ABSTRACT
OBJECTIVE: To analyse the assessments of problematic cases reported to the Dutch Institute for Asbestos Victims (IAS) by the Mesothelioma Working Party of the Netherlands Association of Pulmonologists and Specialists in Tuberculosis (NVALT). DESIGN: Descriptive. METHOD: The pathological confirmation of a malignant pleural mesothelioma of occupational origin is difficult in about 10% of the cases. The IAS has requested the Mesothelioma Working Party of the NVALT to review these cases. When no definitive diagnosis can be made on histological or cytological grounds, three pulmonologists reach a conclusion on the basis of correspondence, X-ray examination and other information. RESULTS: In the period January 2000--March 2004 the Working Party evaluated 132 cases, two-thirds of whom (n = 89) were assessed to be compatible with 'malignant pleural mesothelioma' and one-third of whom (n = 43) were felt to be non-compatible. In 69% of the cases (91/132) the conclusions of the three independent specialists were unanimous. The median time from request to report was 25 days (range: 1-185). CONCLUSION: This approach was effective and rapid.
Subject(s)
Asbestos/adverse effects , Mesothelioma/etiology , Occupational Diseases/etiology , Pleural Neoplasms/etiology , Aged , Aged, 80 and over , Air Pollutants , Environmental Exposure , Female , Humans , Male , Mesothelioma/diagnosis , Mesothelioma/pathology , Middle Aged , Netherlands , Occupational Diseases/diagnosis , Occupational Diseases/pathology , Occupational Exposure , Pleural Neoplasms/diagnosis , Pleural Neoplasms/pathologyABSTRACT
Tracheobronchial granular cell myoblastoma (GCM) is rare. Although the tumor has some malignant properties, it is considered benign, and there is no consensus regarding treatment. Three cases are reported here. Bronchoscopic treatment in patients with GCM may be attempted as a first approach in case the tumor is intraluminal.
ABSTRACT
Several factors are known to promote the development of a lung cancer. Smoking, occupation, environment, chronic bronchitis, and scars in the lung are all risk factors. Many studies have stressed the importance of nutrition, in particular vitamins. Vitamin A is necessary for cell differentiation. Retrospective and prospective studies have proven the inverse relation between provitamin A, beta-carotene, and lung cancer of the squamous and oat cell types. Studies in which beta-carotene or natural vitamin A are supplied to smokers, controls, and patients after resection for lung cancer are in progress. The study of other vitamins such as vitamin C and vitamin E has not led to definitive conclusions. The trace element selenium may also exert a beneficial effect.
Subject(s)
Lung Neoplasms/etiology , Vitamin A Deficiency/complications , Carotenoids/blood , Humans , Lung Neoplasms/blood , Nutritional Requirements , Retrospective Studies , Risk Factors , Vitamin A/administration & dosage , Vitamin A/blood , beta CaroteneABSTRACT
Diagnostic procedures in the presence of superior vena cava obstruction have been reported to be dangerous. We reviewed our experience in 58 patients who presented with this obstruction during the period 1976-1985, to establish the nature and frequency of complications. In 56 of 58 patients we could obtain a diagnosis before instituting therapy. The only complication was one case of peroperative haemorrhage.
Subject(s)
Superior Vena Cava Syndrome/complications , Biopsy , Bronchoscopy , Female , Humans , Male , Retrospective Studies , Superior Vena Cava Syndrome/diagnosis , Superior Vena Cava Syndrome/etiology , Thoracic Neoplasms/complications , Thoracic Neoplasms/pathologyABSTRACT
The activity of adenosine deaminase (ADA) was investigated in pleural effusions from 10 patients with tuberculous pleurisy and 76 patients with pleural effusions of other aetiology. The ADA activity in the tuberculous patients was significantly higher than in the other groups, with the exception of those with empyema. Specificity (87%) and sensitivity (100%) of this test for tuberculosis is high when a reference limit of more than 53 U/l is taken.
Subject(s)
Adenosine Deaminase/metabolism , Nucleoside Deaminases/metabolism , Pleural Effusion/enzymology , Tuberculosis, Pleural/enzymology , Clinical Enzyme Tests , Humans , Lung Diseases/enzymology , Reference Values , Sensitivity and Specificity , Tuberculosis, Pleural/diagnosisABSTRACT
The present study contains the review of 30 patients with malignant mesothelioma of the pleura, examined and treated at our institution. In an attempt to compare various methods of diagnosis in this entity, emphasis was laid on specific abilities and limitation of investigations such as pleural biopsy, pleural fluid cytology, diagnostic thoracoscopy and thoracotomy and radiological studies including computed tomography and magnetic resonance imaging. Clinical management problems encountered in this neoplasm are also discussed.