RESUMEN
Results of histopathological and bacteriological examinations of specimens taken in 213 patients with pleurisy by Abrams' needle biopsy of parietal pleura were presented. Malignant cells were found in histological survey of excisions from pleura in 48/128 patients with final diagnosis of cancer (37.5%). The same examination accompanied by bacteriological survey led to establish proper diagnosis in 41/60 patients with pulmonary tuberculosis (68.3%). In 31 patients with cancer pleural fluid was searched for concentration of the carcinoembryonic antigen (CEA). In this group, in 7/19 patients with negative histological results of pleural biopsy CEA concentrations were markedly increased. This finding strongly supported further searching for malignancy in those cases. Finally, the diagnosis was established due to the pleural needle biopsy in 89/213 patients (41.8%).
Asunto(s)
Antígeno Carcinoembrionario/análisis , Pleura/patología , Derrame Pleural/etiología , Neoplasias Pleurales/diagnóstico , Tuberculosis Pulmonar/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pleura/microbiología , Neoplasias Pleurales/complicaciones , Tuberculosis Pulmonar/complicacionesRESUMEN
Pleural biopsy with Abram's needle was made in 160 consecutive patients with undiagnosed pleural effusions. The sampled fluid and pleural bioptates were examined histologically, cytologically and bacteriologically. In 40 cases malignant changes were found, out of 87 with confirmed malignancy. Neoplastic cells were found in 26 patients, ovreall the diagnosis was made in 65% of lung cancer cases. Out of 41 cases of tuberculosis, pleural biopsy provided this diagnosis in 24 patients (59%). Bacteriological examination and pathological of the biopsy specimen allowed to increase the diagnostic field to 63%. Pleural biopsy did not yield any diagnosis in 9 cases of circulatory insufficiency, nor in ten patients with the following diagnoses -- pleuropneumonia, reumathoid arthritis, pulmonary thromboembolism and thoracic trauma. In 13 cases the diagnosis was not made. The diagnostic yield of pleural biopsy was similar to that reported by others. It is most valuable in cases suspected of malignancy and tuberculosis.
Asunto(s)
Neoplasias Pulmonares/patología , Derrame Pleural/patología , Tuberculosis Pulmonar/patología , Adolescente , Adulto , Anciano , Biopsia con Aguja/métodos , Diagnóstico Diferencial , Reacciones Falso Negativas , Femenino , Humanos , Masculino , Persona de Mediana Edad , TóraxRESUMEN
Efficacy of second line therapy which included vepesid and adriamycin or vepesid, adriamycin and cis-platin, in small cell lung cancer was studied. Objective remission was seen in 35% of the once more treated patients. Analysis of survival time showed significant prolongation of it in cases treated once more in comparison with a group of patients with progression of the neoplastic process during primary therapy or patients not treated due to relapses of the process. The observed difference was bigger in patients that reacted with a remission to the second line therapy.