ABSTRACT
Medullary thyroid cancer (MTC) is a distinct C-cell tumor of the thyroid. We review the oncogenesis and management of both sporadic tumors and those tumors arising as part of specific inherited syndromes. The RET proto-oncogene plays a role in the development of inherited forms of MTC and has become important in the clinical management of patients and their families. The recognition of the high rate of regional nodal involvement has led to lymphadenectomy being strongly considered for patients undergoing thyroidectomy for MTC.
Subject(s)
Carcinoma, Medullary/physiopathology , Thyroid Neoplasms/physiopathology , Carcinoma, Medullary/genetics , Carcinoma, Medullary/therapy , Cell Transformation, Neoplastic , Humans , Lymph Node Excision , Lymphatic Metastasis , Prognosis , Proto-Oncogene Mas , Proto-Oncogenes/genetics , Thyroid Neoplasms/genetics , Thyroid Neoplasms/therapy , ThyroidectomyABSTRACT
Thirty-seven patients presenting with massive or recurrent haemoptysis secondary to tuberculous aetiology were subjected to bronchial artery angiography. Of these, failure, to catheterize the bleeding vessel occurred in two patients while embolization was withheld in two patients due to the presence of anterior spinal artery arising from a common intercosto-bronchial trunk. Immediate arrest of bleeding was performed in the remaining 33 patients by selective embolization of the abnormal bronchial arteries with a resorbable material (Gelfoam). Regular follow up for a duration of 6 months after the procedure revealed relapse of haemoptysis in four patients; three were treated by re-embolization of the abnormal bleeding vessels while one patient died due to aspiration immediately on admission. No recurrence of bleeding was seen in the remaining 29 patients. It is concluded that bronchial artery embolization is an effective treatment for immediate control of life-threatening haemoptysis.
Subject(s)
Bronchial Arteries , Embolization, Therapeutic/methods , Hemoptysis/microbiology , Hemoptysis/therapy , Tuberculosis, Pulmonary/complications , Acute Disease , Adolescent , Adult , Aged , Female , Follow-Up Studies , Gelatin Sponge, Absorbable/therapeutic use , Hemostatics/therapeutic use , Humans , Male , Middle Aged , RecurrenceABSTRACT
Bronchiolitis obliterans or constrictive bronchiolitis is a distant clinical entity with obstructive airway disease. High resolution computed tomography (HRCT) of the thorax can often suggest the diagnosis with the characteristic "mosaic pattern". We present here two cases of bronchiolitis obliterans in which the HRCT showed the presence of this characteristic appearance.
