[Value of bone marrow trephine biopsy in evaluating the extent of small cell lung cancer]. / Wartosc trepanobiopsji szpiku w ocenie rozleglosci drobnokomórkowego raka pluca.

Bone marrow metastases using Jamshidi needle were found before treatment in 28 of 146 small cell lung cancer patients (19.2%). Bone marrow was a sole site of distant metastases in 3.4% of all cases and in 8.2% of those with no metastases in other organs. Patients with bone marrow involvement had more often metastases in 3 or more organs and had significantly more often liver metastases as well. Bone marrow infiltration was more often observed in patients with poor performance status and with disseminated disease, but was also found in 4 of 47 patients with good performance status and without metastases in other organs. Bone marrow trephine biopsy should be included in staging procedure in small cell lung cancer patients with good performance status, without metastases in other organs and with abnormalities in peripheral blood picture.

[Value of transthoracic needle biopsy of the pleura in the diagnosis of diseases of the respiratory tract]. / Znaczenie transtorakalnej iglowej biopsji oplucnej w rozpoznawaniu chorób ukladu oddechowego.

Pleural biopsy with Abram's needle was made in 160 consecutive patients with undiagnosed pleural effusions. The sampled fluid and pleural bioptates were examined histologically, cytologically and bacteriologically. In 40 cases malignant changes were found, out of 87 with confirmed malignancy. Neoplastic cells were found in 26 patients, ovreall the diagnosis was made in 65% of lung cancer cases. Out of 41 cases of tuberculosis, pleural biopsy provided this diagnosis in 24 patients (59%). Bacteriological examination and pathological of the biopsy specimen allowed to increase the diagnostic field to 63%. Pleural biopsy did not yield any diagnosis in 9 cases of circulatory insufficiency, nor in ten patients with the following diagnoses -- pleuropneumonia, reumathoid arthritis, pulmonary thromboembolism and thoracic trauma. In 13 cases the diagnosis was not made. The diagnostic yield of pleural biopsy was similar to that reported by others. It is most valuable in cases suspected of malignancy and tuberculosis.

The diagnosis of pleural effusion by ultrasonic and radiologic techniques.

The value of the A-mode ultrasonic technique and the radiologic method in the diagnosis of pleural effusion was assessed in 116 patients with diseases of the pleura. Ultrasonic and radiologic examinations, as well as needle punctures, were performed, and the results were compared statistically. The pleural fluid was detected by ultrasound in 93 percent (74) and by radiologic examination in 83 percent (66) of the 80 cases with such fluid. The absence of fluid was established by ultrasound in 89 percent (32/36) and by radiologic examination in 61 percent (22/36). For the first time the superiority of the ultrasonic method over the radiologic one was demonstrated, and the difference was most obvious in cases of small pleural effusion. Ultrasound permitted the detection of very small amounts (even 3 to 5 ml) of loculated pleural fluid. In contrast to the radiologic method, ultrasound permitted easy differentiation between loculated pleural fluid and pleural thickenings. The ultrasonic method appeared especially useful in the accurate localization and precise indicating of the site for needle aspiration of even the smallest fluid collections. It made possible thoracocentesis in 94 percent (154) of 163 instances. The practical value of the ultrasonic method, both in establishing diagnosis and in treatment, is emphasized.