Lymphadenopathy in the thoracic cavity is frequently caused by inflammatory diseases. In very rare cases, the node-bronchial fistula has been reported to be the cause of complications of pulmonary tuberculosis. A male patient with necrotizing pneumonia and mediastinal lymph node enlargements identified by chest computed tomography was also found to have a node-bronchial fistula caused by lung cancer. The patient was treated for tuberculosis with pneumonia for one week before a definitive diagnosis was made. A further investigation revealed him to have non-small cell lung cancer (NSCLC, adenocarcinoma) and multiple mediastinal lymphadenopathies accompanied with the node-bronchial fistula. We report this specific case that had been previously treated for tuberculosis but was later revealed to be NSCLC accompanied with a node-bronchial fistula.
Bronchial Fistula ; Carcinoma, Non-Small-Cell Lung ; Fistula ; Humans ; Lung Neoplasms ; Lymph Nodes ; Lymphatic Diseases ; Male ; Pneumonia ; Thoracic Cavity ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

Basing on the data of 41 patients who died due to primary carcinoma of the bronchus and all underwent necropsy, the authors note the clinical and paraclinical features of the diseases as follows: 1/ the modes of onset can be ranged in 3 groups: a/ respiratory symptoms (cough, chest pain, etc...): 29/41 (70.7%); b/ General symptoms (anorexia, tiredness, etc.): 9/41 (21.9%); c/ Radiological abnormalities only 3/41 (7.3%). 2/ The physical signs are seen in most patients: 40/41 (97.5%), among them diminished breath sounds are often noted: 27/41 (65.8%) and before pleuritic syndrome: 8/41 (19.5%). 3/ The radiological abnormalities are limited in 6 groups, three of which are the most common appearances: hilar and medicastinum shadows: 10/26(30.4%). 4/ History: adenocarcinoma: 21/41 (51.2%); epidermoid carcinoma: 16/41 (39%); oat cell carcinoma: 4/41 (9.8%).
Bronchial Neoplasms ; Death

Contribution to the establishment and /or improvement of study on some criteria of cytologic diagnosis 5 major lung carcinomas. 50 cases of lung cancer including 14 squamous carcinomas, 18 adenocarcinomas, 8 large cell carcinomas, 8 small cell carcinomas and 2 adeno-squamous carcinomas were diagnosed cytologically and confirmed by histological confrontation. Criteria of cytologic diagnosis were presented and discussed.
Bronchial Neoplasms ; diagnosis

OBJECTIVETo evaluate the long-term efficacy of bronchial arterial infusion (BAI) chemotherapy in the treatment of centeral non-small cell lung cancer.

METHODSFifty-eight patients with central non-small-cell lung cancer, who were assessed as difficult operable or non-operable by imaging examination, received BAI of cisplatin, epirubicin and mitomycin alone or in combination. It includes 51 cases of squamous cell carcinoma, 6 cases of adenocarcinoma and 1 case of adenosquamous carcinoma. The cinical stage before BAI wasIIb in 3 cases, IIIa in 26 cases and IIIb in 29 cases. Long term follow-up was conducted and the results were statistically analyzed.

RESULTSThe total effective rate of BAI was 43.1%. The mediam survival (MS) of all 58 patients was 29.1 months. 31 patients after BAI became operable and were resected, had a median survival of 65.2 months. 27 patients after BAI were not resected and had a MS of 15.9 months. There was a significant difference between the patients who had been resected and not. The MS of IIIa stage patients was 39.0 months, and IIIb stage 20.4 months.

CONCLUSIONBronchial arterial infusion chemotherapy is a better choice with a definite efficacy for treatment of center-based NSCLC patients, estimated as difficult operable but without distant metastasis.

Adenocarcinoma ; drug therapy ; pathology ; surgery ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Bronchial Arteries ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; surgery ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; surgery ; Cisplatin ; administration & dosage ; Epirubicin ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Infusions, Intra-Arterial ; Lung Neoplasms ; drug therapy ; pathology ; surgery ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Neoplasm Staging ; Survival Rate

One hundred and nine patients with squamous cell carcinoma of lung, including 67 cases had bronchoscopic biopsy sampling and 42 cases had surgical samplings, were studied and histologically classified according to WHO Classification - 1999. Results indicated that: (1) Male/ Female ratio were 4.17/1 to 6.44/1; (2) Four variants of squamous cell carcinoma were found; (3) Identification of exact those variants required larger samplings or surgical sampling from different sites of tumors; (4) Histological criteria for every variants were presented and discussed.
Bronchial Neoplasms ; Neoplasms ; Squamous Cell

OBJECTIVETo explore the clinical effects of bronchial arterial infusion (BAI) with oleum fructus bruceae (OFB) Injection and chemotherapeutic agents (CTA) in treating advanced non-small cell lung cancer (NSCLC).

METHODSOne hundred and three patients with advanced NSCLC were randomized into 2 groups, the 98 patients in the treatment group treated by BAI with OFB + CTA and the 50 in the control group by BAI with CTA alone. The incidence of adverse reaction, change of tumor size and patients' quality of life (QOL) in the two groups were observed and compared.

RESULTSThe objective effective rate (CR + PR) was 63.3% in the treatment group and 46.0% in the control group (P < 0.01); the median survival duration in them was 363 days and 305 days; the 1-year cumulative survival rate was 70.4% and 44.0%, and the QOF improving rate was 83.7% and 62.0% respectively, the difference between groups were all statistically significant (P < 0.01). In addition, the incidence of adverse reactions of digestive symptoms, bone marrow suppression and the hepato-, renal and cardiac toxicities were lower in the treatment group than those in the control group (P < 0.01).

CONCLUSIONBAI with OFB + CTA in treating NSCLC could enhance the objective therapeutic effect of simple chemotherapy, as well as raise the QOL and protect immune and medulla function in patients.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bronchial Arteries ; Brucea ; chemistry ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drug Therapy, Combination ; Female ; Humans ; Infusions, Intra-Arterial ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Plant Oils ; administration & dosage ; Quality of Life ; Seeds ; chemistry

A prospective trial has based a combination of established technique. Such as conventional diagnostic procedures (endobronchial forcepsbiopsy, bronchial brushing) and transbronchial needle aspiration. These techniques result in an excellent diagnostic yield and safe. Study object 61 patients in clinic, x-ray age at diagnosis 32-75 years, (range 53,5 years) having bronchogenic carcinoma in suspection. All most of them were in brochoscopy and operation. 70,49% patients have mediastinal and hilar lympho node. There was no incidence and complication happened.
Lung Neoplasms ; Bronchial Diseases ; diagnosis

OBJECTIVETo study the effect of Aidi Injection (艾迪注射液,ADI) applied in the bronchial artery, applied in the bronchial artery infused (BAI) neo-adjuvant chemotherapy for stage III A non-small cell lung cancer (NSCLC) before surgical operation.

METHODSThe 60 patients with NSCLC stage III A underwent two courses BAI chemotherapy before tumor incision were assigned to two groups, the treatment and the control groups, using a random number table, 30 in each group. ADI (100 mL) was given to the patients in the treatment group by adding into 500 mL of 5% glucose injection for intravenous dripping once daily, starting from 3 days before each course of chemotherapy, and it lasted for 14 successive days, so a total of 28 days of administration was completed. The therapeutic effectiveness and the adverse reaction that occurred were observed, and the levels of T-lymphocyte subsets, natural killer cell activity, and interleukin-2 in peripheral blood were measured before and after the treatment.

RESULTSThe effective rate in the treatment group was higher than that in the control group (70.0% vs. 56.7%, P<0.05). Moreover, as compared with the control group, the adverse reaction that occurred in the treatment group was less and mild, especially in terms of bone marrow suppression and liver function damage (P<0.05). Cellular immune function was suppressed in NSCLC patients, but after treatment, it ameliorated significantly in the treatment group, showing significant difference as compared with that in the control group (P<0.05).

CONCLUSIONADI was an ideal auxiliary drug for the patients in stage III A NSCLC received BAI neo-chemotherapy before surgical operation; it could enhance the effectiveness of chemotherapy, ameliorate the adverse reaction and elevate patients' cellular immune function; therefore, it is worthy for spreading in clinical practice.

Adult ; Aged ; Antineoplastic Agents ; adverse effects ; pharmacology ; therapeutic use ; Bronchial Arteries ; drug effects ; pathology ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; immunology ; surgery ; Chemotherapy, Adjuvant ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Female ; Humans ; Infusions, Intra-Arterial ; Injections ; Interleukin-2 ; blood ; Killer Cells, Natural ; drug effects ; immunology ; Lung Neoplasms ; blood ; drug therapy ; immunology ; surgery ; Lymphocyte Subsets ; drug effects ; immunology ; Male ; Middle Aged ; Neoplasm Staging ; Time Factors ; Treatment Outcome

Study was carried out in 162 bronchial cancer patients (83 males, 75 females) in National Institute of Tuberculosis and Lung Diseases from November 1991 to October 1994. Paraneoplastic syndrome account for 51.8% including the symptoms of bone-articular and connective tissues, 43.6% hematology 22.8%, skin 6.8%, endocrino-metabolism 3.1% and kidney 0.6%. Paraneoplastic syndromes of bone-articular connective tissue, include pain manifestations of bones and joints, finger clubbed, symptoms of hematology: anemia, neutrophilia, eosiniphilia and polyplastocytosis; symptoms of skin: hypertrichosis, keratodermia, chloasma cutaneous dystrophy in two feet, vascularmotrice disturbance of inferior limbs; symptoms endocrino-metabolism: hyperuricemia, inaddition, there are some manifestations on kidney and chronical glomerulo-nephritis
Paraneoplastic Syndromes ; Bronchial Neoplasms ; Diseases ; diagnosis ; Therapeutics

PURPOSE: Metastatic cancer to the brain is a major problem for the patients with bronchogenic carcinoma, and most of these patients have a limited survival expectancy. To increase tumor control and/or to decrease late morbidity with possible shortening in over-all treatment period, multiple daily fraction technique for brain metastasis was performed. The author represented the results of accelerated fractionation radiotherapy in patients with brain metastases from non-small cell lung cancer. MATERIALS AND METHODS: Twenty-six patients with brain metastases from non-small cell lung cancer between 1991 and 1993 received brain radiotherapy with a total dose of 48 Gy, at 2 Gy per fraction, twice a day with a interfractional period of 6 hours, and delivered 5 days a week. The whole brain was treated to 40 Gy and boost dose escalated to 8 Gy for single metastatic lesion by reduced field. Twenty-four of the 26 patients completed the radiotherapy. Radiotherapy was interrupted in two patients suggesting progressive intracerebral disease. RESULTS: This radiotherapy regimen appears to be comparable to the conventional schema in relief from symptoms. Three of the 24 patients experienced nausea and or vomiting during the course of treatment because of acute irradiation toxicity. The author observed no excessive toxicity with escalating dose of irradiation. An increment in median survival, although not statistically significant (p>0.05), was noted with escalating doses(48 Gy) of accelerated fractionation (7 months) compared to conventional treatment(4.5 months). Median survival also increased in patients with brain solitary metastasis(9 months) compared to multiple extrathoracic sites(4 months), and in patients with good performance status(9 months versus 3.5 months), they were statistically significant(p<0.01). CONCLUSION: The increment in survival in patients with good prognostic factors such as controlled primary lesion, metastasis in brain only, and good performance status appeared encouraging. Based on these results, a multi-institutional prospective randomized trial should be initiated to compare the twice-a-day and one-a-day radiotherapy schemes on patients with brain metastasis with careful consideration for the patients' quality of life.
Brain* ; Carcinoma, Bronchogenic ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung* ; Nausea ; Neoplasm Metastasis* ; Quality of Life ; Radiotherapy ; Vomiting