Liver metastases of gestational trophoblastic tumor.

A retrospective study was conducted to determine if a chemotherapy regimen incorporating cis-platinum, etoposide, and actinomycin D (PEA) was associated with an outcome different from that of the standard triple regimen of methotrexate, actinomycin D, and chlorambucil (MAC) in patients with gestational trophoblastic tumor and liver metastases. Subjects were treated at the King Faisal Specialist Hospital Gestational Trophoblastic Center (KFSH-GTC) between January 1980 and December 1990. Of 19 patients with gestational trophoblastic tumor and liver metastases, 6 received MAC chemotherapy, and 8 received PEA.

Echinococcal disease and mycobacterial infection.

The clinical and radiological features of five patients with echinococcal disease in whom mycobacterial infection was also present are described. Three had clinically significant disease due to Mycobacterium tuberculosis (two patients) and M. fortuitum-chelonae (one patient), whilst in two others secondary infection with M.

Triple fine-needle biopsy of Kulchitsky cell carcinomas I, II (bronchial adenomas).

All bronchial adenomas (BA) or Kulchitsky cell tumours I, II, are classified by WHO as low-grade malignomas. In some cases with an established benign clinical course and stability over a period of years, the pre-operative diagnosis of a typical carcinoid (KCCI) may justify a wait-and-see approach. If surgery is indicated, local resection is feasible in place of lobectomy or pneumonectomy.

Importance and value of a preoperative diagnosis in oat cell carcinoma by radiography and its verification by fine needle biopsy (FNB).

Surgical resection currently offers the best hope of cure in Non Small Cell Lung Cancer (NSCLC), while chemotherapy and/or radiotherapy is the primary choice for Small Cell Lung Cancer (SCLC). The preoperative diagnosis of small cell anaplastic carcinoma (oat cell carcinoma) therefore is extremely important for adequate patient management treatment and prognosis. The patients history, clinical findings and radiographic patterns are all important for the differential diagnosis of SCLC (oat cell cancer) constituting a clinical, radiological and histopathological entity.

The direct approach to posterior mediastinal masses by fine-needle biopsy.

Fine-needle biopsy (FNB) is helpful in establishing an accurate cyto-histopathologic diagnosis of posterior mediastinal masses, which, on conventional radiography and with other imaging methods, may remain unclear. By doing so it initiates adequate patient management and therapy in the interest of improved prospects of cure. FNB was carried out in 55 patients with a wide variety of posterior mediastinal masses.

Directed fine needle biopsy of anterior and middle mediastinal masses.

Mediastinal masses are seldom detected early by conventional radiography since density differences between mediastinal tissues often are inconspicuous. With CT mediastinal masses may be recognized more easily and their localization and relationship to other organs as well as their site of origin and extension is revealed. Sometimes clues to the type of tissue, of which they consist, may be obtained, but their specific histology often remains unclear.

Fine needle biopsy of solitary pulmonary metastasis.

When a nodule which is increasing in size is detected on a chest radiograph the question arises whether it is a primary or metastatic tumour. Experience has shown that the removal of a singular metastasis of an extrapulmonary tumour has a 5-year survival of about 25-30%, if the primary tumour is removed as well. The cytologic results of fine needle biopsy may give clues for the possible localization of the primary tumour.

Fine needle biopsy of double or multiple primary carcinomas of the lung.

Any pulmonary mass discovered after obvious successful surgery for bronchogenic carcinoma has to be suspected of potentially being a second primary cancer of the lung. "Recurrent" carcinoma in a bronchial stump may not be a continuation of the original tumor, but a new primary. Early recognition is important for patient management, therapy and prognosis, since curative resection of the second primary may still be feasible.

Fine needle biopsy of tuberculosis coexistent with carcinoma of the lung.

In 62 cases (out of 2726 cases with 613 inflammatory lesions of which 303 showed evidence for specific infection) pulmonary tuberculosis coexistent with lung cancer has been diagnosed by radiography and fine needle biopsy. There was a considerable sex predominance of elderly men. In cases with lung cancer superimposed on pulmonary tuberculosis, there is frequently a delay in the diagnosis of the carcinoma, especially with active tuberculosis.

Needle biopsy and tumor staging (TNM-system).

Needle biopsy is helpful in classifying pulmonary neoplasms according to the TNM-system. A population of 2726 patients is described in which needle biopsy differentiated between neoplasm and inflammatory disease. In the subgroup of patients with neoplasms (46%) TNM-staging was established by needle biopsy.

Computed tomography of pulmonary thromboembolism.

Twenty-one consecutive cases of clinically suspected pulmonary thromboembolism were investigated by radiographic studies, isotopic lung scans and computed tomography. As early as 1976 in 17 of 21 cases morphological details were found not recognizable on lung radiographs but visualized on CT scans. This included peripheral changes (e.

Fine-needle biopsy of hamartomas of the lung.

Hamartomas are unexpectedly detected in asymptomatic patients, in mass surveys, general health examinations, and chest radiographs for other reasons. They often present a difficult problem both for the radiologist and the referring clinician, as their differentiation from lung carcinoma or a metastasis may be impossible by radiography. Although the typical radiographic appearance of a well circumscribed, solitary, lobulated nodule smaller than 4 cm in diameter with popcorn calcification permits confident recognition, most hamartomas present as noncharacteristic nodules.

Computed tomography of "pleuroma"--a cancer mimicking atelectatic pseudotumor of the lung.

Characteristic radiographic features of "pleuroma"--an atelectatic pseudotumor of the lung, have previously been described. Knowledge of the existence of this lesion and its appearance is necessary if confusion with lung carcinoma is to be avoided. In a remarkable case these factors are demonstrated.

The gastrointestinal tract as a vehicle for drug smuggling.

Four cases of attempts to smuggle narcotics (marijuana, heroin, and cocaine) by swallowing a large number of drug-filled foreign bodies (condoms and capsules) and hiding them from customs authorities in the gastrointestinal canal during transit are described. This is compared with a psychiatric patient who swallowed 48 Vicks Inhalers. Drug smuggling by swallowing condoms or capsules containing narcotics is now a worldwide ethical-legal problem.

Needle biopsy of histoplasmosis.

A case of histoplasmosis, simulating a bronchogenic carcinoma, was needle biopsied. "Histoplasma capsulatum" organisms were found in great numbers. Needle biopsy established an accurate diagnosis making an exploratory thoracotomy unnecessary and preventing the patient from an already planned lobectomy.

Pleuroma--a cancer-mimicking atelectatic pseudotumor of the lung. 55 consecutive cases studied by high KV radiography, bronchography, selective pulmonary angiography and needle biopsy.

A form of cancer--mimicking atelectatic pseudotumor of the lung called "pleuroma" is described. Since 1961 55 cases were studied by needle aspiration biopsy. Due to the usual "negative" results ("no cancer cells") of the needle biopsy, a radiographic pattern was recognized, of the basis of which the benignity of the lesion was correctly diagnosed in most cases.

[The computer tomographic differential diagnosis of benign and malignant lipoid masses in the mediastinum and their spread (author's transl)].

Details of the tissues in the mediastinum can nowadays be demonstrated by computer tomography (CT) pictorially and quantitative measurements of their density coefficient carried out. The diagnosis of a fat-containing tumour or of benign lipomatosis of the mediastinum and their differentiation from malignant lesions is important for treatment and prognosis. In the past this could only be done by surgery.

Risk factors in percutaneous transthoracic needle biopsy.

In percutaneous transthoracic needle biopsies, statistical analysis of complications in men and women of different age groups is believed to be helpful in borderline cases for a better evaluation of risk factors versus the value of the information gained by the procedure. The 95 percent confidence interval and the X2 test showed a significantly lower rate of pneumothorax in mediastinal and pleural based lesions as compared to intralobar changes. Age and sex were found to be the most important parameters for the rate and degree of pneumothorax.