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We report a rare case of nonmucinous pulmonary micropapillary adenocarcinoma mimicking pulmonary tuberculosis. A 68-year-old woman was hospitalized with hemoptysis. Her computed tomography revealed cavities and tree-in-bud appearance similar to the extensive form of pulmonary tuberculosis. However, histopathological findings of transbronchial biopsies of all lesions revealed adenocarcinoma and no pulmonary tuberculosis. Tree-in-bud appearance may relate to the floating micropapillary tufts in alveolar spaces. If pulmonary carcinoma is complicated by pulmonary tuberculosis, patients must be isolated and disadvantaged in cancer treatments. Therefore, recognizing this case may be therapeutically useful for respiratory physicians treating both diseases. more...

We present a case of a thrombus in the left brachial artery as a cardioembolic presentation of pulmonary carcinoma. There have been few reports describing this clinical presentation, but if present, prognosis is very poor. Therefore, a cardioembolic event should be borne in mind as an atypical presentation of pulmonary carcinoma. (Level of Difficulty: Beginner.), Central Illustration more...

Presentamos 5 casos de pacientes con un neumotorax espontaneo como primera manifestacion de un carcinoma pulmonar. Las exploraciones complementarias iniciales no descubrieron la neoplasia. En 4 casos el diagnostico fue intraoperatorio y en el quinto al realizar una tomografia computarizada preoperatoria para valorar un enfisema bulloso pulmonar. Todos los pacientes sufrieron fugas aereas mantenidas pese a la correcta colocacion y funcionamiento del drenaje, por lo que se indico la cirugia. Se llevaron a cabo tres segmentectomias, una lobectomia y una toracotomia exploradora por metastasis pleurales. El examen histopatologico diagnostico tres tumores de celulas grandes, un adenocarcinoma y un carcinoma bronquioloalveolar no mucinoso. Creemos que en presencia de factores de riesgo, la existencia de un neumotorax no resuelto tras correcta colocacion de drenaje toracico debe poner ante la sospecha clinica de un carcinoma pulmonar asociado more...

The initial clinical manifestations of lung cancer are diverse and may occur with or without symptoms. Manifestations of pulmonary malignant lesions are produced by local growth or invasion, metastatic disease, or paraneoplastic processes. Patterns of local invasion such as Pancoast's syndrome or the superior vena cava syndrome are relatively uncommon but well recognized. Metastatic lung cancer can involve almost any anatomic area by hematogenous, lymphatic, or, occasionally, interalveolar dissemination. Complications related to malnutrition, infection, electrolyte disturbances, and coexisting diseases influence the initial manifestations. Although individual tumor cell types are associated with characteristic features, no constellation of findings is pathognomonic for a specific histologic variant. Because successful treatment of pulmonary carcinoma depends on early detection, awareness of the typical clinical manifestations is important. more...

Thirty-four patients affected by primary pulmonary carcinoma or in a state of recurrence after surgery were analyzed and 2g/M 2 of etanidazole was administered intravenously. After 30 min (group A), 60 min (group B), and 120 min (group C), both the bronchus affected by the carcinoma and the controlateral bronchus were biopsied. Of the 34 patients, 24 had histologically proven carcinoma and were enrolled in the study. Etanidazole determination was carried out with a polarographic method both in plasma and tissue. The results obtained indicate that the most favorable concentration of etanidazole in the tissue is at 30 min after administration and at this point is most beneficial when associated with radiotherapy. The tumor/plasma ratio of etanidazole examined in three phases is relatively higher than that noted with HPLC; however, it is compatible with the methodology used and previous studies carried out on other tumors. more...

A patient with a remitting non-microcytic pulmonary carcinoma was subjected to Doppler-echocardiography. The detection of a pericardial effusion with compression of the pulmonary artery due to an extrinsic mass indicated that the disease was progressing. The Doppler technique was used to evaluate the degree of arterial stenosis by determining the pressure gradient caused by it (49 mmHg) and to calculate the right ventricle pressure (75 mmHg). Tumor infiltration of mediastinal structures was posteriorly confirmed by computed tomography. more...

The synchronous development of malignant mesothelioma and pulmonary carcinoma is extremely rare. In this case, an 83-year-old woman, without evidence of past asbestos exposure, developed malignant pleural mesothelioma and pulmonary adenocarcinoma. She was discovered to have a lung lesion on an unrelated preoperative chest X-ray. Clinical evaluation suggested primary bronchogenic malignancy. She had a forty pack-year smoking history, but quit twenty years previously. At surgery, she had nodularity of the pleura. Pathology revealed adenocarcinoma of the lung and suspected malignant mesothelioma of the pleura. Malignant mesothelioma was confirmed histologically at a second surgery. more...

Cryptococcosis presenting as an intrabronchial mass is not a recognized cause of complete lung collapse. This case report illustrates this extremely rare manifestation of pulmonary cryptococcosis, which mimicked primary pulmonary carcinoma clinically, radiologically and bronchoscopically. more...

The degree of retention of arsenic trioxide (As 2 O 3 ) and calcium arsenate in rat lung after intratracheal instillation was investigated. Calcium arsenate was retained for a long period (about 50% recovered after 7 days), while AS 2 O 3 disappeared at a much faster rate (2% recovered after 24 h). The association between retention rate of these carcinogens and the subsequent induction of pulmonary carcinoma should be considered. more...

The prognosis of patients subjected to operation for a solitary cerebral metastasis from a pulmonary carcinoma is unfavourable. The prognosis of a solitary cerebral metastasis from a mammary carcinoma that is removed appears to be better: a prolongation of life of acceptable duration and quality is frequently achieved. more...

Seven cases of “undifferentiated” pulmonary carcinoma were studied ultrastructurally; five were of the typical oat cell variety and the remaining two consisted of larger cells. In three of the former and both of the latter cases neurosecretory-like granules were demonstrated. Biochemical analysis of tumor tissue extracts revealed 5-hydroxy-3-indoleacetic acid, vanilylmandelic acid, and catecholamine activity in all instances. No hormonal syndrome or metabolic abnormality was detected in any of the patients. The concomitant morphologic demonstration of neurosecretory-like granules and the presence of 5-hydroxy-3-indoleacetic acid, vanilylmandelic acid, and catecholamines in neoplastic tissue would provide further evidence that these tumors may indeed arise from bronchial endocrine cells and could therefore be classified within the group of neuroendocrine carcinomas. Also it seems apparent that these neuroendocrine bronchial carcinomas may include tumors consisting of cells somewhat larger than the typical oat cell. The observation of 5-hydroxy-3-indoleacetic acid, vanilylmandelic acid, and catecholamine activity in two oat cell carcinomas in which neurosecretory granules could not be demonstrated poses an interesting problem whose solution may only derive from further studies. more...

Summary The case reported concerns a pitch worker who developed a squamous-celled carcinoma of the lung, having previously had multiple skin carcinomata. The literature regarding carcinogenesis due to pitch and related compounds is reviewed, with particular regard to the lung. There have been few cases of pulmonary carcinoma reported among pitch workers. A survey of workers in such occupations might reveal significant numbers of cases, not otherwise evident. Meanwhile periodic chest X-rays are advisable for workers in these industries. more...

SUMMARY 1. Bronchial carcinoma has increased during recent decades. This increased incidence is believed to be real more than apparent. No satisfying explanation has so far been offered although the increased consumption of cigarettes may or may not be of importance. 2. One out of several outstanding differences between life of today and life of 50 years ago is the increased amount of printed material available, not least so with regard to the number, the size and the editions of the newspapers, as well as to the opportunity to read and to get “hot news,” almost smelling with printing ink. 3. If the exposure to printing ink should be of importance one ought to expect an increased incidence of pulmonary carcinoma in printing workers. The material of bronchial carcinoma in Stockholm (as published by Wiklund from other points of view) was accordingly analyzed. 4. During a certain period of time 125 cases of bronchial carcinoma were registered, eight of whom were represented by printing workers (= 6.4 per cent). During the same period of time there were 132,000 men above 40, 1500 of whom were printing workers (= 1.14 ± 0.95 per cent). The difference is conclusive from statistical point of view and will be still more overwhelming if it is remembered that only about 500 printing workers were busy with the printing ink and that, as far as could be elicited, all eight carcinomas belonged to this group. 5. Attention is called to the experiments of Steinbruck in 1929. Mice were painted on the neck with printing ink and malignant tumors was the result (in five cases carcinoma of the lung and of the skin, in three cases neoplastic tissue in the lymphatic nodes, the liver and the spleen). 6. Just as the mining workers of Schneeberg and Joachimsthal, as the laborers of the chromium industry and as those exposed to asbestos the printing workers exposed to printing ink should be considered as particularly susceptible to bronchial carcinoma. Screening by means of x-ray films should be performed of the lungs of printing workers above 40 at least once every second year and more often if any symptoms should appear. more...

Of the new diagnostic techniques introduced into thoracic surgery during the past decade, mediastinoscopy, azygography, ventilation and perfusion scans to evaluate emphysema and pulmonary function, flexible fiberoptic esophagoscopy and bronchoscopy, and esophageal function tests have all proved valuable in clinical practice. Bronchial arteriography, tantalum dust bronchography, and scanning in pulmonary carcinoma promise to be of clinical value in the future but remain experimental at present. more...

Metastatic carcinoma has been scarcely mentioned as a cause of pulmonary cavitation in the texts and articles on this subject.’.2 The purpose of this report is to review the literature and to describe the clinical, roentgen and pathological findings in two cases of cavernous metastatic carcinoma of the lungs. In one of these, spontaneous pneumothorax was an associated finding. Articles pertaining to the roentgen diagnosis of pulmonary metastases stress the classical pictures of nodular, miliary, infiltrative, and massive types. In a 10 year survey of 78 autopsied cases of metastatic pulmonary disease, Farrell3 reported one with multiple cavities in the lungs due to metastatic sarcoma. Minor4 reported four with cavernous lesions in a series of 312 cases of metastatic pulmonary carcinoma. The detailed roentgen and pathological findings were not described in these articles. Five cases of spontaneous pneumothorax associated with metastatic sarcoma have been reported; three by Lodmell and Capps,5 and two by Thornton and Bigelow.6 more...

Available online 1 December 2005., No tiene.

In 172 patients with pulmonary carcinoma, 42 were without metastatic glands at mediastinoscopy or resection; 17 of them (40 percent) were alive and free of cancer for over five to seven years. Mediastinoscopy seems to offer a chance to find those patients with lung cancer among whom curative resections are possible. more...

We believe this is the second case of oat cell carcinoma metastatic to the prostate to be reported. The patient was treated for prostatic carcinoma diagnosed by rectal examination. Subsequent biopsy confirmed oat cell carcinoma and led to the discovery of pulmonary carcinoma. Tumors metastatic to the prostate are rare and are identified when they result in urologic symptoms. A review of tumors metastatic to the prostate is presented. more...