[Early molecular diagnosis of lung cancer: a method to rule out the disease]. / Diagnosi molecolare precoce del tumore polmonare: un metodo per escludere la malattia.

Aim of this study was the determination of new markers for the diagnosis of lung cancer. 61 patients with non-small cell lung cancer (NSCLC) and 42 controls were enrolled. In the NSCLC patients the following markers were increased: H2O2 in exhaled breath condensate, pentane, hexane, nonenal, trans-2-heptanal, trans-2-nonenal in exhaled breath, while pentanal was decreased. Using multivariate statistical models, a sensitivity of 73.8% and a specificity of 76.8% were calculated. This study shows that with this non-invasive test followed by a most powerful test on positives (e.g. PET) it is possible to decrease the number of false positives.

Resection of pulmonary metastases: a growth industry.

Surgical metastasectomy is increasing both in the numbers of operations performed and the extensiveness of surgery that is being undertaken. Radiologists play a central role in this work. It is they who first detect metastases on cancer staging scans and it is they who detect recurrence of cancer on surveillance scans performed in the course of follow-up. Radiologists then play a key role in characterising and diagnosing any lung nodules thus discovered. For colorectal and lung cancer the clinical teams are typically quite separate, but radiologists have a role in both multidisciplinary team meetings. Thus it may well be that the radiologist is party to discussions about the same patient and the same imaging information in quite separate multidisciplinary team meetings and needs to understand the imaging needs and clinical objectives of both. As surgery is becoming more extensive, the inescapable harm done as a consequence of lung resection is increasing. Good quality evidence for benefit is lacking. The purpose of this article is to provide an update on the practice of metastasectomy, the selection of patients, the objectives of surgery, and uncertainties about its effectiveness.

Endotracheal migration of a central venous catheter.

Subcutaneous infusion ports for prolonged central venous access are commonly used for drug administration and parenteral nutrition in a wide range of chronic diseases. The extensive use of these devices has to be balanced against its complications, some of which potentially life-threatening. We describe the case of a patient admitted to our unit with haemoptysis and cough. At bronchoscopy the tip of the central venous catheter was discovered protruding into the tracheal lumen. The catheter was pulled out from the subcutaneous pouch under simultaneous surgical control of the tracheal fistula orifice.