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Fine needle aspiration biopsy in the evaluation of lymphoreticular tumors of the thorax.

The role of fine needle aspiration (FNA) biopsy in the evaluation of lymphoreticular disorders involving the lung and mediastinum was evaluated in a study of 16 cases from the authors' institutions. The cytologic material from these cases was reviewed, and the original cytologic interpretations were compared to the tissue diagnoses, with the overall accuracy of the cytologic interpretation evaluated. There were no false-positive diagnoses of malignancy in this series. A definite diagnosis of malignant lymphoma was most readily made in those cases in which the lymphoma was of the large-cell type. Small-cell and mixed large-cell and small-cell lymphoid proliferations were less able to be definitively interpreted, with pseudolymphoma presenting particular difficulty. The results support the conclusion that FNA biopsy can be useful in evaluating these lesions but also emphasize the fact that accurate diagnosis requires correlation of cytologic, clinical and laboratory data.

Aged↗
PubMed1985

[Hemodynamics in right heart damage under continuous positive pressure respiration. An experimental study of the open thorax].

The haemodynamic effects of isolated right ventricular damage (produced by pressure overloading from temporary banding of the pulmonary artery) under increased positive end-expiratory pressure were investigated in 12 pigs. Under controlled ventilation and anaesthesia with fentanyl and pancuronium bromide the experimental study was performed with an open chest and pericardium; under these circumstances high levels of PEEP resulted primarily in an increase of right ventricular afterload. RAP (+30,2%, p less than 0.05) and RVEDP (+196%, p less than 0,01) of the damaged right ventricle were increased markedly, dRVp/dt is decreased (-18%, p less than 0,05) with a corresponding endsystolic pressure-volume relationship. The decrease of CI after moderate right ventricular lesion is more distinct under PEEP (-27%, p less than 0,01) than previously (-13%). Because of an elevation of TPR-I (+24%) there was no significant fall of systemic arterial pressure (-6,6%); heart rate also remained constant (+3%). Accordingly, with the open chest, haemodynamic changes related to increased positive end-expiratory pressure are very discrete, both in intact and damaged right ventricles; only with high levels of PEEP, elevation of pulmonary vascular resistance--under open chest conditions the predominant factor--limits myocardial performance of the damaged right ventricle and results in a significant reduction of cardiac output.

Anesthesia↗
PubMed1985

[Frontal radiogram of the thorax in the present-day diagnosis of the mediastinum. Technic of execution and semeiology].

The advantages of high kilovoltage and pulmonary filters in frontal chest X ray are described, underliing the possibility of a simultaneous demonstration of both pulmonary fields and mediastinal structures. A description is given of the most important mediastinal lines and of their semeiological value in pathologic conditions. The excellent results obtained by means of hemifiltration in patients with opaque hemithorax are stressed. An increased diffusion of such technique could be justified by its simplicity, and by the low cost and high benefit.

Adult↗
PubMed1986

[Surgery of metastases of the thorax--a new dimension in thoracic surgery].

Surgical operations for metastases are palliative. If no effective alternative treatment is available, excision of metastases may be the treatment of choice also for extrapulmonary metastases in the thoracic region and for multiple pulmonary metastases. Experience has shown that, in some cases, the course of a patient markedly improved by resection. However, the success is dependent on an effective chemotherapy, not on surgical enthusiasm. A case selection based on favourable prognostic criteria is not justifiable today. More experience is needed before a therapeutic algorithm may be developed.

Adolescent↗