OPEN LUNG BIOPSY. (49/293)

Steady improvement in the diagnostic appraisal of obscure pulmonary and mediastinal disease has permitted more intelligent treatment, better prognosis, and where necessary more accurate assessment of compensability. Open lung biopsy is designed to obtain material for pathological study when there is no pleural, mediastinal, or airway lesion on which to base a working diagnosis.A study of 54 patients in whom lung biopsy was performed at the Toronto General Hospital and Weston Sanatorium is reported. A positive tissue diagnosis was obtained in approximately 75%. The procedure is considered relatively innocuous if sensible selection is exercised to exclude patients with terminal disease, particularly that associated with severe cardiorespiratory insufficiency. No major complications occurred in this series. It is concluded that open lung biopsy might reasonably receive much wider application than in the past in cases in which a definite diagnosis cannot otherwise be made.  (+info)

BACTERIOPHAGES THAT LYSE MYCOBACTERIA AND CORYNEBACTERIA, AND SHOW CYTOPATHOGENIC EFFECT ON TISSUE CULTURES OF RENAL CELLS OF CERCOPITHECUS AETHIOPS: A PRELIMINARY COMMUNICATION. (50/293)

Bacteriophages isolated from sputum and resection specimens of patients suffering from carcinoma of the lung were found to lyse corynebacteria and mycobacteria, and to produce a cytopathogenic effect on certain cells in tissue cultures. From the same and other patients with neoplastic disease, bacteria were isolated and described as coryne-mycobacteria because of bacteriological features they shared with both species. These bacteria, which either were sensitive to mycobacteriophages and corynebacteriophages or were phage-immune lysogenic bacteria, could be induced to produce lytic particles with phagolytic activity on corynebacteria and mycobacteria and a cytopathogenic effect on HeLa cells and on the renal cells of Cercopithecus.  (+info)

MUCINOUS BRONCHIOLAR CARCINOMA OF THE RAT LUNG; A CASE REPORT. (51/293)

A rare tumour-the diffuse form of mucinous bronchiolar carcinoma involving the entire left lung was seen in a 23 month old female rat that had been given 2,2-dinitrobiphenyl orally. The neoplastic lesion was characterized by many honey-combed spaces lined by tall, mucus-secreting columnar cells and filled with abundant mucus.  (+info)

Ovarian metastasis originating from bronchioloalveolar carcinoma: a rare presentation of lung cancer. (52/293)

Ovarian metastasis originating from bronchioloalveolar carcinoma (BAC) has not been reported previously. We report a 63-year-old Chinese woman who was diagnosed as BAC with pleural metastasis in 1997. Four years later, she complained of vaginal bleeding, and a pelvic mass was discovered by an abdominal computerized tomography scan. Tumor debulking and total hysterectomy with bilateral salpingo-oopherectomy were performed. Pathology disclosed well-differentiated adenocarcinoma, with abundant clear cytoplasm, in the ovaries. Furthermore, immunohistochemical staining revealed that the tumor cells from the ovary and pleura were reactive to thyroid transcription factor 1 (TTF-1) and cytokeratin-7 (CK-7) but were negative for cytokeratin-20 (CK-20). The results of immunohistochemical staining, clinical course, and pathological features were compatible with the diagnosis of BAC with ovarian metastasis. In conclusion, to investigate the primary site of a metastatic ovarian cancer, clinicians should not forget the lungs since the incidence of lung cancer in females is increasing. Moreover, a monoclonal antibody panel for TTF-1, CK-7, and CK-20 may facilitate discrimination between primary and metastasized ovarian adenocarcinomas and/or identifying tumors of pulmonary origin.  (+info)

Interleukin-7 gene-modified dendritic cells reduce pulmonary tumor burden in spontaneous murine bronchoalveolar cell carcinoma. (53/293)

The antitumor efficiency of dendritic cells transduced with an adenovirus vector expressing interleukin (IL)-7 (DC-AdIL-7) was evaluated in a murine model of spontaneous bronchoalveolar cell carcinoma. These transgenic mice (CC-10 TAg), expressing the SV40 large T antigen under the Clara cell promoter, develop bilateral multifocal pulmonary adenocarcinomas and die at 4 months as a result of progressive pulmonary tumor burden. Injection of DC-AdIL-7 in the axillary lymph node region (ALNR) weekly for 3 weeks led to a marked reduction in tumor burden with extensive lymphocytic infiltration of the tumors and enhanced survival. The antitumor responses were accompanied by the enhanced elaboration of interferon (IFN)-gamma and IL-12 as well as an increase in the antiangiogenic chemokines, IFN-gamma-inducible protein 10 (IP-10/CXCL10) and monokine induced by IFN-gamma (MIG/CXCL9). In contrast, production of the immunosuppressive mediators IL-10, transforming growth factor (TGF)-beta, prostaglandin E(2) (PGE(2)), and the proangiogenic modulator vascular endothelial growth factor (VEGF) decreased in response to DC-AdIL-7 treatment. Significant reduction in tumor burden in a model in which tumors develop in an organ-specific manner provides a strong rationale for further evaluation of DC-AdIL-7 in regulation of tumor immunity and its use in lung cancer genetic immunotherapy.  (+info)

Survivin expression in atypical adenomatous hyperplasia of the lung. (54/293)

Few studies have investigated apoptosis-related factors in atypical adenomatous hyperplasia (AAH) and nonmucinous bronchioloalveolar carcinoma. We studied the expression of survivin, bcl-2, and p53 in 29 AAH lesions (low-grade, 11; high-grade, 18) and 40 nonmucinous BACs using immunohistochemical analysis and of survivin messenger RNA in 6 nonmucinous BACs using reverse transcription-polymerase chain reaction (RT-PCR). The incidence of positive survivin expression was 9% (1/11) in low-grade AAH, 89% (16/18) in high-grade AAH, and 100% (40/40) in nonmucinous BAC. Statistically significant differences were found between low-grade and high-grade AAH and between high-grade AAH and nonmucinous BAC. The percentages obtained for positive bcl-2 and p53 expression were 18% (2/11) and 0% (0/11) in low-grade AAH, respectively, and 28% (5/18) for both in high-grade AAH and 48% (19/40) for both in nonmucinous BAC. In RT-PCR, the intensity of survivin messenger RNA expression was stronger in nonmucinous BACs than in normal lung tissue samples. Thus, the expression of the 3 antibodies in high-grade AAH was intermediate between low-grade AAH and nonmucinous BAC. High-grade AAH may be closely related to nonmucinous BAC.  (+info)

Utility of percutaneous lung biopsy for diagnosing filamentous fungal infections in hematologic malignancies. (55/293)

BACKGROUND AND OBJECTIVES: The incidence of invasive filamentous fungal infections in hematologic patients is increasing as a consequence of high dose chemotherapy and bone marrow transplant procedures. Mortality is usually very high. The diagnosis is often difficult and yet a fast, accurate diagnosis is of fundamental importance for treating the infection and planning subsequent management of the hematologic disease. We evaluated the sensitivity of computed tomography (CT)-guided percutaneous biopsy in diagnosing pulmonary fungal infections. DESIGN AND METHODS: Between 1997 and 2002 we performed 17 CT-guided percutaneous transthoracic lung biopsies in 17 hematologic patients with suspected filamentous fungi infection with negative BAL, to obtain a certain diagnosis and to know what species of fungi was responsible for infection. In all cases suspected mycosis began during the post-chemotherapy aplastic period. Patients were receiving antifungal therapy at the time of all biopsies. When the platelet count rose above 50 x 10(9)/L, CT-guided percutaneous lung biopsy with fine-needle aspiration for cytology was performed. RESULTS: Twelve of 17 patients had histologic confirmation of the fungal infection (70.5%), 8 with Aspergillus spp. 4 with Mucorales spp. Biopsies provided non-specific results in 4 cases; in 2 of these cases, clinical course and response to therapy confirmed the diagnosis of mycosis; in the last case bronchoalveolar carcinoma was found as a new diagnosis. Cultures were positive in only 6 cases, all for Aspergillus spp. The sensitivity of CT-guided percutaneous lung biopsy was 70.6% and its positive predictive value (PPV) was 100%. This procedure provided an immediate diagnosis and only one side-effect (1 pneumothorax, without complications). INTERPRETATION AND CONCLUSIONS: Histologic discrimination between aspergillosis and mucormycosis is very important for deciding secondary prophylaxis during transplant procedures, because Mucor is usually resistant to azoles.  (+info)

Synchronous overexpression of epidermal growth factor receptor and HER2-neu protein is a predictor of poor outcome in patients with stage I non-small cell lung cancer. (56/293)

PURPOSE: Despite maximal therapy, surgically treated patients with stage I non-small cell lung cancer (NSCLC) are at risk for developing metastatic disease. Histopathologic findings cannot adequately predict disease progression, so there is a need to identify molecular factors that serve this purpose. Because the ErbB receptors play an important role in lung cancer progression, we analyzed the expression of epidermal growth factor receptor (EGFR), phosphorylated EGFR, transforming growth factor alpha (TGFalpha), and HER2-neu as potential prognostic factors in stage I NSCLC. EXPERIMENTAL DESIGN: Using immunohistochemical techniques, we retrospectively analyzed formalin-fixed, paraffin-embedded samples from 111 patients with resected pathological stage I NSCLC. Then we correlated these data with patient clinical outcome. RESULTS: Median follow-up was 69.3 months. EGFR overexpression (defined as >10% membranous staining) was found in 66 tumors (59.5%). It was significantly more common in T(2) tumors than in T(1) tumors (P = 0.001), and in more squamous cell carcinomas than in adenocarcinomas (P = 0.07). HER2-neu overexpression was found in 19 tumors (17.1%) and was significantly more common in adenocarcinomas than in squamous cell carcinomas (P = 0.035). Synchronous overexpression of EGFR and HER2-neu was found in 11 tumors (9.9%). Patients with these tumors had a significantly shorter time to recurrence (P = 0.006) and a trend toward shorter overall survival (P = 0.093). Phosphorylated EGFR and transforming growth factor alpha were detected but were not related to prognosis. CONCLUSIONS: Synchronous overexpression of EGFR and HER2-neu at the protein level predicts increased recurrence risk and may predict decreased survival in patients with stage I NSCLC. This suggests that important interactions take place among the different members of the ErbB family during tumor development and suggests a method for choosing targeted therapy. A prospective study is planned.  (+info)