ABSTRACT
Homem negro de 65 anos de idade referia, há 5 meses, queixas respiratórias e urinarias. A rivestigaçao realizada demonstrou a existência de carcinoma de próstata com metástases ósseas, brônquica, parenquimatosa e ganglionar hilar pulmonar. Biópsias de próstata e de brônquio revelaram carcinoma; a pesquisa de antígeno prostático específico foi positiva em ambas. O paciente foi submetido à prostatectomia e orquiectomia bilateral, bem como hormonioterapia antiandrogênica; houve involuçao das metástases brônquicas, pulmonar e ganglionar, mantendo-se inalteradas as ósseas. Em conclusao: metástases pulmonar e brônquica de carcinoma de próstata podem simular carcinoma brônquico primitivo; o tratamento hormonal foi satisfatório, evitando-se, assim, radio e quimioterapia; regressao completa com terapia antiandrogênica é possível, evitando-se radio e quimioteerapia.
Subject(s)
Humans , Male , Aged , Adenocarcinoma/secondary , Flutamide/therapeutic use , Lung Neoplasms/secondary , Bronchial Neoplasms/secondary , Bone Neoplasms/secondary , Prostatic Neoplasms/pathology , Biopsy , Tomography, X-Ray Computed , Lung Neoplasms/diagnosis , Lung Neoplasms/pathology , Lung Neoplasms/drug therapy , Remission Induction , Bronchial Neoplasms/diagnosis , Bronchial Neoplasms/pathology , Bronchial Neoplasms/drug therapy , Prostatic Neoplasms/surgeryABSTRACT
UNLABELLED: A 65 year old male Negro had respiratory and urinary symptoms for the last 5 months. The work-up disclosed a prostatic carcinoma with metastases in bones, bronchus, lung parenchyma and hilar lymphnodes. Prostatic and bronchial biopsies revealed carcinoma; specific prostatic antigen was detected in both. A prostatectomy with bilateral orchiectomy was performed followed by anti-androgenic hormotherapy. Complete remission of metastatic bronchial, lung parenchyma and lymphatic lesions was observed; bone lesions did not change. IN CONCLUSION: lung and bronchial metastases of prostatic carcinoma may resemble primitive bronchial tumor; complete remission with anti-androgenic therapy is possible, saving the patient from unnecessary radio and/or chemotherapy.
Subject(s)
Adenocarcinoma/secondary , Bone Neoplasms/secondary , Bronchial Neoplasms/secondary , Flutamide/therapeutic use , Lung Neoplasms/secondary , Prostatic Neoplasms/pathology , Aged , Biopsy , Bronchial Neoplasms/diagnosis , Bronchial Neoplasms/drug therapy , Bronchial Neoplasms/pathology , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Male , Prostatic Neoplasms/surgery , Remission Induction , Tomography, X-Ray ComputedABSTRACT
A diagnosis of Hodgkin's disease was made 20 years ago in a 37-year-old woman; treatment included thoracic irradiation and chemotherapy. She was considered cured and remained well up to one year before, when she developed bilateral pleural effusion. No evidence of activity of Hodgkin's disease was detected. The pleural liquid was an exudate, with lymphocytic predominance. On thoracoscopy, enlarged lymphatic channels in the visceral pleura were noted, with tissue confirmation. To our knowledge, this report is the first to confirm by thoracoscopy and histologic study the proposed pathophysiologic condition of this uncommon entity.
Subject(s)
Mediastinum/pathology , Pleural Effusion/etiology , Radiotherapy/adverse effects , Adult , Combined Modality Therapy , Female , Fibrosis , Hodgkin Disease/drug therapy , Hodgkin Disease/radiotherapy , Humans , Lymphatic System/pathology , Time FactorsABSTRACT
As manifestacoes articulares e as concentracoes sericas e na urina de 24 horas do acido urico foram estudadas em quarenta pacientes com tuberculose e em tratamento com pirazinamida. Cinco pacientes apresentaram manifestacoes articulares e nao apresentaram diferencas significativas com os demais em relacao a idade, uricemia e diminuicao significativa da uricosuria diurna na fase de tratamento com pirazinamida foram observados em todos os pacientes - a uricosuria noturna nao se alterou significativamente.Nos periodos pre e pos-tratamento. Questionamos se do ponto de vista etico e justificada a utilizacao rotineira de uma droga que altera a eliminacao do acido urico em todos os pacientes, pois existem medicacoes alternativas com efeito terapeutico equivalente e com menores efeitos colaterais