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

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

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

Clinico-pathological profile of bronchogenic carcinoma cases presented to Chest Department, Cairo University in the last 10 years

Introduction: Lung cancer was the most commonly diagnosed cancer as well as the leading cause of cancer death in males in 2008 globally

Aim of the work: To evaluate the clinico-pathological profile of the bronchogenic carcinoma cases in the Chest Department, Cairo University

Patients and methods: Retrospective study was carried out in the Chest Department, Cairo University, in which four hundred and four confirmed cases of bronchogenic carcinoma were admitted during July 2002 till July 2012. Data regarding demographics, smoking, histology, clinical presentation, radiographic findings are reported

Results: Our study included 404 confirmed cases of bronchogenic carcinoma. Male to female ratio was 4.6:1. The highest incidence was in the sixth and seventh decades of life [63.6%]. Smoking was found to be the main risk factor in 75.7% of patients. Cough was the most common symptom found in 347 patients [85.9%], followed by dyspnea in 276 patients [68.3%]. Most common radiological finding was mass lesion [49.8%]. Majority of cases were diagnosed by bronchoscopy [68.1%]. Four types of bronchogenic carcinoma were found: squamous cell carcinoma 37.4% adenocarcinoma 29.5%, small cell carcinoma 14.9%, large cell carcinoma 7.2% and undifferentiated carcinoma 11.1%. In females, adenocarcinoma was the predominant cell type [54.2%] while in males, squamous cell carcinoma was the predominant cell type [42.5%]

Conclusion: Bronchogenic carcinoma is more frequent beyond the middle age. Smoking is still the major risk factor. Adenocarcinoma is more common in females and was the most frequent tumor in non-smokers, while in males, squamous cell carcinoma is still the predominant cell type

Endobronchial ultrasonography for lung cancer staging in negative mediastinum on computed tomography

Lung cancer is the most common cause of cancer -related deaths. Chest CT scan is fre-quently unreliable in staging mediastinal lymph node metastases of lung cancer, since interpretation relies on lesion size. EBUS offers a unique way of imaging and parabronchial structures. The pro-cedure is safe, minimally invasive and does not require general anesthesia or hospitalization. The complication rate is extremely low. This study was conducted on eleven patients who were found without CT evidence of enlarged mediastinal lymph nodes. Bronchoscopy and EBUS were performed for the diagnosis of lung cancer. TBLB of detected mediastinal lymph nodes was performed. CT guided biopsies were done for non-diagnosed cases. In this study bronchogenic carcinoma was diagnosed by bronchoscopic biopsy in 6 cases [54.5%], by EBUS-TBNA in 2 cases [18.2%], and by CT guided biopsy in 3 cases [27.3%]. From the eleven patients with negative CT scan, EBUS of mediastinal L.N was positive in four cases [36.4%]. The first case showed 2 small subcarinal L.N station [7] and 2 right hilar lymph node stations[10R]. In the second case EBUS detected 2 subcarinal lymph node stations [7] and one left hilar station [10L] In the third case there was one subcarinal lymph node station [7]. The fourth case showed a left hilar lymph node station [10L]. EBUS is safe and minimally invasive technique in the detection of mediastinal lymph metastasis. EBUS in combination with conventional radiologic tools may contribute to improve diagnosis and staging of lung cancer

level of bronchoalveolar lavage fluid prostaglandine E2; is it diagnostic of bronchogenic carcinoma?

Lung cancer is the leading cause of cancer-related mortality in the United States. Cigarette smoking is the number one risk factor for lung cancer. It causes about 90% of lung cancers [14]. Evaluation of bronchoalveolar lavage level of PGE2 in patients with primary bronchogenic carcinoma. The study was conducted on forty subjects; including twenty patients with bronchogenic carcinoma, ten patients with non-malignant lesions, and ten healthy control subjects. All subjects were submitted to fiberoptic bronchoscopy with bronchoalveolar lavage was done and examined for prostaglandin E2. The PGE2 level was significantly higher in BALF of group III [malignant group] compared to group I and II, with no significant difference between group I and group II. The cut- off value of PGE2 was 45.63 pg/ml with minimal overlap between malignant and benign lesions. Bronchoalveolar lavage level of PGE2 was significantly increased in patients with bronchogenic carcinoma

Fiberoptic bronchoscopy; diagnostic role, a local experience

To demonstrate the usefulness of Bronchoscopy as a diagnostic tool in various pulmonary disorders. Prospective study. Nawaz Medicare Hospital Faisalabad. June 2004 to December 2007. This study was conducted on 52 patients, 37 were male and 15 were female. Their ages ranged from 26 to 85 years. These patients who under went Bronchoscopy were either suspected cases of bronchogenic carcinoma or had difficult to treat un-resolving pneumonias. Endobronchial biopsies and bronchial aspirates were obtained. In the patients suspected of bronchogenic tumor 66.67% patients turned out to be positive on endobronchial biopsies. Bronchial aspirates were diagnostic in 73.32% cases of un-resolving pneumonias. The commonest symptoms in patients under going Bronchoscopy were haemoptysis and cough. Bronchoscopy is very useful in the diagnosis of suspected cases of bronchogenic carcinoma. Bronchial aspirates are helpful in the diagnosis of un-resolving pneumonias

Massive chondroid hamartoma of the lung clinically masquerading as bronchogenic carcinoma.

Chondroid hamartomas of the lung are uncommon lesions which are generally small sized and asymptomatic. Herein we describe a case of a large-sized pulmonary chondroid hamartoma which clinically mimicked bronchogenic carcinoma. A large hilar growth was detected in the left lung on radiological studies. Left upper lobectomy was done. The growth was well defined with a lobulated bluish cut surface. Histopathology disclosed lobules of mature cartilage rimmed by long slit-like epithelial channels admixed with mature adipose tissue.

Cáncer pulmonar / Lung cancer

El cáncer pulmonar fue causa de 2.200 muertes anuales en Chile y de 155.000 en los EE.UU. en años recientes. En nuestro país la frecuencia de la enfermedad aumenta anualmente. La causa de esta enfermedad es fundamentalmente el hábito tabáquico, aunque hay otras causas de menor importancia. La mayor parte de los cánceres pulmonares son sintomáticos al momento del diagnóstico, ya sea síntomas respiratorios, generales o de las metástasis. En cualquier patología respiratoria de un fumador debe sospecharse y la confirmación es por imágenes radiológicas y citología o biopsias. El método más útil para obtener histología es la broncofibroscopía. El estudio de extensión requiere análisis de los sitios más frecuentes de metástasis que son el cerebro, los huesos, el hígado y las suprarenales. El PET o Tomografía de Emisión de Positrones tiene un papel de progresiva importancia en la detección de metástasis. La etapificación del cáncer pulmonar es fundamental desde el punto de vista pronóstico y de elección de terapia. La clasificación TNM es la más utilizada. Sólo la cirugía es una acción curativa en algunos cánceres pulmonares en etapas precoces. Lamentablemente esta opción sólo cubre el 15 por ciento de todos los pacientes. La quimioterapia con adición de radioterapia es la elección en los cánceres de células pequeñas una variedad histopatológica que compende el 20 por ciento de todos los csrcinomas broncogénicos. En los demás tipos celulares, la quimioterapia puede ser un aporte a la cirugía en algunas etapas y beneficia a los cánceres avanzados en mejor forma que mejor terapia de soporte.

Influencia de la demora en el diagnóstico y el tratamiento en la supervivencia de pacientes con cáncer pulmonar / Influence of diagnosis and treatment delay on the survival of patients with lung cancer

El carcinoma broncogénico es la causa más frecuente de fallecimiento por cáncer y con un incremento sorprendente en su incidencia. En Cuba, se ha convertido en la segunda causa de muerte para todas las edades por su pobre supervivencia la cual depende de la comorbilidad, la edad, el sexo, el tipo histológico, el estadio tumoral y de la demora en el diagnóstico y el tratamiento. En este trabajo se investigó la influencia de las demoras en el diagnóstico y en el tratamiento, así como algunos factores clínicos y sociodemográficos, de 149 pacientes con diagnóstico de cáncer broncogénico en este hospital desde enero del 2003 hasta abril del 2006. Se realizó una descripción de la información en tablas y figuras; se utilizó el método de Kaplan Meier y de regresión de Cox (divariado y multivariado) para analizar la sobrevida. En el análisis del estadiamiento predominaron los pacientes en el estadio IV (46 casos- 30,9 por ciento), seguido de los estadios IIIB (36 casos - 24,2 por ciento) y IB (26 - 17,4 por ciento); sin embargo, en los estadios IA y IIA se encontraron cifras muy bajas: 3 casos (2 por ciento) y 1 caso (0,7 por ciento), respectivamente. La media en el tiempo de demora en el diagnóstico fue de 3,97 meses y de 13,89 días para el tiempo en la demora en el tratamiento. La probabilidad de que un paciente viva a los 3 ½ años con una neoplasia de pulmón, independientemente del tipo histológico y el estadio clínico, es de 7,47 por ciento.

Le cancer bronchique au Senegal

En Afrique; l'incidence du cancer bronchique (CB) est en forte progression. Nous avons realise une analyse prospective des caracteristiques cliniques; therapeutiques et evolutives des CB observes a l'Hopital Principal de Dakar entre 2002 et 2007. En 5 ans; 72 cas ont ete colliges. Dans 88des cas; il s'agit d'un fumeur de sexe masculin; age en moyenne de 59;2 ans. L'histologie est obtenue dans 79;1des cas apres fibroscopie bronchique (n=33); ponction transthoracique scano-guidee (n=17) ou a partir d'un site metastatique (n=7). Il s'agit de 23 carcinomes epidermoides; 14 adenocarcinomes; 17 carcinomes a grandes cellules; 2 CB a petites cellules; 1 cancer bronchiolo-alveolaire. Ces tumeurs se repartissent en 6 stades I-II; 17 stades III et 49 stades IV. La prise en charge est symptomatique pour 68des malades ; dans les autres cas; elle associe : chimiotherapie (n=22); radiotherapie antalgique (n=5); chirurgie (n=1). Dix patients sont perdus de vue. La survie mediane est de 7 mois ou de 3 mois; selon qu'une chimiotherapie est administree ou non. Le taux de confirmation histologique largement superieur aux donnees dans la sous-region illustre l'apport d'une unite d'endoscopie bronchique entrainee et l'acces a la ponction scanno-guidee depuis septembre 2003. L'administration de cytotoxiques est possible mais trop couteuse faute de couverture sociale generalisee : 2/3 des indications sont abandonnees alors que la chimiotherapie ameliore significativement la surviemediane de 4 mois (p0;0001). Le pronostic reste severe car la maladie est prise en charge a un stade avance. Le CB est une realite a Dakar. Il est desormais urgent de promouvoir des standards therapeutiques adaptes au contexte socio-economique africain; et une politique de prevention du tabagisme

Diagnosis of multiple myeloma by demonstration of M protein in bone marrow aspirate by agar gel electrophoresis: a case report.

A number of laboratory tests are used to confirm the diagnosis of multiple myeloma, including M protein in the serum. Since M protein in the serum originate from tumour cells in the bone marrow before circulating in the serum, demonstration of M protein in bone marrow aspirate can be added to the batteries of diagnostic parameters.

study of paraneoplastic syndrome patterns in patients with bronchogenic carcinoma

Paraneoplastic syndromes, which are the distant effect of underlying carcinoma, which can present early, well before the primary lung lesion produces local symptoms and even when the tumor is undetected or very small. Paraneoplastic syndromes are common in patients with bronchogenic carcinoma. They may be the presenting finding or the first sign of recurrence. To assess the incidence and pattern of paraneoplastic syndrome [PNS] in patients with bronchogenic carcinoma. Peripheral Hospital in Kuwait. Retrospective study. A retrospective study of 52 confirmed bronchogenic carcinoma patients occurring from January 2000 to June 2004 in our hospital was carried out. The Medical records of all the confirmed cases of bronchogenic carcinoma admitted between January 2000 and June 2004 were reviewed. The clinical and biochemical parameters recorded were: age, sex, underlying medical illness, presentation complete blood count, blood urea, electrolytes and serum calcium levels, and appropriate hormone levels where indicated. The localization of the tumors was done by chest x-ray and CT scan. Tissue biopsy was obtained by bronchoscopy or under CT scan guidance and histopathological examination of the specimen was carried out. The type and pattern of PNS if any was noted. These parameters were entered into a database and later analyzed. The data management and statistical package used was Epi Info version 6 provided readily by the CDC [Centre for Disease Control] Bethesda USA. Forty-nine patients were male and 3 were females. All were heavy smokers or exsmokers. The histological types were 12 [22.4%] small cell carcinoma and 40 [67.6%] nonsmall carcinoma. The mean age 67.46 +/- 12.15 years. Associated illness found was diabetes mellitus [DM] ' 24 [46%], hypertension - 33 [63.6%], and chronic obstructive pulmonary disease [COPD] - 14 [27%]. Almost all the patients presented with cough - 52 [100%], shortness of breath [SOB] - 51 [99%], haemoptysis - 22 [42%], pleural pain - 16 [31%] and fever - 22 [42%] and weight loss - 39 [75%]. The PNS found were: Hypercalcemia - 22 [42%], thrombocytosis - 5 [9.6%], limbic encephalitis - 3 [5.8%], SIADH - 3 [5.8%], peripheral neuropathy - 2 [3.8%], GBS - 1 [1.9%], pancytopenia - 3 [5.8%]. There was no case with ACTH secretion or Lambert-Eaton syndrome. Hypercalcemia, thrombocytosis, SIADH, pancytopenia, limbic encephalitis and other unexplained neurological problems occurring in the middle aged or elderly smokers should arouse the suspicion of an occult bronchogenic carcinoma

Diagnostic yield of adenosine deaminase in bronchoalveolar lavage.

Adenosine deaminase (ADA) activity rises in various body fluids in patients with tuberculosis. A prospective study was conducted to determine the diagnostic value of ADA activity in bronchoalveolar lavage. Between March 2001 and February 2003, 148 patients were enrolled in our study, mean age 55.6 years (SD 14.6), and a male to female ratio of 2.4:1. The mean duration of symptoms was 66.2 days. All patients were either sputum-smear negative for AFB or failed to produce sputum. The final diagnosis resulted in three patient groups: 43 with pulmonary tuberculosis, 70 malignancy, and 35 miscellaneous causes. The mean ADA activity in the bronchoalveolar lavage for the pulmonary tuberculosis, malignancy, and miscellaneous causes groups was 8.98 (95% CI, 3.79-14.17), 7.63 (95% CI, 4.12-11.14), and 11.61 U/l (95% CI, 3.59-19.62), respectively. No difference was detected in the ADA level in the pulmonary tuberculosis vs other groups (p=0.56, one-way ANOVA). A high level of ADA activity was found in non-tuberculous conditions such as bronchogenic carcinoma, pulmonary hemosiderosis, chronic pneumonia with empyema thoracis and chronic myeloid leukemia. We concluded that ADA activity in the bronchoalveolar lavage was not clearly diagnostic of smear-negative pulmonary tuberculosis. Early diagnosis required histopathology of biopsied transbronchial specimens obtained by fiberoptic bronchoscopy.

Avaliação do escarro induzido no diagnóstico do carcinoma brônquico / Assessment of induced sputum in the diagnostic of broncogenic carcinoma

Introdução: o diagnóstico não invasivo de carcinoma brônquico é extremamente útil e prático, facilitando aconduta terapêutica. Objetivo: avaliar a sensibilidade e a especificidade da citologia do escarro induzido e doescarro espontâneo no diagnóstico do carcinoma brônquico e o rendimento do escarro induzido em relação àscaracterísticas da lesão. Casuística: foram estudados 42 pacientes portadores de carcinoma brônquico - entre abrilde 1998 e abril de 1999 - sendo avaliada a citologia do escarro induzido com solução hipertônica a 3 por cento (n igual a 42) ea citologia do escarro espontâneo (n igual a 35). Resultados e Discussão: a sensibilidade obtida foi de 7,7 por cento e 19,2 por cento ea especificidade foi de l00 por cento e 85,7 por cento, respectivamente, para a citologia do escarro espontâneo e do escarroinduzido (n igual a 33). A concordância entre a citologia do escarro induzido e espontâneo foi fraca, contudo a sensibilidadedo escarro induzido foi superior à do escarro espontâneo, sendo que a citologia do escarro induzido apresentoualta especificidade, porém baixa sensibilidade. A relação entre a citologia do escarro induzido e a invasão debrônquios principais e traquéia pelo tumor apresentou significância limítrofe (p igual a 0,086). Quanto à localização dalesão, visibilidade endoscópica e tipo histológico, não houve associação significativa.

Transbronchial needle aspiration (TBNA) in the early diagnosis and staging of bronchogenic carcinoma.

BACKGROUND: Transbronchial needle aspiration (TBNA) has evolved as a useful technique to establish diagnosis in patients suspected of having bronchogenic carcinoma. METHODS: Transbronchial needle aspiration (TBNA) was done in twenty-five patients with either proved or suspected bronchogenic carcinoma using a flexible bronchoscope. Results of 19 patients who had pulmonary malignancy were analysed. RESULTS: In the 12 patients with endobronchially visible abnormality, TBNA could correctly identify eleven patients with carcinoma and one patient, who was a treated case, with no evidence of residual disease. In the seven patients with bronchoscopically invisible extrabronchial disease, TBNA could identify four patients with malignancy and also characterize true negative disease in a treated case with subcarinal lymph node. TBNA could define the correct cytology in all the patients with visible tumours and in 59% of patients with bronchoscopically invisible tumours. The procedure was diagnostic in 84% of the cases. Mediastinal lymph node sampling in nine patients by TBNA, with the help of contrast enhanced CT scans, was positive in five patients and negative in the other four patients thus helping in nodal staging. CONCLUSIONS: Although the sample size of the study was small, the procedure was found to be very useful for the early diagnosis and staging of bronchogenic carcinoma. It was safe, well tolerated and no untoward complications were observed.

Pulmonary aspergilloma simulating bronchogenic carcinoma.

When a pre-existing lung cavity is colonized by Aspergilius fumigatus, it forms a fungal ball (pulmonary aspergilloma) and the presenting symptom is usually haemoptysis that may be massive and often-times life threatening. The radiological finding is that of a ball-like structure within a lung cavitation and the typical air crescent around the ball both on plain radiography and CT scan of the chest. The present case is of a 50-year-old male who had a 25-year history of heavy smoking (40 cigarettes per day) and haemoptysis. Although the cavitating lesion, ball-like structure and the crescenteric rim of air were present on the radiographs, the possibility of bronchogenic carcinoma was held high in view. Flexible fibreoptic and transbronchial biopsies were negative for malignancy. Sputum and bronchoalveolar lavage examinations showed neither malignant cells nor fungal elements. Right thoracotomy, cavernostomy, removal of the fungal ball and obliteration of the cavity by suturing (capitonnage) were done with an uneventful postoperative period.

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

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

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

Colonic metastasis from bronchogenic carcinoma presenting as pancolitis.

The colonic metastases from bronchogenic carcinoma are rare. We present a 73-year-old man presented with features suggestive of pan colitis after metastasis from undifferentiated large cell carcinoma of the lung. The plain radiograph and computed tomography scan of the chest had revealed a mass lesion in the right lower lobe of lung. He had no evidence of significant lesions elsewhere. Considering the advanced stage and poor differentiation of the tumour, no active therapy was undertaken and he survived for three months.

Foreign body-induced Actinomycosis Mimicking Bronchogenic Carcinoma

Actinomycosis is a slowly progressive infectious disease caused by an anaerobic and microaerophilic bacteria that colonizes the face, neck, lung, pleura and the ileocecal region. There have been a few cases of this disease which have involved in the lung but one very rare case has been reported. We report a case of foreign body-induced endobronchial actinomycosis mimicking bronchogenic carcinoma in a 69-year-old man. On admission, the patient presented with weight loss, cough and hemoptysis. The fiberoptic bronchoscopy revealed a soft tissue mass, with a partial occlusion of the left upper bronchus, which resembled bronchogenic carcinoma. Contrary to the first impression, the biopsy of the bronchus revealed the mass lesion to be an actinomycotic infection involving the bronchus. After the confirmation of the lesion, treatment with penicillin was initiated. The follow-up bronchoscopy revealed an aspirated fish bone at the site of infection. The foreign body was safely removed.

Cancer broncogenico: tipo celular y presentacion radiologica: Estudio multicentrico / Bronchogenic cancer: Cellular type and radiographic patterns

Introducción: Los textos y descripciones clásicas señalan patrones diferentes de presentación del cáncer broncogénico según el tipo celular, que han comenzado a ser cuestionados. Objetivo: Identificar los patrones del cáncer broncogénico en la radiografía del tórax de acuerdo con el tipo celular y compararlos con las descripciones usuales. Tipo de Estudio: Serie de casos. Lugar de Estudio: Cuatro hospitales en Bogotá: Hospital Central de la Policía, Instituto Nacional de Cancerología, Hospital Santa Clara, Hospital de la Samaritana. Pacientes y Métodos: En pacientes con diagnóstico histológico de cáncer broncogénico y clasificación precisa del tipo celular se revisaron en forma estándar las principales características radiológicas al momento del diagnóstico y se compararon con las series más conocidas (Clínica Mayo y Marshfield). Resultados: En 236 pacientes (edad promedio 61 años, 39 por ciento mujeres), la mayoría escamocelular (37 por ciento ) o adenocarcinoma (36 por ciento ), la localización de los adenos en general sigue la tendencia reciente (predominio central: 60 por ciento ) al igual que los escamocelulares (72 por ciento ) y las características radiológicas generales son similares entre estos tipos celulares más frecuentes. En etapas tempranas del adeno tiende a localizarse más hacia la periferia y los escamocelulares son tanto centrales como periféricos. En etapas avanzadas todos los tipos celulares predominan en localización central. Conclusión: En esta serie de casos no se encuentra diferencia significativa en la localización entre escamo y adenocarcinoma, siendo estos resultados diferentes a los de las descripciones clásicas. Es probable que la presentación radiológica del tumor esté cambiando y que parte de los hallazgos se expliquen por el estado al momento del diagnóstico

Paraneoplastic limbic encephalitis associated with bronchogenic carcinoma: a case report.

Paraneoplastic limbic encephalitis is a rare clinical entity, associated most often with the oat cell carcinoma of the lung. Clinically, it presents with affective changes in personality, memory loss, confusional state, hallucinations, and seizures; with dementia being the common feature as the disorder progresses. Response to treatment is disappointingly poor.