Pneumonologia i alergologia polska
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Pneumonol Alergol Pol · Jan 2014
Case Reports[Synchronous multiple primary lung cancers in a 65-year old heavy smoker. Case report].
Here we present a 65-year old ex-smoker with history of recent surgery for vocal cord tumor (histology: moderate grade intraepithelial neoplasia), who reported to the pulmonary outpatient clinic for the nodular lesions in the left lung seen on chest X-ray. Subsequent chest CT scan revealed focal lesion of 18 mm in diameter with spicular margins located in the right upper lobe, another irregular cyst with septa, 62 × 58 mm in the right lower lobe, and calcified nodule in the left lung, no enlarged lymph nodes or pleural effusion was seen. He underwent upper right lobe resection and wedge resection of the lower right lobe. ⋯ During 20 months of the follow-up, he remained in good health with no signs of the disease progression. Patients with synchronous multiple primary lung cancers have significantly less favorable outcome than those with single primary lung malignancies, although it can be considerably improved with radical surgical treatment. Basing on the above case report, we discussed diagnostic and therapeutical scheme in patients with the primary multiple lung cancers, and have analyzed epidemiological data and some aspects of MPM etiology.
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Pneumonol Alergol Pol · Jan 2014
Methodological recommendations for the diagnostics of EGFR gene mutations and ALK gene rearrangement in the selection of non-small-cell lung cancer patients to molecularly targeted therapies.
Testing for EGFR gene mutations and ALK gene rearrangement is routinely used in advanced non-small-cell lung cancer for adequate patient selection to molecularly targeted therapies. We present Polish methodological recommendations for molecular analysis of EGFR and ALK genetic abnormalities. Recommendations specify clinical indications for testing, sample types and handling, as well as requirements for laboratories performing molecular diagnostics.
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Pneumonol Alergol Pol · Jan 2014
Case Reports[Neuroendocrine cell hyperplasia of infancy--case study].
Neuroendocrine cell hyperplasia of infancy is a rare form of children's interstitial lung disease recognised usually in infancy and in children younger than two years old. The typical clinical scenario, such as chest retractions, tachypnoea, hypoxaemia, crackles, characteristic changes in high-resolution computed tomography and histological examination of the lung parenchyma, is the cornerstone for diagnosis. In the article, the authors describe clinical manifestation of neuroendocrine cell hyperplasia and a present case of an infant with this rare interstitial lung disease.
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Pneumonol Alergol Pol · Jan 2014
Pulmonary alveolar proteinosis during a 30-year observation. Diagnosis and treatment.
Pulmonary alveolar proteinosis (PAP) is a rare disease characterised by the abnormal accumulation of surfactant-like material in macrophages within the alveolar spaces and distal bronchioles. The course of the disease is variable and the prognosis is often good. However, progressive disease in some patients can cause respiratory dysfunction and can be life threatening. In this situation, the only effective treatment is whole lung lavage. The objective of the study was to present the characteristics and the course of pulmonary alveolar proteinosis in our own material, the diagnostic methods used, the indications for treatment and the treatment efficacy. ⋯ Pulmonary alveolar proteinosis is a rare interstitial disease with a mild course in most cases. In 13/17 patients diagnosis was based on histological examination of samples from open lung biopsy. The presented patients were observed in the years 1984-2004, and at that time histologic examination was the main diagnostic method. The most common abnormality in pulmonary function tests was decrease of DLCO. In most cases, spontaneous remission of the disease was observed. In four patients with severe course of PAP, WLL was performed with subjective, functional and radiological improvement in 3 of them.
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Pneumonol Alergol Pol · Jan 2014
Application of impulse oscillometry in respiratory system evaluation in elderly patients.
Spirometry, which is a basic diagnostic tool of the respiratory system, may cause problems to patients of advanced age because of required cooperation and specific respiratory manoeuvres. Impulse oscillometry (IOS) may be an interesting alternative for spirometry as the examination is made during quiet breathing and gives information about resistive properties of the respiratory system. ⋯ As R5-R20 is regarded as a measure of peripheral airways resistance, IOS may serve as an interesting complementary or alternative method for spirometry in elderly subjects for evaluation of the state of respiratory system.