AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. METHODS: Forma...AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. METHODS: Formalin-fixed, paraffin-embedded tissues were cut into 5 urn thick sections and routinely stained with hematoxylin and eosin. Some slides were also stained with Alcian-PAS. Antibodies used were primary antibodies to pancytokeratin, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, vimentin, smooth muscle actin and CD-117. RESULTS: We observed three patients who presented with multiple metastases from large cell bronchial carcinoma to small intestine. Two of them had abdominal symptoms (sudden onset of abdominal pain, constipation and vomiting) and in one case the tumor was incidentally found during autopsy. Microscopically, all tumors showed a same histological pattern and consisted almost exclusively of strands and sheets of poorly cohesive, polymorphic giant cells with scanty, delicate stromas. Few smaller polygonal anaplastic cells dispersed between polymorphic giant cells, were also observed. Immunohistochemistry showed positive staining of the tumor cells with cytokeratin and vimentin. Microscopically and immunohistochemically all metastases had a similar pattern to primary anaplastic carcinoma of the small intestine. CONCLUSION: In patients with small intestine tumors showing anaplastic features, especially with multiple tumors, metastases from large cell bronchial carcinoma should be first excluded, because it seems that they are more common than expected.展开更多
During a 17-year period, 38 patients with primary tracheobronchial tumors received surgical treatment in PUMC Hospital. Arnong the 38. 12 had low-malignancy tracheal tumors, 11 had benign tracheal tumors, 14 had low m...During a 17-year period, 38 patients with primary tracheobronchial tumors received surgical treatment in PUMC Hospital. Arnong the 38. 12 had low-malignancy tracheal tumors, 11 had benign tracheal tumors, 14 had low malignancy bronchial tumors and 1 had a benign bronchial tumor. Fifteen operations were perforrned on 12 patients with low-malignancy tracheal tumors, including local resection of the tumor and tracheal wall in 4 and curettage of the tumor plus electrical cauterization in 10. Postoperative radiotherapy was used as an adjuvant treatment in 8 patients with adenocystic carcinoma. Eight patients have survived for more than 5 years and 3 patients have survived for longer than 10 years postoperatively. All 11 patients with benign tumors received curettage of the tumor and were followed up for an average of 6. 5 years. Among them, 9 are still alive. Of the 14 patients with low malignancy bronchial tumors, 5 underwent curettage of the tumor plus electrical cauterization through incision of the main bronchus or intermedial bronchus, and 7 underwent lobectomy or pneumonectomy. The authors conclude that the correct diagnosis rate can be increased by enhancing recognition of this disease and applying tracheal tomography and bronchoscopy.展开更多
In order to understand the effect of surgery in the treatment of the bronchial carcinoid tumor and the factors affecting prognosis, 18 cases of bronchial carcinoid tumor are presented, including 5 cases with Cushing&#...In order to understand the effect of surgery in the treatment of the bronchial carcinoid tumor and the factors affecting prognosis, 18 cases of bronchial carcinoid tumor are presented, including 5 cases with Cushing's syndrome. There were lobectomy in 10, lung wedge resection in 3, excision of intraluminal tumor of bronchus in 3, exploratory thoracotomy in 2 cases. No operation death. Pathological examination revealed 14 cases were typical carcinoid tumor and 4 cases were atypical carcinoid tumor. By 2-13 years follow-up . 3 , 5 and 10 years survival rate were 82% , 78%and 70% respectively. Bronchial carcinoid tumor is often confused with small cell carcinoma of lung, the correct diagnosis can be obtained by light microscopic, electron microscopic and immunohistochemistry studies. Those patients accompanied with ectopic-ACTH secretion always have Cushing,s syndrome , resection of tumor can produce gho result. Proper operation method depends on the location of the tumor and patient's extent of cardiac and pulmonary reserve.Atypical carcinoid tumor had high malignancy and poor prognosis. The size of tumor, lymph node involvement and adjuvant therapy seem no definite effect on the patients' survival rate.展开更多
Objective： The aim of our study was to explore the clinical experience of surgical treatment for primary tracheobronchial malignant tumors. Methods： The clinicopathological data of 18 patients with primary tracheobr...Objective： The aim of our study was to explore the clinical experience of surgical treatment for primary tracheobronchial malignant tumors. Methods： The clinicopathological data of 18 patients with primary tracheobronchial malignant tumors surgically treated from February 1994 to August 2007 were reviewed retrospectively. The surgical management included sleeve tracheal resection in 8 cases, lower trachea and carina resection with carina reconstruction in 4 cases, local enucleation of the tumor in 4 cases, left or right carino-pneumon-ection in 2 cases, and resection of the tracheal or bronchial tumor and reconstruction of the airway under cardiopulmonary bypass （CPB）in 6 cases. Results： Among the 18 cases, there were 7 adenoid cystic carcinomas, 9 squamous cell carcinomas, 1 lymphoepithelial-like carcinoma and 1 follicular non-Hodgkin tymphoma. All the cases recovered well except one who died of endotracheal bleeding and asphyxia at the 10th postoperative day. Conclusion： Surgical resection is the most effective treatment for primary tracheobronchial malignant tumors. The selection of operation modes should be individualized according to patients＇ condition. Both complete resection and safety should be taken into consideration simultaneously.展开更多
文摘AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. METHODS: Formalin-fixed, paraffin-embedded tissues were cut into 5 urn thick sections and routinely stained with hematoxylin and eosin. Some slides were also stained with Alcian-PAS. Antibodies used were primary antibodies to pancytokeratin, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, vimentin, smooth muscle actin and CD-117. RESULTS: We observed three patients who presented with multiple metastases from large cell bronchial carcinoma to small intestine. Two of them had abdominal symptoms (sudden onset of abdominal pain, constipation and vomiting) and in one case the tumor was incidentally found during autopsy. Microscopically, all tumors showed a same histological pattern and consisted almost exclusively of strands and sheets of poorly cohesive, polymorphic giant cells with scanty, delicate stromas. Few smaller polygonal anaplastic cells dispersed between polymorphic giant cells, were also observed. Immunohistochemistry showed positive staining of the tumor cells with cytokeratin and vimentin. Microscopically and immunohistochemically all metastases had a similar pattern to primary anaplastic carcinoma of the small intestine. CONCLUSION: In patients with small intestine tumors showing anaplastic features, especially with multiple tumors, metastases from large cell bronchial carcinoma should be first excluded, because it seems that they are more common than expected.
文摘During a 17-year period, 38 patients with primary tracheobronchial tumors received surgical treatment in PUMC Hospital. Arnong the 38. 12 had low-malignancy tracheal tumors, 11 had benign tracheal tumors, 14 had low malignancy bronchial tumors and 1 had a benign bronchial tumor. Fifteen operations were perforrned on 12 patients with low-malignancy tracheal tumors, including local resection of the tumor and tracheal wall in 4 and curettage of the tumor plus electrical cauterization in 10. Postoperative radiotherapy was used as an adjuvant treatment in 8 patients with adenocystic carcinoma. Eight patients have survived for more than 5 years and 3 patients have survived for longer than 10 years postoperatively. All 11 patients with benign tumors received curettage of the tumor and were followed up for an average of 6. 5 years. Among them, 9 are still alive. Of the 14 patients with low malignancy bronchial tumors, 5 underwent curettage of the tumor plus electrical cauterization through incision of the main bronchus or intermedial bronchus, and 7 underwent lobectomy or pneumonectomy. The authors conclude that the correct diagnosis rate can be increased by enhancing recognition of this disease and applying tracheal tomography and bronchoscopy.
文摘In order to understand the effect of surgery in the treatment of the bronchial carcinoid tumor and the factors affecting prognosis, 18 cases of bronchial carcinoid tumor are presented, including 5 cases with Cushing's syndrome. There were lobectomy in 10, lung wedge resection in 3, excision of intraluminal tumor of bronchus in 3, exploratory thoracotomy in 2 cases. No operation death. Pathological examination revealed 14 cases were typical carcinoid tumor and 4 cases were atypical carcinoid tumor. By 2-13 years follow-up . 3 , 5 and 10 years survival rate were 82% , 78%and 70% respectively. Bronchial carcinoid tumor is often confused with small cell carcinoma of lung, the correct diagnosis can be obtained by light microscopic, electron microscopic and immunohistochemistry studies. Those patients accompanied with ectopic-ACTH secretion always have Cushing,s syndrome , resection of tumor can produce gho result. Proper operation method depends on the location of the tumor and patient's extent of cardiac and pulmonary reserve.Atypical carcinoid tumor had high malignancy and poor prognosis. The size of tumor, lymph node involvement and adjuvant therapy seem no definite effect on the patients' survival rate.
文摘Objective： The aim of our study was to explore the clinical experience of surgical treatment for primary tracheobronchial malignant tumors. Methods： The clinicopathological data of 18 patients with primary tracheobronchial malignant tumors surgically treated from February 1994 to August 2007 were reviewed retrospectively. The surgical management included sleeve tracheal resection in 8 cases, lower trachea and carina resection with carina reconstruction in 4 cases, local enucleation of the tumor in 4 cases, left or right carino-pneumon-ection in 2 cases, and resection of the tracheal or bronchial tumor and reconstruction of the airway under cardiopulmonary bypass （CPB）in 6 cases. Results： Among the 18 cases, there were 7 adenoid cystic carcinomas, 9 squamous cell carcinomas, 1 lymphoepithelial-like carcinoma and 1 follicular non-Hodgkin tymphoma. All the cases recovered well except one who died of endotracheal bleeding and asphyxia at the 10th postoperative day. Conclusion： Surgical resection is the most effective treatment for primary tracheobronchial malignant tumors. The selection of operation modes should be individualized according to patients＇ condition. Both complete resection and safety should be taken into consideration simultaneously.
