Bronchoalveolar lavage in the assessment of primary and metastic lung cancer

341

of patients varying

wth

biopsy or autopsy proven

according

bronchioloalveolar

carcinoma).

diagnosis of pulmonary particularly

BAL

involvement

the sensitiwty

can prove

useful

also

in lymphoproliferative

when the immunologic

performed.

neoplasm,

to the type and growth pattern of the tumour (93 46 in

evaluation

We conclude that in the appropriate

in the

disorders,

of surface markers

is

setting BAL represents

Trends in the association of Lamhert-Eaton myasthenic syndrome with carcinoma Gutmann 22908.

LH,

II Gutmann

Health

Neurology

Sri.

carcinoma.

ofNebraska

Medirin

Univ

Omaha,

NE 68198-

Bronchoalveolar

Medical

2465.

Respiration

lavage (BAL)

cases of primary

6RI

South

1992;59:Suppl

1:41-3.

of primary

to that of other widely

as transbronchial

lung cancers,

considerations

Include:

1) methods to assure lavage of the appropriate preparation

Infections

and anti-nwplastic

m anway

epithelial

4) the optimum

chemotherapy,

for the performance

in staging patients with pnmary

wdl

whom

be an important

malignancy

These

such as viral

from malignancy,

of lavage. Lavage may situations,

caring for patients in

of the lung IS suspected.

of Pathology,

Depamtent

Bridgeport,

CT06616

Anal

Sadoun D, Vaylet Service

Bridgeport

Hospital, Histol

We

of Virgima

to

We Identified

over the past decade, which suggests that the

of the disease may be changmg.

de Pr

F, Valeyre

Battesti,

D, Natali

Hopital

F, Gorges

Avicenne,

R, Allard

P et al.

Bobigny.

Chest

83009

1992;101:1610-3. Five

cases of bronchogenic

patients with pulmonary diagnosis

carcinoma

histiocytosis

were observed

X (Hx).

of diagnosis

267 Grant

of cancer.

among

cancer occurred

Comparison

10.5

to smoke heavily of the five

associatmg Hx and lung carcinoma with a group of 88 control suffering

93

Mean age at the time of

of Hx was 42 years; on the average,

at the time

cases

patients

from Hx alone suggested that smoking played the predominant

role in the pathogenesis of cancer. In fact, among the four patients with Hx

QuadCytol

and the Universrty

years later. All patients were. smokers and continued

DNA analysis of malignant effusion% Comparison with cytologic diagnosis and uwcinoemhryonic antigen content Street,

University

lower.

of the neuromuscular

and 14 had cancer. There IS a dlstmct trend for

manifestations

and carcinoma

significantly

Pinto MM.

be substantially

experience

Bronchogenic carcinoma in patients with pulmonary histiocytosis X

lung cancer, but may be

tool for the physician

tumor may

with

has been

suggests that

the rate of occurrence of cancer in this disorder.

28 patients with LEMS.

segment, 2) the

useful in staging metastatlc lung cancer. In selected clinical

tumor

experience

more

which can Induce changes

to distinguish

is often associated

of patients with

Recent clinical

the clinical

services at West Virginia

clinical

VA

than in

defined.

and stain used, 3) conditions

cells very difficult

technique

with

for the performance

for the diagnosis of cancer remain incompletely

data from

determine

Charlottesville,

material

yieldforcytologicexammation

of BAL

type of cytologic

in

used endoscopic techniques such

biopsy. Technical

number ofpatients

combined

a lower tumor frequency

cell carcinoma and adenocarcinoma

Tbediagnostic

squamouscellcarcinoma.

BAL

Street,

can provide diagnostic information

in about 50%

accuracy m bronchoalveolar

be limited

42nd

and me&static disease to the lung. Diagnostic

can be obtained

IS comparable

Centr.

theactual

Box 394,

myasthenic syndrome (LEMS)

The exact number

reported to be as high as 70%.

Bronchoalveolar lavage in the assessment of primary and m&static lung cancer Rennard SI. Pulmonary and Crit Care Med Se, Department of Internal

ofNeurology,

L. Department

Center,

1992;42:848-50.

The Lamb&-Eaton with

a useful tool for studymg patients with lung cancer.

L, Phillips

of Virginia

Llniv.

15 control p
older

greater (64.7 patients

than 45 years,

tobacco

k 37 pack-year,

mean f SD) than that of tht:

of the same age with

In light ofthis

good correlation,

only

consumption

Hx

(40.8

thediagnosisof

advocates stopping tobacco smoking and long-term

k

was

11.6,

Hx strongly

medical follow-up.

1992; 14:222-

6. Twenty-three

consecutive

malignant

submitted forcytologicexamination antigen (CEA)

content and for DNA

study was undertaken would CEA

improve

to determine

the sensitivity

examination

was performed

with

radiologic

studies,

endometrium

pnmary

(l),

mutinous

extraovarian

and large cell lymphoma 100% and specificity

DNA

30%).

were

clinical

effusions

of the colon (l),

carcinoma

(I),

and in

19

unknown

mesothelioma

of cytologic

aneuploidy,

of two separate peaks in the histogram, (sensitivity,

smears and

of the breast (5), lung (S), ovary

(2). The sensitivity

100%.

assay.

diagnoses

patients),

malignant

carcinoma

papillary

Final

(four

The

The

analysis

diagnosis and CEA

blocks.

examination

and follow-up. (l),

of DNA

on Papanicolaou-stained

patients were secondary to carcinoma (I),

19 patients

analysis by flow cytometry.

cell

histologic

from

forcarcinoembryonic

if the addition

of cytologic

hematoxylin-and-eosin-stained correlated

effusions

wereanalyzed

(2)

diagnosis was

defined as the presence

was present in 7 of 23 fluids

Four fluids had insufficient

cells for analysis,

onehistogramshoweddebris(followingchemotherapy).

and

Plasmapheresis and antineoplastic treatment in CNS paraneoplastic syndromes with antineuronal autoantibodies Graus F, Vega F, Delattre JY, Bonavenhtra I, Rene R, Arbaiza D et al. Depattment 08036

ofNeurology,

Barcelona.

We retrospectively lung

carcinoma,

paraneoplastic and anti-Y0 (nine),

a severe neurologic

DNA

analysis of cells in malignant

sensitive than cytologtc diagnosis, and CEA assay for routine

use in the diagnosis of malignant

effusions

of

is less

and isnot recommended

effusions.

antibodies,

and

(PCD),

(PEM), four

(PE)

m

small-cell

patrents

with

ovarian or breast cancer,

(eight),

or treatment of the tumor (five).

disabled by the time PEbegan.

with that offivepatients(PEM,

All

Theclinical

four; PCD,

deficit at the onset of the antineoplastic

No patient improved.

one)

treatment.

Two patients treated with PE and antineoplastlc

for at least 6 months. Four of the five patients with a stable course

started the treatment

was 68%.

encephalomyelitis

who only had treatment of the tumor. Only one of these five pattents had

stable

CEA

J 70.

In addition to PE, patients received prednisone

butone patient wereseverely

(1) and lymphoma

the sensitivity

anti-Hu

cyclophosphamide

outcomewascompared

Villarroel

the effect of plasmapheresls

cerebellardegeneration

antibodies.

i Provincial,

therapy and three who only received treatment of the tumor remained

DNAaneuploidy

as the cutoff,

evaluated

and

Clinic

1992;42:536-40.

seven patients with paraneoplastic

was detected in effusions secondary to carcinoma of the breast (4), lung (2). Using 5 ng/mL

Hospital

Neurology

when the neurologic

deficit

was not severe. We

conclude that the efficacy of PE with other immunosuppressive in the stabilization

of the neurologic

deficit

is uncertain.

theraples