[Sarcoid reaction in patients with lung neoplasm--personal experiments]. / Odczyn sarkoidalny u chorych na raka pluca--doswiadczenia wlasne.

In two cases histological examination of the lymph nodes excised during mediastinoscopy showed non-caseous epithelioid granulomas. In one patient with hilar lymphadenopathy sarcoidosis was misdiagnosed. One-year later progression of lesions in lungs was found and adenocarcinoma was diagnosed. In second patient with tumour in chest x-ray examination after misdiagnosed sarcoidosis thoracotomy was done and histological examination of samples from tumour showed nonsmall cell lung cancer. In both carcinomatous cases sarcoid reaction was recognised.

[Extrapulmonary manifestations of sarcoidosis as the cause of primary symptoms--4 case reports]. / Pozaplucna manifestacja sarkoidozy jako przyczyna pierwszoplanowych dolegliwosci--opis 4 przypadków.

Sarcoidosis is a multisystem disorder most frequently presenting with hilar lymphadenopathy, pulmonary infiltrations, ocular and skin lesions. However pulmonary manifestations typically dominate, any organ can be affected. Sometimes leading symptoms are caused by extrapulmonary manifestation of the disease, and together with the absence of typical picture in chest radiographs may be confusing for the physicians. We present 4 cases of proven sarcoidosis in which leading symptoms were caused by sarcoidal involvement of different organs (liver, spleen, heart and skin) without typical changes in the lung. In all cases multiorgan involvement was documented and disease was successfully treated.

[The relation between lymphocyte profile in BALF and the course of sarcoidosis based on short term observation]. / Zaleznosc miedzy zawartoscia limfocytów w BALF a krótkotrwala obserwacja przebiegu sarkoidozy.

The aim of this study was to assess how the extent of the number and percentage of lymphocytes in BALF and also the CD4 to CD8 ratio can help to predict the short outcome in sarcoidosis. Material consisted of 74 patients, 39 men and 35 women in the age from 23 to 58 years. 11 patients had chest lesions in stage I, 43 in stage II and 20 in stage III. Clinical markers of activity (fever, erythema nodosum) were present in 22 cases. Extrathoracic lesion were present in 31 and abnormal pulmonary function in 30. In all patients BAL was done before treatment and lymphocyte count, percentage and CD4/CD8 ratio was calculated. 50 patients were treated with corticosteroids and 24 were observed without treatment. After 6-12 month of observation regression of sarcoid lesions was observed in 46 of 50 patients treated with corticosteroids and in 17 out of 24 patients observed without treatment. There were no differences in lymphocyte count and percentage in BALF and in the short term outcome between group treated with corticosteroids and without treatment. The patients in whom regression of lesions was observed have however significantly higher CD4/CD8 ratio than others.

[Myocardial infarction as a cause of death in patients treated for small cell lung cancer]. / Zawal miesnia sercowego jako przyczyna zgonu chorych leczonych z powodu drobnokomórkowego raka pluca.

The aim of our study was to assess frequency of death from myocardial infarction in patients (pts) treated for small cell lung cancer (SCLC). 33 out of 845 patients treated for SCLC died from myocardial infarction. All patients were smokers. In 6 patients coexisted hypertension, in 2--diabetes and in 5--obesity. Eight patients have had cardiac disease in anamnesis. All patients were treated with one or more number of cardiotoxic drugs as DDP, VCR or VBL, E, MTX and ADR which are able to cause ischemic heart disease or myocardial infarction. Sixteen out of 33 patients have had radiotherapy of lung tumour. Death from myocardial infarction occurred from 0.5 up till 98.5 months from the beginning of start treatment. Eighteen men died from myocardial infarction in the first year of treatment. Risk of death from myocardial infarction was 15 times greater in men with SCLC than in men of the polish population at the same age and at the same time.

[Predisposing factors for bronchiectasis--analysis of 69 patients treated in the years 1995-1999]. / Czynniki predysponujace do powstania rozstrzeni oskrzeli--analiza 69 chorych leczonych w latach 1995-1999.

The aim of this study was to analyze the predisposing factors for bronchiectasis in 69 patients hospitalized in the 3rd Dept. of the Institute of TB and Lung Diseases in Warsaw in years 1995-1999. Bronchiectasis was diagnosed on the basis of the high resolution computed tomography (HRCT) scan. Among 69 patients at the age of 15-72 years there were 45 women (65%) and 24 men (35%). Fifty patients were nonsmokers. The most frequent predisposing factors of bronchiectasis in that group of patients were as follows: pneumonia (30.1%, in it recurrent pneumonia--19.3%, a single pneumonia--10.8%), sinobronchial syndrome (19.3%), pulmonary tuberculosis (12.1%), nontuberculous mycobacterial lung infections (7.2%), recurrent pneumonia and bronchitis in childhood (7.2%) and connective-tissue diseases (3.6%). Among other predisposing factors there were allergic bronchopulmonary aspergillosis, foreign body in bronchus, hypogammaglobulinemia and colitis ulcerosa.

[Long-term survival of patients with small cell lung cancer]. / Dlugotrwale przezycia chorych na drobnokomórkowego raka pluca.

The analysis of clinical determinants of long-term survival in small cell lung cancer was investigated in consecutive series of 469 patients included in prospective multicenter clinical trials from 1981 to 1985. Forty eight patients (19.2%) were alive after 2 years from initiation of therapy and among them 27 (5.8%) were disease free. The most important clinical determinants of long-term survival were: extent of disease, performance status and sex. 38 out of 243 patients with limited disease (15.6%) survived for 2 years or more as well as 10 out of 226 patients with extensive disease (4.4%, p less than 0.001), 33 out of 237 patients with WHO performance status 0 and 1 (13.9%), and 15 out of 232 patients with performance status from 2 to 4 (6.4%, p less than 0.01), 29 out of 229 (12.2%) with absence of weight loss before therapy and 19 out of 240 (7.9%) with weight loss (N.S.), 32 out of 392 males (8.2%) and 16 out of 77 females (20.7%, p less than 0.01). Out of 27 disease-free survivors 21 are alive with no sign of malignancy after 3.5 to 7 years from initiation of therapy. Ten patients out of 229 followed up for a minimum 5 years after inclusion to the studies survived this period with no signs of disease. This study confirms the possible curability of small cell lung cancer, especially in patients with favorable prognostic characteristic.