Surgical management of pulmonary mucosa-associated lymphoid tissue-derived lymphoma: retrospective study of 86 cases / 中华胸心血管外科杂志

Objective:To summarize our experience in diagnosis and treatment of patients with pulmonary mucosa-associated lymphoid tissue-derived(MALT) lymphoma and to explore the role of surgery.Methods:We retrospectively analyzed the clinical and follow-up data of 86 patients with pulmonary MALT lymphoma in Shanghai Pulmonary Hospital from January 2000 to December 2018. 86 cases were identified with 44 males and 42 females. The mean age was(56.7±10.6) years old. 38(44.2%) cases had symptoms mainly presenting as cough and sputum at diagnosis. The chest CT scan of the patients showed pulmonary consolidation in 39 cases, nodule/mass shadow in 37 cases, usually with air bronchogram. Only 8(9.3%) cases could be diagnosed by non-surgical approach. 58 cases received complete resection, 10 of which followed chemotherapy. 8 of 17 cases who received incomplete resection accepted chemotherapy. The rest 11 cases who experienced surgical biopsy because of uncertain diagnosis were treated by chemotherapy or radio-chemotherapy or just watch-to-wait.Results:The median follow-up of 83 cases was 64 months, ranged from 24 to 219 months. The estimated 5-year and 10-year OS rates were 95.0% and 76.8%, while 5-year and 10-year PFS were 75.7% and 35.1% respectively. Patients who received complete resectionhad better PFS( P<0.001)but similar OS( P=0.395), compared with those received incomplete resection. There were no significant difference in OS and PFS between patients who received complete resection accepted chemotherapy or not( P>0.05). Conclusion:Pulmonary MALT lymphoma has an indolent nature with an excellent long-term survival. Diagnosis is difficult to be made by non-surgical approach. Surgery plays an important role of treatment of pulmonary MALT lymphoma, due to significant improvement of diagnosis rate and radical treatment of localized disease by complete resection.

Relationship between drainage volume on the first postoperative day and complications after video-assisted thoracoscopic surgery lobectomy / 中国胸心血管外科临床杂志

@#Objective 聽 聽To investigate the correlation between the postoperative day 1 (POD1) drainage volume and postoperative pulmonary complications (PPCs). Methods 聽 聽The clinical data of 254 non-small cell lung cancer (NSCLC) patients undergoing thoracoscopic lobectomy at our department from January 2014 to June 2018 were retrospectively reviewed. According to whether there were PPCs after operation, patients were divided into a PPCs group (51 patients, 33 males and 18 females, aged 65.2卤7.3 years) and a non-PPCs group (203 patients, 110 males and 93 females, aged 62.4卤8.2 years). The correlation between POD1 drainage volume and PPCs was analyzed. Results 聽 聽The POD1 drainage volume in the PPCs group was significantly more than that in the non-PPCs group (337.5卤127.4 ml vs. 208.7卤122.9 ml, P=0.000). The result of regression analysis showed that POD1 drainage volume was an independent risk factor for the occurrence of PPCs. Receiver operating characteristic curve (ROC curve) analysis showed that POD1 drainage volume of 265 ml was the cut-off point to predict PPCs. The rate of PPCs in the group of POD1 drainage volume less than 265 ml was significantly lower than that in the group of drainage volume more than 265 ml (8.3% vs. 43.0%, P=0.000). Conclusion 聽 聽The POD1 drainage volume is closely related to the occurrence of PPCs, which can be used to predict the occurrence of PPCs.

Achados patológicos e imuno-histoquímicos de neoplasmas pulmonares primários em caninos na região metropolitana de Porto Alegre, Rio Grande do Sul / Pathological and immunohistochemical findings of primary pulmonary neoplams in dogs in the metropolitan region of Porto Alegre, Rio Grande do Sul

Neoplasmas pulmonares primários são pouco frequentes na medicina veterinária, mas a principal espécie afetada é a canina. Acredita-se que o número de neoplasmas pulmonares primários vem aumentando em animais de companhia, em decorrência do aumento da expectativa de vida, da melhora nas técnicas de diagnóstico e pelo maior contato com poluentes atmosféricos. Este estudo foi realizado para identificar, analisar a frequência, e caracterizar achados patológicos e imuno-histoquímicos dos neoplasmas pulmonares primários em cães na região metropolitana de Porto Alegre, Rio Grande do Sul. No período de janeiro de 2003 a junho de 2016 foram submetidos à necropsia 6.307 caninos. Destes, 36 cães tinham diagnóstico de neoplasma pulmonar primário. O neoplasma mais frequente neste estudo foi o adenocarcinoma papilar (30,5%), seguido do carcinoma lepídico (22,2%). A idade dos cães variou de quatro a 16 anos, com média de 11 anos. Observou-se que a frequência de cães machos (63,9%) prevaleceu sobre as fêmeas (36,1%). Na avaliação imuno-histoquímica, todos os neoplasmas epiteliais foram positivos para pancitoqueratina, 70,6% foram positivos para fator de transcrição de tireoide-1 e 23,5% tiveram coexpressão de pancitoqueratina e vimentina. Dois tumores mesenquimais tiveram imunomarcação para vimentina e S-100, foram negativos para a imuno-histoquímica de actina de músculo liso e melan-A e para a técnica histoquímica de tricrômico de Masson e foram diagnosticados como tumor da bainha de nervo periférico maligno, raramente encontrado como tumor primário de pulmão em animais. Quando é difícil estabelecer um diagnóstico apenas com o exame histológico de rotina, é necessário ressaltar a importância da técnica de imuno-histoquímica para o diagnóstico de neoplasmas pulmonares primários em cães.(AU)

Primary pulmonary neoplasms are uncommon in veterinary medicine; but most frequently affected are dogs. It appears that the number of primary pulmonary neoplasms is increasing in companion animals, due to the increase in life expectancy, improvement of diagnostic techniques and greater contact with air pollutants. This study was realized to identify, analyze the frequency, and to characterize pathological and immunohistochemical findings of primary pulmonary neoplasms in dogs of the metropolitan region of Porto Alegre, Rio Grande do Sul. From January 2003 to June 2016, 6,037 necropsies were performed and in 36 of them primary pulmonary neoplasm was found. The most frequent neoplasm in this study was papillary adenocarcinoma (30.5%) followed by lepidic adenocarcinoma (22.2%). The age of affected dogs ranged from 4 to 16 years, with a mean of 11 years. The frequency of male dogs (63.9%) prevailed over females (36.1%). Through immunohistochemical evaluation all epithelial neoplasms were positive for pancytokeratin, 70.6% were positive for thyroid-1 transcription factor and 23.5% had co-expression of pancytokeratin and vimentin. Two mesenchymal tumors showed immunostaining for vimentin and S-100, were negative for smooth-muscle actin and melan-A immunohistochemistry and Masson's trichrome histochemical technique and were diagnosed as malignant peripheral nerve sheath tumors, rarely found as primary lung tumor in animals. If one has difficulty to establish a diagnosis only through routine histological examination, it is necessary to emphasize the importance of the immunohistochemical technique for the diagnosis of primary pulmonary neoplasms in dogs.(AU)

Analysis of influencing factors of intrafractional positioning errors in the hypofractionated radiotherapy for pulmonary tumors / 中华放射肿瘤学杂志

Objective Image-guided radiation therapy(IGRT)was performed to investigate the intrafractional body motion and identify the relevant influencing factors during hypofractionated radiotherapy for malignant pulmonary tumors. Methods A total of ninety-six patients with malignant pulmonary tumors receiving hypofractionated radiotherapy in Jiangsu Cancer Hospital were enrolled in this clinical trial. The kilo-voltage cone beam CT(kV-CBCT)was acquired prior to each fraction and matched to the planning CT images to correct the set-up errors. CBCT was performed immediately after the end of treatment to evaluate the intrafractional variation in the mediolateral,anteroposterior and craniocaudal dimensions.The relationship between relevant influencing factors and intrafractional variation was analyzed using multivariate linear regression. Results In the anteroposterior and craniocaudal directions,the intrafractional positioning errors were reduced along with the increase of ordinal number of fraction(P= 0.000). In the mediolateral direction, the intrafractional positioning errors were increased along with the longer duration of hypofractionated radiotherapy(P=0.010).The intrafractional positioning errors were decreased over larger body weight(P=0.003).The intrafractional positioning errors were significantly increased when vacuum bag and thermoplastic film were utilized for fixation(P= 0.009). Conclusions Certain intrafractional positioning errors occur during hypofractionated radiotherapy. Relevant influencing factors differ in different directions. Relevant influencing factors should be modified to reduce intrafractional positioning variation and improve the treatment accuracy.

Multifocal kaposiform hemangioendothelioma of soft tissue with bilateral pulmonary involvement in an adolescent / 소아과

Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor of intermediate malignancy with resemblance to Kaposi sarcoma. It occurs predominantly in pediatric age groups as a cutaneous lesion with focal infiltration into the adjacent soft tissue and bone. Although visceral involvement is very uncommon, several cases with bone, retroperitoneal, or mediastinal involvement have been described. KHE has been reported to occasionally occur in unusual sites such as the thymus, tonsils, larynx, paranasal sinuses, deltoid muscle, spleen, uterine cervix, thoracic spine, and even the breast. Multifocal KHE is an extremely rare entity with few reports available in the literature, none of which describes pulmonary involvement. Herein, we report a unique case of multifocal KHE in a 13-year-old boy presenting with a huge soft tissue mass in the upper extremity complicated by bilateral pulmonary nodules that developed into large, necrotic tumor masses.

SPECT/CT fusion imaging analysis of costal single hot spots in patients with lung cancer / 中国医师进修杂志

Objective To analyze the imaging features and clinical significance of solitary costal hot spots in patient with lung cancer on SPECT/CT fusion imaging and the value of low-dose CT for diagnosis.Methods SPECT/CT scan was performed on 68 patients with lung cancer and costal single hot spots using whole body bone imaging.The sites of lesions were classified into four types:junction between costal cartilage and rib,frontal rib,lateral rib,posterior rib.The shapes of lesions were classified into two forms:punctiform and strip shapes,and were analyzed and classified.The differences of the diagnosis of whole body bone imaging and SPECT/CT scan were analyzed.Results Punctiform spots were mainly due to costal fractures(36/68,52.94％).The majority of spots in strip shape were costal metastases (21/23,91.30％).The lesions of junction between costal cartilage and rib were punctiform shape and benign.Hot spots in posterior ribs were mainly costal metastases (18/22,81.82％).Sensitivity of diagnosis of the metastatic bone tumor with whole body bone imaging and SPECT/CT in single hot spot of spine and rib was 69.23％ (18/26) and 92.31％(24/26),specificity 59.52％(25/42) and 85.71％(36/42),accuracy 63.24％(43/68) and 88.24％ (60/68),positive predictive value 51.43％ (18/35) and 80.00％ (24/30),negative predictive value 75.76％ (25/33) and 94.74％ (36/38).SPECT/CT scan had differences with whole body bone imaging in sensitivity (P ＜ 0.05),SPECT/CT scan had significant differences with whole body bone imaging in coincidence and specificity (P ＜ 0.01).Conclusions Useful imaging features can be obtained from SPECT/CT fusion imaging with single costal hot spots,being helpful to differential diagnosis of benign and malignant lesions.SPECT/CT fusion imaging may improve the accuracy to diagnose the rib disease.

Surgical resection for the diagnosis and treatment of primary pulmonary mucosa-associated lymphoid tissue lymphoma / 中国肿瘤临床

Objective:To discuss the clinical and imaging features as well as the treatment and prognosis of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. Methods:We retrospectively analyzed the clinical, imaging, and follow-up data of 13 patients with pulmonary MALT lymphoma in the Chinese PLA General Hospital from April 2000 to July 2012. Results:Of the 13 patients with pulmonary MALT lymphoma, 8 were male and 5 were female (1.6:1 ratio). The age of onset varies from 21 years to 67 years, and the median age is 59 years. The major clinical manifestations include chest discomfort in 6 cases, cough in 2 cases, fever in 2 cases, and chest pain in 1 case. Two cases had no observable discomfort. One patient suffered from Sj?gren's syndrome. The chest CT of the patients showed pulmonary consolidation with air bronchogram in 3 cases, patchy shadows in 3 cases, mass shadow in 4 cases, and ground-glass opacities in 4 cases. In addition, 10 cases showed bilateral pulmonary multiple changes, 4 showed mediastinal lymph node enlargement, and 1 showed pleural effusion. Operation was performed on 6 patients, 3 of which were given postoperative adjuvant chemotherapy. Four patients underwent chemotherapy involving the CHOP or R-CHOP regimen, whereas three patients received symptomatic and supportive treatment only. One case was lost to follow-up. The follow-up period ranged from 1 year to 11 years. In one patient, the disease progressed four years after the diagnosis, and the patient died after 11 years. One patient died from the side effects of chemotherapy. The remaining 10 cases were still alive and did not show any progression of the disease. Conclusion:The clinical feature of pulmonary MALT lymphoma is not typical. Thus, imaging techniques cannot detect specific changes. Surgical resection is vital in the diagnosis and treatment of this disease because it can help provide a clear diagnosis, particularly to patients with limited lesions and from which specimens could not be obtained using conventional methods. Moreover, the prognosis of this treatment is generally good.

Value of promoter methylation of RASSF1A, p16, and DAPK genes in induced sputum in diagnosing lung cancers / 中南大学学报(医学版)

Objective To determine the aberrant methylation status of RASSF1A,p16 and DAPK gene promoter region in induced sputum from lung cancer patients and the value of their combined detection in diagnosing lung cancers. Methods Methylation-specific PCR (MSP) was used to detect the promoter methylation status of RASSF1A,p16, and DAPK genes in induced sputum and pathological tissues from 82 patients with lung cancers and 25 patients with pulmonary benign lesion.We also analyzed the relation between methylation status and clinical pathological data.Results The positive rates of promoter methylation of RASSF1A,p16, and DAPK genes in pathological tissues from patients with lung cancers were 63.4%,59.8%, and 58.5%, respectively,and those in induced sputum were 54.9%,48.8%,and 51.2%, respectively. The promoter methylation of RASSF1A,p16, and DAPK genes were not detected in patients with pulmonary benign lesion.There was a significant difference between the lung cancer group and pulmonary benign lesion group (P＜0.05). The methylation rate of RASSF1A gene was significantly lower in the middle and high differentiation and non-metastastic lymph node of lung cancer tissues than that in the poor differentiation and the metastatic lymph node of lung cancer tissues(P＜0.05), and was not correlated with age, sex, smoking index, clinical stage, and pathological types.The methylation rate of p16, and DAPK genes was not significantly correlated with all the above mentioned factors (P＞0.05). The methylation rate of joint detecting RASSF1A, p16, and DAPK genes was 73.2%. Conclusion Joint detection for promoter hypermethylation of RASSF1A, p16, and DAPK genes in induced sputum may be used as a simple and effective index of the diagnosis and prognose of lung cancers, and can improve the positive rate.

Dynamic determination of serum osteopontin level in Pre-and postoperative patients with non-small cell lung cancer / 肿瘤研究与临床

Objective To explore the change of serum osteopontin levels in preoperative and postoperative patients with non-small cell lung cancer (NSCLC) and its clinic significance.Methods The levels of serum osteopontin were detected by ELISA.Results In 88 NSCLC patients,serum osteopontin levels were significantly higher than in benign pulmonary disease and healthy control group(P＜0.05.P＜0.01.respectively) There was no difference between benign pulmonary disease and healthy control group(P＞0.05).Serum osteopontin levels were related to clinical stage and lymph node metastasis,and the levels of serum osteopontin were lower in postoperative patients than in preoperative cases(P＜0.05).For NSCLC.the detection of osteopontin had a sensitivity of 84.1%,a specificity of 92.5%,and an accuracy of 88.1%. Conclusion Increased serum levels of osteopontin may be useful as a helpful clinical biomarker to diagnose earlier,predict prognosis and differentiate from benign pulmonary disease.

Hamartoma pulmonar: informe de un caso / Pulmonary hamartoma: a case report

El caso correspondió a un hombre de 71 años en el que se detectó incidentalmente una tumoración en ápice pulmonar izquierda de aproximadamente 4.5 cm de diámetro, asociada al antecedente de tabaquismo intenso. Se realizó broncoscopia, toma de biopsia y punción transtorácica, sugiriendo carcinoma epidermoide. En los controles radiológicos subsecuentes, se observó crecimiento de la lesión de 4.5 cm a 5 cm en un lapso de tres meses, motivo por el cual se decidió realizar tumorectomía mediante toracotomía posterolateral izquierda. La evolución postoperatoria fue satisfactoria y el diagnóstico histopatológico final fue de hamartoma pulmonar.

A 71-years-old man presented with an incidentally finding of a tumor in the left pulmonary apex that measured approximately 4.5 cm of diameter. The patient, had de preceding of chronic smoking. Bronchoscopy with biopsy by transthoracic punction suggested the presence of epidermoid carcinoma. In the radiologic control, an increase in tumor size from 4.5 cm to 5 cm of the lesion was observed in a period of three months. The patient was submited to surgery and a tumorectomy by posterolateral thoracotomy was performed. The postoperatory evolution was satisfactory. The final diagnosis was hamartoma of the lung.

Endobronchial Myoepithelioma - A Rare Pulmonary Tumour.

An uncommon case of endobronchial myoepithelioma is being presented. Patient presented with progressively increasing obstructive and irritative respiratory symptoms.Awell-circumscribed homogenous endobronchial lesion was detected on computed tomography involving the right main bronchus. Microscopic examination showed no evidence of invasion into bronchial mucosa and surrounding lung tissue. On immuno-staining by PAP method, tumor cells showed positivity for S-100 protein, vimentin and smooth muscle actin. The patient is healthy and free of recurrence four years after right lower lobectomy.

Clinical Analysis of Pulmonary Hamartoma: 37 Cases / 대한흉부외과학회지

BACKGROUND: Pulmonary hamartomas are the most common form of pulmonary benign tumors, and they occur in approximately 2~5% of all pulmonary neoplasm. However, only a few reports have been published on the clinical characteristics of pulmonary hamartoma in Korea. MATERIAL AND METHOD: The charts, X-rays and pathological specimens of 37 pulmonary hamartoma patients who were diagnosed by a pathological examination from January of 2000 to May of 2005 at the Catholic Medical Center were retrospectively reviewed. RESULT: The peak incidence of the tumor occurred in the seventh decade of life (32.4%). There were 23 men (62.6%) and 14 women (37.8%), with mean age of 55.6 years. Twenty-six patients (70.3%) were asymptomatic and 11 patients (29.7%) had symptoms. A total of 29 tumors (78.4%) were parenchymal, and 8 (21.6%) were endobronchial. Twenty cases (54.1%) were in the right lung and 17 cases (45.9%) were in the left lung. The right lower lobe was most commonly involved. Thirty-two (86.5%) hamartomas were diagnosed by surgical resection, 4 cases (10.8%) were diagnosed by bronchoscopic biopsy and 1 case (2.7%) was diagnosed by a fine needle aspiration biopsy. Thirty-four hamartomas (91.9%) were managed by surgical resection without complication. No recurrence or malignant changes were seen during the follow up period. CONCLUSION: Pulmonary hamartomas are most common in males during their fifth to seventh decade and they more commonly involve the right lung. No recurrence or malignant changes were seen during the follow up period.

Diagnosis and surgical treatment of pulmonary sclerosing hemangioma: Report of 33 cases / 中国微创外科杂志

Objective To discuss the diagnosis and surgical management of pulmonary sclerosing hemangioma(PSH).Methods Clinical records of 33 cases of PSH(34 lesions) in this hospital from 1987 to 2002 were reviewed.There were 6 male cases and 27 female cases,with a mean age of 41.3 years(range,24~57 years).Twenty-three cases had an initial symptom of bloody sputum,while 10 cases were disclosed by physical examinations.Image findings revealed solitary mass of the lung in all the cases,in 5 of which a "crescent sign" was presented.Results Preoperatively,28 cases were diagnosed as having pulmonary benign tumors(including 5 cases of suspected sclerosing hemangioma),1 case was clarified as having PSH by percutaneous needle aspiration cytology,and 4 cases were misdiagnosed as having lung cancer. All the patients received surgical treatment,including 21 cases of unilateral pulmonary lobectomy,1 case of bilateral lobectomy,5 cases of segmentectomy,4 cases of wedge resection(including 1 case of bilateral thoracoscopic wedge resection),and 2 cases of tumor excision.The operation time was 45~210 min(mean,90 min),and the blood loss was 100~600 ml(mean,230 ml).No peri-operative deaths were encountered.Follow-up surveys in 33 cases for(3~)10 years(mean,5.5 years) found no recurrence.Conclusions In middle-aged women,if the sign of bloody sputum develops,and image findings indicate the solitary mass of the lung,especially with a "crescent sign",a diagnosis of PSH is possible.Percutaneous needle aspiration cytology is helpful to make a confirmative diagnosis in some patients.It is advisable to manage the disease surgically.

Clinical Analysis of Pulmonary Hamartoma: 29 Cases / 결핵

BACKGROUND: Pulmonary hamartomas are the most common form of benign tumors, occurring in approximately 0.2% of routine autopsies. However, only a few reports on the clinical characteristics of pulmonary hamartoma in Korea have been published. METHODS: The charts, X-rays and pathological specimens of 29 pulmonary hamartoma patients who were diagnosed by a pathological examination from 1990 to 1999 at the Catholic Medical Center were retrospectively reviewed. RESULTS: The peak incidence of the tumor occurred in the sixth decade of life (37.5%). Seventeen patients (58.6%) were asymptomatic and 12 patients (41.4%) had symptoms. Chest discomfort was the most common symptom (31.0%). A total of 25 tumors (86.2%) were parenchymal, and 4 (13.8%) were endobronchial. Twenty cases were in the right lung and 9 cases were in the left lung (approximately 1:2.2). The RLL was the most commonly involved lobe (31.0%). Calcification was noted in 5 cases (19.2%) on a plain X-ray and in 5 cases (29.4%) on chest CT. Accompanied neoplasms were observed in 2 cases. Twenty-four hamartomas (82.8%) were diagnosed by a surgical resection and 4 cases (13.8%) were diagnosed by a fine needle aspiration biopsy. Twenty-six hamartomas (89.7%) were managed by a surgical resection. The follow up ranged from 4 to 55 months (mean, 19.6 months) and no recurrent pulmonary hamartomas were noted. CONCLUSION: Pulmonary hamartoma is more common in females and more commonly involved in the right lung. Calcification was noted only in 19.2% on a plain chest X-ray and 29.4% on a chest CT. No recurrent hamartomas had developed during the follow up period.

Changes of Plasma Von Willebrand Factor Content in Chronic Obstructive Pulmonary Disease and Late Lung Cancer Patients with Qi Deficiency / 广州中医药大学学报

Objective To observe the changes of plasma Von Willebrand factor(vWF) content in chronic obstructive pulmonary disease(COPD) and late lung cancer(LLC) patients with Qi deficiency.Methods The changes of vWF content in 26 COPD patients with Qi deficiency and in 15 LLC patients with Qi deficiency were observed before and after treatment,and were compared with those in 30 healthy volunteers.Results Plasma vWF content before treatment was increased in COPD and LLC patients with Qi deficiency(P0.05).Conclusion Abnormal platelet activation exists in COPD and LLC patients with Qi deficiency,the function of vascular endothelial cells decreases,and the blood is in hypercoagulable state,which accords with the traditional Chinese medical theory of Qi failing in promoting blood circulation.

Clinical study of ~(99)Tc~m-HL91 in diagnosis of pulmonary neoplasms / 西安交通大学学报(医学版)

Objective To evaluate the clinical value of 9 9 Tc m-HL91 as a tumor positive imaging agent in diagnosis of pulmonary neopl asms. Methods We performed 2 h,4 h planar and 4 h tomogr aphy fusion imaging after injection of HL91 on 42 patients with high probability of pulmonary cancer. Tumor-to-normal tissue background (T/N) ratios were meas ured for all scans. Results T/N ratios at 2 h,4 h planar and 4 h transectional imaging in malignant group were 1.50? 0.17 ,1.71?0.22 and 2.72?0.75, respectively; while in benign group, they were 1.21?0.10,1.25 ?0.22 and 1.49?0.36, respectively. 4 h delay T/N ratios in malignant group we re obviously higher than 2 h ( P 0.05). There were no remarkable differences of T/N ra tios in different phases and histological types of lung carcinoma. Using maligna nt transection ratio ( -1s ) as diagnostic threshold, the sensitivity , specificity and accuracy were 84.85% , 88.89% and 85.71% , respectiv ely. Using transection ratio( +1s ) of benign group as diagnostic th reshold , the sensitivity, specificity and accuracy were 90.91%, 88.89% and 95.2 4%,respectively. Conclusion The results indicate that as a tumor positive imaging agent 99 Tc m-HL91 is useful in diagosising pulmon ary neoplasms.