Perfil epidemiológico de pacientes com diagnóstico de carcinoma broncogênico atendidos em uma unidade de alta complexidade em oncologia / Epidemiological profile of patients diagnosed with bronchogenic carcinoma seen in a high complexity oncology unit

Introdução: No Brasil, o carcinoma broncogênico é o segundo tipo de câncer de maior incidência em homens e o quarto tipo de câncer de maior incidência em mulheres. É a principal causa de mortalidade por câncer no país. O objetivo do presente estudo é avaliar o perfil epidemiológico dos pacientes com diagnóstico de carcinoma broncogênico atendidos em uma unidade de alta complexidade em oncologia. Métodos: Estudo observacional descritivo, retrospectivo, com coleta de dados secundários e de abordagem quantitativa. A pesquisa foi aplicada em uma unidade de alta complexidade em oncologia de um hospital de uma cidade do extremo-sul catarinense, através de prontuários eletrônicos. A coleta foi composta por 90 atendimentos no período de janeiro de 2015 a dezembro de 2017. Foram inclusos na amostra todos os pacientes com tumores broncogênicos malignos com idade igual ou superior a 18 anos, e foram exclusos 14 pacientes com prontuários incompletos. Resultados: A média de idade ao diagnóstico foi 62,39 ± 10,53 anos. Houve discreto predomínio no sexo masculino (58,9%). O tabagismo foi verificado em 78,9% dos pacientes, com uma mediana de 40,0 maços/ano. Como método diagnóstico, observou-se a maior realização de biópsia percutânea orientada por TC em 58,9% dos casos. Em relação aos tipos histológicos, 54,4% apresentaram adenocarcinoma. O estágio mais prevalente foi o IVA (42,2%). Conclusão: São de extrema importância métodos de rastreamento e diagnóstico precoce da neoplasia, bem como encorajar os pacientes ao abandono do tabagismo, a fim de reduzir sua incidência e mortalidade.

Introduction: In Brazil, bronchogenic carcinoma is the second more incident type of cancer in men, and the fourth in women. It is the leading cause of cancer mortality in the country. The aim of the present study is to assess the epidemiological profile of patients diagnosed with bronchogenic carcinoma seen in a high complexity oncology unit. Methods: This is a descriptive, observational, retrospective study with collection of secondary data and quantitative approach. The research was conducted in a high complexity oncology unit of a hospital in a municipality of the southernmost region of the state of Santa Catarina, Brazil, using electronic medical records. The sample consisted of 90 patients from January 2015 to December 2017. All patients with malignant bronchogenic tumors aged 18 years or older were included in the sample, and 14 patients with incomplete medical charts were excluded. Results: Mean age at diagnosis was 62.39 ± 10.53 years. There was a slight predominance of men (58.9%). Smoking was present in 78,9% of patients, with a median of 40.0 packets/year. CT-guided percutaneous biopsy was the most used diagnostic method, being performed in 58.9% of the cases. With regard to histological type, 54.4% of patients presented adenocarcinoma. The most prevalent stage was IVA (42.2%). Conclusion: Screening methods and early diagnosis of neoplasm are extremely important, as well as encouraging patients to quit smoking, in order to reduce disease incidence and mortality.

Metástasis infrecuentes en el carcinoma broncogénico / Uncommon metastases in bronchogenic carcinoma

Introducción: El pulmón es el órgano con mayor localización de enfermedad y mortalidad tumoral. En el momento del diagnóstico 55 por ciento de los casos presentan metástasis a distancia lo que implica un estadio avanzado de la enfermedad. Las metástasis cutáneas y en huesos distales de neoplasias internas son infrecuentes comparadas con las producidas en otras vísceras. La invasión cutánea puede presentarse por extensión directa de estructuras subyacentes y suelen asentar en la pared torácica anterior, por implantación accidental en maniobras diagnósticas, embolización vía linfática y por vía hematógena con posibles lesiones en zonas muy distantes y cuya aparición suele ser más precoz. Histológicamente, es el cáncer de pulmón indiferenciado el que con mayor frecuencia metastiza en la piel. Objetivo: Presentar dos casos con diagnóstico de carcinoma de pulmón células no pequeñas que desarrollaron metástasis en localizaciones infrecuentes. Presentación de los casos: Se presentan dos casos con metástasis infrecuentes de un carcinoma broncogénico. El primero a nivel nasal y el segundo en los metacarpianos y zonas blandas de la mano izquierda, ambas lesiones tumorales aparecieron en el curso del tratamiento oncológico para el cáncer del pulmón. El segundo caso fue tratado como una tendinitis y flebitis. Ambos casos evolucionaron hacia las metástasis múltiples y la muerte. Conclusiones: Se presentaron dos casos con metástasis infrecuente de un carcinoma de pulmón células no pequeñas, y aunque una vez diagnosticadas el pronóstico es malo a corto plazo, se deben de tener en cuenta para evitar diagnósticos y conductas erróneas(AU)

Introduction: The lung is the organ with the greatest location of disease and tumor mortality. At the time of diagnosis, 55 percent of the cases present distant metastases, which implies an advanced stage of the disease. Cutaneous and distal bone metastases from internal neoplasms are rare compared to those produced in other viscera. Cutaneous invasion can occur by direct extension of underlying structures and usually settle in the anterior chest wall, by accidental implantation in diagnostic maneuvers, lymphatic and hematogenous embolization with possible lesions in very distant areas and whose appearance is usually earlier. Histologically, it is undifferentiated lung cancer that most frequently metastasizes to the skin. Objective: To report two cases with a diagnosis of non-small cell lung carcinoma that developed metastases in infrequent locations. Case report: Two cases are reported with rare metastases from bronchogenic carcinoma. The first at the nasal level and the second in the metacarpals and soft areas of the left hand, both tumor lesions appeared in the course of oncological treatment for lung cancer. The second case was treated as tendinitis and phlebitis. Both cases progressed to multiple metastases and death. Conclusions: There were two cases with infrequent metastases of non-small cell lung carcinoma, and although once diagnosed the prognosis is poor in the short term, they should be taken into account to avoid misdiagnosis and misconduct(AU)

A clinico-epidemiological, pathological, and molecular study of lung cancer in Northwestern India

Introduction: Lung cancer is the most common malignant disease and is the topmost cause of cancer deaths in the world across all age groups and in both sexes. It is the most common cause of cancer deaths in developed countries and is also rising at an alarming rate in the developing countries. Objective: The present study was undertaken to explore the clinicopathological and molecular profile of bronchogenic carcinoma in northwestern population of India. Materials and Methods: A total of 136 consecutive patients with histologically proven bronchogenic carcinoma, registered between May 2014 and April 2016 at a tertiary care hospital in New Delhi, India, were analyzed. Results: Out of a total of 136 diagnosed cases, 6% were in the third to fourth decade of life, 49% in the fifth to sixth decade, and 45% in the seventh decade and above. Seventy-one percent of patients were male. Smoking was the major risk factor in 65.40% of patients. About 33% of female patients were smokers with a significant overlap in the use of smoking objects. Twenty-one percent of patients had been initially empirically treated with antitubercular therapy. Most common symptoms at presentation were cough, dyspnea, weight loss, and chest pain. Pleural effusion, paraneoplastic phenomenon, clubbing, peripheral lymphadenopathy, and Pancoast syndrome were the major signs at presentation. Twenty-one percent of nonsmokers and 40% of smoker patients presented with ECOG Performance Status 3 or 4. Ninety-three percent of patients presented in stage III or IV. Metastases to skeleton, brain, liver, pleura, adrenals, lung, and distant lymph nodes were present in 30.8%, 16.9%, 15.4%, 15.4%, 14.7%, 13.2%, and 11.8%, respectively. Fiberoptic bronchoscopy was found to be the most efficient diagnostic procedure as compared to transthoracic and thoracoscopic methods. Histologically, squamous cell carcinoma, adenocarcinoma, and small cell carcinoma and its variants were seen in 35.30%, 44.9%, and 15.40% cases, respectively. Nearly 4.4% of patients were diagnosed as poorly differentiated carcinoma. Driver mutations (epidermal growth factor receptor or anaplastic lymphoma kinase) were detected in 48% (25 of 52 tested) of adenocarcinomas and 55.55% (5 of 9 tested) of young, nonsmoker, female squamous cell carcinoma patients. Conclusion: This study highlights that the adenocarcinoma incidence is surpassing squamous cell carcinoma in Indian lung cancer patients also, as observed in Western population. Mean age at diagnosis is about one decade earlier than in the Western population. Driver mutations are more common in India than in the West as also reported in other Asian studies

A study of radiological presentation in bronchogenic carcinoma along with prevelance of pulmonary TB in a tertiary center

Background: Lung cancer is most common cause of cancer related death in men and women world wise responsible for over 1 million death annually. Lung cancer is leading cause of cancer death in united states and worldwide. Lung cancer is the most common neoplasm contributing more frequent among males causing cancer related mortality in both sexes. Objective of this study was to radiological presentation in bronchogenic carcinoma along with   prevalence of pulmonary TB in a tertiary center.Methods: Total of 100 patients with histologically proven lung cancer, from July 2018 to June 2019 at a tertiary center Kota Rajasthan. Data of participants regarding demographics, history of smoking habit, clinical presentation, histopathological type, radiographic findings on chest radiograph, ultrasonography, computed tomography (CT) scan, Statistical analysis was performed using descriptive statistics of the collected data.Results: Most common age group of bronchogenic carcinomas was seen between 60-69 years of age (37%) with male predominance (82%).  smoking history present in about (80%) patients.  Most common radiological presentation was a mass lesion present in 91% patients (n=91) followed by unilateral hilar prominence present in 44% of patients (n=44). Other common finding includes mediastinal widening (38%), collapse (26%). pleural effusion (22%), metastasis (22%), cavitation (13%), consolidation (12%), bony erosion (11%), pneumothorax (5%), and pancost tumor (4%).  prevalence of pulmonary TB in bronchogenic carcinoma is 9% and this is due to high burden of pulmonary TB in India.Conclusions: In this study adenocarcinoma was found to be most common type of lung cancer. Smoking is most common risk factor. Pulmonary TB coexistence with bronchogenic carcinoma was more common. The local immunity is deteriorated in cancer cases.

To Evaluate the Diagnostic Yield of Transbronchial Needle Aspiration in Cases of Lung Cancers and Mediastinal Masses or Adenopathy

Background: A great deal of interest in transbronchial needlespiration (TBNA) lies in its utility as a staging tool in patientswith bronchogenic carcinoma. The aim of this study toevaluated the diagnostic yield of TBNA in cases of lungcancers and mediastinal masses or adenopathy.Materials & Methods: The study was carried out and datawere gathered in a prospective fashion and all the data werereviewed retrospectively. Samples were collected from allpatients bronchial washings (BW), brush biopsy (BB), EBB,and TBNA. All TBNA specimens were sent for cytologicevaluation without ROSE as per recommended guidelines.Results: The mean age of studied cases was 58.07 years. Thecommon radiological presentation on x-ray chest was masslesions in 76.66%, mediastinal widening 60%, consolidation26.66% and SPN 3.33% of cases. The diagnostic yield ofvarious bronchoscopic procedure were 27% by BW, 47% byBB, 60% by EBB, 87% by TBNA.Conclusion: We conclude that the overall diagnostic yield offlexible bronchoscopy procedure is increased in patients withEML or SPD by the addition of TBNA. The TBNA is a safeprocedure that should be routinely used to increase diagnosticyield in patients with EML or SPD. In cases of SPD, TBNAshould be considered the procedure of choice.

Spectrum of Bronchogenic Carcinoma

Introduction: The incidence of lung carcinoma has rapidlyincreased since the beginning of there 20th century and currentlyrepresents the main of cancer related mortality. Diagnosticsmethods may adequately explain frequent recognition of thepresence of neoplasm, but also a fact that histological findingshave yielded a considerably higher percentage. More recentlythe emergence of combined PET CT imaging has greatlyaided the investigation of lung carcinoma by allowing evenbetter delineation of areas with increased tracer uptake and byimproving staging and detection of metastatic disease, guidingtherapy and allowing clinical outcome to be predicted. Studyaimed to find the prevalence and associated symptoms of lungcarcinoma.Material and methods: The study included a 109 patientsand was a retrospective study. The method was to note thepresenting symptoms of bronchogenic carcinoma and tonote the site of metastasis of bronchogenic carcinoma withPET CT. To note the variant of bronchogenic carcinoma withhistologically proven.Results: There were a total of 109 patients of which 77were male and 32 were female. The presenting symptom ofbronchogenic carcinoma was cough 75% preceded by weightloss 68%, dyspnea 60%, chest pain 49%, and hemoptysis 35%,bone pain 25%, clubbing 20%, fever 20%, weakness 10%,superior vena obstruction 4%, dysphagia 2%, wheeze andstridor 2%.Out of the 109 patients the frequent presentationof bronchogenic variant is adenocarcinoma 56%, followed bysquamous cell carcinoma 34% and small cell carcinoma 15%.Conclusion: The frequent symptom of bronchogeniccarcinoma presentation was cough followed by weight lossand dyspnea. The frequent site of metastatic of bronchogeniccarcinoma is supraclavicular node followed by contralaterallung, bone metastasis. majority of bronchogenic carcinomapresentation were of adenocarcinoma followed by squamouscell carcinoma and small cell carcinoma

Panhipopituitarismo secundario a metástasis del sistema nervioso central por un adenocarcinoma broncogénico / Panhypopituitarism secondary to metastasis of the central nervous system due to a bronchogenic adenocarcinoma

Resumen Mujer de 45 años de edad con antecedente de extabaquismo pesado, cursó con cuadro crónico de cefalea en región occipital irradiado a región temporal asociado a disminución de la agudeza visual de ojo izquierdo. El cuadro empeoró en los últimos seis meses y se asoció a polidipsia y poliuria. Presentó cuadro sincopal con amnesia retrógrada, para lo cual se realizó una tomografía axial computarizada (TAC) contrastada de cráneo que mostró múltiples lesiones parenquimatosas cerebrales y del cerebelo compatibles con metástasis. Se hizo estudio hormonal para evaluar la función hipofisiaria evidenciando un panhipopituitarismo secundario. Se detectó foco primario neoplásico mediante TAC contrastada de tórax, evidenciando una lesión espiculada en el lóbulo superior derecho sugestiva de carcinoma broncogénico, posteriormente se tomó biopsia por fibrobroncoscopia el cual confirmó por histopatología e inmunohistoquímica el diagnóstico de un adenocarcinoma broncogénico. (Acta Med Colomb 2018; 43: 115-118).

Abstract A 45-year-old woman with a history of heavy extabaquism presented with chronic headache in the occipital region irradiated to the temporal region associated with decreased visual acuity of the left eye. The picture worsened in the last six months and was associated with polydipsia and polyuria. She presented a syncopal picture with retrograde amnesia, for which a contrast computed tomography (CT) of the skull was performed, which showed multiple parenchymal brain and cerebellar lesions compatible with metastasis. Hormonal study was done to evaluate the hypophyseal function evidencing a secondary panhypopituitarism. A primary neoplastic focus was detected by a contrast chest CT scan, showing a spiculated lesion in the right upper lobe suggestive of bronchogenic carcinoma. A biopsy was subsequently taken by fibrobronchoscopy, which confirmed the diagnosis of a bronchogenic adenocarcinoma by histopathology and immunohistochemistry. (Acta Med Colomb 2018; 43: 115-118).

Importancia del cepillado bronquial a ciegas en lesiones tumorales periféricas no visibles endoscópicamente / Importance of blind bronchial brushing in peripheral endoscopically non visible lesions

Introducción: el diagnóstico rápido de las enfermedades neoplásicas pulmonares, primarias o metastásica, tiene una influencia importante sobre el resultado del tratamiento y el pronóstico de este grupo de enfermedades con alta letalidad. En el diagnóstico de estas se usan varias técnicas, entre ellas el cepillado bronquial para estudio citológico con el cual se alcanza un gran rendimiento diagnóstico en las lesiones visibles endoscópicamente y que también es de gran utilidad en los tumores periféricos diagnosticados en un porciento significativo y con el mínimo de complicaciones. Objetivo: evaluar los resultados del cepillado bronquial a ciegas en lesiones pulmonares periféricas de posible etiología tumoral. Métodos: estudio descriptivo, de corte transversal retrospectivo, en pacientes a los que se les realizó cepillado bronquial a ciegas en lesiones pulmonares periféricas sugestivas de ser tumorales en el servicio de neumología del Hospital Hermanos Ameijeiras, en un periodo de 10 años. Se tomaron en cuenta variables como: la localización de la lesión, cepillado útil para diagnóstico, positivo y negativo, tamaño de la lesión y los diagnósticos definitivos. Resultados: se realizó cepillado a ciegas a 517 pacientes, fue útil para diagnóstico en 491 (95 por ciento), en 289 (56 por ciento) se obtuvo resultado positivo. Conclusiones: el cepillado a ciegas en lesiones pulmonares periféricas tumorales es una técnica que mejora considerablemente el rendimiento diagnóstico del carcinoma broncógeno con un número bajo de complicaciones(AU)

Introduction: The rapid diagnosis of pulmonary, primary or metastatic neoplastic diseases has significant influence on the outcome of treatment and the prognosis of this group of high lethal diseases. In their diagnosis, several techniques are used, among them the bronchial brushing for cytological study which achieves great diagnostic performance in endoscopically visible lesions and it is also very useful in the peripheral tumors diagnosed in a significant percentage and with minimum complications. Objective: To evaluate the results of blind bronchial brushing in peripheral lung lesions of possible tumor etiology. Methods: A descriptive, retrospective, cross-sectional study in patients who underwent blind bronchial brushing in peripheral pulmonary lesions suggestive of tumor was conducted in the Pneumology Department at Hermanos Ameijeiras Hospital, over a period of 10 years. The variables taken into account were location of the lesion, brushing useful for diagnosis, positive and negative results, size of the lesion, and the definitive diagnoses. Results: Blind brushing was performed on 517 patients, it was useful for diagnosis in 491 (95 percent), a positive result was obtained in 289 (56 percent). Conclusions: Blind brushing technique in peripheral lung lesions considerably improves the diagnostic performance of bronchogenic carcinoma with low number of complications(AU)

Pulmonary actinomycosis masquerading as lung cancer: A case report

Pulmonary actinomycosis is a rare yet important and challenging diagnosis to make. It is commonly confused with other lung diseases, such as tuberculosis and bronchogenic carcinoma, leading to delay diagnosis or misdiagnosis. A 49-year-old man presented with a chronic cough, hemoptysis, and pleuritic chest pain. His initial imaging studies including computed tomography (CT) was suggestive of bronchogenic carcinoma. A subsequent CTguided biopsy was consistent with pulmonary actinomycosis and excluded the possibility of bronchogenic carcinoma. He was treated with antibiotic therapy and achieved remission with complete radiological resolution upon follow-up.

Citología aspirativa con aguja fina transbroncoscópica en lesiones endobronquiales / Transbronchoscopic Needle Aspiration Cytology in Endobronchial Lesions

Introducción: el diagnóstico temprano del cáncer del pulmón es de vital importancia para tratar de disminuir la mortalidad por esta enfermedad (que es muy alta). La citología aspirativa con aguja fina transbronscoscópica juega un papel significativo en el diagnóstico y estadiamiento del carcinoma broncógeno. Objetivo: determinar la eficacia de la citología aspirativa con aguja fina transbroncoscópica en lesiones tumorales endobronquiales. Métodos: se realizó un estudio descriptivo, de corte transversal prospectivo, en pacientes a los que se les realizó citología aspirativa con aguja fina transbroncoscópica en lesiones endobronquiales, en el servicio de Neumología del Hospital Hermanos Ameijeiras, en el periodo comprendido entre enero de 2015 a enero de 2016. Se tomó en cuenta como variables la ubicación del tumor endobronquial, el diagnóstico citológico, el tipo de lesión tumoral y las complicaciones. Resultados: predominó el sexo masculino, el rango de edad mayor de 60 años y el color de piel blanca. Las lesiones fueron más frecuentes del lado derecho, fue más eficaz el proceder cuando los tumores se ubicaron hacia los bronquios inferiores, y se describían como masa tumoral o tipo mixta. La sensibilidad diagnóstica fue de aproximadamente 70 por ciento. El número de complicaciones fue muy bajo. Conclusiones: la biopsia aspirativa con aguja fina de tumores endobronquiales tiene un alto rendimiento diagnóstico con un número bajo de complicaciones(AU)

Introduction: Early diagnosis of lung cancer is vital in trying to reduce mortality from this disease (which is very high). Transbronscoscopic needle aspiration cytology plays a significant role in the diagnosis and staging of bronchogenic carcinoma. Objective: Determine the efficacy of transbronchoscopic needle aspiration cytology in endobronchial tumor lesions. Methods: A prospective, cross-sectional, descriptive study was performed in patients undergoing transbronchoscopic needle aspiration cytology in endobronchial lesions, in the Pulmonology Department of Hermanos Ameijeiras Hospital, from January 2015 to January 2016. The location of the endobronchial tumor, the cytologic diagnosis, the type of tumor lesion and the complications were taken into account as variables. Results: Age range was greater than 60, male gender and white skin color predominated. The lesions were more frequent on the right side, the procedure was more effective when the tumors were located towards the lower bronchi, and they were described as tumor mass or mixed type. The diagnostic sensitivity was approximately 70 percent The number of complications was very low. Conclusions: Spinal biopsy with fine needle of endobronchial tumors has a high diagnostic yield with a low number of complications(AU)

Histopathological Profile Of The Bronchogenic Carcinoma Among Saurashtra Region Of Gujarat.

Background: Bronchogenic carcinoma is a malignant neoplasm of the lung arising from the epithelium of the bronchus or bronchiole. The bronchogenic carcinoma is classified as Squamous cell carcinoma, Small cell carcinoma, Adenocarcinoma, Large cell Carcinoma and Adeno-squamous carcinoma. Methodology: 50 patients of known bronchogenic carcinoma from the P.D.U. Genral hospital and Medical College were included in the study; 48 patients were investigated as Fine Needle Aspiration Cytology for histopathological classification. Results: The commonest bronchogenic carcinoma was squamous cell carcinoma (42%) followed by adenocarcinoma (20%), small cell carcinoma (4%), adenosqumaous cell carcinoma (4%) and large cell carcinoma (2%). Conclusion: The histopathological examination of bronchogenic carcinoma cases is helpful for the management of the patients.

Pulmonary Mycetoma Due To Candida Albicans Masquerading Bronchogenic Carcinoma In A Patient With Type -2 Diabetes Mellitus

Fungal lesions of lung presenting as a mass are called mycetomas. Mycetoma is a conglomeration of cellular debris and mucous with finely woven fungal hyphae present in a cavity in pulmonary parenchyma or a bronchus.The most common infections causing pulmonary mycetoma are aspergillus.Candida species causing pulmonary mycetoma is rare. A70 year old patient of Diabetes and chronic obstructive pulmonary diseases (COPD), presented with acute on chronic respiratory symptoms. On contrast enhanced CT scan of thorax he was diagnosed as having a heterogeneously enhancing mass lesion in left lower lobe and minimal pleural effusion with a provisional diagnosis of neoplasm. Thorough examination of oral cavity revealed thrush. CT guided biopsy confirmed pulmonary candidiasis. Patient responded well to medical treatment. Only a few such cases have been reported in literature.

A rare case of primary adenoid cystic carcinoma of lung.

A 33-year-old male presented with repeated episodes of blood-streaked sputum for last one-and half-year. Chest radiograph showed consolidation in the right lower zone. Fibreoptic bronchoscopy revealed an endoluminal growth in the right lower lobe bronchus. Histopathological examination of bronchoscopic biopsy specimen confirmed adenoid cystic carcinoma.

Comparison study of clinicoradiological profile of primary lung cancer cases: An Eastern India experience.

Context: According to the first population-based cancer registry from eastern part of India, Kolkata and its surrounding areas have the highest prevalence of lung cancer in India. However, there is very limited data from this part of the country. Aims: The aim of this study is to find out the demographic and clinicoradiological profile of primary bronchogenic carcinoma. Settings and Design: This is a retrospective review of lung cancer cases diagnosed in two tertiary institutes of Kolkata over a period of 4 years. Materials and Methods: We have reviewed the cases with proven histological or cytological diagnosis of primary bronchogenic carcinoma and chi-square test is done to calculate statistical significance. Results: Out of 607 patients, male 489 and female 118, 67.7% are from rural area, 67.2% are smoker and only 9.4% are ≤40 years of age. Smoking is the major risk factor for primary lung cancer (P = 0.000) but no significance could be established with the different histological subtypes (P = 0.207). Though squamous cell carcinoma (SCC) is the most predominant variety (35.1%), adenocarcinoma and undifferentiated type are overrepresented in ≤40 years. SCC occurs at a significantly higher age group (60.84 ± 12.16 years) than other subtypes (P = 0.000). At least 55.2% cases of nonsmall cell lung cancer and 54% of small cell lung cancer presented in very advanced stage. Conclusions: SCC is the most common histological subtype of primary bronchogenic carcinoma. The relatively increased frequency of adenocarcinoma in our study as compared to other studies from India is probably due to higher proportion of nonsmokers.

Surgical results and prognosis of patients with primary bronchogenic carcinoma aged less than 30 years / 中华胸心血管外科杂志

ObjectiveTo investigate and analyze the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients.MethodsA retrospective review is presented of patients less than 30 years with surgical treatment of bronchogenic carcinoma between 1969 and 2008.There were59 patients (36 male and 23 female).Mean age was 23 years ( range 8-29 ) .The ratio of men to women patients was 1.7∶1.Forty-nine cases ( 83.0% ) were symptomatic at presentation and 18 cases(30.5% )were misdiagnosed as other diseases.Surgical procedures included radical resection in 46 cases,palliative resection in 3 cases,thoracotomy only for unresectable disease in 7 cases and VATS biopsy in 3 cases.The histological types were 18 adenocarcinomas,13 carcinoids,9 mucoepidermoid carcinoma,5 squamous cell carcimomas,4 small cell lung cancer,3 adenosquamous carcinoma and 4 others.On TNM staging,8 cases in stage Ⅰa,3 cases in stage Ⅰb,9 cases in stage Ⅱ a,12 cases in stage Ⅱb,15 cases in stage Ⅲa,8 cases in stage Ⅲb,4 cases in stageⅣ.ResultsThere were no operative death in radical group.Post-operative atelectasis in 3 cases.One case died from postoperative respiratory failure in explosive group,the postoperative five year survival rate was 27.0%.radical resection group 5-year survival was 35%.Univariate analysis identified TNM stage and surgical procedures as predictors of survival( P <0.05).factors that had no significant effect on overall survival included gender,histologic sbutype and postoperative chemotherapy (P > 0.05).The 5 year survival in stage Ⅰ,Ⅱ,Ⅲa,Ⅲb + Ⅳ were 75.0%,33.3%,14.3% and 0,respectively.The 5 year survival in lobectomy,pneumonectomy and exporsive were 43.0%,18.2% and O,respectively.On multivariate analysis,TNM stage of disease was the only independent predictor of survival ( P =0.000) .ConclusionWe should pay attention to adolescent lung cancer and improve the diagnosis rate avoiding of delaying surgical treatment.The five year survival rate of radical resection for adolescent lung cancer was good.They should be treated with aggressive multimodality therapy and surgical resection is the first-line treatment for them.

Hallazgos frecuentes por broncoscopía con luz blanca / Frequent findings during bronchoscopy with white light

Se determinó la frecuencia de los hallazgos observados en el Servicio de Broncoscopía del Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, en las broncoscopías realizadas del 1º de 180 enero al 31 de diciembre de 2005, captando la información en una hoja basada en las alteraciones descritas por Shigeto Ikeda. De las 923 broncoscopías realizadas, se incluyen las de 595 adultos en quienes se exploró todo el árbol bronquial. No se incluyeron los enfermos menores de 18 años o con exploración parcial. Fueron 334 del sexo masculino y 261 del femenino. Se utilizaron videofibrobroncoscopios de 4.9 y 6.3 mm de diámetro externo. En 67 broncoscopías, 11.2%, no se encontraron alteraciones. En 528 hubo una o más, sumando en total 1,208 alteraciones. Los cambios anormales orgánicos de la pared bronquial fueron los más frecuentes con 637, 52.7%; las anormalidades endobronquiales 320, 26.4%; las sustancias anormales en la luz bronquial 232, 19.2%; finalmente, alteraciones dinámicas en 19, 1.5%. Predominan los cambios relacionados con cáncer. Se incluyen imágenes representativas.

During 2005 we did a prospective study to determine the frequency of macroscopic findings during conventional white light bronchoscopy; findings were registered in a database specifically designed for this purpose according to Shigeto Ikeda's bronchoscopic findings classification. Five hundred and ninety five adults (334 males, 261 females) underwent a complete bronchoscopic examination; we did not include incomplete studies nor cases without photo or videorecordings; a 4.9 and a 6.3 mm external diameter fiberoptic videobronchoscopes were used. We did not find abnormalities in 11.2%; the rest, 88.8% had one to four abnormalities for a total of 1208 abnormalities; 637 organic changes of the bronchial wall (52.7%), 320 endobronchial abnormalities (26.4%), 232 abnormal substances in the lumen of the airways (19.2%) and 19 functional dynamic disorders (1.5%). Lung cancer associated abnormalities were the commonest bronchoscopic findings. Representative images are shown.

Epidemiología del carcinoma broncogénico en España en los comienzos del siglo XXI / Epidemiology of bronchogenic carcinoma in the early XXI century in Spain

In the early 1990s the Spanish lung cancer incidence and mortality rates where clearly lower than European rates. But recently, in 2002, the incidence and mortality rates where 55.8 and 49.2 cases/100 000 respectively in men (similar to the mean of Southern European countries) and 5.4 y 4.7 cases/100 000 in women (very low rates although growing). This tumor is the most frequent in men and responsible of the highest mortality (15 995 deaths in 2002, 26.2% of all tumor deaths). 2 119 women also died (5.8% of tumor derived deaths). The men from Extremadura, Asturias and Cantabria, and the women from País Vasco, Castilla-León and Navarra showed the highest mortality rates among Spanish communities. Absolute survival in five years time is around 8% based on clinical and epidemiological Spanish studies and the age-adjusted relative survival is 12.4% in men and 12.8% in women based in the Eurocare-3 study

A pesar de que a principios de los '90 las tasas ajustadas de incidencia y mortalidad del carcinoma broncogénico se encontraban en España claramente por debajo de las correspondientes a los países de su entorno europeo, en el año 2002 llegaron a 55.8 y 49.2 casos por 100 000, respectivamente, en hombres, similares ya a la media de los países del sur de Europa. En las mujeres alcanzaron 5.4 y 4.7 por 100 000, valores muy bajos en el contexto continental pero que se encuentran en continuo crecimiento actualmente. El carcinoma broncogénico es el tumor diagnosticado con mayor frecuencia en los hombres españoles y el que ocasiona mayor mortalidad (15 995 fallecimientos en 2002; 26.2% de todas las muertes por tumores). Fue también causa de muerte en 2 119 mujeres (5.8% de las causadas por tumores). Por comunidades autónomas, las tasas brutas de mortalidad más altas las presentan los hombres extremeños, asturianos y cántabros, junto con las mujeres del País Vasco, Castilla-León y Navarra. Según estudios clínico-epidemiológicos españoles, la supervivencia absoluta a los 5 años se halla próxima al 8%, pero la supervivencia relativa (ajustada por edad según otras causas de muerte en una población similar) alcanza el 12.4% en hombres y el 12.8% en mujeres, de acuerdo con los resultados del estudio Eurocare-3

Lavado y cepillado bronquiales en tumores pulmonares centrales y periféricos sospechosos de malignidad / Bronchial washing and brushing in central and peripheral lung masses suspicious of malignancy

El diagnóstico citológico e histopatológico en casos de tumores pulmonares se realiza con alta confiabilidad a través de muestras obtenidas por fibrobroncoscopía (FBC). Puede haber diferencias que dependen de la localización del tumor. Objetivo: Determinar la sensibilidad del lavado, cepillado bronquial y biopsia por (FBC) en una muestra de tumores pulmonares centrales, donde hay alteraciones endoscópicas evidentes y en otra de tumores pulmonares periféricos con sospecha de malignidad donde las alteraciones son menos frecuentes. Casos: Se estudiaron 86 enfermos con tumores pulmonares, 44 centrales (Grupo A) y 42 periféricos (Grupo B). Todos fueron objeto de estudio por FBC con lavado y cepillado; en 15 casos se practicó biopsia. Resultados: Hubo una diferencia significativa (p < 0.005) con respecto a la apariencia normal y anormal entre tumores centrales (A) y periféricos (B). El diagnóstico de malignidad basado en la presencia de células malignas por cepillado y lavado bronquiales fue positivo en 21 del Grupo A y en 14 del Grupo B con sensibilidad de 60 y 40%, respectivamente. En 15 casos de tumor endobronquial se practicó biopsia. En los casos negativos, 23 del A y 28 del B, se emplearon otros métodos diagnósticos (p < 0.05). Se detectaron 76 casos de neoplasias, predominando el carcinoma bronquiogénico (43%). Diez casos fueron procesos infecciosos. Conclusión: El estudio por FBC permanece como un importante método diagnóstico en casos de tumores pulmonares. El lavado y el cepillado tuvieron resultados positivos en 35/86, cifra relativamente baja que sugiere la necesidad de mejorar la calidad de las muestras obtenidas. La negatividad por FBC obliga el empleo de otros métodos diagnósticos. El costo estimado de los procedimientos, erogado por el paciente en dólares americanos, es notablemente menor que en países como Holanda, que se tomó como comparativo.

Cytologic and histologic diagnosis of lung tumors can usually be done by means of fiberoptic bronchoscopy (FOB), but there are some differences in cases of central or peripheral tumors. Objective: To determine the sensititivity of bronchial brushing, lavage and biopsy performed by FBO in a sample of central tumors, with evident bronchial alterations, and another sample of peripheral lesions in which these alterations are less frequent. A preliminary comparison of the costs of FOB in Mexico and Holland was also done. Cases: There were 86 patients with tumoral lesions suspicious of malignancy, 44 central (Group A) and 42 peripheral (Group B); all were subjected to FOB, lavage and bronchial brush ings; biopsy was done in 15 cases of endobronchial lesions. Results: There was a significat difference (p < 0.005) as to the normal or abnormal appearance of the bronchial mucosa between central tumors (A) and peripheral (B) lesions. Diagnosis of malignancy by lavage and brushing based in the finding of malignant cells was positive in 21 of the Group A and in 14 of Group B, sensitivity of 60% and 40% respectively. Biopsy was performed in 15 cases with endobronchial tumor. In the negative cases, 23 in Group A and 28 in Group B, other diagnostic methods were employed (p < 0.05). A total of 76 cases of malignancy were detected; bronchogenic carcinoma was predominant (43%). Ten cases of infectious diseases were identified. Conclusion: FOB remains as an important diagnostic tool in cases of lung tumors. Bronchial lavage and brushing had positive results for malignant cells in 35/86; this relative low figure suggests the need to improve the quality of the samples obtained by FOB. Other diagnostic methods must be used in cases with negative FOB results. Estimated costs, in US dollars, of diagnostic methods are much lower in Mexico than in an European country, The Netherlands.

Rendimento diagnóstico da broncofibroscopia no diagnóstico do câncer de pulmão: análise de 84 exames / Diagnostic yield of fiberoptic bronchoscopy in the diagnosis of lung cancer: analysis of 84 procedures

Introdução: a broncofibroscopia (BFC) é o principal método diagóstico do câncer de pulmão (CP). O objetivo deste estudo foi avaliar o rendimento da BFC no diagnóstico do CP. Métodos: foram restrospectivamente estudados os prontuários de pacientes com suspeita clínica de CP, submetidos a BFC, no período de 1° de Janeiro de 2001 a 31 de Março de 2002, em um hospital universitário terciário. O rendimento da BFC foi avaliado em 3 grupos, de acordo com o resultado obtido ao exame endoscópico: presença de lesão visível, ausência de lesão visível e sinais indiretos de lesão brônquica. Resultados: foram estudados os prontuários de 84 pacientes (62 homens), com média de idade de 55,4 anos (variando de 32-83 anos). O diagnóstico definitivo foi estabelecido através da BFC em 80%dos casos (67/84). O maior rendimento da BFC ocorreu na presença de lesão visível (91%, 58/64), com a biópsia obtendo o diagnóstico em 75% (48/65) dos casos, o lavado brônquico e/ou broncoalveolar em 39% (33/84) e escovando brônquico em 31%; 26/84). O carcinoma escamoso foi o tipo histológico mais frequente (38%; 32/84), seguido do adenocarcinoma (31%; 26/84). Ocorreram complicações em 8% (7/84) dos casos e em somente 2% (2/84) dos pacientes foi necessário interromper o exame por sangramento. Conclusões: a BFC apresenta bom rendimento diagnóstico no CP, sendo os tipos histológicos mais frequente o carcinoma escamoso e o adenocarcinoma.

Introduction: Fiberoptic bronchoscopy (FB) is an excellent method to investigated patients with suspicion of lung cancer (LC). The aim of this manuscript was to evaluate the yield of bronchoscopy for LC in a Universitary Hospital In Rio de Janeiro. Methods: charts of patients underwent to a bronchoscopy from January 1, 2001 to March, 31, 2002 in a University Hospital were retrospectively evaluated. The authors decribe the yield of FB in 3 groups: presence of visible lesion on endoscopy, absence of visible lesion and indirect findings. Results: 84 patients (62 men) were studied with a mean age of 55.4 years (range 32-83 years). A diagnosis was established by FB in 67 (80%, 67/84). Higher yields (90.6%) were found among patients with visible lesion on endoscopy (58/64). Biopsy specimens provided a positived result in 75% (49/65), bronchial washing in 39% (33/84), and bronchial brushing in 31% (10/32). Highest yields were seen in squamous cell lung center cancer (38%, 32/84). Complications were low (8%, 7/84) and severe bleeding leading to interruption of the procedure was associated only with bronchial brushing in 2% (2/84). Conclusions: FB reached a reasonable yield in the diagnosis of LC and most prevalent histological type were squamous cell lung center and adenocarcinoma.

The role of transbronchial fine needle aspiration in the diagnosis of submucosal bronchogenic carcinoma

Transbronchial needle aspiration in the diagnosis of submucosal bronchogenic carcinoma. Although exophytic endobronchial lesions can readily be diagnosed by forceps biopsy through the rigid bronchoscope. The lesion of submucosal or peribronchial by forceps biopsy difficult to diagnose by biopsy. The utility of transbronchial fine needle aspiration through rigid bronchoscope was made in 98 patients presenting with endoscopic abnormalities suggestive of submucosal bronchigenic carcinoma of respiratory department of Bachmai hospital from 3/1991 to 7/1996. Forceps biopsy was positive in 48 patients (58.77%). Transbronchial needle aspiration was positive in 88 patients (88.79%) and detected 6 cases additional carcinomas (who were treated by anti-tuberculosis of the lung). We concluded that TBNA significantly increases the yield, more effective than forceps biopsy alone in the detection of the infiltration of submucosal bronchogenic carcinoma.