Современный подход к компьютерно-томографической диагностике аденокарциномы легкого

The classification of tumors of the lung, pleura, thymus and heart was published by the World Health Organization (WHO) in 2015. It presents a completely different approach to adenocarcinoma compared to the 2004 WHO classification.Adenocarcinoma is the most common histological type of lung cancer.The interdisciplinary classification is based on consensus among oncologists, thoracic surgeons, pulmonologists, pathologists, molecular biologists, radiologists, radiologists and identifies a wide range of adenocarcinoma types and subtypes with varying prognosis and treatment. They are accompanied by a variety of manifestations and features on computed tomography, which usually correlate with histopathological findings, highlighting one of the key roles of the radiologist in the diagnosis and treatment of such patients.The aim of the work is to familiarize radiologists with the WHO 2015 classification, terminology and computed tomographic diagnostic criteria for various types of lung adenocarcinoma.Классификация опухолей легкого, плевры, тимуса и сердца опубликована Всемирной организации здравоохранения (ВОЗ) в 2015 г. В ней представлен совершенно иной подход к аденокарциноме по сравнению с классификацией ВОЗ 2004 г.Аденокарцинома – наиболее распространенный гистологический тип рака легких.Междисциплинарная классификация основана на консенсусе между онкологами, торакальными хирургами, пульмонологами, патологами, молекулярными биологами, рентгенологами, радиологами и определяет широкий спектр типов аденокарциномы и подтипов с различным прогнозом и лечением. Они сопровождаются разнообразными проявлениями и особенностями при компьютерной томографии, которые обычно коррелируют с гистопатологическими данными, подчеркивая одну из ключевых ролей врача-рентгенолога в диагностике и лечении таких пациентов.Целью работы является ознакомление врачей-рентгенологов с классификацией ВОЗ 2015, терминологией и компьютерно-томографическими диагностическими критериями различных типов аденокарциномы легкого.

Results of combination treatment for triple-negative breast cancer

The authors give the results of treatment in 128 patients with operable triple-negative breast cancer (BC). All the patients underwent surgical intervention, the volume of which depended on the stage of the disease. The efficiency of adjuvant and neoadjuvant chemotherapy, as well as pre- and postoperative radiotherapy was evaluated. The side effects of different treatment options were analyzed. Five-year relapse-free and overall survival rates were traced in this patient group. It is concluded that the used procedures of combination treatment for operable triple- negative BC are highly effective

Short-term results of surgical treatment of retroperitoneal tumours

Retroperitoneal tumours arre rare and compose 0,01-0,3% of all tumours types. The basic method of retroperitoneal tumour treatment is surgical resection which is carried out in 43-95% of patients. In this study we present analysis of surgical treatment of 104 patients with retroperitoneal tumours. Complited resection was made in 87 patients (83,7%); partial surgical resection - in 7 patients (6,7%), explorative laparotomyes have been executed in 8 patients (7,7%), symptomatic operations - 2 patients (1,9%). Operability percentage - 88,1%. Resectobility - 90,3%. Level of an intraoperation and postoperation complications was 29,8% and hospital lethality - 4,2%. Analysis of surgical treatment direct resultstestifies to high indicators of operability of patients with retroperitoneal tumours resectobility. Surgical treatment of retroperitoneal tumours isn't accompanied with high frequency of postoperative complications and lethality

REHABILITATION OF ONCOGYNECOLOGIC PATIENTS. VIEW OF A PROBLEM

The problem of rehabilitation of cancer patients continues to be actual. Development of methods of therapy of malignant tumors has improved the results of survival of patients. At the same time feature of the applied methods are numerous complications. The rehabilitation course is necessary for all oncological patients who received radical surgeries, radiation and medication therapy. The existing directions of the rehabilitation help to onсogyneсologic patients are limited to treatment of an oncopathology, prevention and treatment of climacteric disturbances, psychological assistance and, in some cases, physiotherapeutic procedures. It is expedient to create the system of the rehabilitation help to cancer patients allowing to provide consecutive stage-by-stage rehabilitation of patients according to individually developed program

Open laryngectomy: Clinical experience

Introduction. The problem of treatment and rehabilitation of patients with laryngeal cancer has been a complicated and controversial one.Important conditions for selection of the type and scale of functionally sparing surgical intervention are accurate preoperative diagnosis of advancement of the tumor and oncological appropriateness of the intervention. Currently, the problem of single-step reconstruction of lost laryngeal functions after organ-preserving surgeries remains open. For this purpose, researchers use both auto-/homografts and endoprosthetics made of various materials. In some cases, endoprosthetics in lyrengectomy didn’t allow to restore laryngeal lumen due to granulation tissue, cicatricial stenosis, laryngotracheomalacia.The study objective is to increase treatment and rehabilitation effectiveness in patients with laryngeal cancer after open laryngectomy.Materials and methods. Our experience is based on open laryngectomies in 86 patients performed at the Clinical Oncology Dispensary No. 1 of the Moscow Healthcare Department in the period from 2011 to 2014. Primary laryngeal cancer was diagnosed in 84 (97.7 %) patients, recurrent laryngeal cancer after a full course of radiation therapy – in 2 (2.3 %) patients. Vertical laryngectomy was performed in 74 patients, horizontal – in 12 patients.Vertical laryngectomies were performed for tumors located near the vocal and vestibular flaps, anterior commissure, subglottis, laryngeal sinus;horizontal for tumors located near the epiglottis, vestibular flaps, vallecula, root of the tongue if arytenoids were intact and vocal cords were mobile. In the postoperative period, an important factor was restoration of the organ’s function through early rehabilitation of respiratory, vocal, and protective functions. Evaluation of the laryngeal lumen was performed using endoscopic examination. Any diagnosed ligatures, granulation tissue, scars were resected. Prior to decannulation, ultrasound examination of the larynx was performed. Effectiveness of vocal function restoration was evaluated using computer acoustic analysis of the voice.Results. Restoration of the lost laryngeal functions after organ-preserving open laryngectomies in patients with laryngeal cancer is achieved through reconstruction of the remaining parts of the organ, formation of an adequate lumen for breathing through postoperative endoscopic correction, and early rehabilitation of respiratory, vocal, and protective function.Conclusion. Open laryngectomies with restoration of the remaining parts and single-step reconstruction of the lumen with an endoprosthesis, as well as subsequent combined treatment, allowed to restore respiratory function in 93.1 % patients, vocal function – in 91.9 % patients

PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)

Primary mesothelioma of the pericardium is a rare heart tumor with a difficult diagnosis, revealed in vivo in less than a quarter of cases. The disease occurs at any age, more common in men and variably exhibits a broad spectrum of non-specific symptoms of congestive heart failure, constrictive pericarditis, pericardial effusion or cardiac tamponade. Patients are usually observed with peripheral edema, ascites, dyspnea, cough, chest pain and atrial fibrillation. Such symptoms, in the absence of cancer alertness, are erroneously attributed by doctors to more common cardiovascular diseases. As a result, primary mesothelioma is detected in 75-90% of cases only at necropsy. The article describes a case of detection at autopsy of primary pericardial mesothelioma sarcomatous type with invasion into the myocardium in a patient of 74 years old. The patient also suffered from concomitant coronary artery disease with a long history of chronic heart failure and recurrent pulmonary embolism, associated with deep vein thrombosis at the final stage of the disease. An objective study revealed signs of chronic heart failure. The laboratory data included mild iron deficiency anemia, insignificant leukocytosis and leukocyturia, as well as signs of moderate chronic kidney disease. Instrumental results corresponded to long-term course of hypertension, signs of congestive heart failure in the presence of atrial fibrillation, atherosclerosis of lower limbs arteries in patient with abdominal obesity. Thus, there were no clinical signs of pericardial damage in a standard examination of the patient. The article describes the complexity of the disease diagnosis, variable clinical picture, as well as the diagnostic value of various instrumental methods from the perspective of evidence-based medicine. It is noted that clinical alertness is still the most important factor in the lifetime diagnosis of pericardial mesothelioma. Disease should be considered in patients with recurrent pericardial effusion, constrictive pericarditis, pericardial mass or thickening of pericardium leaflets. For reliable diagnosis of a tumor, modern imaging studies and histological examination are required

Risk factors of laryngeal cancer in central and eastern europe

A case-control epidemiologic study in squamous-cell carcinoma of the larynx (LC) vs. smoking was carried out. Although no independent influence of drinking was found, the synergetic effect of the two habits potentiated the carcinogenic impact. Approximately 87% of LC cases are attributable to tobacco use in Central and Eastern Europe. Occupational exposure to coal dust is regarded as a possible cause