ABSTRACT
The close observation of patients treated for testicular cancer led to the suspicion of intrathoracic and/or mediastinal metastases on radiologic examination in a number of patients without other evidence of relapse. This report presents two patients with combined seminomatous and nonseminomatous germ cell tumors with isolated sarcoid reactions of hilar and interlobular lymph nodes, detected concomitant with diagnosis and 12 months after diagnosis, respectively. Histologic examination appears to be imperative in these cases to avoid unnecessary chemotherapy.
Subject(s)
Dysgerminoma/diagnosis , Lymphatic Diseases/diagnosis , Neoplasms, Germ Cell and Embryonal/diagnosis , Sarcoidosis/diagnosis , Testicular Neoplasms/pathology , Adult , Diagnosis, Differential , Dysgerminoma/pathology , Humans , Lymphatic Diseases/pathology , Lymphatic Metastasis , Male , Neoplasm Staging , Neoplasms, Germ Cell and Embryonal/pathology , Sarcoidosis/pathologyABSTRACT
In critically ill patients accurate measurement of total energy expenditure (TEE) is possible by means of continuous indirect calorimetry. Since in many ICUs the necessary equipment is not available, the Harris-Benedict formula (HB) is frequently used to calculate TEE. Supplemental application of a clinical correction factor (HBc) has been advised. In this study we assessed the reliability of both methods of calculation and of a standard nutritional regimen, all three compared to the calorimetrically measured TEE (gold standard). Although the basic HB-formula did not perform better than the standard regimen, significantly better results were obtained by supplemental application of the clinical correction factor (HBc). It is left undecided, whether or not indirect calorimetry is actually to be preferred in daily clinical practice.
