Oat-cell carcinoma of the bronchus: radiotherapy versus surgery.
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The neodymium-yttrium-aluminium-garnet laser has proved to be a useful therapeutic tool for the management of endobronchial lesions. Between October 1, 1986 and October 31, 1987, 31 patients received 41 laser treatments at the Peter MacCallum Cancer Institute mainly for bronchial obstruction, haemoptysis or persistent cough. Good symptomatic relief was obtained in the majority of patients with no operative mortality and a moderate morbidity. When the endobronchial lesion is malignant, concurrent radiotherapy is needed to prevent the early recurrence of the cancer.
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Our first experiences with polychemotherapy (COMB-regimen) followed by radiotherapy for patients with small cell carcinomas are encouraging. 7 patients out of 18 showed a complete remission. The treatment was well tolerated by all patients.
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Aspiration of a foreign body in young children is rare but can still cause considerable morbidity and mortality. The case of a 5 1/2-month-old infant with aspiration of a piece of apple is presented, together with a review of the literature.
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Each developmental stage in the process towards bronchial squamous cell carcinoma (normal epithelium, squamous metaplasia and early stage squamous cell carcinoma including in situ carcinoma) was examined for p21/waf1 protein expression and cell proliferation using MIB1. P21/waf1 immunoreactivity was classified into four patterns: predominantly cytoplasmic staining, exclusively nuclear staining, both nuclear and cytoplasmic staining and negative. The cases with predominantly cytoplasmic staining showed suppression of cell proliferation. Most cases with either negative or exclusively nuclear staining revealed high cell proliferation. The simultaneous evaluation of p21/waf1 and cell proliferation is valuable for clinical determination of the high risk for malignant transformation.
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A 47-year-old asymptomatic female was referred to our outpatient department with pulmonary infiltration in the left S6. PPD skin test revealed 12 x 11 mm redness. The infiltration disappeared without treatment. Hilar lymphadenopathy appeared 2 months after the first visit. In 6 months after the first visit, the hilar lymphadenopathy disappeared without treatment, but infiltration appeared in the left S6 (different site to that of the first visit). A repeated PPD revealed 47 x 40 mm redness and 20 x 15 mm induration. Bronchoscopy revealed a polipoid lesion at the orifice of left B6, MTD (Mycobacterium tuberculosis direct test) was positive from the bronchial washing of left B6. She was diagnosed as tuberculosis based on the courses and radiographic appearances. After antituberculous chemotherapy, the pulmonary infiltration and the polipoid lesion at the orifice of left B6 improved.