ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Microscopic examination of stained smears and tissue sections remains the standard method for definitive diagnosis and classification of lung cancer. However, the morphology of lung cancer is complex, and consensus classifications such as those prepared by a panel World Health Organization (WHO) are required for the sake of consistency and clinical relevance. In the most recent (1999) WHO classification, the diagnostic categories of greatest clinical importance, small cell lung carcinoma and non-small cell lung carcinoma, remain fundamentally unchanged. However, application of immunohistochemistry and electron microscopy has revealed expression of neuroendocrine markers in a wide variety of tumors. Expression of these markers is not taken into account in current treatment protocols, and additional correlative studies will be required to determine the clinical relevance of neuroendocrine differentiation in lung carcinoma. In addition to histological classification, microscopic analysis can providein situevidence of response to chemotherapy, as well as information on precursor lesions and multistep carcinogenesis in the airways. Finally, it is likely that morphological assessment of lung carcinoma and preneoplastic lesions will continue to be refined as new diagnostic modalities such as spiral computed tomography and fluorescence bronchoscopy provide previously inaccessible specimens for morphological and correlative molecular studies.

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Lung cancer remains the leading cause of cancer death among men and women in the United States. Early detection of premalignant lesions provides the possibility of treatment at earlier stages. Because malignancy develops from genetic alterations, the early detection of these genetic changes should be associated with the earliest clues to transformation. This article presents an overview of detection of molecular markers and their relevance to lung cancer. In the future, such molecular markers may play a role in guiding therapy for lung cancer.

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Screening for lung cancer has remained controversial since the completion, more than two decades ago, of the three large randomized controlled trials, sponsored by the National Cancer Institute, which led to the recommendation against screening by major medical organizations. Details of the controversy are given, which include concerns about the study design, implementation, and analysis. New evidence about the potential benefit of screening with chest radiography that has emerged since the completion of those trials is reviewed, as well as the results of studies of CT screening for lung cancer.

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Chronic immunosuppression in organ transplant recipients predisposes to the development of malignant disease. The authors describe their 29-year institutional experience of bronchogenic carcinoma developing after heart and lung transplantation. Seven cases of bronchogenic carcinoma were diagnosed in 1,119 heart and lung transplant recipients. Computed tomography scans and radiographs at time of diagnosis, as well as prior radiographs available in six patients were retrospectively analyzed by two radiologists in consensus. The seven cases involved six heart and one lung transplant recipients. Six patients were smokers with a mean smoking history of 66 pack-years. Mean time interval from transplantation to cancer detection was 25 months. Radiologic findings consisted of a solitary pulmonary nodule (n = 3), mass with satellite nodules (n = 1), and obstructive pneumonitis (n = 1). In the sixth patient, the cancer was not radiographically visible because of obscuration by adjacent fibrosis. On review, radiographic abnormalities were present a mean of 12 months prior to diagnosis in 66% of patients. In the heart or lung transplant population, bronchogenic carcinoma develops in recipients with extensive smoking histories. It presents radiographically as a nodule, mass, or obstructive pneumonitis, and is usually visible on radiographs before the time of diagnosis.

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The purpose of this study is to describe the magnetic resonance (MR) features of bronchioloalveolar carcinoma. MR examinations of 18 patients with proven bronchioloalveolar carcinoma were reviewed. Detection at computed tomography (CT) and pathologic confirmation were the entry criteria. Nine patients had a solitary nodule, three patients a lobar consolidation, and six patients had diffuse disease. For each patient, both breath-hold T2-weighted fast spin-echo, and breath-hold T1-weighted gradient-echo images, before and after injection of gadolinium, were available. Nine patients with pulmonary consolidation or diffuse disease had also heavily T2-weighted MR imaging (Haste or TSE 240; Siemens, Erlangen, Germany). MR imaging showed pulmonary abnormalities in 17 of 18 patients. Unenhanced T1-weighted and T2-weighted images depicted tumor in 16 of 18 patients. Contrast-enhanced T1-weighted images showed tumor in 17 of 18 patients. In no case did MR imaging depict abnormalities corresponding to the ground-glass opacities seen on CT scans. In three patients with mucinous bronchioloalveolar carcinoma, heavily T2-weighted images showed lesions isointense with respect to static fluid of the human body. In conclusion, the ability of MR imaging in detecting small nodules and ground-glass opacities is limited. However, heavily T2-weighted sequences are able to show the presence of mucin. This is useful information because mucinous bronchioloalveolar carcinoma carries a poor prognosis.

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

To evaluate the performance of a computer-aided diagnosis (CAD) scheme for estimating increased pulmonary blood flow on chest radiographs, we compared computerized assessment with findings by radiologists. Our CAD scheme extracts selectively linear opacities corresponding to vessels in regions of interest (ROIs) in the right upper and lower lung zones on digitized chest radiographs, and then calculates a radiographic index as a physical measure that reflects the area of the extracted opacities in selected ROIs. As a measure of increased pulmonary blood flow, the upper/lower radiographic index ratio was calculated for each patient. Seven radiologists estimated the degree of increased pulmonary blood flow for the same images of ROI sets presented on a cathode-ray tube monitor in a randomized order. Between the normal-pulmonary capillary wedge pressure (PCWP) group and increased-PCWP groups, there was no significant difference in performance between CAD and radiologists (p = 0.105). However, when the normal and mild PCWP groups were compared, the performance of CAD was superior to that of radiologists (p = 0.001). This study indicates that our CAD scheme is promising for quantitative estimation of increased pulmonary blood flow, especially in mild cases.

ISSN:0883-5993    

出版商:OVID    

年代:2000

数据来源: OVID