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Aim: To determine the contribution of percutaneous biopsy with core cutting needle (Trucut) in the diagnosis of mediastinal tumours., Method: Retrospective review of 56 patients with mediastinal lesions who underwent percutaneous core cutting needle biopsy, oriented but not guided by computer assisted tomography of the thorax, 1999 - 2008., Results: Percutaneous biopsy with core cutting needle provided adequate material in 49/56, with a total positive sample rate of 88%. In 7/56 (12%) cases the material was insufficient to define the diagnosis. Percutaneous core cutting needle biopsy established a specific histological diagnosis in 88% of the patients: 23/56 (41%) lymphomas; 12/56 (21%) thymomas; 5/56 (3%) thymic carcinomas; 3/56 (2%) small cell carcinoma and 1/56 (0.6%) metastatic adenocarcinoma, metastatic squamous cell carcinoma, neuroendocrine primitive carcinoma, plasmocytoma, teratoma and goiter. All patients underwent thoracic X-ray after the procedure. No complications were found in these patients., Conclusion: Percutaneous core cutting needle biopsy (Trucut) oriented but not guided by computer assisted tomography of the thorax is an easy and safe procedure which can provide a precise diagnosis in the majority of mediastinal tumours and can prevent the need for exploratory thoracic surgery in cases which are medically treatable or non-resectable.

Background: Besides clarifying the etiology of unidentified lymphadenomegaly, puncturing hilar and mediastinal lymph nodes by a flexible bronchoscopic needle is an aid in diagnosing and staging broncho- genic cancer or other metastatic cancers., Objective: Our study had the principal objective to evaluate the positivity of transbronchial needle aspiration (TBNA)., Method: We evaluated retrospectively the effectiveness of all TBNA done in 74 consecutive patients. Forty-nine patients were male and the median age was 59. We used Wang-needles, 21-gauge (Bard, USA), and the same technique described for different authors. Of the 74 patients evaluated, 11(15%) showed mediastinal mass and 65 (85%) hilar mass. We observed 76 endoscopic abnormalities., Results: According to the classification of the specimens, we had 32/74 (43%) unsatisfactory specimens, 34/74 (46%) satisfactory and diagnostic specimens, and 8/74(11%) satisfactory and non-diagnostic specimens. Thirty four (46%) of the examinations were found to be positive out of the total amount of specimens. Of the positive results, 30/34 specimens (88%) contained malignant disease. Small-cell carcinoma was the most frequent finding, with 10/34 cases (29%); squamous cell carcinoma 7/34 (21%); adenocarcinoma 7/34 (21%), non- -small cell carcinoma 6/34 (17%); sarcoidosis 2/34 (6%) and tuberculosis 2/34 (6%)., Conclusion: Our study indicated that this method is safe, easy to per- form, with a minimum of complications and useful for the diagnosis and staging of pulmonary neoplasms.

Pulmonary blastoma is a rare primary lung tumor with poor prognosis that commonly presents at a younger age than the non-small cell lung cancer. Classically they are large, symptomatic tumors with lymph nodal metastasis and carry poor prognosis. Pathological examination revealed features suggesting a biphasic tumor with mesenchymal and epithelial components. Over 200 cases have been reported so far worldwide since the first description of the tumor in 1945. Authors present a case of pulmonary blastoma with literature revision.

Objectives: The objective of our study was to identify the risks factors for the de development of a second pulmonary primary cancer., Methods: It was a primary, observational, multicentric and retrospective study with 104 patients from the Cancer National Institute and the Antonio Pedro Universitary Hospital, in Rio de Janeiro, Brazil., Results: The sites of primary tumors were: head and neck (56.7%); with laryngeal carcinoma (42.4%); lungs (15.5%); bladder (8.6%); uterine cervix (7.6%); stomach (4.8%); others (6.8%). Male patients represented 84.6%. Average age 56.7 +/- 10.7 years, with a coefficient of variation 18.8%. Among the patients 91.4% were smokers and 92.0% were alcohol consumers. Multiple logistic regression model: site of primary tumor (OR:8.22; CI 95% - 2.21 to 30.56; p = 0,0017); specific histologic of primary cancer (OR:0.21; IC 95% : 0.04 to 0.99; p = 0.0498); sex (OR: 0.25; CI 95% : 0.03 to 1.81; p = 0.1711); age (OR: 0.98; CI 95%: 0.92 to 1.04; p = 0.6318); smoking (OR: 2.80; CI 95%: 0.44 to 17.55; p = 0.2711) and alcohol consumption (OR:0.76; CIIC 95%: 0.19 to 2.95; p = 0.6964). Adjusted model: odds ratio of the site of the primary tumor was 4.14, ; CI 95%; from 1.36 and 12.78 and p = 0.0123 (p < 0.05). Accuracy or the model: 82. 69%., Conclusion: In this study teh site of the primary tumor was the only predictor of risk for the second pulmonary primary cancer.