Renal cell carcinoma (RCC) is rare relative to other urological cancers, but relatively common overall among males. Even when primary tumors are successfully removed by surgery, metastases are often noted within a few years. On the other hand, masses found at other sites in patients with RCC may represent different primary cancers. We present the case of a 63-year-old man with a right lung mass and a left lung nodule who underwent radical right nephrectomy for RCC. We found no local recurrence of RCC in the abdomen. Despite treatment for RCC, the right lung mass increased in size. We performed a lung needle biopsy and diagnosed primary lung cancer. Postoperatively, the remaining left lung nodule also increased in size. It was diagnosed as an RCC metastasis upon biopsy and removed by wedge resection. The patient was treated with everolimus after the second surgery.
Abdomen ; Biopsy ; Biopsy, Needle ; Carcinoma, Bronchogenic ; Carcinoma, Renal Cell* ; Hand ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence ; Urologic Neoplasms ; Everolimus

Bronchogenic carcinoma involving the carina has remained a challenging problem for thoracic surgeons. Carinal resection and reconstruction is limitedly indicated because this aggressive surgical approach has been reported to be associated with significant morbidity and mortality while long-term outcome has not been determined. Wesuccessfully performed carinal reconstruction and sleeve right upper lobectomy assisted with ECMO for a 60-year-old male with squamous cell carcinoma in the right upper lobe extending to the carina.
Carcinoma, Bronchogenic ; Carcinoma, Squamous Cell ; Extracorporeal Membrane Oxygenation ; Humans ; Lung ; Male ; Membranes ; Middle Aged ; Oxygenators, Membrane

Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein.
Brachiocephalic Veins/*pathology ; Carcinoma, Bronchogenic/complications/drug therapy ; *Catheterization, Central Venous/methods ; Catheters, Indwelling ; Constriction, Pathologic ; Endovascular Procedures/*methods ; Humans ; Lung Neoplasms/drug therapy ; Male ; Middle Aged ; Palliative Care ; *Stents ; Vena Cava, Superior/*pathology

BACKGROUND AND OBJECTIVEThe aim of this study is to evaluate diagnostic yield and the safety of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis ofbronchogenic carcinoma.

METHODSBetween July, 2009 and February, 2010, 95 patients with mediastinal/hilar lymphadenopathy and/or intrathoracic peritracheal or peribronchial masses previously detected with CT scan underwent EBUS-TBNA. No rapid onsite cytology was performed.

RESULTSIn all 95 patients, 60 cases were newly diagnosed lung cancer through the pathological examination and clinical follow-up certification. In 60 lung cancer cases, 112 samples were obtained from lymph nodes (LNs) and 11 samples were obtained from intrapulmonary lesions. Fifty-eight cases of patients were diagnosed, false negative in 2 cases. Sensitivity and specificity of EBUS-guided TBNA method in distinguishing benign from malignant LNs or thoracic masses were 96.67% and 100%, respectively. There was any major complication in this series, the procedure was uneventful.

CONCLUSIONEBUSTBNA seemed a safe and effective technique in making bronchogenic carcinoma diagnosis for mediastinal/hilar LNs and intra-pulmonary masses.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Bronchi ; diagnostic imaging ; pathology ; Carcinoma, Bronchogenic ; diagnosis ; Endosonography ; methods ; Female ; Humans ; Lung Neoplasms ; diagnosis ; Male ; Middle Aged

BACKGROUND AND OBJECTIVEBecause radical resection for lung cancer invading the initial borderline of different lobes and carina is difficult, we tried to analyse the variables of successful tracheal carinoplasty and bronchovasculoplasty to discover a proper approach for appropriate early and long-term results.

METHODSOf 1 399 lung resections for primary lung cancer performed in our hospital from April 1985 to December 2006, 133 underwent bronchoplastic surgeries, including 15 carinoplasty cases and 118 sleeve lobectomy (SL) cases, and 118 pneumoectomy (PN) cases were compared at the same time.

RESULTSComplications occurred in 18 cases, with no operative related mortality. For all patients, the 1 year, 3 year, and 5 year survival rates were 79.8%, 56.7% and 31.2%, respectively. The 5 year survival rate by cancer stage was 69.2% for Ib, 40.6% for IIb, 19.6% for IIIa, and 16.6% for IIIa (N2).

CONCLUSIONSelection of cases, clearance of lymph nodes, disposal of the bronchus and pulmonary vessel and replacement or restoration of the superior vena cava are the main factors influencing prognosis.

Adult ; Aged ; Carcinoma, Bronchogenic ; mortality ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Survival Rate ; Trachea ; pathology ; surgery ; Treatment Outcome

Among the bronchogenic carcinomas, especially squamous cell carcinoma and large cell carcinoma frequently present with cavitation, which may result from tumor necrosis. Cavitary lesions of the tumor are occasionally associated with infection and misdiagnosed as benign lung abscess owing to the partial responsiveness to antibiotics. It is very difficult to distinguish the carcinomatous abscess from the benign lung abscess, because of their similar clinical and radiologic features. Delay in diagnosis of underlying lung cancer may result in poor outcome. Therefore, clinicians should remember that the patients with highly suspicious carcinoma of the lung should undergo further precise examinations to find out malignant cells.
Abscess ; Anti-Bacterial Agents ; Carcinoma, Bronchogenic ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Humans ; Liver Abscess ; Lung ; Lung Abscess ; Lung Neoplasms ; Necrosis

Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.
Bronchiectasis ; Carcinoma, Bronchogenic ; Humans ; Intestines ; Korea ; Lung ; Lung Abscess ; Lung Diseases ; Male ; Mouth ; Opportunistic Infections ; Polymers ; Trichomonas ; Trichomonas vaginalis

OBJECTIVETo evaluate the early outcome of patients who underwent video-assisted thoracic surgery (VATS) lobectomy for primary lung carcinoma.

METHODSThe records of 121 patients with lung cancer undergoing VATS lung resection from 1997 to 2004 were reviewed retrospectively, I stage: 101 cases, 34 cases underwent right upper lobectomy, 13 cases underwent right middle lobectomy, 17 cases underwent right down lobectomy, 21 cases underwent left upper lobectomy, 16 cases underwent left down lobectomy. Thirty-eight cases underwent VATS lobectomy without assisted mini-incision.

RESULTSThere were 18 cases of morbidities (15%) and no surgical mortality. The 1-year, 2-year and 3-year survival rates of primary non-small cell lung cancer with I stage is: 99% (76/77), 96% (49/51) and 79% (15/19), respectively. There are statistic difference (P < 0.01) between adenocarcinoma and the others. There are no statistic difference (P > 0.05) between the VATS lobectomy with assisted mini-incision (n = 38) and without (n = 63), also no statistic difference (P > 0.05) between the VATS lobectomy and the standard procedure.

CONCLUSIONOur findings suggest that VATS lobectomy is superior regarding its ability to achieve the same survival rates and little morbidities in comparison with the standard procedure.

Adult ; Aged ; Carcinoma, Bronchogenic ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Pneumonectomy ; methods ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Time Factors ; Treatment Outcome

OBJECTIVETo evaluate the role of transbronchial needle aspiraion (TBNA) in the diagnosis of bronchogenic carcinoma with enlarged mediastinal and/or hilar lymph node.

METHODSPatients with mediastinal and/or hilar lymphoadenopathy proven by CT scan were eligible for TBNA as reported by WANG. All specimen was directly and instantly smeared for cytological examination.

RESULTSFrom June 2004 to May 2006, 77 such patients were examined: including 38 lung cancers, 35 lung benign diseases and 4 without definite diagnosis. All TBNA procedures were successfully carried out in 222/225 ( 98.7%). Positive TBNA rate was 81.6% (31/38) in patients who had been proven to suffer from bronchogenic carcinoma. The diagnosis of lung cancer was confirmed via TBNA only in 9 patients. A total of 63 lymph nodes in the 38 lung cancer patients were aspirated by TBNA with a positive rate of 65.1% (41/63). The sensitivity of TBNA was significantly correlated with pathology type, lymph node size and experience of the cytologist. Severe complications were rare except small amount of bleeding at the TBNA site (52/77, 67.5%).

CONCLUSIONTBNA is quite safe and helpful in diagnosis and staging of bronchogenic carcinoma, yet it is not helpful in diagnosis of benign lung diseases.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Bronchoscopy ; Carcinoma, Bronchogenic ; pathology ; Carcinoma, Non-Small-Cell Lung ; pathology ; Carcinoma, Small Cell ; pathology ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; pathology ; Lymph Nodes ; pathology ; Male ; Mediastinum ; Middle Aged ; Reproducibility of Results

BACKGROUND: Endobronchial tumors cause?life-threatening dyspnea and can lower the quality of life due to central airway obstruction.?In those cases with an intraluminal tumor, various bronchoscopic techniques are available for tumor debulking. The therapeutic effect of bronchoscopic electrocautery for palliation in patients with a symptomatic tumor obstruction was studied. METHOD: Nineteen patients with bronchogenic carcinomas (n=15) and metastatic tumors affecting the bronchi (n=4), between March 2002 and March 2005, were enrolled in this study. Electrocautery was performed under local anesthesia using an electroprobe and diathermic snare. Using flexible bronchoscopy, a follow-up bronchoscopic examination was performed 3-4 days later. Symptom improvement was evaluated by FEV1, FVC and dyspnea score (Modified Borg Category Scale (0~10)), both before and after the electrocautery. RESULTS: The success rate of electrocautery on the follow up examination was 84%. Patients with endoluminal airway lesions had a mean overall decrease in the size of the obstruction to 47.8+/-15.7%. The mean Improvement in the dyspnea score immediately after the endobronchial tumor debulking was 2.78+/-1.42.The average improvements in the FEV1 and FVC after electrocautery were 0.32+/-0.19L and 0.5+/-0.22L, respectively. There were 2 cases of complications related with electrocautery (one each of pneumothorax and pneumonia). CONCLUSION: Electrocautery using an electroprobe and diathermic snare was an effective and safe palliative treatment for a symptomatic endoluminal airway obstruction in lung cancer.
Airway Obstruction* ; Anesthesia, Local ; Bronchi ; Bronchoscopy ; Carcinoma, Bronchogenic ; Dyspnea ; Electrocoagulation* ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Palliative Care ; Pneumothorax ; Quality of Life ; SNARE Proteins*