[Difficult diagnosis in a case of pulmonary epidermoid carcinoma]. / Diagnostic dificil intr-un caz de carcinom epidermoid pulmonar.

We present a case of a 66 years old male patient, from urban area, smoker for 54 years, without special antecedents, hospitalized in our service with a pulmonary right lower lobe abscess, whose onset was 4 months ago, persistent under treatment in another pneumology service. Clinically and radiologically we suspected a pulmonary excavated right lower lobe neoplasia, but unsustained by fiber-bronchoscopy and thoracic computer tomography. By this reason the patient underwent exploratory thoracotomy and the diagnosis was confirmed by the biopsy of the resected specimen: pulmonary epidermoid carcinoma. The short term outcome was favourable.

[Imaging in screening and diagnosis of lung cancer]. / Imagistica în screening-ul si diagnosticul cancerului bronho-pulmonar.

While the lung cancer is detected, the majority of the patients could not be surgical cured. Thus appears the great necessity of prevention, of a more efficient treatment and the developing of new methods for early detection. The first screening trials for lung cancer had negative results. None of the studies had no prove in decreasing of mortality by screening for lung cancer. The lack of sensitivity of thoracic radiographs and sputum cytology was leading the investigators to use the monoclonal antibodies in detecting the neoplastic changes in sputum, the spiral computerized tomography with low dose of radiations, the autofluorescence bronchoscopy and more recent the positron emission tomography, offering the possibility of reducing mortality by early detection in lung cancer.

[Evolution of pulmonary metastasis in osteosarcoma]. / Evolutia metastazelor pulmonare de osteosarcom.

Osteosarcomas are tumors with a high aggressivity which gives early and frequent pulmonary metastasis. These patients have a poor prognosis. The reveal of prognosis factors and early detection of pulmonary relapse would influence the outcome of these patients. We performed a retrospective study at Oncology Institute from Cluj, observing 35 patients with osteosarcomas and pulmonary metastasis at the onset or in evolution. We tried to quantify some prognosis factors. We observed the predominance of male sex (20), from urban area (25), with age between 11-20 years (16 cases), with primary tumors localized more frequently at the limbs. Pulmonary metastasis were shown without free interval from the onset (12 patients), or in the first years (17 cases), more frequently with multiples locations (26 cases). 28 patients were submitted to surgical treatment for cure of primary tumor, 18 chemotherapy, and pulmonary metastasis resection in 5 cases only. The outcome under treatment was favorable in 4 cases only, compared with other studies. Early detection of pulmonary metastasis and aggressive therapy with augmentation of resection criteria for pulmonary metastasis would improve the prognosis of this patients.

[Rare histological type of pulmonary adenocarcinoma--two clinical cases]. / Tip histologic rar de adenocarcinom pulmonar--doua cazuri clinice.

Two cases of primary signet-ring cell adenocarcinoma of the lung are presented. The patients were: a 53-year-old man with a left lung mass and a 40-year-old woman with a right lung mass. Endobronchial biopsy performed after fiber-bronchoscopy reveal this rare histological type for pulmonary localizations of neoplasms. It is well known that this histological type is found in digestive localizations of neoplasms, especially gastric, but in these two cases we excluded such a neoplasm. The tumor we found in these two cases is a very rare intrapulmonary neoplasm with a poor clinical course and prognosis. Signet-ring cell adenocarcinoma is a recently described neoplasm whose histology is different from most lung adenocarcinomas and represented a spectrum of malignant potential. Little is known of the behaviour of more malignant subtype.

Abdominal miliary tuberculosis in a patient with AIDS: a case report.

We present a 34 year old patient, intravenous drug user, hospitalized with fever, distortion of general status, dry irritating cough, abdominal colicative pains, and we established the diagnosis of HIV infection advanced stage/AIDS; his antecedents revealed (August 2000) abdominal tuberculosis not treated during the last 3 months. He presented a pneumonia with Pneumocystis carinii during hospitalization. Death was due to a colon perforation with secundary peritonitis. Miliary tuberculous lesions in liver, spleen and colon were revealed at necropsy and cytomegalovirus was identified in necrotic samples also.

[Primary pleural-pulmonary non-Hodgkin lymphoma]. / Limfom non-Hodgkin primar pleuro-pulmonar.

Primary pleuro-pulmonary non-Hodgkin lymphomas are very rare tumors, possibly under diagnosed, with a very long, frequently asymptomatic evolution. The authors present the diagnostic difficulties of such pathology, in a particular case, which was diagnosed only by open biopsy and immunohistochemical analysis of tissue fragments. Chemotherapy and radiotherapy determined a favorable course of the disease.