavia Pleural effusion is a common clinical problem. Although there are many causes, the most frequent one is cancer, especially in elderly patients. The purpose of the study was to determine the most frequent etiology of pleural effusion in patients over 60 years of age. The second common cause in our group of patients is congestive heath failure (18.6% and TB 16.3%). We separately analyzed the exudation of malignant etiology in patients hospitalized during 1995 at the Institute for Pulmonary Diseases and TB. In more than half of these group of patients (55.8%) malignant pleural effusion was confirmed. The diagnosis was confirmed by pleuroscopy in all patients. The exudation was unilateral and on right side more than half cases. Slower exudate absorption in elderly patients is due to immunodeficiency and the terminal phase of their illness. Drainage of pleural fluid followed by intercavitary therapy offers the potential for long term palliation of respiratory symptoms by reducing or eliminating the formation of fluid. Giant cell carcinoma of the lung with paraneoplastic hypereosinophilia V. Kacÿar, G. Radosavljevi«c, S. Filipovi«c. Institute of Lung Disease and TB, Beograd Yugoslavia The exact incidence of paraneoplastic syndromes is difficult to estimate. We define paraneoplastic syndrome as a symptome complex that cannot be ascribed to local or direct effects of the cancer process and which appears to be mediated by factors released by tumors during their growth and metabolism. Multiple tumor types may be associated with extreme eosinophilia both in the tumor itself and in peripheral blood or within both localizations. Eosinophilia may be found up to l0% in hematological neoplasms and from 1-3% in patients with lung cancer. A male patient, 50 years old, was admitted at the Institute for determining the etiology of sinister pleural exudate and diffuse bilateral pulmonary lesions. Following the laboratory tests, the extreme peripheral leukocytosis(59x10) with eosinophil predominant of 47% was noticed. Aspiration puncture of bone marrow and bone biopsy were performed due to hypereosinophilia.The findings revealed reactive hypercellular bone marrow with marked eosinophil predomination (37% ) and existing secondary deposits being analogous to adenocarcinoma. Lethal outcome with the signs of respiratory insufficiency ensued rather quickly. Autopsy findings showed primary bronchial giant cell carcinoma with multiple organ metastases. Cardiological finding in patients with lung cancer and superior
vena cava syndrome (SVCS) Vasic N., Stevic R., Radosavljevic G., Jovanovic D., Kacar V., Institute of Lung Diseases and TB, Clinical Center of Serbia, Belgrade, Yugoslavia In order to investigate the initial cardiac lesions in patients with lung diseases and SVCS we analyzed 90 patients treated at the Institute of Lung Diseases and TB in Belgrade during the period of three years (1996-1998). The study group consisted of 78 male and 12 female patients, aged 58 yrs, in average. In this period the total number of patients treated for lung cancer was 4404. Two patients were excluded from the study due to previous heart disease. Clinical cardiological examinations with arterial and peripheral venous pressure measurements, PA thoracic radiography and ECG were performed in all patients at the time of diagnosis. ECG was performed in patients with cardiomegaly and ECG signs of pericardial effusion. The incidence of SVCS at the time of lung cancer diagnosis was 2% (90/4404), and in patients with right side tumor localization it was 80% (72/90). According to the histopathological type the findings were the following: microcellular 49% (24), squamous cell carcinoma 37% (18), adenocarcinoma 14% (7). Clinical findings indicated: peripheral venous hypertension in 47% (41) (average 31/49 cm H2), arterial hypertension in 13% (11), arterial hypotension in 10% (9) of patients. Enlargement of cardiac shadow on PA thoracic radiography was observed in 24% (21) of patients. ECG lesions were found in 58% (51) of patients: QRS complex voltage decrease in 32% (38), dysrhythmia in 16% (14), ST-T segment changes in 10% (9) patients. More than half of the patients with lung cancer and SVCS had ECG changes and 1/4 had radiographic enlargement of the cardiac shadow. Cardiac lesions (pericardial effusion, tamponade, lung edema and cardiac rhythm disorders) potentiate the severity of urgency of the underlying disease. This demands adequate and prompt cardiological treatment (pericardial punctures, diuretics, antiarrhythmics) in order to initiate specific oncological treatment as soon as possible. Operation of a foetal type lung cancer M. Juh‡sz, M. Orosz1, K. Ivaskevics2, Zs. MŽsz‡ros, E. Unger, Zs. Dobosi. BajcsyÐZsilinszky Hospital Surgical Department Semmelweis Medical University Pulmonological Clinic1 BajcsyÐZsilinszky Hospital Pathological Department, Budapest, Hungary2 The authors describe the case of a 50 years old female patient who was operated on suspected malignancy of the right lung. On operation a rare malignancy was found: a foetal type adenocarcinoma. The authors give an account on the histological feature of this tumour type, review the symptomatology, diagnosis, differential diagnosis and the survival by literature. Correlation between aerosol deposition patterns and preferential sites of lung cancers in human and rat lungs Imre Bal‡sh‡zy1 and Werner Hofmann2 1KFKI Atomic Energy Research Institute, Radiation and Environmental Physics Department, Budapest, Hungary 2University of Salzburg, Institute of Physics and Biophysics, Salzburg, Austria The documented site selectivity of lung tumors suggests that the preferential sites of tumor occurrence may be correlated with the distribution of inhaled particulate matter throughout the respiratory system. Most of the lung tumors in humans originate in the bronchial airways, while the majority of lung cancers in rats has been observed at the bronchiolar-alveolar level. In the present