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1.
Rev. cuba. cir ; 60(3): e1187, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1347390

ABSTRACT

Introducción: Los cambios en la tecnología médica abarcan todas las especialidades y dentro de ellas, en la cirugía general. Las técnicas mínimamente invasivas han ocupado un papel cimero en el diagnóstico y tratamiento de enfermedades en la cavidad torácica. Objetivo: Describir el uso de las técnicas mínimamente invasivas en el diagnóstico de enfermedades intratorácicas. Métodos: Se realizó un estudio observacional, retrospectivo de corte transversal para evaluar el uso de técnicas mínimamente invasivas en el diagnóstico de las enfermedades intratorácicas en el Hospital Universitario "Manuel Ascunce Domenech" desde enero de 2017 hasta mayo de 2020. El universo estuvo compuesto por 104 pacientes con sospecha diagnóstica de enfermedades benignas o malignas del tórax. Resultados: La mayor parte de los pacientes con enfermedades benignas y malignas del tórax tenían una edad de 49 (±7,05) años, sin significación intersexo. La hipertensión arterial predominó como principal comorbilidad. La videotoracoscopia fue la técnica mínimamente invasiva más empleada y la sospecha de cáncer pulmonar y enfermedad pleural constituyeron las indicaciones más frecuentes que motivaron el proceder. El diagnóstico posoperatorio que predominó en la serie fue el cáncer pulmonar. Las técnicas mínimamente invasivas empleadas mostraron una alta validez. La mayoría de los pacientes egresaron vivos y sin complicaciones. Conclusiones: El uso de técnicas mínimamente invasivas en varias enfermedades intratorácicas son de vital importancia para definir diagnóstico y tratamiento(AU)


Introduction: Changes in medical technology cover all specialties and, within them, general surgery. Minimally invasive techniques have played a paramount role in the diagnosis and treatment of thoracic cavity diseases. Objective: To describe the use of minimally invasive techniques in the diagnosis of intrathoracic diseases. Methods: An observational, retrospective and cross-sectional study was carried out, from January 2017 to May 2020, in order to assess the use of minimally invasive techniques in the diagnosis of intrathoracic diseases at Manuel Ascunce Domenech University Hospital. The universe was made up of 104 patients with suspected benign or malignant diseases of the chest. Results: Most of the patients with benign and malignant chest diseases were 49 (± 7.05) years old, without intersex significance. Arterial hypertension predominated as the main comorbidity. Videothoracoscopy was the most widely used minimally invasive technique, while suspicion of lung cancer and pleural disease were the most frequent indications that motivated the procedure. The postoperative diagnosis that predominated in the series was lung cancer. The minimally invasive techniques used showed high validity. Most of the patients were discharged alive and without complications. Conclusions: The use of minimally invasive techniques in various intrathoracic diseases are of vital importance to define diagnosis and treatment(AU)


Subject(s)
Humans , Pleural Diseases/etiology , Comorbidity , Minimally Invasive Surgical Procedures/adverse effects , Thoracic Cavity/diagnostic imaging , Lung Neoplasms/diagnosis , Cross-Sectional Studies , Retrospective Studies , Observational Studies as Topic
2.
Rev. cuba. med ; 60(2): e1402, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280357

ABSTRACT

Introducción: El melanoma maligno es un tumor de etiología multifactorial, cuando afecta al sistema respiratorio su origen es casi siempre metastásico, y como tumor primario es muy infrecuente, constituye el 0,07 por ciento de los tumores pulmonares malignos. Objetivo: Presentar un caso clínico con diagnóstico de melanoma maligno primario de pulmón. Presentación del caso: Se presenta el caso de una mujer de 64 años de edad, exfumadora, sin antecedentes de melanoma, que presenta tos seca asociada a disnea, los esfuerzos físicos y dolor torácico. Además de astenia y pérdida de peso. Se le realizó biopsia pulmonar mediante broncoscopia y se le diagnosticó melanoma. Conclusiones: El melanoma primario pulmonar es uno de los más raros del tipo de melanoma visceral, es una entidad neumológica infrecuente y el diagnóstico preciso requiere una investigación detallada y el cumplimiento de criterios clínicos y anatomopatológicos específicos(AU)


Introduction: Malignant melanoma is a tumor of multifactorial etiology, when it affects the respiratory system its origin is almost always metastatic, and as a primary tumor it is very infrequent, it constitutes 0.07 por ciento of malignant lung tumors. Objective: To report a clinical case with a diagnosis of primary malignant melanoma of the lung. Case report: We report the case of a 64-year-old woman, former smoker, with no history of melanoma, who had dry cough associated with dyspnea with physical exertion and chest pain. In addition to asthenia and weight loss, she had a lung biopsy by bronchoscopy and was diagnosed with melanoma. Conclusions: Primary pulmonary melanoma is one of the rarest of the visceral melanoma type, this is an infrequent pneumological entity and the precise diagnosis requires detailed investigation and the fulfillment of specific clinical and pathological criteria(AU)


Subject(s)
Humans , Female , Bronchoscopy/methods , Lung Neoplasms/diagnosis , Melanoma/diagnosis
3.
Neumol. pediátr. (En línea) ; 16(4): 172-176, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1362265

ABSTRACT

El sarcoma sinovial primario de pulmón (SSPP) localizado en bronquio, es una entidad no reportada en la edad pediátrica. Se presenta el caso de un niño de siete años con antecedente de aparentes neumonías recurrentes derechas de siete meses de evolución; en la evaluación por neumología pediátrica se destaca en las radiografías de tórax, la presencia de atelectasias recurrentes en lóbulo medio e inferior derecho, por lo que se realiza broncoscopia, donde se observa una masa obstruyendo el 100% de la luz del bronquio fuente derecho y se sospecha tumor carcinoide. Se realiza extirpación de masa endobronquial con fines diagnósticos y terapéuticos, incluyendo resección segmentaria bronquial y anastomosis término-terminal. El respectivo análisis inmunohistoquímico muestra hallazgos sugestivos de sarcoma sinovial monofásico. Se descarta compromiso tumoral extrapulmonar, por lo que se diagnostica como tumor primario de bronquio. Se administraron 7 ciclos de quimioterapia y 31 sesiones de radioterapia. Actualmente en control, sin evidencia de metástasis, tumores residuales o recidivas.


Primary Synovial Sarcoma of Lung (PSSL) located in the bronchus is an unreported entity in pediatric age. We present the case of a 7-year-old child with a history of apparent recurrent right pneumonia of 7 months of evolution; in the evaluation by pediatric pulmonology, the presence of recurrent atelectasis in the middle and lower right lobe is highlighted on chest X-rays, so bronchoscopy is performed, where a mass is observed obstructing 100% of the right bronchus lumen and carcinoid tumor is suspected. Endobronchial mass resection is performed for diagnostic and therapeutic purposes, including bronchial segmental resection and termino-terminal anastomosis. The respective immunohistochemical analysis shows suggestive findings of monophasic synovial sarcoma. Extrapulmonary tumor involvement is ruled out, so it is diagnosed as a primary bronchial tumor. 7 cycles of chemotherapy and 31 sessions of radiation therapy are given. Currently in control, with no evidence of metastasis, residual tumors, or recurrence.


Subject(s)
Humans , Male , Child , Sarcoma, Synovial/surgery , Sarcoma, Synovial/diagnosis , Lung Neoplasms/surgery , Lung Neoplasms/diagnosis , Bronchoscopy , Radiography, Thoracic , Sarcoma, Synovial/pathology , Lung Neoplasms/pathology
4.
Chinese Journal of Lung Cancer ; (12): 867-873, 2021.
Article in Chinese | WPRIM | ID: wpr-922153

ABSTRACT

The incidence rate of lung cancer is one of the highest incidence of malignancies in China. The gold standard for diagnosis requires pathological examination or cytological examination of biopsy. The invasive and sensitive nature of the two limits their use. Sputum contains a large number of nucleic acids and proteins, which is a good reflection of lung function. Lung cancer tissue will also affect the biological components in sputum. The detection of bioactive substances in sputum can contribute to the diagnosis of lung cancer. Based on the current research results at home and abroad, this paper reviews the bioactive substances in sputum that can be used for the diagnosis of lung cancer.
.


Subject(s)
Biopsy , China , Humans , Lung , Lung Neoplasms/diagnosis , Sputum
5.
Chinese Journal of Lung Cancer ; (12): 796-803, 2021.
Article in Chinese | WPRIM | ID: wpr-922149

ABSTRACT

Lung cancer is a leading cause of cancer-related morbidity and mortality globally, which is the biggest menace to the health and life of the population. Screening and early detection of lung cancer are effective in reducing its mortality, and the measurement of volatile organic compounds (VOCs) has become a promising clinical means for early detection, course detection and prognosis management of lung cancer, with advantages of rapid speed, non-invasiveness and convenience. Now, a variety of VOCs collection ways and analysis methods have emerged at home and abroad. This report summarized three aspects, including VOCs collection, multiple methods of analysis and progress in the diagnosis and treatment of lung cancer. At last, we discussed the limitations and prospects of VOCs analysis.
.


Subject(s)
Breath Tests , Early Detection of Cancer , Humans , Lung Neoplasms/diagnosis , Volatile Organic Compounds
6.
Chinese Journal of Lung Cancer ; (12): 723-728, 2021.
Article in Chinese | WPRIM | ID: wpr-922133

ABSTRACT

Lung cancer, with the highest incidence in China, is the leading cause of death in cancer patients. Of these, about 85% are patients with non-small cell lung cancer (NSCLC). Therefore, the diagnosis and treatment of patients with lung cancer have always been a top priority nowadays. Fluid biopsy has many advantages, such as safety, convenience, repeatability, low trauma and so on, which are not available in traditional invasive biopsy. In recent years, with the rapid progress of molecular biological detection technology, fluid biopsy, as a new technology, has become the focus of attention. What's more, it contributes to the development of precision treatment and individualized treatment of lung cancer. Liquid biopsy mainly detects circulating tumor DNA (ctDNA), circulating tumor cells (CTCs) and exosomes in peripheral blood. We will make an introduce to the detection and clinical applications of ctDNA, CTCs and exocrine in this article, in order that it can provide insights into future clinical treatment for NSCLC.
.


Subject(s)
Biomarkers, Tumor , Carcinoma, Non-Small-Cell Lung/diagnosis , Circulating Tumor DNA , Humans , Liquid Biopsy , Lung Neoplasms/diagnosis
7.
Medisan ; 24(3)mayo.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1125122

ABSTRACT

Introducción: Se denomina como cáncer de pulmón a un conjunto de enfermedades resultantes del crecimiento aberrante de células del tracto respiratorio, en particular del tejido pulmonar. Objetivo: Determinar los aspectos broncoscópicos e histológicos útiles en la confirmación del diagnóstico de dichas neoplasias malignas. Métodos: Se realizó una investigación descriptiva y transversal de los 346 pacientes atendidos por cáncer de pulmón en el Servicio de Neumología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba durante los años 2016 y 2017, en quienes se realizó broncoscopia. Para ello se utilizaron las variables edad, sexo, técnica diagnóstica empleada, diagnóstico histopatológico, localización más frecuente. Resultados: Predominaron los pacientes en las edades entre los 56 y 75 años (66,1 %), así como el sexo masculino (65,0 %). La biopsia bronquial fue el procedimiento que mayormente reveló la presencia del cáncer (61,3 %) y el tipo histológico más frecuente fue el carcinoma epidermoide (67,8 %). Conclusiones: Se demostró la importancia de la broncoscopia y sus procedimientos diagnósticos para confirmar la existencia del proceso morboso.


Introduction: It is denominated as lung cancer to a group of diseases resulting from the abnormal growth of cells of the breathing tract, in particular of the lung tissue. Objective: To determine the useful bronchoscopic and histologic aspects in the confirmation of the diagnosis of these neoplasms. Methods: A descriptive and cross-sectional investigation of the 346 patients assisted due to lung cancer in the Pulmonology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba during 2016 and 2017 to whom a bronchoscopy was carried out. The variables used were age, sex, diagnostic technique used, histopatologic diagnosis and more frequent localization. Results: The patients aged 56 and 75 (66.1 %), as well as the male sex (65.0 %) prevailed. The bronchial biopsy was the procedure that mostly revealed the presence of cancer (61.3 %) and the most frequent histologic type was the squamous cell carcinoma (67.8 %). Conclusions: The importance of bronchoscopy and its diagnostic procedures to confirm the existence of the morbid process was demonstrated.


Subject(s)
Carcinoma, Squamous Cell/diagnostic imaging , Lung Neoplasms , Lung Neoplasms/diagnosis , Bronchoscopy , Adenocarcinoma
8.
Article in Chinese | WPRIM | ID: wpr-880770

ABSTRACT

OBJECTIVE@#To propose a probabilistic neural network classification method optimized by simulated annealing algorithm (SA-PNN) to discriminate lung cancer and adjacent normal tissues based on permittivity.@*METHODS@#The permittivity of lung tumors and the adjacent normal tissues was measured by an open-ended coaxial probe, and the statistical dependency (SD) algorithm was used for frequency screening.The permittivity associated with the selected frequency points was taken as the characteristic variable, and SA-PNN was used to discriminate lung cancer and the adjacent normal tissues.@*RESULTS@#Three frequency points, namely 984 MHz, 2724 MHz and 2723 MHz, were selected by SD algorithm.SA-PNN was used to discriminate 200 samples with the permittivity at the 3 frequency points as the characteristic variable.After 10-fold cross-validation, the final discrimination accuracy was 92.50%, the sensitivity was 90.65%, and the specificity was 94.62%.@*CONCLUSIONS@#Compared with the traditional probabilistic neural network, BP neural network, RBF neural network and the classification discriminant analysis function (Classify) in MATLAB, the proposed SA-PNN has higher accuracy, sensitivity and specificity for discriminating lung cancer and the adjacent normal tissues based on permittivity.


Subject(s)
Algorithms , Humans , Lung Neoplasms/diagnosis , Neural Networks, Computer , Sensitivity and Specificity
9.
Säo Paulo med. j ; 137(5): 423-429, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1059103

ABSTRACT

ABSTRACT BACKGROUND: Osteosarcoma is the most prevalent malignant bone tumor in children and adolescents. Lung metastases are associated with poor prognosis. OBJECTIVE: The aim here was to explore the prevalence of and risk and prognostic factors for lung metastases in high-grade osteosarcoma patients. DESIGN AND SETTING: Retrospective cohort study based on the Surveillance, Epidemiology and End Results (SEER) database in the United States. METHODS: Data on 1,408 high-grade osteosarcoma patients registered in the SEER database between 2010 and 2015 were extracted. From these, all patients with high-grade osteosarcoma and initial lung metastasis were selected for analysis on risk and prognostic factors for lung metastases. Overall survival was estimated. RESULTS: There were 238 patients (16.90%) with lung metastases at diagnosis. Axial location, tumor size > 10 cm (odds ratio, OR 3.19; 95% confidence interval, CI: 1.58-6.45), higher N stage (OR 4.84; 95% CI: 1.94-12.13) and presence of bone metastases (OR 8.73; 95% CI: 4.37-17.48) or brain metastases (OR 25.63; 95% CI: 1.55-422.86) were significantly associated with lung metastases. Younger age and surgical treatment (hazard ratio, HR 0.46; 95% CI: 0.30-0.71) favored survival. Median survival was prolonged through primary tumor surgery. CONCLUSIONS: The factors revealed here may guide lung metastasis screening and prophylactic treatment for osteosarcoma patients. A primary tumor in an axial location, greater primary tumor size, higher lymph node stage and presence of bone or brain metastases were significantly correlated with lung metastases. The elderly group (≥ 60 years) showed significant correlation with poor overall survival. For improved survival among high-grade osteosarcoma patients with lung metastases, aggressive surgery on the primary tumor site should be encouraged.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Osteosarcoma/pathology , Lung Neoplasms/secondary , Prognosis , Osteosarcoma/surgery , Osteosarcoma/diagnosis , Osteosarcoma/mortality , Survival Analysis , China/epidemiology , Prevalence , Risk Factors , Cohort Studies , Lung Neoplasms/surgery , Lung Neoplasms/diagnosis , Lung Neoplasms/mortality
10.
Salud pública Méx ; 61(3): 347-351, may.-jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1094473

ABSTRACT

Resumen: La detección temprana de cáncer pulmonar (CP) en población de alto riesgo tiene el potencial de diagnosticar la enfermedad en estadios tempranos y facilitar el tratamiento oportuno con el fin de disminuir la tasa de mortalidad. En México, como en otros países en vías de desarrollo, además del tabaquismo, la exposición al humo de leña se posiciona como uno de los principales factores de riesgo para desarrollar CP, lo cual no se ha considerado en estudios de tamizaje previamente publicados. Distintas interrogantes surgen en relación con quiénes son las personas que presentan un alto riesgo de desarrollar CP en América Latina, cuál es el costo-beneficio de poner en marcha un programa de detección oportuna de CP en México y cuáles son los obstáculos que los países de la región enfrentan para su implementación.


Abstract: Lung cancer screening has the potential to be diagnosed at an early stage which increases the possibility of curative treatment in order to decrease the mortality rate. In Mexico, as in other developing nations, along with wood smoke exposure is one of the main risk factors for developing lung cancer, not considered in previously published screening trials. Different questions arise concerning the population at higher risk to develop lung cancer in Latin America, the cost-benefit of implementing a lung cancer screening program and the obstacles facing developing countries when implementing a detection program. To knowledge, there are no lung cancer screening trials in Mexico.


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Early Detection of Cancer , Lung Neoplasms/diagnosis , Mexico
11.
Salud pública Méx ; 61(3): 318-328, may.-jun. 2019. tab, graf
Article in English | LILACS | ID: biblio-1094470

ABSTRACT

Abstract: Objective: To perform a systematic review of the main epigenetic aberrations involved in non-small cell lung carcinomas' (NSCLC) diagnosis, progression, and therapeutics. Materials and methods: We performed a systematic review of the scientific literature on lung cancer epigenetics, focusing on NSCLC. Results: Several advances in the molecular study of classical epigenetic mechanisms and massive studies of lung cancer epigenome have contributed relevant new evidence revealing that various molecular complexes are functionally influencing genetic-epigenetic and transcriptional mechanisms that promote lung tumorigenesis (initiation, promotion, and progression), and are also involved in NSCLC therapy-resistance mechanisms. Conclusion: Several epigenetic complexes and mechanisms must be analyzed and considered for the design of new and efficient therapies, which could be fundamental to develop an integrated knowledge to achieve a comprehensive lung cancer personalized medicine.


Resumen: Objetivo: Realizar una revisión sistemática y estructurada de las principales aberraciones epigenéticas involucradas en el diagnóstico, progresión y terapia del cáncer pulmonar de células no pequeñas (CPCNP). Material y métodos: Revisión sistemática de literatura científica sobre epigenética del cáncer pulmonar del grupo CPCNP. Resultados: El estudio de los diversos mecanismos epigenéticos y su impronta epigenética en el epigenoma del cáncer pulmonar han arrojado nuevas evidencias a nivel biológico, biomédico y médico-clínico del impacto que los mecanismos epigenético-transcripcionales promueven de manera activa y reversible sobre los procesos de tumorigénesis, progresión histopatológica y mecanismos de resistencia a la terapia oncológica pulmonar. Conclusión: Deben analizarse diferentes complejos y mecanismos epigenéticos para el estudio y diseño de esquemas nuevos y eficaces de terapia epigenética, los cuales podrían ser fundamentales para desarrollar un conocimiento integral en el desarrollo de la medicina personalizada en el cáncer pulmonar del grupo CPCNP.


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/genetics , Epigenesis, Genetic , Lung Neoplasms/genetics , Histones/genetics , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/therapy , Disease Progression , DNA Methylation/genetics , Lung Neoplasms/diagnosis , Lung Neoplasms/therapy
12.
Salud pública Méx ; 61(3): 265-275, may.-jun. 2019. tab, graf
Article in English | LILACS | ID: biblio-1094464

ABSTRACT

Abstract: Objective: To analyze the differences in the clinico-pathological and molecular characteristics of non-small cell lung cancer (NSCLC) as well as the clinical outcome of patients by sex and hormonal status. Materials and methods: We performed a retrospective study among 1 104 NSCLC patients. Clinic-pathologic data was recorded and survival outcomes were compared between male and female sex patients, and further by pre and postmenopausal status in females. Results: Women were significantly more likely to be non-smokers (p<0.001), had higher frequency of wood-smoke exposure (p<0.001), EGFR-sensitizing mutations (p<0.001), had better performance status (p=0.020) and had a better overall survival (OS) compared to men (p=0.021). Differences were found also by hormonal status, postmenopausal women had a longer OS compared to premenopausal women (31.1 vs. 19.4 months p=0.046). Conclusion: Our results support the differences in lung cancer presentation by sex and also by hormonal status.


Resumen: Objetivo: Analizar las diferencias en las características clínico-patológicas, moleculares y en la evolución del cáncer de pulmón de células no pequeñas (CPCNP) por sexo y estadio hormonal. Material y métodos: Estudio retrospectivo (N=1 104) en pacientes con CPCNP. Se recabaron datos clínico-patológicos y desenlaces de sobrevida y se compararon entre hombres y mujeres, y entre mujeres pre y postmenopáusicas. Resultados: Las mujeres de este estudio tuvieron significativamente mayor probabilidad de ser no fumadoras (p<0.001), tener exposición a humo de leña (p<0.001), mutaciones en EGFR (p<0.001), mejor estado funcional (p=0.020), y una mejor sobrevida global (SG) en comparación con los hombres (p=0.021). Estas diferencias también se encontraron en cuestión al estatus hormonal, con las mujeres postmenopáusicas presentando una mayor sobrevida en comparación con las premenopáusicas (31.1 vs. 19.4 meses; p=0.046). Conclusión: Los presentes resultados apoyan las diferencias en la presentación del CPCNP de acuerdo con el sexo y estatus hormonal.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/mortality , Lung Neoplasms/diagnosis , Lung Neoplasms/mortality , Sex Factors , Survival Rate , Retrospective Studies , Premenopause , Postmenopause , Mexico
14.
Medicina (B.Aires) ; 79(3): 208-211, June 2019. ilus
Article in Spanish | LILACS | ID: biblio-1020062

ABSTRACT

Los linfomas derivados del tejido linfoide asociado a las mucosas (MALT) son entidades poco frecuentes, de bajo grado de malignidad con escaso o nulo compromiso ganglionar y representan cerca del 80% de los linfomas primarios pulmonares. La aparición sincrónica con adenocarcinoma de pulmón es un hallazgo extremadamente infrecuente. Presentamos el caso de un hombre de 68 años, ex-tabaquista, en quien durante el seguimiento de un nódulo pulmonar se identificó un segundo nódulo y la biopsia quirúrgica confirmó el diagnóstico de ambas neoplasias.


The lymphomas of mucosa-associated lymphoid tissue (MALT), are uncommon entities, of low grade of malignancy with very infrequent or no lymph node involvement. They represent about 80% of the primary pulmonary lymphomas. The synchronous appearance with lung adenocarcinoma is an extremely rare finding. We present the case of an ex-smoker 68-year-old man, in whom, in the follow-up of a pulmonary nodule, a second pulmonary nodule was found. The surgical biopsy confirmed the diagnosis of both neoplasms.


Subject(s)
Humans , Male , Aged , Adenocarcinoma/diagnosis , Lymphoma, B-Cell, Marginal Zone/diagnosis , Adenocarcinoma of Lung/diagnosis , Lung Neoplasms/diagnosis , Neoplasms, Multiple Primary/diagnosis , Adenocarcinoma/surgery , Adenocarcinoma/pathology , Adenocarcinoma/diagnostic imaging , Tomography, X-Ray Computed , Adenocarcinoma of Lung/surgery , Adenocarcinoma of Lung/pathology , Adenocarcinoma of Lung/diagnostic imaging , Lung Neoplasms/surgery , Lung Neoplasms/pathology , Lung Neoplasms/diagnostic imaging
15.
Rev. medica electron ; 41(2): 410-422, mar.-abr. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1004277

ABSTRACT

RESUMEN Introducción: las metástasis cerebrales cuando aparecen en el curso de un cáncer de pulmón reportan una precaria supervivencia al paciente, los tratamientos incluyen la cirugía o radiocirurgía. La radioterapia holocraneal constituye el estándar cuando los tratamientos locales no son posibles. Se han reportado respuestas del cerebro a la quimioterapia a un nivel comparable al de la enfermedad extra craneal, por lo que la terapia sistémica es una opción razonable para los pacientes sin síntomas neurológicos, o con síntomas relativamente controlados. Objetivo: evaluar la supervivencia de los pacientes según esquemas de tratamientos recibidos. Materiales y métodos: se realizó un estudio descriptivo y retrospectivo en pacientes con diagnóstico cito-histológico de cáncer de pulmón y metástasis cerebral, atendidos en la consulta externa del Centro Oncológico Provincial de Matanzas, en el período comprendido desde enero del 2013 a diciembre del 2016. Para obtener los datos de los tratamientos realizados, determinar fecha de fallecimiento o de última noticia del paciente se utilizaron las historias clínicas de los enfermos y las bases de datos del Servicio de Radioterapia del Centro. Resultados: el 86,5% de los pacientes recibieron tratamiento con quimioterapia de primera línea, el 76% radioterapia al cerebro y el 61,5% con nimotuzumab. Conclusiones: la aplicación de la quimioterapia, la radioterapia holocraneal y la inmunoterapia tuvieron un valor significativo, proporcionando un aumento de la supervivencia de los pacientes estudiados.


ABSTRACT Introduction: brain metastasis report a precarious survival when they appear during the course of a lung cancer. The treatments include surgery or radiosurgery. Whole brain radiotherapy is the standard treatment when the local ones are not possible. There are reports of brain answer to chemotherapy at the level of extra brain diseases; therefore, systemic therapy is a reasonable option for the patients without neurological symptoms, or with relatively controlled symptoms. Objective: to assess the patients´ survival according to the schemes of the received treatments. Materials and methods: a retrospective descriptive study was carried out in patients with cytohistological diagnosis of lung cancer and brain metastasis, who attended the external consultation of the Provincial Oncological Center of Matanzas in the period from January 2013 to December 2016. The clinical records and databases of the Radiotherapy Service of the Center were used to obtain the data of the treatments carried out, the patients' date of dead or of the last information about them. Results: 86.5 % of the patients received treatment with front-line chemotherapy, 76 % brain radiotherapy, and 61.5 % with Nimotuzumab. Conclusions: the application of chemotherapy, whole brain radiotherapy and immunotherapy achieved great improvement, increasing the survival of the studied patients.


Subject(s)
Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/mortality , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapy , Neoplasm Metastasis/diagnosis , Neoplasm Metastasis/drug therapy , Neoplasm Metastasis/radiotherapy , Epidemiology, Descriptive , Prospective Studies
16.
Arch. endocrinol. metab. (Online) ; 63(2): 175-181, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001221

ABSTRACT

SUMMARY Cushing's syndrome (CS) is an uncommon condition that leads to high morbidity and mortality. The majority of endogenous CS is caused by excessive ACTH secretion, mainly due to a pituitary tumor - the so-called Cushing's disease (CD) - followed by ectopic ACTH syndrome (EAS), an extra-pituitary tumor that produces ACTH; adrenal causes of CS are even rarer. Several methods are used to differentiate the two main etiologies: specific laboratory tests and imaging procedures, and bilateral inferior petrosal sinus sampling (BIPSS) for ACTH determination; however, identification of the source of ACTH overproduction is often a challenge. We report the case of a 28-year-old woman with clinical and laboratory findings consistent with ACTH-dependent CS. All tests were mostly definite, but several confounding factors provoked an extended delay in identifying the origin of ACTH secretion, prompting a worsening of her clinical condition, with difficulty controlling hyperglycemia, hypokalemia, and hypertension. During this period, clinical treatment was decisive, and measurement of morning salivary cortisol was a differential for monitoring cortisol levels. This report shows that clinical reasoning, experience and use of recent methods of nuclear medicine were decisive for the elucidation of the case.


Subject(s)
Humans , Female , Adult , ACTH Syndrome, Ectopic/diagnosis , Carcinoma, Neuroendocrine/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Saliva/metabolism , ACTH Syndrome, Ectopic/etiology , Hydrocortisone/blood , Petrosal Sinus Sampling , Carcinoma, Neuroendocrine/complications , Carcinoma, Neuroendocrine/diagnosis , Adrenocorticotropic Hormone/blood , Diagnosis, Differential , Positron Emission Tomography Computed Tomography , Lung Neoplasms/complications , Lung Neoplasms/diagnosis
17.
Rev. cuba. cir ; 58(1): e740, ene.-mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1093143

ABSTRACT

RESUMEN Introducción: El cáncer de pulmón representa una gran carga de enfermedad a nivel global. La centralización de la atención de los pacientes para el diagnóstico y tratamiento añade un salto de calidad en la atención sanitaria. Objetivo: Evaluar los resultados de la consulta multidisciplinaria de cáncer pulmonar en la provincia de Camagüey. Métodos: Se realizó un estudio observacional analítico retrospectivo desde noviembre de 2015 hasta febrero de 2017. El universo quedó conformado por 182 pacientes evaluados en la consulta multidisciplinaria con cáncer pulmonar. La muestra, la cual fue de tipo probabilística, la constituyeron los 182 pacientes diagnosticados de cáncer pulmonar, coincidiendo con el universo. Se trabajó con una población objetiva conformada por todos los pacientes adultos que acudieron a la consulta antes mencionada y que fueron diagnosticados de cáncer pulmonar en la sistemática diagnóstica. Resultados: Prevaleció el sexo masculino y el grupo de edad entre 60 y 69 años. Todos los pacientes tenían relación con el hábito de fumar, y al menos, una radiografía de tórax al momento de la primera evaluación. El síntoma fundamental fue la tos. Más de la mitad de los pacientes acudieron antes de 60 días de comienzo de los síntomas, y recibieron el diagnóstico e iniciaron el tratamiento antes del mes. El adenocarcinoma fue el tipo histológico más frecuente, como la localización tumoral periférica, el estado funcional se deterioró en relación con la etapa clínica y el tratamiento quirúrgico fue el más indicado. Conclusiones: La atención multidisciplinaria en pacientes con cáncer pulmonar se ha convertido en el estándar de cuidado. La centralización de la atención, así como la aplicación de una vía clínica optimiza el uso de la tecnología disponible adecuada a cada caso en particular(AU)


ABSTRACT Introduction: Lung cancer represents a great burden of disease worldwide. Patient care centralization for diagnosis and treatment adds a leap in the quality of health care. Objective: To evaluate the results of the multidisciplinary consultation of lung cancer in the province of Camagüey. Methods: A retrospective, analytical, observational study was conducted from November 2015 to February 2017. The study population consisted of 182 patients with lung cancer who were evaluated in the multidisciplinary consultation. The sample, which was probabilistic, was made up of 182 patients diagnosed with lung cancer, coinciding with the population. We worked with an objective population made up of all the adult patients who attended the aforementioned consultation and who were diagnosed with lung cancer in the diagnostic systematics. Results: There was a predominance of the male sex and the age group between 60 and 69 years old. All the patients were associated with the smoking habit, and had at least one chest radiograph at the time of the first evaluation. The main symptom was coughing. More than half of the patients came before 60 days after the onset of symptoms, were diagnosed and started treatment before the month. The adenocarcinoma was the most frequent histological type, as the peripheral tumor location. The functional state was deteriorated in relation to the clinical stage and the surgical treatment was the most indicated. Conclusions: Multidisciplinary care in patients with lung cancer has become the standard of care. The centralization of care, as well as the application of a clinical approach, optimizes the use of available technology appropriate to each particular case(AU)


Subject(s)
Humans , Male , Middle Aged , Aged , Adenocarcinoma of Lung/therapy , Lung Neoplasms/diagnosis , Retrospective Studies , Observational Study
18.
Rev. chil. enferm. respir ; 35(1): 58-62, mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1003647

ABSTRACT

Introducción: La linfangioleiomiomatosis Pulmonar (LAM) es una rara y progresiva enfermedad; caracterizada por proliferación excesiva de células musculares lisas a partir de vasos linfáticos, sanguíneos y vías aéreas. En conjunto al anormal crecimiento celular descrito, se aprecia degeneración quística difusa del parénquima pulmonar, lo que puede reflejarse desde cuadros completamente asintomáticos hasta el deterioro severo del intercambio gaseoso con insuficiencia respiratoria fulminante. Descripción del caso: Paciente femenino de 41 años de edad, con cuadro clínico consistente en tos seca ocasional, asociada a dolor leve de características pleuríticas en 'puntada de costado ' derecha. Ante la no mejoría clínica, se indica estudio imagenológico donde se demuestra neumotorax espontáneo derecho. En estudio tomográfico se aprecian además lesiones pulmonares quísticas. El estudio anátomo-patológico demuestra cambios estructurales que se reportan compatibles con LAM. Conclusión: Dada la simplicidad de los síntomas con que la LAM puede debutar, su confirmación diagnóstica se genera en fases avanzadas de la enfermedad, cuando el daño pulmonar importante conlleva a la aparición de factores clínicos con mayor repercusión sobre el estado general de los pacientes por lo que la realización de estudios imagenológicos tempranos gana vital importancia.


Introduction: Pulmonary lymphangioleiomyomatosis (LAM) is a rare and progressive disease; characterized by airway, lymphatic and blood vessels-smooth muscle cells excessive proliferation. Added to the abnormal cell growth, parenchymal cystic degeneration is present, which can be reflected initially as a asymptomatic course and can progress to severe gaseous exchange deterioration and fulminating respiratory insufficiency. Case description: A 41-year-old female patient with a clinical course consisting of occasional dry cough, associated with mild pleuritic pain on the right side of thorax. As no improvement was achieved, thoracic imaging study was performed, where a right pneumothorax was found. Tomography images showed multiple lung cystic lesions. Anatomopathological study reports structural changes compatible with LAM. Conclusion: Given the simplicity of the symptoms that LAM can debut with, its diagnostic confirmation is generated in advanced stages of the disease, when the important pulmonary damage leads to the appearance of clinical factors with greater impact on the general state of patients so early thoracic imaging studies gain vital importance.


Subject(s)
Humans , Female , Adult , Lymphangioleiomyomatosis/diagnosis , Lymphangioleiomyomatosis/therapy , Lung Neoplasms/diagnosis , Lung Neoplasms/therapy , Pneumothorax/etiology , Spirometry , Radiography, Thoracic , Tomography, X-Ray Computed , Lymphangioleiomyomatosis/complications , Sirolimus/therapeutic use , Cysts/etiology , Lung Neoplasms/complications
19.
Säo Paulo med. j ; 137(1): 100-103, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-1004736

ABSTRACT

ABSTRACT CONTEXT: Non-islet-cell-tumor-induced hypoglycemia (NICTH) is caused on rare occasions by secretion of insulin from tumor cells that are reported to have a single tissue origin. CASE REPORT: A 67-year-old male patient had cardia adenocarcinoma and concomitant lung adenocarcinoma with extensive metastases and repeated episodes of intractable hypoglycemia. Immunohistochemical staining for insulin showed that lung adenocarcinoma stained positive and gastric cardia adenocarcinoma stained weakly positive. These results indicate that tumor cells of different tissue origins co-secreted insulin. CONCLUSIONS: This is the first report on intractable hypoglycemia due to co-secretion of insulin from two kinds of primary tumor cells in a single patient.


Subject(s)
Humans , Male , Aged , Stomach Neoplasms/complications , Cardia , Adenocarcinoma/complications , Hypoglycemia/etiology , Lung Neoplasms/complications , Stomach Neoplasms/diagnosis , Immunohistochemistry , Adenocarcinoma/diagnosis , Fatal Outcome , Positron Emission Tomography Computed Tomography , Lung Neoplasms/diagnosis
20.
Rev. medica electron ; 41(1): 130-141, ene.-feb. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-991331

ABSTRACT

RESUMEN Introducción: en las últimas tres décadas, las enfermedades cardiovasculares y las neoplasias malignas han pasado a ser los principales problemas de salud en Cuba como consecuencia de la constante mejoría de los niveles de salud, la prevención de las enfermedades transmisibles, y el incremento de la esperanza de vida al nacer; entre ellas se destaca el cáncer de pulmón como el tumor primario que con mayor incidencia causa compromiso cerebral metastásico. Objetivo: analizar el comportamiento de las metástasis cerebrales en pacientes con cáncer de pulmón. Materiales y métodos: se realizó un estudio descriptivo y retrospectivo en 96 pacientes con diagnóstico cito-histológico de cáncer de pulmón y metástasis cerebral, atendidos en la consulta externa del Centro Oncológico Provincial de Matanzas, entre enero del 2013 y diciembre del 2016. Se obtuvieron los datos clínicos-demográficos a partir de las historias clínicas individuales de los enfermos y el documento de Reporte de Cáncer. Resultados: la mayor incidencia de cáncer de pulmón corresponde a las personas entre 45 y 64 años de edad; comportándose de forma similar para el género masculino como para el femenino, aunque el primero con un mayor número de casos y el color de la piel predominante para ambos sexos fue la blanca. En tanto las metástasis cerebrales son más comunes de la quinta a la séptima década de la vida. Conclusiones: la metástasis cerebral aparece desde edades tempranas hasta la tercera edad y el mayor porcentaje fue diagnosticado a inicio de la enfermedad constituyendo esto un factor de riesgo importante.


ABSTRACT Introduction: in the last three decades, cardiovascular diseases and malignant neoplasms have become the main health problem in Cuba as a consequence of the steady improvement of the health levels, the prevention of the communicable diseases, and the increase of the life expectancy at birth; among them lung cancer stands out as the primary tumor that more frequently causes metastatic brain compromise. Objective: to analyze the behavior of brain metastases in patients with lung cancer. Materials and methods: a retrospective and descriptive study was carried out in 96 patients with cyto-histological diagnosis of lung cancer and brain metastases, who attended the external consultation of the Provincial Oncologic Center of Matanzas, from January 2013 to December 2016. Clinic-demographic data were obtained from the patients´ individual clinical reports and the Cancer Report document. Results: the highest incidence of lung cancer corresponds to people aged 45-64 years; it behaves very similar both in male and in female genders, thought the first one shows more quantity of cases; white color skin predominated in both sexes. As for the brain metastases, they are more common from the fifth to the seventh decade of life. Conclusions: brain metastasis appears from early ages and up to the elder age; the highest percent was diagnosed at the beginning of the disease, being this an important risk factor.


Subject(s)
Humans , Brain Neoplasms/etiology , Brain Neoplasms/epidemiology , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lung Neoplasms/pathology , Lung Neoplasms/epidemiology , Neoplasm Metastasis , Survival Analysis , Epidemiology, Descriptive , Survival Rate , Retrospective Studies
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