22 research outputs found
Odkrivanje zgodnjih oblik pljuÄnega raka v kirurÅ”kih resektatih in bronhialnih in transbronhialnih biopsijah
Background. Overall bad progmpsis of lung is mostly due to too late detection of early lung cancer, which may be teated with good success. Therefore different diagnostic methods are developing for more efficient detection of early lung cancer: besides modern radiological, bronchoscopic methods with additional fluorescence techniques, quantitative cytological investigations, also histological and molecular investigations are included. History may reveal early preinvasive lung xcancer lesions, associated early during multistep lung carcinogemesis with molecular genetic changes. Patients and methods. Preinvasive epithelial lung cancer lesions we searched in two groups of patients. In the first group of 316 patients from the period March 2003 - August 2006, 498 bronchial and transbronchial biopsies were examined for squamous metaplasia and dysplasia, carcinoma in situ, and invasive tumours. Inthe second group of 238 patients from the period January 2004 - August 2006,resected primary lung tumours were analysed for preinvasive neuroendocrine tumours and atypical adenomatous hyperplasia. Resuots. The mostfrequent changes in bronchial and transbronchial biopsies were squamous metaplasia (46.5%), simple or goblet cell hyperplasia of the bronchial epithelium (44.3%), malignant tumours (20.66%) and squamous dysplasia (16.1%),but rare carcinoma in situ (0.63%). Diffuse idiopoathic pulmonary neuroendocrine cell hyperplasia was found in 15 (6.3%) cases in the vicinity of 238 resected lung cancer specimens, carcinoid in12 patients (5%), and mostly combined large neuroendocrine cancer in 21 patients (8.8%). Atypical denomatous hyperplasia was found in 2 patients. Conculsions. Classical histological analysis should be focused on detection of early preinvasive epithelial lung cancer lesions. (Abstract truncated at 2000 characters).IzhodiÅ”Äa. V celoti slaba napoved preživetja pljuÄnega raka je v veÄji meri posledica poznega oooooooodkrivanja te bolezni, saj le zgodnje oblike lahko uspeÅ”no zdravimo. Zato danes razvijamo razliÄne diagnostiÄne metode, s katerimi bi lahko uspeÅ”neje odkrivali zgodnje oblike pljuÄnega raka. Poleg modernih raduioloÅ”kih, novejÅ”ih bronhoskopskih z dosdatnimi fluorescenÄnimi metodami, kvantitativnih citoloÅ”kih preiskav tudi histoloÅ”ke in molekularne. Histoklogija lahko odkrije predinvazivne oblike pljuÄnega raka, ki jih že zgodaj na doloÄenih stopnjah kancerogeneze spremljajo doloÄene molekularne oziroma genetske spremembe. Bolniki in metode. Predinvazivne epitelne oblike pljuÄnega raka so isjkali pri dveh skupinah bolnikov. V prvi skupini 316 bolnikov iz ob dobja od marca 2003 do avgusta 2006 so v 498 bronhialnih in transbronhialnih biopsijah iskali predvsem ploÅ”ÄatoceliÄno metaplazijo in displazijo, carcinoma in situ in invazivne tumorje. V drugi skupini 238 bolonikov iz obdobja od januarja 2004 do avgusta 2006, ki so jim kirurÅ”ko odstranili primarne pljuÄne tumorje, pa so iskali predvsem predinvazivne in invazivne nevroendokrine tumorje in atipiÄno adenomatozno hiperplazijo. Rezultati. NajpogostejÅ”e spremembe v bronhialnih biopsijah so bile ploÅ”ÄatoceliÄna metaplazija (46.5%), enostavna ali mukocelularna hiperplazija bronhialnega epitelija (44.3%), maligni tumorji (20.55%) in dispazija (16.1%),redko je bil odkrit carcinoma in situ (0.63%). V pljuÄnih resektatih je bila difuzna idiopatska hiperplazija pljuÄnih nevroendokrinih celic odkritapri 15 (6.3%), karcinoid pri 12 (5%) in pretežno kombinirani velikoceliÄni nevroendokrini karcinom pri 21 bolnikih (8.8%). AtipiÄna adenomatozna hiperplazija je bila prisotna pri 2 bolnikih. ZakljuÄki. KlasiÄnihistoloÅ”ki pregled mora biti osredotoÄen na odkrivanje zgodnjih predinvazivnih epitelnih oblik pljuÄnega raka. (IzvleÄek prekinjen pri 2000 znakih
[Citologija mediastinalnih tumorjev]
Our experience with cytological examinations of tumorous mediastinal lesions is evaluated. A group of 117 patients with mediastinal tumor have been included into the study. Among them carcinomas prevailed (60,7%), followed by lymphomas (18,8%), other tumors (15.4%) and thymic neoplasms (5.1%). Malignantor suspicious cells were found in 77.4% of patients with carcinoma. The cells indicating a possibility of non-Hodgkin\u27s lymphoma were found in 9 out of 14 patients. In 5 out of 6 thymic neoplasms the cytological pattern wasconsistent with the diagnosis of thymic neoplasm. One case of thymoma was cytologically falsely diagnosed as malignant lymphoma. One case of neurofibroma was falsely diagnosed as adenocarcinoma. The sensitivity of cytological examinations was 67.5%. If 18 patients with diagnostically unsatisfactory material were excluded from the analysis, the sensitivity wouldincrease to 80.8%. Owing to the wide variety of primary and metastatic tumors that can occur in the mediastinum, apart from the routine cytological techniques, additional staining methods should be used. For final cytological diagnosis the integration of cytological findings with clinical and radiological data is often required. Owing to the characteristics of the obtained material and biological behaviour of some mediastinal tumors, some tumors cannot be definitively diagnosed by cytological examinations alone.Avtorji predstavijo izkuÅ”nje KliniÄnega oddelka za pljuÄne bolezni in alergiÄna stanja Golnik s citoloÅ”kimi pregledi mediastinalnih tumorjev. V retrospektivno Å”tudijo je bilo vkljuÄenih 117 bolnikov z mediastinalnim tumorjem. NajpogostejÅ”i so bili karcinomi (60,7%0, sledijo limfomi (18,8%), drugi tumorji (15,4%), in timiÄne neoplazme (5,1%). Maligne ali sunljive celice so naÅ”li pri 77,4% bolnikov s karcinomom. Celice, ki so dopuÅ”Äale možnost ne-Hodgkinovega limfoma, so naÅ”li pri 9 od 14 bolnikov. Pri 5 od 6 primerov timiÄnih neplazem je bila citoloÅ”ka slika skladna z diagnozo timiÄne neoplazme. En primer timoma je bil citoloÅ”ko napaÄno opredeljen kot maligni limfom, en primer neurofibroma pa je bil napaÄno opredeljen kot adenokarcinom.Senzitivnost citoloÅ”kih pregledov je bila 67,5%. Äe bi 18 bolnikov, pri katerih dobljeni material ni bil ustrezen, izkljuÄili iz analize, bi senzitivnost zrasla na 80,8%. Ker so primarni in metastatski tumorji, ki se pojavljajo v mediastinumu zelo raznoliki, so za njihovo opredelitev poleg rutinskih citoloÅ”kih tehnik potrebne tudi dodatne metode barvanja. Za konÄno citoloÅ”ko diagnozo je nujno poznati tudi kliniÄne podatke in podatke slikovnih diagnostiÄnih metod. Glede na znaÄilnosti dobljenjega materiala in bioloÅ”ko obnaÅ”anje nekaterih mediastinalnih tumorjev vseh ni možno definitivno opredeliti na osnovi citoloÅ”kega pregleda