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  1 / 11532 MEDLINE  
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[PMID]:29223272
[Au] Autor:Linnik YA; Hoegemann Savellano D; Phillips JD; Black CC
[Ad] Endereço:Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH. Electronic address: yevgeniy.a.linnik@hitchcock.org.
[Ti] Título:A 49-Year-Old Woman With Right Apical Thoracic Mass.
[So] Source:Chest;152(6):e133-e138, 2017 12.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 49-year-old woman with a medical history of essential hypertension presented to the ED with severe pain in the left superior chest and dull aching pain in the upper flank, lasting for the last 2 days.
[Mh] Termos MeSH primário: Ganglioneuroma/diagnóstico
Neoplasias do Mediastino/diagnóstico
Toracoscopia/métodos
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Feminino
Ganglioneuroma/cirurgia
Seres Humanos
Imagem por Ressonância Magnética
Neoplasias do Mediastino/cirurgia
Meia-Idade
Radiografia Torácica
Procedimentos Cirúrgicos Robóticos/métodos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171211
[St] Status:MEDLINE


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[PMID]:29465555
[Au] Autor:Sheth HS; Maldonado F; Lentz RJ
[Ad] Endereço:D. Y. Patil University School of Medicine, Mumbai, India.
[Ti] Título:Two cases of Dieulafoy lesions of the bronchus with novel comorbid associations and endobronchial ablative management.
[So] Source:Medicine (Baltimore);97(8):e9754, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Dieulafoy lesions are aberrantly large submucosal arteries most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive hemoptysis. PATIENT CONCERNS: We present three episodes of massive hemoptysis in two patients, the first with comorbid Alagille syndrome including multiple cardiac and pulmonary vascular abnormalities and the second with thyroid cancer metastatic to the mediastinum. DIAGNOSES: All episodes were due to Dieulafoy lesions of the bronchus based on bronchoscopic appearance. INTERVENTIONS: Bronchoscopic ablation using Nd:YAP laser was attempted both patients. OUTCOMES: Nd:YAP laser successfully ablated the Dieulafoy lesion in the first case with long-term relief from recurrent hemoptysis. The first episode in the second patient responded to bronchial artery embolization; laser ablation of a different Dieulafoy lesion responsible for the second episode was unsuccessful but additional bronchial artery embolization has provided relief from further episodes. LESSONS: Bronchoscopic ablation of Dieulafoy lesions of the bronchus can provide durable relief from recurrent symptoms. Clinical and anatomical features should be considered carefully before intervention, which should only be attempted by experienced operators with appropriate ancillary support available.
[Mh] Termos MeSH primário: Técnicas de Ablação/métodos
Broncopatias/cirurgia
Broncoscopia/métodos
Hemoptise/cirurgia
Malformações Vasculares/cirurgia
[Mh] Termos MeSH secundário: Idoso
Síndrome de Alagille/patologia
Brônquios/irrigação sanguínea
Brônquios/cirurgia
Broncopatias/complicações
Comorbidade
Feminino
Hemoptise/etiologia
Seres Humanos
Masculino
Neoplasias do Mediastino/secundário
Meia-Idade
Neoplasias da Glândula Tireoide/patologia
Malformações Vasculares/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009754


  3 / 11532 MEDLINE  
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[PMID]:29265182
[Au] Autor:Shah NN; Szabo A; Huntington SF; Epperla N; Reddy N; Ganguly S; Vose J; Obiozor C; Faruqi F; Kovach AE; Costa LJ; Xaiver AC; Okal R; Kanate AS; Ghosh N; Kharfan-Dabaja MA; Strelec L; Hamadani M; Fenske TS; Calzada O; Cohen JB; Chavez J; Svoboda J
[Ad] Endereço:Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
[Ti] Título:R-CHOP versus dose-adjusted R-EPOCH in frontline management of primary mediastinal B-cell lymphoma: a multi-centre analysis.
[So] Source:Br J Haematol;180(4):534-544, 2018 02.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Primary mediastinal (thymic) large B-cell lymphoma (PMBCL) is an uncommon subtype of non-Hodgkin lymphoma (NHL) that presents with a mediastinal mass and has unique clinicopathological features. Historically, patients with PMBCL were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy ± involved field radiation. Since a phase II trial, published in April 2013, demonstrated excellent results using dose-adjusted (DA) R-EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin), this treatment has gained popularity. We performed a retrospective, multicentre analysis of patients aged ≥18 years with PMBCL since January 2011. Patients were stratified by frontline regimen, R-CHOP versus DA-R-EPOCH. 132 patients were identified from 11 contributing centres (56 R-CHOP and 76 DA-R-EPOCH). The primary outcome was overall survival. Secondary outcomes included progression-free survival, complete response (CR) rate, and rates of treatment-related complications. Demographic characteristics were similar in both groups. DA-R-EPOCH use increased after April 2013 (79% vs. 45%, P < 0·001), and there was less radiation use after DA-R-EPOCH (13% vs. 59%, P < 0·001). While CR rates were higher with DA-R-EPOCH (84% vs. 70%, P = 0·046), these patients were more likely to experience treatment-related toxicities. At 2 years, 89% of R-CHOP patients and 91% of DA-R-EPOCH patients were alive. To our knowledge, this represents the largest series comparing outcomes of R-CHOP to DA-R-EPOCH for PMBCL.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Linfoma de Células B/tratamento farmacológico
Neoplasias do Mediastino/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Anticorpos Monoclonais Murinos/efeitos adversos
Anticorpos Monoclonais Murinos/uso terapêutico
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Terapia Combinada
Ciclofosfamida/efeitos adversos
Ciclofosfamida/uso terapêutico
Gerenciamento Clínico
Doxorrubicina/efeitos adversos
Doxorrubicina/uso terapêutico
Etoposídeo/efeitos adversos
Etoposídeo/uso terapêutico
Feminino
Seres Humanos
Linfoma de Células B/diagnóstico
Linfoma de Células B/mortalidade
Masculino
Neoplasias do Mediastino/diagnóstico
Neoplasias do Mediastino/mortalidade
Meia-Idade
Gradação de Tumores
Estadiamento de Neoplasias
Prednisona/efeitos adversos
Prednisona/uso terapêutico
Recidiva
Estudos Retrospectivos
Rituximab/administração & dosagem
Falha de Tratamento
Resultado do Tratamento
Vincristina/efeitos adversos
Vincristina/uso terapêutico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Murine-Derived); 0 (R-CHOP protocol); 4F4X42SYQ6 (Rituximab); 5J49Q6B70F (Vincristine); 6PLQ3CP4P3 (Etoposide); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15051


  4 / 11532 MEDLINE  
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[PMID]:29443792
[Au] Autor:Ding L; Hu Y; Zhao K; Wei G; Wu W; Wu Z; Xiao L; Huang H
[Ad] Endereço:Bone Marrow Transplantation Center.
[Ti] Título:Pleural cavity cytokine release syndrome in CD19-directed chimeric antigen receptor-modified T cell therapy: A case report.
[So] Source:Medicine (Baltimore);97(7):e9992, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Cytokine release syndrome (CRS) is a common and potentially fatal complication of CAR-T cell therapy. However, compartment CRS is relatively rare in hematological malignancies, as well as in solid tumors. The pathogenesis and prognosis of compartment CRS are unclear and there is no standardized treatment yet. In this case report, we will introduce a patient developing pleural cavity CRS after CART19s infusion. PATIENT CONCERNS: A 28-year-old woman was admitted for evaluation of mediastinal mass. Her relevant examinations were comoleted. DIAGNOSES: She was diagnosed as diffuse large B cell lymphoma (DLBCL, non-GCB type). INTERVENTIONS: She received chemotherapies including 1 cycle of R-DAEPORCH, 1 cycle of R-CHOPE, 2 cycles of R-CHOP, and 4 cycles of R-GDP during the disease course. OUTCOMES: The cytokine levels of hydrothorax were considerably high when serum cytokines were within normal range, with IL-6 at 1212.45 versus 5.69 pg/mL. qPCR analysis for CAR constructs showed 1,119,696 copies/µg DNA in hydrothorax and 522,227 copies/µg DNA in blood. LESSONS: The results indicated that CART19 cells trafficked to the pleural cavity and interacted with the CD19-positive lymphoma cells directly, causing cytokine release in situ.
[Mh] Termos MeSH primário: Citocinas/metabolismo
Imunoterapia Adotiva/efeitos adversos
Linfoma Difuso de Grandes Células B/terapia
Neoplasias do Mediastino/terapia
Cavidade Pleural/metabolismo
Receptores de Antígenos de Linfócitos T/imunologia
[Mh] Termos MeSH secundário: Adulto
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Feminino
Seres Humanos
Linfoma Difuso de Grandes Células B/tratamento farmacológico
Neoplasias do Mediastino/tratamento farmacológico
Síndrome
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CD19-specific chimeric antigen receptor); 0 (Cytokines); 0 (Receptors, Antigen, T-Cell)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009992


  5 / 11532 MEDLINE  
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[PMID]:29390499
[Au] Autor:Xiang Y; Tu S; Zhang F
[Ad] Endereço:Department of Cardiothoracic Surgery, Zhejiang University, Lishui Center Hospital, Lishui, Zhejiang, P.R. China.
[Ti] Título:Rapid metastasis of mediastinal solitary fibrous tumor: Report a case.
[So] Source:Medicine (Baltimore);96(51):e9307, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Mediastinal solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms. Complete resection is considered as the effective treatment and the prognosis is quite good. Rapid metastasis after surgery is extremely rare. PATIENT CONCERNS: In this case report we describe a 42-year-old man who present with a mediastinal malignant SFTs. Enhanced computed tomography of chest revealed a 4.5 × 4.0-cm mass in the anterior mediastinum. DIAGNOSES: The tumor is composed of massive proliferation of atypical spindle cells. Immunohistochemical staining for cluster of differentiation (CD) 34, CD99, and vimentin were strongly positive. INTERVENTIONS: Due to the possibility that the tumor was malignant, a standard median sternotomy was performed under general anesthesia. The mediastinal tumor and the affected part of the pericardium and right upper lobe of the lung were completely resected. OUTCOMES: The patient underwent surgery and recovered uneventfully. After 2 months follow-up postoperation, there was recurrence in the chest wall and right middle lung. The patient refused any treatment and was dead after 2 months. LESSONS: The present cases indicate that mediastinal SFTs should always be kept in mind for rapid metastasis. Once found, surgical intervention should be performed promptly. Due to the rapid metastasis, radiotherapy, and chemotherapy may be needed after surgery and long-term follow-up is required to monitor the metastasis of this type of tumor.
[Mh] Termos MeSH primário: Neoplasias Pulmonares/secundário
Neoplasias do Mediastino/patologia
Pericárdio/patologia
Tumores Fibrosos Solitários/patologia
[Mh] Termos MeSH secundário: Adulto
Evolução Fatal
Seres Humanos
Neoplasias Pulmonares/diagnóstico por imagem
Masculino
Neoplasias do Mediastino/diagnóstico por imagem
Neoplasias do Mediastino/cirurgia
Invasividade Neoplásica
Tumores Fibrosos Solitários/diagnóstico por imagem
Tumores Fibrosos Solitários/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009307


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[PMID]:29390446
[Au] Autor:Corrias G; Escalon JG; Tang L; Monti S; Saba L; Mannelli L
[Ad] Endereço:Department of Radiology, Memorial Sloan Kettering Cancer Center, York Avenue, New York, NY, USA.
[Ti] Título:Hepatic angiosarcomatous transformation of a mediastinal germinal cell tumor: A care case report.
[So] Source:Medicine (Baltimore);96(51):e9152, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Mediastinal nonseminomatous germ cell tumor (NSGCT) is an uncommon entity. Metastatic hepatic sarcomatous transformation is rare. PATIENT CONCERNS: We report a 24-year-old man with no previous related medical history presented with chest pain and left arm numbness. DIAGNOSES: The x-ray showed an anterior mediastinal mass. The chest computed tomography (CT) confirmed the presence of a mildly enhancing mass in the same location, without invasion of any vascular structure. A CT-guided biopsy was performed, revealing a primary mediastinal nonseminomatous germ cell tumor (NSGCT), yolk sac histology, with areas of somatic transformation to malignant nerve sheath tumor. After surgery patient was followed-up with imaging. Two years later a CT scan showed a new hepatic hyper vascular lesion, confirmed by a subsequent magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. A CT-guided biopsy revealed a hepatic metastatic transformation to angiosarcoma of the primitive NSGCT. INTERVENTIONS: The patient went on to received palliative chemotherapy. OUTCOMES: The patient is being followed-up regularly at the outpatient department. LESSONS: Because of the potential of metastatic sarcoma arising from germ cell tumors, these patients should undergo periodical follow-up, with periodical scans. PET\CT scan might have a role in the follow-up of these patients.
[Mh] Termos MeSH primário: Transformação Celular Neoplásica
Hemangiossarcoma/patologia
Neoplasias Hepáticas/patologia
Neoplasias do Mediastino/patologia
Neoplasias Embrionárias de Células Germinativas/patologia
[Mh] Termos MeSH secundário: Diagnóstico por Imagem
Hemangiossarcoma/diagnóstico por imagem
Seres Humanos
Neoplasias Hepáticas/diagnóstico por imagem
Masculino
Neoplasias do Mediastino/diagnóstico por imagem
Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009152


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[PMID]:29384931
[Au] Autor:Lu C; Wang Z; Wang G; Wang X; Liu X
[Ti] Título:Superior mediastinal typical carcinoid detected by 99mTc-MIBI SPECT/CT imaging: A case report.
[So] Source:Medicine (Baltimore);96(52):e9457, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: This is a rare case of mediastinal typical carcinoid tumor with elevated parathyroid hormone (PTH) and hypercalcemia detected by Tc -methoxy-isobutyl-isonitrile(Tc-MIBI) single photon emission computed tomography/computed tomography (SPECT/CT) imaging. PATIENT CONCERNS: A 65-year-old male patient presented with hypercalcemia and elevated PTH. DIAGNOSES: The preoperative diagnosis was ectopic parathyroid adenoma in the right superior mediastinum. INTERVENTIONS: We performed endoscopic removal of the mass in the superior mediastinum. OUTCOMES: Histopathology and immunohistochemistry revealed typical carcinoid. LESSONS: The differential diagnosis of mediastinal tumors with elevated PTH detected by Tc-MIBI dual-phase imaging should include ectopic parathyroid adenoma as well as carcinoid.
[Mh] Termos MeSH primário: Tumor Carcinoide/diagnóstico por imagem
Neoplasias do Mediastino/diagnóstico por imagem
Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
[Mh] Termos MeSH secundário: Idoso
Tumor Carcinoide/cirurgia
Seres Humanos
Masculino
Neoplasias do Mediastino/cirurgia
Compostos Radiofarmacêuticos
Tecnécio Tc 99m Sestamibi
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 971Z4W1S09 (Technetium Tc 99m Sestamibi)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009457


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[PMID]:29182001
[Au] Autor:Weaver HL; Preston SD; Wong HH; Jani P; Coonar AS
[Ad] Endereço:Department of Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard , Cambridge , UK.
[Ti] Título:Surgical resection of a massive primary mediastinal liposarcoma with cervical extension.
[So] Source:Ann R Coll Surg Engl;100(2):e22-e27, 2018 Feb.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 73-year-old man was referred for surgical excision of a massive mediastinal and cervical liposarcoma following neoadjuvant chemotherapy. Surgery was performed via a cervical incision, sternotomy and right posterolateral thoracotomy. The tumour arose from the oesophagus, which underwent extensive dissection and was oversewn with pleura after tumour resection. Histology confirmed a completely excised grade 2 de-differentiated liposarcoma with complete macroscopic excision. The patient made an excellent recovery. Oesophageal liposarcomas are rare and, unlike in this case, often extend intraluminally, necessitating oesophagectomy. To our knowledge, this is the largest such tumour found in the literature.
[Mh] Termos MeSH primário: Neoplasias Esofágicas
Lipossarcoma
Neoplasias do Mediastino
[Mh] Termos MeSH secundário: Idoso
Neoplasias Esofágicas/diagnóstico
Neoplasias Esofágicas/patologia
Neoplasias Esofágicas/cirurgia
Seres Humanos
Lipossarcoma/diagnóstico
Lipossarcoma/patologia
Lipossarcoma/cirurgia
Masculino
Neoplasias do Mediastino/diagnóstico
Neoplasias do Mediastino/patologia
Neoplasias do Mediastino/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0163


  9 / 11532 MEDLINE  
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[PMID]:29181991
[Au] Autor:Joshi V; Offer G; Richards C; Rathinam S
[Ad] Endereço:University Hospitals of Leicester NHS Trust , UK.
[Ti] Título:Chest wall resection and reconstruction for Rosai-Dorfman disease masquerading as a chest wall sarcoma.
[So] Source:Ann R Coll Surg Engl;100(2):e28-e30, 2018 Feb.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Rosai-Dorfman disease (RDD) is a rare benign histiocytic proliferative disease that can present as a pseudotumour of soft tissue. We describe the first chest wall resection and reconstruction.
[Mh] Termos MeSH primário: Histiocitose Sinusal
Neoplasias do Mediastino
Parede Torácica
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Feminino
Histiocitose Sinusal/diagnóstico
Histiocitose Sinusal/patologia
Histiocitose Sinusal/cirurgia
Seres Humanos
Neoplasias do Mediastino/diagnóstico
Neoplasias do Mediastino/patologia
Neoplasias do Mediastino/cirurgia
Meia-Idade
Procedimentos Cirúrgicos Reconstrutivos
Sarcoma
Procedimentos Cirúrgicos Torácicos
Parede Torácica/patologia
Parede Torácica/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0199


  10 / 11532 MEDLINE  
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[PMID]:29173765
[Au] Autor:Kuijvenhoven JC; Crombag L; Breen DP; van den Berk I; Versteegh MIM; Braun J; Winkelman TA; van Boven W; Bonta PI; Rabe KF; Annema JT
[Ad] Endereço:Department of Respiratory Medicine, Academic Medical Center (AMC), Amsterdam, The Netherlands.
[Ti] Título:Esophageal ultrasound (EUS) assessment of T4 status in NSCLC patients.
[So] Source:Lung Cancer;114:50-55, 2017 Dec.
[Is] ISSN:1872-8332
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mediastinal and central large vessels (T4) invasion by lung cancer is often difficult to assess preoperatively due to the limited accuracy of computed tomography (CT) scan of the chest. Esophageal ultrasound (EUS) can visualize the relationship of para-esophageally located lung tumors to surrounding mediastinal structures. AIM: To assess the value of EUS for detecting mediastinal invasion (T4) of centrally located lung tumors. METHODS: Patients who underwent EUS for the diagnosis and staging of lung cancer and in whom the primary tumor was detected by EUS and who subsequently underwent surgical- pathological staging (2000-2016) were retrospectively selected from two university hospitals in The Netherlands. T status of the lung tumor was reviewed based on EUS, CT and thoracotomy findings. Surgical- pathological staging was the reference standard. RESULTS: In 426 patients, a lung malignancy was detected by EUS of which 74 subjects subsequently underwent surgical- pathological staging. 19 patients (26%) were diagnosed with stage T4 based on vascular (n=8, 42%) or mediastinal (n=8, 42%) invasion or both (n=2, 11%), one patient (5%) had vertebral involvement. Sensitivity, specificity, PPV and NPV for assessing T4 status were: for EUS (n=74); 42%, 95%, 73%, 83%, for chest CT (n=66); 76%, 61%, 41%, 88% and the combination of EUS and chest CT (both positive or negative for T4, (n=34); 83%, 100%, 100% 97%. CONCLUSION: EUS has a high specificity and NPV for the T4 assessment of lung tumors located para-esophageally and offers further value to chest CT scan.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem
Esôfago/diagnóstico por imagem
Neoplasias Pulmonares/diagnóstico por imagem
Invasividade Neoplásica/diagnóstico por imagem
Estadiamento de Neoplasias/métodos
Ultrassonografia/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Carcinoma Pulmonar de Células não Pequenas/patologia
Carcinoma Pulmonar de Células não Pequenas/cirurgia
Endossonografia/métodos
Feminino
Seres Humanos
Neoplasias Pulmonares/patologia
Neoplasias Pulmonares/cirurgia
Masculino
Neoplasias do Mediastino/diagnóstico por imagem
Neoplasias do Mediastino/patologia
Neoplasias do Mediastino/secundário
Mediastino/diagnóstico por imagem
Mediastino/patologia
Meia-Idade
Invasividade Neoplásica/patologia
Países Baixos/epidemiologia
Estudos Retrospectivos
Toracotomia/métodos
Toracotomia/estatística & dados numéricos
Tomografia Computadorizada por Raios X/métodos
Neoplasias Vasculares/diagnóstico por imagem
Neoplasias Vasculares/patologia
Neoplasias Vasculares/secundário
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE



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