[Pulmonary mycobacteriosis--diagnostic problem and prevalence in Poland (a retrospective study)]. / Mykobakterioza pluc--problem diagnostyczny i wystepowanie w Polsce (badanie retrospektywne).

The diagnosis of pulmonary mycobacteriosis was verified in 267 patients in Poland, classified in the years 1991-1995 to group VI M. Among 267 patients, 213 were men in age 28-83 years (median 43 years) and 54 women in age 24-81 years (median 50 years). The verification of the diagnosis was based on the authors own criteria of pulmonary mycobacteriosis and colonisation. These criteria included at least two positive sputum cultures and presence or absence of the respiratory tract inflammation. Pulmonary mycobacteriosis was recognised in 199 patients (168 men and 31 women). Colonisation was diagnosed in 41 patients (23 men and 18 women). Non-tuberculous mycobacteria most often responsible for pulmonary mycobacteriosis were identified as M. kansasii, M. avium--intracellulare and M. xenopi. Majority of patients with pulmonary mycobacteriosis or with colonisation had pulmonary lesions caused by tuberculosis in the past or suffered from chronic obstructive pulmonary disease. In 63 cases, data concerning previous diseases of the respiratory tract were not available.

[Kartagener syndrome and hemangiomatous proliferation of lung capillaries: case report and literature review]. / Zespól kartagenera i naczyniakowatosc kapilarów plucnych: opis przypadku i przeglad pismiennictwa.

The authors present a case of Kartagener syndrome complicated by pulmonary hypertension accompanied by the lung capillaries haemangiomatous proliferation (post mortem diagnosis). Review of a literature (23 published cases) of the haemangiomatous proliferation of lung capillaries emphasizes clinico-pathological aspects and differential diagnosis. A rarity of Kartagener syndrome is another interesting point of a published case.

[A case of lung eosinophilic granuloma (histiocytosis X) without clinical symptoms]. / Przypadek ziarniniaka kwasochlonnego pluc (histiocytozy X) bez objawów klinicznych.

The asymptomatic case of eosinophilic granuloma (Histiocytosis X). 24 years old men with disseminated lung lesions which were present for six years was presented. Histiocytosis X was diagnosed on the basis of the examination of open lung biopsy specimen and high resolution computer tomography. The patient will be observed without treatment as no symptom were present and some regression of lung lesions was noted.

Combination chemotherapy with cyclophosphamide, epirubicin and etoposide in small cell lung cancer.

From March 1987 to February 1991, 136 patients with untreated small cell lung cancer (64 patients with limited disease and 72 with extensive disease), were treated as part of a prospective multi-center study, with a combination of cyclophosphamide 1000 mg/m2 i.v. on day 1, epirubicin 70 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 i.v. on days 1, 3 and 5. Courses were repeated every 3 weeks. One-hundred thirty-four patients were evaluable. There were 42 (31%) complete responses and 66 (49%) partial responses for an overall response rate of 80% (95% confidence interval 71-87%). A complete response was seen in 24 patients (38%) with limited disease and in 18 patients (26%) with extensive disease, while a partial response was observed for 31 (48%) and in 35 (50%) patients, respectively. The median duration of response for all patients was 8.9 months (range, 1-60+ months). The median duration of survival for the entire group was 11.4 months (12.5 months for limited disease and 9.8 months for extensive disease). The 2-year survival rate for the whole group was 13%. The main side-effects were myelosuppression, alopecia, nausea and vomiting. Grade 4 toxicity was seen in 8.5% of patients. In conclusion, the studied regimen was found to be active and well tolerated and may be considered as an alternative to standard chemotherapy combinations in SCLC.

Risk of late recurrence and/or second lung cancer after treatment of patients with small cell lung cancer (SCLC).

The aim of this study was to illustrate some difficulties in distinguishing late recurrence of small cell lung cancer (SCLC), from second primary lung cancer. Three-hundred fourteen SCLC patients were observed at the Institute of Tuberculosis and Chest Diseases in Warsaw, during the period 1976-1985. All patients were treated with chemotherapy and 125 were also treated with radiotherapy on the tumour and mediastinum. Nineteen patients (6%) survived 3 years. This group consisted of eight females (9%) and 11 males (5%). In all of them a complete remission was obtained. In six patients from this group no progression of lung cancer was observed. Four of them are still living, 7.9-16.2 years after the start of treatment. Two patients died of heart infarct. In the remaining 13 patients, progression of SCLC or development of new cancer was noted in the course of observation. In seven of them, histological proof of the character of progression was obtained. In four cases non-small cell lung cancer (NSCLC) was diagnosed after 3-11 years of observation. In one of them SCLC metastases in the liver were unexpectedly found in the autopsy, although adenocarcinoma in the lung diagnosed during bronchoscopy was also confirmed in the autopsy. In three cases SCLC was diagnosed. In one case, 2.7 years from the beginning of treatment, only SCLC metastases were found during laparoscopy. SCLC was found in two other cases after a 7-year cancer-free period. In one of those patients, a new lesion was found in the other lung while the second patient developed a new lesion exactly in the place of the former cancer. In six other patients no histological proof of the character of progression was obtained. Two of the six are still living, 8.2 and 15.1 years later. In the first of these two, a new lesion developed very early in the course of treatment in the same place as the primary tumour and it was regarded as the progression of SCLC. In the second patient, who probably had NSCLC the lesion developed in the contralateral lung after 12.5 years of remission and disappeared after radiotherapy. Four patients died of cancer after 3.2-6.4 years of observation. The cumulative risk of a second primary lung cancer after a 3-year survival period oscillated in our SCLC patients between 4% and 6% for every patient/year of observation. It was concluded that prognosis in SCLC patients is still doubtful, nevertheless, some patients made a complete recovery.

[Neoplastic metastasis in lungs simulating primary tumor of the respiratory system]. / Przerzuty nowotworowe w plucach symulujace pierwotna chorobe ukladu oddechowego.

16 patients with clinical and radiological symptoms suggesting lung disease were described. Metastatic character of process was documented in 7 of them during life and in 9 after death. The pulmonary symptoms without any signs of primary tumor lasted from few months to 3 years. Two patients revealed primary tumor in ovary, 1-in uterus, 4-in thyroid gland, 2-in prostata, 2-in breast, 2-in pancreas, 1-in bone, one in testicle, and 2-in kidney.

[Pulmonary infections in patients with lung cancer during antineoplastic therapy]. / Zakazenia u chorych na raka pluca w czasie leczenia przeciwnowotworowego.

162 pulmonary infection episodes were observed in 94 patients with lung cancer undergoing antineoplastic therapy. 80 (40%) episodes occurred during leukopenia. Elevation of leucocyte count was seen in 12 episodes only. Elevated body temperature was the only sign in 20 episodes, of which in 7 cases microorganisms were cultured from the blood. Purulent pulmonary infections were observed in 71 episodes, in 66 the causative agent was identified. Purulent urinary tract infections were observed in 29 episodes, of which in 28 the microorganisms were identified. A coexistent pulmonary and urinary tract infection was seen in 13 cases, of which in all the causative agent was identified. Purulent infections of the nasopharyngeal mucosal membranes were observed in 16 cases, while herpes zoster in 13. The most often isolated organism in these cases were: Gram negative rods (E. coli, Klebsiella sp., Proteus sp., Hemophilus influenzae); less commonly Gram positive bacteria were isolated, mainly Staphylococcus aureus. Candida sp. was the most common fungus that was isolated from these patients. In four cases Candida was isolated from blood.

[Difficulties in diagnosing a case of chronic necrotic aspergillosis with an unfavorable course]. / Trudnosci diagnostyczne w przypadku przewleklej martwiczej aspergillozy o niepomyslnym przebiegu.

A case of chronic necrotic aspergillosis was discussed. Diagnostic and therapeutic difficulties were described in patient with an insufficiency of immune response mainly in polymorphonuclear leukocytes function.

[Changes in the respiratory system of patients with rheumatoid arthritis]. / Zmiany w ukladzie oddechowym u chorych na reumatoidalne zapalenie stawów.

Rheumatoid changes in the lungs are seen in 30% of cases of rheumatoid arthritis. Three cases with different patterns of pulmonary involvement in the course of rheumatoid arthritis (RA) are presented. In all cases pleural involvement was seen, in two subjects since the beginning, in the remaining in the course of developing interstitial lung disease. In two cases the dominant changes in the respiratory system were interstitial pneumonitis. In one case the interstitial pneumonitis took a fulminating course, being resistant to treatment with prednisone, endoxan, penicillamine. In the third case, the interstitial pneumonitis was of chronic character, despite the fact that the subject did not receive any treatment, it did not progress. In the first case the main features were pulmonary cavities. The could have evolved from necrosis of rheumatoid nodules or vessel changes.

[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.