- Email: [email protected]
Frequency of distribution according to histological types of lung cancer in the tracheobronchial tree
269
carcinoma are described. Detection of Occult Cardiac Invasion b y Two Dimentional Echocardiography in Patients with Bronchial Carcinoma. corris, P.A., Kertes, P.J., Jennings, K. et al. Regional Cardiotheracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, U.K. Thorax 41: 138-141, 1986. Cardiac invasion by bronchial carcinoma may prevent successful resection but may be undetected before operation. In a retrospective analysis of i00 consecutive thoracotomies nine patients had unsuspected cardiac invasion by tumour. A prospective study of preoperative two dimensional echocardiography was therefore undertaken in patients with bronchial carcinoma who had no clinical evidence of cardiac tumour. Comparison with anatomical findings was possible in 65 patients in whom an echocardiogram of suitable quality had been obtained. There was one false negative among 55 negative echocardiograms and three false positives among l0 positive echocardiograms; non-malignant pericardial disease accounted for the echocardiographic finding in one of the latter. The predictive value of a negative test was 98%, and the predictive value of a positive test was highest (80%) if the echocardiogram suggested atrial invasion. Frequency of Distribution According to Histological Types of Lung Cancer in the Tracheobronchial Tree. Celikoglu, S.I., Aykan, T.B., Karayel, T. et al. Pneumology Department of Internal Medicine, Medical Faculty of Istanbul University, Istanbul, Turkey. Respiration 49: 152-156, 1986. The incidence of the location within the bronchi related to the cell types was investigated with the flexible fiberoptic bronchoscope in 355 cases of lung carcinoma. In 5 patients carcinoma was situated only in the trachea. In the other 350 cases the cell types other than adenocarcinoma were found to show different locations following their cell type. Epidermoid carcinoma was found more frequently in the two upper lobes (p < 0.001), while small cell carcinomas showed predilection for the main bronchus on the right side, and the upper lobe in the left (p < 0.001). No difference could be found between the upper, lower lobes and main bronchi for adenocarcinoma. It was also observed that large cell carcinomas were situated more often in the right upper lobe. The most important finding in this investigation was that, apart from adenocarcinomas, the other types were located mainly in the upper lobes, and much less frequently in the lower lobes, The predilection of localization of epidermoid and small cell carcino-
mas in the upper lobes suggests a possible relationship to tobacco smoke inhalation as these regions have been shown to be more affected by the smoke. Radiographic Differences Between two Subtypes of Bronchioalveolar Carcinoma. Schraufnagel, D.E., Peloquin, A., Pare, J. A.P., Wang, N.-S. Montreal Chest Hospital Centre, Montreal, Quebec, Canada. J. Can. Assoc. Radiol. 36: 244-247, 1985. Bronchioalveolar carcinoma has two lightmicroscopic, morphologic types, the alveolar type which has cuboidal cells resembling Type II pneumocytes, and the bronchiolar type in which these cells are of the tall columnar variety. To determine if these two different cellular patterns are associated with different clinical or radiologic patterns of disease, we compared the anthropometric, demographic and past medical history, the presenting symptoms, signs, radiographic changes and survival of patients with these two diseases. Clinical records, chest radiographs and pathologic specimens were reviewed by individuals blinded to the hypothesis. Of 30 patients reviewed, we found only one purely alveolar pattern, one predominantly alveolar, 13 mixed, 12 predominantly bronchiolar, and three purely bronchiolar. For analysis we combined the alveolar and the mixed groups and compared them to the purely and predominantly bronchiolar groups. Anthropometric and historical data were similar. The radiographs were different; the most striking difference was the presence of air bronchograms only in the bronchiolar group (p < 0.001). Of those who had previous chest films, 80% in the alveolar-mixed group were abnormal, whereas none of those in the bronchiolar group were (p = 0.02). All the initial films in the bronchiolar group had a lesion with definable borders, whereas only twothirds of the mixed alveolar group did (p = 0.02). Some of the radiographic changes of bronchioalveolar carcinoma depend on the histologic subtype. Carcinoma of the Lung with Osseous Stromal Metaplasia. McLendon, R.E., Roggli, V.L., Foster, W.L. Jr., Becsey, D. Department of Pathology, Duke University Medical Center, Durham, NC 27710, U.S.A. Arch. Pathol. Lab. Med. 109: 1051-1053, 1985. Calcification has long been a determinant of the radiologic distinction of a benign pulmonary mass. However, rare examples of calcification without ossification in pulmonary adenocarcinoma and ossification in the bronchial carcinoid have led some investigators to warn against this approach. A case of pulmonary adenocarcinoma with
carcinoma are described. Detection of Occult Cardiac Invasion b y Two Dimentional Echocardiography in Patients with Bronchial Carcinoma. corris, P.A., Kertes, P.J., Jennings, K. et al. Regional Cardiotheracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, U.K. Thorax 41: 138-141, 1986. Cardiac invasion by bronchial carcinoma may prevent successful resection but may be undetected before operation. In a retrospective analysis of i00 consecutive thoracotomies nine patients had unsuspected cardiac invasion by tumour. A prospective study of preoperative two dimensional echocardiography was therefore undertaken in patients with bronchial carcinoma who had no clinical evidence of cardiac tumour. Comparison with anatomical findings was possible in 65 patients in whom an echocardiogram of suitable quality had been obtained. There was one false negative among 55 negative echocardiograms and three false positives among l0 positive echocardiograms; non-malignant pericardial disease accounted for the echocardiographic finding in one of the latter. The predictive value of a negative test was 98%, and the predictive value of a positive test was highest (80%) if the echocardiogram suggested atrial invasion. Frequency of Distribution According to Histological Types of Lung Cancer in the Tracheobronchial Tree. Celikoglu, S.I., Aykan, T.B., Karayel, T. et al. Pneumology Department of Internal Medicine, Medical Faculty of Istanbul University, Istanbul, Turkey. Respiration 49: 152-156, 1986. The incidence of the location within the bronchi related to the cell types was investigated with the flexible fiberoptic bronchoscope in 355 cases of lung carcinoma. In 5 patients carcinoma was situated only in the trachea. In the other 350 cases the cell types other than adenocarcinoma were found to show different locations following their cell type. Epidermoid carcinoma was found more frequently in the two upper lobes (p < 0.001), while small cell carcinomas showed predilection for the main bronchus on the right side, and the upper lobe in the left (p < 0.001). No difference could be found between the upper, lower lobes and main bronchi for adenocarcinoma. It was also observed that large cell carcinomas were situated more often in the right upper lobe. The most important finding in this investigation was that, apart from adenocarcinomas, the other types were located mainly in the upper lobes, and much less frequently in the lower lobes, The predilection of localization of epidermoid and small cell carcino-
mas in the upper lobes suggests a possible relationship to tobacco smoke inhalation as these regions have been shown to be more affected by the smoke. Radiographic Differences Between two Subtypes of Bronchioalveolar Carcinoma. Schraufnagel, D.E., Peloquin, A., Pare, J. A.P., Wang, N.-S. Montreal Chest Hospital Centre, Montreal, Quebec, Canada. J. Can. Assoc. Radiol. 36: 244-247, 1985. Bronchioalveolar carcinoma has two lightmicroscopic, morphologic types, the alveolar type which has cuboidal cells resembling Type II pneumocytes, and the bronchiolar type in which these cells are of the tall columnar variety. To determine if these two different cellular patterns are associated with different clinical or radiologic patterns of disease, we compared the anthropometric, demographic and past medical history, the presenting symptoms, signs, radiographic changes and survival of patients with these two diseases. Clinical records, chest radiographs and pathologic specimens were reviewed by individuals blinded to the hypothesis. Of 30 patients reviewed, we found only one purely alveolar pattern, one predominantly alveolar, 13 mixed, 12 predominantly bronchiolar, and three purely bronchiolar. For analysis we combined the alveolar and the mixed groups and compared them to the purely and predominantly bronchiolar groups. Anthropometric and historical data were similar. The radiographs were different; the most striking difference was the presence of air bronchograms only in the bronchiolar group (p < 0.001). Of those who had previous chest films, 80% in the alveolar-mixed group were abnormal, whereas none of those in the bronchiolar group were (p = 0.02). All the initial films in the bronchiolar group had a lesion with definable borders, whereas only twothirds of the mixed alveolar group did (p = 0.02). Some of the radiographic changes of bronchioalveolar carcinoma depend on the histologic subtype. Carcinoma of the Lung with Osseous Stromal Metaplasia. McLendon, R.E., Roggli, V.L., Foster, W.L. Jr., Becsey, D. Department of Pathology, Duke University Medical Center, Durham, NC 27710, U.S.A. Arch. Pathol. Lab. Med. 109: 1051-1053, 1985. Calcification has long been a determinant of the radiologic distinction of a benign pulmonary mass. However, rare examples of calcification without ossification in pulmonary adenocarcinoma and ossification in the bronchial carcinoid have led some investigators to warn against this approach. A case of pulmonary adenocarcinoma with