About 5% of patients with SCLC have the ectopic production of ACTH. Ectopic ACTH production of SCLC is suspected when patients of SCLC have unexplained metabolic alkalosis and hypokalemia. Most patients lack the classic feature of Cushing's syndrome. According to the recent report, they have poor prognosis, which median survival is less than 4 months and associated with a high rate of complication during chemotherapy. Also a case of paraneoplastic CRH production with SCLC can mimic the ectopic ACTH syndrome hut it can be distinguished by immunohistochemistry or direct measurement of serum CRH level. We report here a case of small cell lung cancer associated with Cushing's syndrome of ectopic ACTH production. That is immunohistochemically provened by staining with ACTH.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone* ; Alkalosis ; Cushing Syndrome* ; Drug Therapy ; Humans ; Hypokalemia ; Immunohistochemistry ; Lung Neoplasms* ; Lung* ; Prognosis ; Small Cell Lung Carcinoma

PURPOSE: Advanced gastric cancer, the most common malignancy in Korea is a kind of systemic disease. At dignosis, 50~80% of patients have systemic cancer. Therefore, the most patients require systemic chemotherapy. Cisplatin and 5-FU have been suggested to be active in the treatment of gastric cancer, a high response rate was observered with a combination of 5-FU infusion and cisplatin, and the biochemical modulation of 5-FU by leucovorin has been demonstrated to enhance the activity of 5-FU in gastrointestinal tract cancer. MATERIALS AND METHODS: The patients with advanced gastric cancer whose disease had relapsed or unresectable were treated with 5-FU(800 mg/m2 12 hr IV infusion, D 1~5), leucovorin(20 mg/m2 IV, D 1~5, max. 30 mg), cisplatin(100 mg/m2 15min IV dripping, D1). The cycles of treatment were repeated at 3-weeks intervals. RESULTS: Between Sep. 1994 and Aug. 1996, previously untreated 44 patients(39 eligible patients) were admitted to this study, the median age was 55 years(range 17~73) and male to female ratio was 20:19. The rate of complete remission was 5%(2/39), the rate of partial remission was 21%(8/39). The median-response duration was 26 weeks(5+~38+ ). The median-time to progression was 25 weeks(4+~62+). The range of overall survival time was from 4 to 62+ weeks. 24 weeks survival rate was 71.5% but the median survival time was not reached. The leukopenia and anemia were the main hematologic toxicities. Non-hematologic side effects were nausea, vomiting, diarrhea, stomatitis, peripheral neuropathy. These toxicities were observed commnonly, but tolerable. Two treatment-related deaths were associated with sepsis. CONCLUSION: Based on these results, FLP combination chemotherapy seems to be a moderate efficacy for advanced gastric cancer with tolerable toxicities. To confirm the efficacy further, the long-term follow up and a large scale of clinical studies are needed.
Anemia ; Cisplatin* ; Diarrhea ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Fluorouracil* ; Follow-Up Studies ; Gastrointestinal Neoplasms ; Humans ; Korea ; Leucovorin* ; Leukopenia ; Male ; Nausea ; Peripheral Nervous System Diseases ; Sepsis ; Stomach Neoplasms* ; Stomatitis ; Survival Rate ; Vomiting

No abstract available.
Cisplatin* ; Etoposide* ; Ovarian Neoplasms*

When a Korean child is living in close contact with a person with active pulmonary tuberculosis, the risk of his acquiring the disease is great. In seeking an effective means of reducing this risk to the chi1d, isoniazid was given as secondary chemoprophylaxis to 233 tuberculin-positive children under 5 years of age who were clinically free of disease but were living in close contact with a household member with active tuberculosis. The condition of these children after 9 to 12 months of chemoprophylaxis was compared with a similar control group of 216 children living under exact1y comparable circumstances. An analysis of tile results of this study indicates that secondary chemoprophylaxis with isoniazid is effective and worthwhile for children under 4 years of age who are under constant exposure to tuberculosis. That there was such a protection is indicated by the fact that (1) isoniazid markedly reduced the size of the tuberculin reaction and that (2) only 2 children receiving isoniazid developed active tuberculosis (0.8%) as against the 8 controls who did (3.70%). The faithful cooperation of parents in administering prophylactic isoniazid to small children is often difficult to obtain. This difficulty is suggested by the fact that in the case of the 2 children in the isoniazid test group who developed active tuberculosis, the actual drug intake had been irregularly given and amounted to less than half the prescribed dose.
Chemoprevention ; Child ; Family Characteristics* ; Humans ; Isoniazid ; Parents ; Tuberculin ; Tuberculosis ; Tuberculosis, Pulmonary*

Neuroendocrine tumors originate from neuroendocrine cell, so called APUD (amine precursor uptake and decarboxylation). Most neuroendocrine tumors have typical histopathology, immunohistochemical findings, and can be diagnosed by specific electromicroscopic feature of dense core granules. Neuroendocrine tumors are a diverse group of neoplasms that include carcinoid tumors, islet cell tumors, neuroblastoma, and small cell carcinoma. Neuroendocrine carcinoma of thymus bears similarities to neuroendocrine carcinoma in other organs, but it is clinicopathologically distinct from other tumors of thymus. Rare reports have been seen about thymus neuroendocrine carcinoma. Authors experienced a case of neuroendocrine carcinoma of thymus which cannot be classified as carcinoid, atypical carcinoid, or small cell carcinoma. Herein, we report this case with a review of the literatures.
Adenoma, Islet Cell ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Carcinoma, Small Cell ; Neuroblastoma ; Neuroendocrine Cells ; Neuroendocrine Tumors ; Thymus Gland*

The paraneoplastic nephrotic syndrome can be diagnosed by clinical and immunologic features. We have had a case of paraneoplastic nephrotic syndrome in the patients with aadeno-carcinoma of the lung, whose diagnosis was made by excluding other causes of nephrotic syndrome. The type of renal lesion was membranous glomerulopathy which commonly occurs in carcinoma. The quantity of proteinuria in this patient had decreased according to the improvement of lung cancer with combination chemotherapy. After fourth chemotherapy he was refractory to treatment, and unfortunately he had passed away with cardiac tamponade.
Adenocarcinoma* ; Cardiac Tamponade ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Glomerulonephritis, Membranous* ; Humans ; Lung Neoplasms ; Lung* ; Nephrotic Syndrome ; Paraneoplastic Syndromes ; Proteinuria

No abstract available.
Drug Therapy, Combination* ; Lymphoma, Non-Hodgkin*

Intracardiac metastasis as the initial presentation of malignant neoplasm is very rare. We report here on a 64-year-old man with non-small cell lung cancer (NSCLC) initially presenting with intracardiac metastasis which was identified with 18-F fluorodeoxyglucose positron emission tomography (FDG PET). The patient was admitted with complaints of exertional dyspnea and vague chest discomfort that had developed a few weeks ago. Two-dimensional echocardiography revealed a heart mass attached to its akinetic wall in the right ventricular chamber. CT and MRI demonstrated a large tumor involving the epicardium and myocardium in the right ventricle, and there was a mass in the right lower lobe of the lung along with multiple lymphadenopathies. Cytologic examination of the percutaneous needle aspiration of a lymph node in the anterior mediastinum revealed malignant epithelial cell nests, and this was strongly suggestive of squamous cell carcinoma. Subsequent FDG PET confirmed that the intracardiac mass had an abnormally increased FDG uptake, and again this was strongly suggestive of malignancy. By systemically considering these imaging studies, we were able to diagnose the mass as intracardiac metastasis of NSCLC.
Carcinoma, Non-Small-Cell Lung/*diagnosis ; Heart Neoplasms/diagnosis/*secondary ; Heart Ventricles/pathology ; Humans ; Lung Neoplasms/*diagnosis ; Male ; Middle Aged

PURPOSE: To evaluate the response rate and toxicity of combination chemotherapy including 5-fluorouracil (F), leucovorin (L), ifosfamide (I) and cisplatin (P) for the previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer. MATERIALS AND METHOD: The doses of FLIP were 5-fluorouracil 800 mg/m2 CI days 1-5, leucovorin 20 mg/m2 IV days 1-5, ifosfamide 1000 mg/m2 CI days 1-3, cisplatin 100 mg/m2 IV day 1 respectively. Cycles were repeated every 3 weeks until disease progression. Seventy-three previously untreated patients were enrolled. Age ranged from 30 to 73 (median 56 years); 43 were male, 30 female. Fifty-three patients had performance status (ECOG) 0-1 and 19 performance status 2. Twenty-two patients had stage IIIB and 51 stage IV. Follow-up ranged from 7+ to 160weeks (median 57 weeks). RESULTS: The overall response rate was 46.7% for 62 evaluable patients. (CR 1 patient, PR 28 patients) Median response duration was 24 weeks (range 1+ to 36+ weeks). Toxicity > Grade II (WHO) included: granulocytopenia 19.8%, anemia 13.5%, nausea and vomiting 31.5% stomatitis 46.5%, neuropathy 24.6%. CONCLUSION: FLIP chemotherapy was comparable to other combination chemotherapy for advanced non-small cell lung cancer with moderate toxicities.
Agranulocytosis ; Anemia ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Disease Progression ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Fluorouracil* ; Follow-Up Studies ; Humans ; Ifosfamide* ; Leucovorin* ; Lung ; Male ; Nausea ; Stomatitis ; Vomiting

Primary extranodal non-Hodgkin's lymphomas comprise approximately 10% of all non-Hodgkin's lymphomas. However, primary tracheal non-Hodgkin's lymphoma is extremely rare, being mainly mucosa-associated lymphoid tissue lymphoma. A 65-year-old female has dry cough for one year. She was diagnosed as diffuse large B-cell lymphoma via bronchoscopic-guided biopsy. She was treated with four cycles of the R-CHOP regimen and adjuvant radiotherapy. After completion of the combined treatment, the treatment response was complete remission, and the disease free survival was 26 months.
Aged* ; B-Lymphocytes* ; Biopsy ; Cough ; Disease-Free Survival ; Female* ; Humans ; Lymphoma* ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Radiotherapy, Adjuvant