Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 256
Chinese Journal of Lung Cancer ; (12): 847-852, 2021.
Article in Chinese | WPRIM | ID: wpr-922137


BACKGROUND@#The curative potential of various bronchoscopic treatments such as electric snare, carbon dioxide freezing, argon plasma coagulation (APC), Neudymium-dopted Yttrium Aluminium Garnet (Nd:YAG) laser and photodynamic therapy (PDT) for the treatment of intraluminal tumor has been administered previously, but this regimen is not common in the treatment of typical carcinoid. The aim of this study is to investigate the curative effects both in short-term and long-term of interventional bronchoscopy in the treatment of typical carcinoid.@*METHODS@#We retrospectively reviewed the clinical data of typical carcinoid patients who were treated with interventional bronchoscopy for tumor suppression and they were hospitalized in the Emergency General Hospital from December 2010 to December 2020, and Wilcoxon rank sum test and chi-square test were used for analysis.@*RESULTS@#A total of 32 patients were included, including 18 cases of preoperative bronchial artery embolization (embolization rate 56%, 95%CI: 31%-79%). The grade score of dyspnea decreased from before treatment to after treatment, and the difference was statistically significant [(1.44±1.03) score vs (0.25±0.58) score, P=0.003]; The degree of bronchial stenosis decreased from pre-treatment to post-treatment, and the difference was statistically significant [(87.50%±13.90%) vs (17.50%±6.83%), P<0.001]; There was significant difference in bronchial diameter before and after treatment [(0.14±0.18) cm vs (0.84±0.29) cm, P<0.001].@*CONCLUSIONS@#Bronchoscopic interventional therapy has significant short-term and long-term effects in the treatment of typical carcinoid.

Bronchial Neoplasms/surgery , Bronchoscopy , Carcinoid Tumor/surgery , Humans , Neuroendocrine Tumors , Retrospective Studies
J. bras. pneumol ; 45(5): e20180140, 2019. tab, graf
Article in English | LILACS | ID: biblio-1040277


ABSTRACT Objective: To analyze determinants of prognosis in patients with bronchial carcinoid tumors treated surgically and the potential concomitance of such tumors with second primary neoplasms. Methods: This was a retrospective analysis of 51 bronchial carcinoid tumors treated surgically between 2007 and 2016. Disease-free survival (DFS) was calculated by the Kaplan-Meier method, and determinants of prognosis were evaluated. Primary neoplasms that were concomitant with the bronchial carcinoid tumors were identified by reviewing patient charts. Results: The median age was 51.2 years, 58.8% of the patients were female, and 52.9% were asymptomatic. The most common histology was typical carcinoid (in 80.4%). Five-year DFS was 89.8%. Ki-67 expression was determined in 27 patients, and five-year DFS was better among the patients in whom Ki-67 expression was ≤ 5% than among those in whom it was > 5% (100% vs. 47.6%; p = 0.01). Concomitant primary neoplasms were observed in 14 (27.4%) of the 51 cases. Among the concomitant primary neoplasms that were malignant, the most common was lung adenocarcinoma, which was observed in 3 cases. Concomitant primary neoplasms were more common in patients who were asymptomatic and in those with small tumors. Conclusions: Surgical resection is the mainstay treatment of bronchopulmonary carcinoid tumors and confers a good prognosis. Bronchial carcinoid tumors are likely to be accompanied by second primary neoplasms.

RESUMO Objetivo: Analisar os determinantes do prognóstico em pacientes com tumores carcinoides brônquicos tratados cirurgicamente e possível segunda neoplasia primária concomitante. Métodos: Trata-se de uma análise retrospectiva de 51 tumores carcinoides brônquicos tratados cirurgicamente entre 2007 e 2016. A sobrevida livre de doença (SLD) foi calculada pelo método de Kaplan-Meier, e os determinantes do prognóstico foram avaliados. As neoplasias primárias concomitantes aos tumores carcinoides brônquicos foram identificadas por meio da análise dos prontuários dos pacientes. Resultados: A mediana de idade foi de 51,2 anos, 58,8% dos pacientes eram do sexo feminino e 52,9% eram assintomáticos. A classificação histológica mais comum foi carcinoide típico (em 80,4%). A SLD em cinco anos foi de 89,8%. A expressão de Ki-67 foi determinada em 27 pacientes, e a SLD em cinco anos foi melhor nos pacientes nos quais a expressão de Ki-67 foi ≤ 5% do que naqueles nos quais a expressão de Ki-67 foi > 5% (100% vs. 47,6%; p = 0,01). Neoplasias primárias concomitantes foram observadas em 14 (27,4%) dos 51 casos. Entre as neoplasias primárias malignas concomitantes, a mais comum foi o adenocarcinoma pulmonar, observado em 3 casos. Neoplasias primárias concomitantes foram mais comuns em pacientes assintomáticos e naqueles com tumores pequenos. Conclusões: A resseção cirúrgica é o principal tratamento de tumores carcinoides broncopulmonares e propicia um bom prognóstico. É provável que tumores carcinoides brônquicos se relacionem com segunda neoplasia primária.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Bronchial Neoplasms/surgery , Carcinoid Tumor/surgery , Neoplasms, Second Primary/surgery , Time Factors , Bronchial Neoplasms/pathology , Carcinoid Tumor/pathology , Retrospective Studies , Neoplasms, Second Primary/pathology , Statistics, Nonparametric , Disease-Free Survival , Ki-67 Antigen/analysis , Length of Stay
Article in Chinese | WPRIM | ID: wpr-776058


Objective To improve our knowledge of primary benign tracheobronchial tumors and increase the early diagnosis rate. Method The clinical and imaging features of 22 patients with benign tracheobronchial tumors were retrospectively analyzed. The lesions were surgically or pathologically confirmed as schwannomas(n=2),lipomas(n=3),hamartomas(n=3),leiomyomas(n=9),inflammatory myofibroblastoma(n=1),and pleomorphic adenomas(n=2).The early symptoms were concealed and atypical,accompanied by misdiagnoses at different time points.The tumors were located at trachea in 5 patients and at bronchus in 17 patients.All lesions manifested as intraluminal growth with mild to moderate enhancement,without thickening of the tracheobronchial wall.They had smooth margins and wide basements.The lesions were cast-shaped and occluded the lumen in 3 cases;in the remaining 19 cases,the lesions appeared as round or oval nodules. Conclusions Primary benign tracheobronchial tumors are rare.Patients with repeated cough and expectoration that respond poorly to treatment should be screened for benign tracheobronchial tumors.On CT,the benign tracheobronchial tumors are small intraluminal nodules with the smooth surface and wide basement,without thickening of the wall.

Bronchi , Diagnostic Imaging , Pathology , Bronchial Neoplasms , Diagnostic Imaging , Humans , Retrospective Studies , Tomography, X-Ray Computed , Trachea , Diagnostic Imaging , Pathology
Rev. chil. enferm. respir ; 34(2): 118-121, ago. 2018. graf
Article in Spanish | LILACS | ID: biblio-959416


Resumen El carcinoma mucoepidermoide bronquial es una neoplasia infrecuente, representando el 0,1 a 0,2% de los tumores malignos primarios del pulmón. En general tiene un buen pronóstico, sin embargo, existe un subtipo de alto grado de pronóstico más ominoso. En este artículo se presentan dos casos clínicos de carcinoma mucoepidermoide bronquial de bajo grado, enfocado en su diagnóstico y manejo quirúrgico.

ABSTRACT Bronchopulmonary mucoepidermoid carcinoma is an uncommon neoplasm, accounting for 0.1 to 0.2% of primary malignant tumors of the lung. In general it has a good prognosis, however there is a subtype of high grade of more ominous prognosis. In this paper we present two clinical cases of low grade pulmonary mucoepidermoid carcinoma, focused on their diagnosis and surgical management.

Humans , Male , Female , Adolescent , Adult , Bronchial Neoplasms/surgery , Bronchial Neoplasms/diagnosis , Carcinoma, Mucoepidermoid/surgery , Carcinoma, Mucoepidermoid/diagnosis , Prognosis , Thorax/diagnostic imaging , Bronchoscopy/instrumentation , Tomography, X-Ray Computed , Microscopy/instrumentation
Arch. argent. pediatr ; 115(4): 260-264, ago. 2017. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-887359


Los tumores bronquiales son raros en los niños. La mayoría son malignos; el más común es el tumor carcinoide. Con menor frecuencia, se asienta en el árbol traqueobronquial el carcinoma mucoepidermoide. El carcinoma mucoepidermoide representa del 0,1% al 0,2% de los tumores malignos broncopulmonares. Se manifiesta con síntomas de obstrucción de la vía aérea y/o neumonías recurrentes. El diagnóstico precoz y el tratamiento adecuado son de gran importancia en el pronóstico. La broncoscopía con biopsia de la masa endobronquial es el método de elección para confirmar el diagnóstico. El tratamiento consiste en la resección quirúrgica de la lesión. Se presenta a una niña de 11 años con disnea de esfuerzo y tos debidas a un carcinoma mucoepidermoide bronquial de bajo grado de malignidad. Se describen las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de esta rara neoplasia en pediatría.

Bronchial tumors are rare in children. Most of them are malignant, being the carcinoid tumor the most common. Less frequently the mucoepidermoid carcinoma is found in the tracheobronchial tree. Mucoepidermoid carcinoma accounts for 0.1 to 0.2% of all malignant bronchopulmonary tumors. It manifests with symptoms of airway obstruction and/or recurrent pneumonias. Early diagnosis and appropriate treatment are of great importance in the prognosis. Bronchoscopy with biopsy of the endobronchial mass is the method of choice to confirm the diagnosis. Treatment consists of surgical resection of the lesion. We present an 11-year-old girl with dyspnea on exertion and cough due to a low malignant mucoepidermoid carcinoma of the bronchi. We describe the clinical manifestations, the diagnostic methods and the treatment of this rare neoplasia in pediatrics.

Humans , Female , Child , Bronchial Neoplasms/surgery , Bronchial Neoplasms/diagnosis , Carcinoma, Mucoepidermoid/surgery , Carcinoma, Mucoepidermoid/diagnosis
J. bras. pneumol ; 43(4): 259-263, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-893855


ABSTRACT To evaluate the findings on chest CTs in 16 patients (8 men and 8 women) with laryngotracheobronchial papillomatosis. Methods: This was a retrospective study involving patients ranging from 2 to 72 years of age. The evaluation of the CT scans was independently performed by two observers, and discordant results were resolved by consensus. The inclusion criteria were presence of abnormalities on the CT scans, and the diagnosis was confirmed by anatomopathological examination of the papillomatous lesions. Results: The most common symptoms were hoarseness, cough, dyspnea, and recurrent respiratory infections. The major CT findings were nodular formations in the trachea, solid or cavitated nodules in the lung parenchyma, air trapping, masses, and consolidation. Nodular formations in the trachea were observed in 14 patients (87.5%). Only 2 patients had lesions in lung parenchyma without tracheal involvement. Only 1 patient had no pulmonary dissemination of the disease, showing airway involvement only. Solid and cavitated lung nodules were observed in 14 patients (87.5%) and 13 (81.2%), respectively. Masses were observed in 6 patients (37.5%); air trapping, in 3 (18.7%); consolidation in 3 (18.7%); and pleural effusion, in 1 (6.3%). Pulmonary involvement was bilateral in all cases. Conclusions: The most common tomography findings were nodular formations in the trachea, as well as solid or cavitated nodules and masses in the lung parenchyma. Malignant transformation of the lesions was observed in 5 cases.

RESUMO Objetivo: Analisar os achados em TCs de tórax em 16 pacientes (8 homens e 8 mulheres) com papilomatose laringotraqueobrônquica. Métodos: Estudo retrospectivo que incluiu pacientes com idade variando de 2 a 72 anos. As imagens de TC foram avaliadas por dois observadores, de forma independente, e os casos discordantes foram resolvidos por consenso. Os critérios de inclusão foram presença de anormalidades na TC, e o diagnóstico foi confirmado por exame anatomopatológico das lesões papilomatosas. Resultados: Os sintomas mais frequentes foram rouquidão, tosse, dispneia e infecções respiratórias de repetição. Os principais achados na TC foram formações nodulares na traqueia, nódulos sólidos e/ou escavados no parênquima pulmonar, aprisionamento aéreo, massas e consolidação. Formações nodulares na traqueia foram observadas em 14 pacientes. Somente 2 pacientes apresentaram lesões parenquimatosas pulmonares na ausência de acometimento traqueal, e 1 paciente não apresentou disseminação pulmonar da doença, somente comprometimento de via aérea. Nódulos sólidos no parênquima pulmonar foram observados em 14 pacientes (87,5%) e nódulos escavados em 13 (81,2%). Massas foram observadas em 6 pacientes (37,5%); aprisionamento aéreo, em 3 (18,7%); consolidação, em 3 (18,7%); e derrame pleural, em 1 (6,3%). O comprometimento pulmonar foi bilateral em todos os pacientes. Conclusões: Os achados tomográficos mais frequentes foram formações nodulares na traqueia, nódulos sólidos e/ou escavados no parênquima pulmonar e massas parenquimatosas. A transformação maligna das lesões foi observada em 5 casos.

Humans , Male , Female , Child, Preschool , Adolescent , Adult , Middle Aged , Aged , Young Adult , Papilloma/diagnostic imaging , Bronchial Neoplasms/diagnostic imaging , Laryngeal Neoplasms/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Retrospective Studies
Autops. Case Rep ; 6(4): 35-40, Oct.-Dec. 2016. ilus
Article in English | LILACS | ID: biblio-905088


Solitary fibrous tumor (SFT) is a mesenchymal neoplasm that appears primarily in the pleura and rarely in intrapulmonary or endobronchial topography. The authors report the case of a 47-year-old woman who presented obstructive respiratory symptoms for 4 years. The chest computed tomography and bronchoscopy showed an obstructive polypoid lesion located between the trachea and the left main bronchus associated with distal atelectasis of the left lung. A resection of the lesion was performed and, macroscopically, the mass was oval, encapsulated, and firm, measuring 2.3 × 1.7 × 1.5 cm. Histology revealed low-grade mesenchymal spindle cell neoplasm, with alternating cellularity, myxoid areas, and mature adipose tissue outbreaks, as well as blood vessels with irregular walls. The immunohistochemical study was positive for CD34, CD99, and BCL2. The diagnosis was SFT in an unusual topography. The patient's symptoms remitted after tumor excision, and no systemic problems were evident. SFTs primarily affect adults and often follow a benign course; however, their behavior is unpredictable. The presence of necrosis and mitotic activity may portend a poor prognosis. Endobronchial SFTs are rare but should be evaluated and monitored similar to SFTs at other sites, with a long-term follow-up

Humans , Female , Middle Aged , Bronchial Neoplasms/diagnosis , Solitary Fibrous Tumors/pathology
Article in Korean | WPRIM | ID: wpr-37295


We experienced a 59-year-old immunocompetent female patient who complained progressive cough. A bronchoscopic examination revealed an endobronchial mass protruding from the left lower lobe and occluding anterior-basal segment bronchus. Bronchial biopsy and endobronchial ultrasound guided transbronchial needle aspiration were consistent with cryptococcal infection. However, the response of medical therapy was an unsuccessful. Finally, the patient underwent left lower lobectomy with lymph node dissection. We report a case of pulmonary cryptococcosis mimicking bronchogenic lung cancer, and surgical therapy with antifungal treatment resulted in successful resolution of the pneumonia.

Biopsy , Bronchi , Bronchial Neoplasms , Bronchoscopy , Cough , Cryptococcosis , Female , Humans , Lung Neoplasms , Lung , Lymph Node Excision , Middle Aged , Mycoses , Needles , Pneumonia , Ultrasonography
Rev. chil. radiol ; 22(1): 47-50, 2016. ilus
Article in Spanish | LILACS | ID: lil-782656


We describe two cases of lipomatous endobronquial tumors diagnosed by CT. The first case showed a homogeneous fat density endobronquial nodule in the right intermediate bronchus compatible with lipoma. The second patient underwent a CT under the suspicion of a endobronquial lesion after two episodes of pneumonia localized in left lower lobe. The TC demonstrated a fat predominant nodule in the left lower lobe bronchus. The anatomopathologic study confirmed a lipomatous hamartoma with areas of mature cartilage.

. Describimos 2 casos de tumores lipomatosos endobronquiales diagnosticados mediante TC. El primer caso mostró un nódulo homogéneo de densidad grasa de 11 mm localizado en el bronquio intermediario derecho, que correspondió a un lipoma. El segundo paciente se sometió a una TC por la sospecha de lesión endobronquial luego que cursara con 2 episodios de neumonías localizadas en el lóbulo inferior izquierdo. En esta se demostró un nódulo de predominio graso con pequeñas áreas de densidad de partes blandas en el bronquio inferior izquierdo. El estudio patológico confirmó que se trataba de un hamartoma lipomatoso con áreas de cartílago maduro.

Humans , Male , Middle Aged , Aged , Bronchial Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Lipoma/diagnostic imaging , Bronchial Neoplasms/pathology , Hamartoma/diagnostic imaging
Braz. j. med. biol. res ; 48(11): 1039-1047, Nov. 2015. tab, graf
Article in English | LILACS | ID: lil-762910


We collected a series of 136 lung/bronchial and 56 matched lung parenchyma tissue samples from patients who underwent lung/bronchial biopsies and presented invasive carcinoma after lung surgery. The lung/bronchial samples included basal cell hyperplasia, squamous metaplasia, moderate dysplasia, adenomatous hyperplasia, severe dysplasia, squamous cell carcinoma and adenocarcinoma. Matched lung parenchyma tissue samples included 25 squamous cell carcinomas and 31 adenocarcinomas. Immunohistochemistry was performed to analyze for the distribution of hyaluronidase (Hyal)-1 and −3, and hyaluronan synthases (HAS)-1, −2, and −3. Hyal-1 showed significantly higher expression in basal cell hyperplasia than in moderate dysplasia (P=0.01), atypical adenomatous hyperplasia (P=0.0001), or severe dysplasia (P=0.03). Lower expression of Hyal-3 was found in atypical adenomatous hyperplasia than in basal cell hyperplasia (P=0.01) or moderate dysplasia (P=0.02). HAS-2 was significantly higher in severe dysplasia (P=0.002) and in squamous metaplasia (P=0.04) compared with basal cell hyperplasia. HAS-3 was significantly expressed in basal cell hyperplasia compared with atypical adenomatous hyperplasia (P=0.05) and severe dysplasia (P=0.02). Lower expression of HAS-3 was found in severe dysplasia compared with squamous metaplasia (P=0.01) and moderate dysplasia (P=0.01). Epithelial Hyal-1 and −3 and HAS-1, −2, and −3 expressions were significantly higher in pre-neoplastic lesions than in neoplastic lesions. Comparative Cox multivariate analysis controlled by N stage and histologic tumor type showed that patients with high HAS-3 expression in pre-neoplastic cells obtained by lung/bronchial biopsy presented a significantly higher risk of death (HR=1.19; P=0.04). We concluded that localization of Hyal and HAS in lung/bronchial pre-neoplastic and neoplastic lesions was inversely related to malignancy, which implied that visualizing these factors could be a useful diagnostic procedure for suspected lung cancer. Finalizing this conclusion will require a wider study in a randomized and prospective trial.

Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bronchial Neoplasms/enzymology , Carcinoma, Squamous Cell/enzymology , Glucuronosyltransferase/metabolism , Hyaluronoglucosaminidase/metabolism , Lung Neoplasms/enzymology , Neoplasm Proteins/metabolism , Precancerous Conditions/enzymology , Bronchial Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Cell Adhesion Molecules/analysis , Hyaluronoglucosaminidase/analysis , Hyperplasia/enzymology , Immunohistochemistry , Kaplan-Meier Estimate , Lung Neoplasms/pathology , Multivariate Analysis , Metaplasia/enzymology , Prognosis , Precancerous Conditions/pathology , Severity of Illness Index , Statistics, Nonparametric
Curitiba; s.n; 20151117. 127 p. ilus, graf, tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1037918


O câncer de pulmão é a principal tipo que leva a mortalidade. O objetivo deste estudo foi caracterizar os perfis das neoplasias malignas de brônquio, de pulmão e de pleura no sul do Brasil. Teve abordagem epidemiológica, descritiva e retrospectiva, do banco de dados secundários do Instituto Nacional do Câncer José de Alencar, de janeiro de 2001 a dezembro de 2013, com análise das variáveis disponíveis relacionadas aos indivíduos e a patologias. Para análise de dados foi utilizado o sistema estatístico SPSS versão 21, para analisar a freqüência de 18.115 registros de neoplasia maligna de brônquio, de pulmão e de pleura e 57 casos de mesotelioma. Os resultados apresentaram para a neoplasia maligna de brônquio, de pulmão e de pleura, teve maior incidência no Rio Grande do Sul, com prevalência no sexo masculino (66%), faixa etária entre 60 a 69 anos, da cor branca, casados, com ensino fundamental incompleto, histórico de tabagismo ativo (50%), do grupo CBO-6 trabalhadores de atividades agrícolas. As variáveis sobre a patologia observam-se a prevalência do tipo histológico de adenocarcinoma (34,5%), com estádio III e IV (52%), que necessitaram de tratamentos combinados no combate a neoplasia e 20% evoluíram ao óbito. Evidenciou que a demora na detecção da neoplasia é um problema de saúde pública, sendo investigada inicialmente como uma patologia respiratória benigna. Em relação às variáveis do mesotelioma, verifica se a incidência no sexo masculino, na faixa etária 60 a 69 anos, casados, raça branca, com ensino fundamental completo, com histologia de mesotelioma maligno, estádio IV, fizeram tratamento quimioterápico e 27% evoluíram ao óbito. A prevalência dos casos de mesotelioma foram nos trabalhadores da siderurgia e condutores de veículos. No obstante da tempestividade nota que o estado do Paraná está dentro da tempestividade estabelecida pelo Ministério da Saúde, para o inicio do tratamento. Entretanto esta pesquisa teve como prerrogativa a falta de informações nas variáveis do Inca e da investigação histológica do câncer de pleura que dificulta na análise da situação atual do câncer na região Sul do Brasil, além de fragilizar as políticas de atenção oncológica.

Lung cancer is the leading type that leads to mortality. The objective of this study was to characterize the profiles of malignant neoplasms of bronchus, lung and pleura in southern Brazil. Had epidemiological approach, descriptive and retrospective, the secondary database of the National Cancer Institute José de Alencar, from January 2001 to December 2013, with analysis of the variables available to individuals and related pathologies. For data analysis was performed using SPSS statistical system version 21, to analyze the frequency of malignancy 18,115 records of bronchus, lung and pleura and 57 cases of mesothelioma. The results presented for the malignant neoplasm of bronchus, lung and pleura, had higher incidence in Rio Grande do Sul, with prevalence among males (66%), aged between 60-69 years old, of white, married, with incomplete primary education, history of active smoking (50%), the CBO-6 group activities agricultural workers. The variables on the pathology observed the prevalence of histologic type of adenocarcinoma (34.5%) with stage III and IV (52%), who required combined treatments in the fight against cancer and 20% progressed to death. It showed that the delay in the detection of cancer is a public health problem, being investigated initially as a benign respiratory disease. Regarding mesothelioma variables, verifies that the incidence in males, aged 60 to 69 years, married, Caucasian, with completed elementary school, with histology of malignant mesothelioma, stage IV, did chemotherapy and 27% have evolved death. The prevalence of cases of mesothelioma were workers in the steel and vehicle drivers. In spite of the timing note that the state of Paraná is within the timing set by the Ministry of Health to the start of treatment. However this research was to right the lack of information on the variables of the Inca and histological investigation of pleural cancer that complicates the analysis of current cancer situation in southern Brazil, as well as weakening the cancer care policies.

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Epidemiology , Bronchial Neoplasms , Pleural Neoplasms , Lung Neoplasms , Mesothelioma , Neoplasms , Public Health/statistics & numerical data , Health Information Systems
Article in English | WPRIM | ID: wpr-149067


Epithelial-myoepithelial carcinoma (EMC) of lung is a minor subset of salivary type carcinoma of lung of known low grade malignancy. Histologically, two-cell components forming duct-like structure with inner epithelial cell layer and outer myoepithelial cell layer are characteristics of EMC. In salivary gland, dedifferentiation of conventional low grade malignancy has been reported and is thought to be related with poor prognosis. However, precise histomorphology and prognostic factors of pulmonary EMC have not been clarified due to its rarity. Herein, we reported a rare case of EMC presented as endobronchial mass in a 53-year old woman, which showed predominant solid lobular growth pattern and lymph node metastases.

Bronchial Neoplasms , Epithelial Cells , Female , Humans , Lung , Lymph Nodes , Middle Aged , Neoplasm Metastasis , Prognosis , Salivary Glands
Medicina (B.Aires) ; 74(6): 437-442, dic. 2014. graf, tab
Article in Spanish | LILACS | ID: lil-750485


Con el objetivo de evaluar el valor pronóstico de la 7a estadificación TNM se analizaron 43 mujeres (61%) y 28 hombres (39%) con diagnóstico de tumor carcinoide tratados quirúrgicamente desde enero/1975 hasta diciembre/2011. Mediana de edad: 38 años (13-67). Presentaron carcinoide típico (CT) 63 (89%) pacientes y 8 (11%) carcinoide atípico (CA). Mediana de seguimiento: 4 años (1 - 24 años). Los estadios correspondientes a CT fueron: IA = 33 (52%), IB = 10 (16%), IIA = 2 (3%), IIB = 2 (3%), IIIA = 12 (19%) y IIIB = 2 (3%); para los CA fueron: IA = 1 (12.5%), IIB = 1 (12.5%), IIIA = 2 (25%) y IIIB = 4 (50%). No hubo diferencia estadísticamente significativa en la supervivencia global a cinco años en el análisis estratificando por estadios (p = 0.689), ni analizando separadamente cada tipo histológico (CT p = 0.547; CA p = 0.592). El intervalo libre de enfermedad fue significativamente menor (CT: 3 años vs CA: 2 años, p = 0.000) y las recaídas más frecuentes en el grupo de carcinoides atípicos (CA: 50% vs CT: 2%, p = 0.000). Los pacientes con CT presentaron buena evolución aun en estadios avanzados, mientras que los que tuvieron CA presentaron menor tiempo de supervivencia e intervalo libre de enfermedad, y mayor frecuencia de recurrencia. El subtipo histológico resultó un factor significativo de pronóstico, mientras que la 7ª estadificación TNM no contribuyó en predecir la supervivencia en los tumores carcinoides.

We analyzed 43 women (61%) and 28 men (39%) surgically treated for carcinoid tumors from Jan/1975 to Dec/2011. Median age: 38 years (13-67). Typical carcinoid (TC) appeared in 63 (89%) patients, 8 (11%) suffered from atypical carcinoid (AC). Median follow-up: 4 years (1-24). TC stages were: IA = 33 (52%), IB = 10 (16%), IIA = 2 (3%), IIB = 2 (3%), IIIA = 12 (19%) and IIIB = 2 (3%); AC stages were: IA = 1 (12.5%), IIB = 1 (12.5%), IIIA = 2 (25%) and IIIB = 4 (50%). TNM classification did not show significant differences on 5-years survival period by stage (p = 0.689), even according to histological type (TC: p = 0.547; AC: p = 0.592). The disease-free survival rate was significantly lower (TC: 3 years vs. AC: 2 years, p = 0.000) and relapses were more frequent in AC (AC: 50% vs. TC: 2%, p = 0.000). The 7th TNM staging was not influential in estimating survival from carcinoid tumours in our population. The histological subtype was a better prognostic factor.

Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Bronchial Neoplasms/pathology , Carcinoid Tumor/pathology , Lung Neoplasms/pathology , Neoplasm Staging , Bronchial Neoplasms/surgery , Carcinoid Tumor/surgery , Disease-Free Survival , Lung Neoplasms/surgery , Prognosis , Recurrence
Article in English | WPRIM | ID: wpr-224800


Although endobronchial hamartoma is a rare benign tumor, most patients with endobronchial hamartoma have respiratory symptoms such as obstructive pneumonia, hemoptysis, cough, or dyspnea due to bronchial obstruction. It can cause irreversible post-obstructive pulmonary destruction, thus early diagnosis and treatment is very important. Recently, there have been cases of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and electrocautery procedures for bronchoscopic treatment of malignant or benign central airway obstruction with comparable therapeutic efficacy and few complications. Bronchoscopic cryotherapy is a newly developed technique for management of central airway obstruction. Moreover, it provides diagnostic methods with improving diagnostic yield and safety. We report two cases of endobronchial hamartoma, each diagnosed and definitively treated with bronchoscopic techniques. Endobronchial biopsy and removal was successfully performed by cryotherapy via flexible bronchoscopy without notable complications. Follow-up bronchoscopic examinations excluded residual or recurrent disease.

Airway Obstruction , Aluminum , Biopsy , Bronchial Neoplasms , Bronchoscopy , Cough , Cryotherapy , Diagnosis , Dyspnea , Early Diagnosis , Electrocoagulation , Follow-Up Studies , Hamartoma , Hemoptysis , Humans , Pneumonia , Yttrium
São Paulo; s.n; 2014. [115] p. ilus, tab, graf.
Thesis in Portuguese | LILACS | ID: lil-730875


Os tumores carcinoides broncopulmonares típicos são considerados tumores de baixo grau de malignidade, o que faz com que muitas vezes seja negligenciada sua capacidade de gerar metástases e levar a óbito. A atual impossibilidade de se fazer predições fidedignas do potencial metastático para individualizar a terapêutica e o manejo clínico do paciente portador de tumor carcinoide típico muitas vezes impõe situações de dúvida nas decisões da prática clínica diária. O conhecimento das características moleculares e genéticas desses tumores é a esperança de melhor compreensão de sua história natural, da identificação de seus fatores prognósticos e da avaliação de novas propostas terapêuticas. O objetivo deste estudo foi quantificar três imunomarcadores: o D2-40, o CD-34 e o Ki-67 e avaliar se eles são capazes de predizer metástase. Como informação adicional também foram avaliadas as variáveis clínicas e suas associações com metástases. Material e métodos: Foram analisados prontuários de 97 pacientes submetidos à cirurgia para tratamento de tumor carcinoide típico broncopulmonar e que apresentavam período de acompanhamento pós operatório de cinco anos completos. Foi estabelecido um banco de dados epidemiológicos, anátomopatológicos, cirúrgicos e clínicos relacionados à doença. Os blocos de parafina contendo os tumores primários, metastáticos e os linfonodos ressecados foram recuperados e reavaliados por dois patologistas para confirmação do diagnóstico histológico. Após confirmação diagnóstica foram realizadas as reações imunohistoquímicas para o D2-40, o CD34 e Ki-67. As variáveis demografia, gênero, idade, localização do tumor, tamanho do tumor, margem comprometida, total de linfonodos dissecados e a quantificação dos marcadores Ki-67, CD34 e podoplanina (área linfática e densidade) foram comparadas a cinco desfechos: metástase linfática; metástase em linfonodos hilares, peribrônquicos e pulmonares ipsilaterais (N1); metástase em linfonodos mediastinais...

Typical bronchopulmonary carcinoid tumors are slow-growing tumors considered to be of low malignancy, a fact that often underscores their capacity to generate metastasis that leads to death. The literature does not contain any assessment of the metastatic potential that would allow for individualized and optimized therapy that could have a positive impact upon the survival rate of patients. Genetic and biomolecular studies are the most promising venues for better comprehension of the behavior and natural history of such tumors. The objective of this investigation was to analyze three immunomarkers associated to malignity phenotypes: D2-40, CD-34, and Ki-67, and to verify whether or not they are associated to metastasis. D2-40 is a specific marker of the proliferation of the lymphatic endothelium and allows for the quantification of lymphangiogenesis. CD-34 identifies the endothelial cells of micro vessels and quantifies angiogenesis. Ki-67 in turn is a marker of neoplasia cell proliferation. As additional information several clinical variables were scrutinized for their association to metastasis. Ninety-seven subjects were assessed herein. These had undergone surgery for typical bronchopulmonary carcinoid tumor and all had complied with a full 5-year follow-up period. The paraffin blocks containing the primary and metastatic tumors and the dried lymph nodes were recovered. Once the histologic diagnosis was confirmed immunohistochemical reactions were performed for D2-40, Ki-67, and CD-34. The variables demography, gender, age, tumor site, tumor size, compromised margin, total dissected lymph nodes and quantification of D2-40 (lymphatic area and density), Ki-67 and CD-34 markers were compared to 5 outcomes: lymphatic metastasis, metastasis in hilar, peribronchic and ipsilateral pulmonary lymph nodes (N1), metastasis in ipsilateral mediastinal lymph nodes (N2), haematogenic metastasis, and lymphatic or haematogenic metastasis. It was concluded that there is...

Humans , Male , Female , Adolescent , Young Adult , Middle Aged , Immunohistochemistry , Lymphangiogenesis , Neoplasm Metastasis , Neuroendocrine Tumors , Bronchial Neoplasms/pathology , Cell Proliferation , Carcinoid Tumor/pathology
Egyptian Journal of Chest Diseases and Tuberculosis [The]. 2013; 62 (4): 713-716
in English | IMEMR | ID: emr-187200


Objectives: In support with field cancerization theory, some patients with lung cancer [LC] will also have synchronous invasive or pre-invasive bronchial lesions. In this cross sectional - analytic study autofluorescence bronchoscopy [AFB] was used to assess the prevalence of synchronous lesions in patients with LC

Materials and methods: All patients with abnormal sputum cytology underwent white light and AFB. From 335 patients with abnormal sputum cytology referred for AFB, lung cancer was detected in 91 patients [89 male and 2 female] of age [mean +/- SD], 67 +/- 8 years. 77 had squamous cell carcinoma [SqCC], 13 had adenocarcinoma and one patient with small cell lung cancer [SCLC]

Results: Synchronous lesions detected in 26 [29%] patients, 25 [33%] of patients with SqCC, one with adenocarcinoma, no synchronous lesion detected in one patient with SCLC. The most severe detected synchronous lesion was adenocarcinoma in one patient, Carcinoma insitu [CIS] in 4 patients, severe dysplasia in 3 patients, moderate dysplasia in 10 patients, and mild dysplasia in 8 patients. Synchronous lesions were more frequently detected in current smokers [35%], than in ex-smokers [20%] and non-smokers [15%]

Conclusion: Synchronous preinvasive lesions are frequent in patients with LC and AFB should be included in pre-operative evaluation of these patients

Humans , Male , Female , Bronchial Neoplasms , Bronchoscopy/methods , Sputum/cytology
Article in Korean | WPRIM | ID: wpr-646325


The bronchogenic cyst is an uncommon benign congenital anomaly of the primitive ventral foregut. They usually occur in the mediastinum and intrapulmonary regions. Localization in the cervical area is unusual and the majority of cases reported have been found in the pediatric population. Radiologically, it can not be differentiated from other cystic lesions. Therefore, it is pa-thologically confirmed only when there are bronchial tissues such as pseudostratified ciliated columnar epithelium, smooth muscle, mucous gland or cartilage. Since this cyst has potential for complication, a complete excision is mandatory. We recently experienced a case of retropharyngeal bronchogenic cyst presenting as a lump sensation in 32-year-old male. In this article, we reviewed the etiology, the diagnosis, and the treatment of this case with a review of the literatures.

Bronchial Neoplasms , Bronchogenic Cyst , Cartilage , Epithelium , Humans , Male , Mediastinum , Muscle, Smooth , Oropharyngeal Neoplasms , Sensation
Yonsei Medical Journal ; : 403-409, 2013.
Article in English | WPRIM | ID: wpr-89569


PURPOSE: Endobronchial metastasis is defined as documented extrathoracic malignancies metastatic to the endobronchus within a bronchoscopically visible range. Although the clinical and radiologic findings of endobronchial metastasis are similar to primary lung cancer, treatment and prognosis may be different. We hereby investigated the clinical, radiologic and bronchoscopic aspects of endobronchial metastases (EBM) in Korean patients. MATERIALS AND METHODS: A total of 43 patients with EBM who underwent bronchoscopic biopsies from June 1991 to December 2009 at Severance Hospital, Yonsei University College of Medicine in Seoul, Korea, were analyzed retrospectively. We evaluated clinical, radiologic and bronchoscopic characteristics of EBM. RESULTS: The patients consisted of 27 males and 16 females and their ages ranged from 18 to 77 years. The common primary cancers related to EBM were rectal (16.3%), colon (11.6%), breast (9.3%) and uterine (9.3%) cancers. The mean interval from diagnosis of primary cancer to EBM was 36 months, and the mean survival duration from diagnosis of EBM was 16.1 months in 33 deceased patients. CONCLUSION: EBM develop in various types of malignancies at various times with unremarkable manifestations. Therefore, physicians should consider the possibility of EBM, especially if a patient has a history of any malignancy, regardless of respiratory symptoms. Respiratory symptoms related with EBM can be treated by various safe procedures.

Adolescent , Adult , Aged , Breast Neoplasms/pathology , Bronchial Neoplasms/epidemiology , Bronchoscopy , Colonic Neoplasms/pathology , Female , Humans , Male , Middle Aged , Prevalence , Rectal Neoplasms/pathology , Retrospective Studies , Treatment Outcome , Uterine Neoplasms/pathology