Abstracts/Lung Cancer 12 (1995) 265-329

the extreme rarity constituted for the SRC in general. It’s defined as the partial or total diippewance ofa histnlogkal confimxd malignant turnour, without definitive treatment. The mechanism of the SRC remain in the dark, although the most of explanations arc referenecd to non specific stimulation of the immune system. We report the case of a patient with histological diagnosis of lung adcnocarcinoma (TZ, Nl, MO) and with the necessary criteria of SRC.

Droochioloalveolar carcinoma with bronchorrboea treated with erythromyeht Suga T, Sugiyama Y, Fujii T, Kitamura S. Deporbnenr Pulmonary Medicine. &hi Medical School, Minomikawochi-mochi. Tochigi 329-04. EM Respir J 1994;lQ249-5 I.

Recent reports have shown that crythromycin inhibits bronchial hypcr- socrction, and, accordingly, erythromycin was administered to * patient with bronchioloalvcolar carcinoma with bronchorrhoca. After administration of crythmmycin, marked reduction in the volume of sputum was observed, and the patient’s quality of life was improved. It is concluded that erythromycin may rcduc~ hypersccretion in bronchioloalveolar carcinoma.

Diagnostic yield of transtboracic needle aspiration biopsy following negative tiberoptic broachoscopy in 103 patients with peripheral cinxunscribed pulmonary lesions MilmmN,F~~houP,GmdcG. Dcpman~tofPulmonayMedicine I: Genb$e Hospital, DK-2900 Hellerup. Respiration 1995;62: l-3.

The diagnostic potential of secondary transthoracic nccdlc biopsy (TNB) following negative fiberoptic bronchoscopy (FOB) in patients with peripheral circumscribed pulmonary lesions was evaluated in a retrospective study. The records from 224 patients who had TNB over a S-year period were reviewed. Of these, 103 patientsmet the criteria for inclusion in this series. The overall diagnostic yield of TNB in malignancy was 73.8% (54 of 73 patients). TNB allowed cytologic classitication of the tumor type in 72.2% (39 of the 54 phmts). Five of the 54 patients (9.3%) presented with small-cell annplastic bronchogenic carcinoma, diagnosed at TNB, and were refed to chemotherapy. Of the 49 patients with a negative TNB, 27 went on to diagnostic surgical procedures, 19 had malignancy, 3 benign htmor. 2 infection, and 3 sequelae after pulmonary infarction. The remaining 22 undiagnosed patients were followed up over a long period of time, 5 showed progression of the pulmonary lesion suggesting malignancy. TNB appeared unsuitable for the diagnosis of benign lesions. Unspecific inflammation was not considercd evidence of benignity, and therefore no definitive benign diagnosis was made by TNB in this series. There were no serious complications to TNB. In 18. I% of the procedures a pneumothorax developed. indicating a chest tube in 8.6% of the procedures. TNB is a suitable diagnostic procedure with a high diagnostic yield in patients with peripheral localized malignant pulmonary lesions.

Solitary pulmonary nodule: Preliminary study of evaluation with inc~emeataldynamicfX Yamashita K. Matsunobc S, Tsuda T, Nemoto T, Mstsumoto K, Miki H. Deporbnent of Radio&, Shiga He&h Insurance Hospital, 16-l. Fujimidai. 0f.m 520. Radiology 1995;194:399-i05.

Purpose: To use incremental dynamic computed tomography (CT) to evaluate solitary pulmonary nodules (SPNs). Marerials and Methods: Thirly-hvo adult patients with SPNs less than 3 cm in diameter had 18 primary lung cancers, 10 tuberculomas, and four hamartomas. The CT numbers of the inner area of the nadulc were calculated before and 30 seconds, 2 minutes, and 5 minutes after administration of contrast material. Results: All lung cancas and one of four hamartomas showed significantly greater enhancement (P < .OOOl) than benign SPNs, which did not show cnhanccmmt (except for one hamartoma). All lung cancers and one of four hamartomas showed complete enhancement, one hamartoma showed peripheral enhancement, hvo hamsrtomas and eight of IO tubcrculomas showed capsular enhancement, and hvo tuberculomas showed no enhancement. Conclusion: Maximum attenuation of 20-60 HU appears to bc a good predictor of malignancy.

Interobserver variation in the computed tomographic evaluation of media&ml lymph node size in patients with potentially resectable lung cancer Guyatt GH, Lcfca M, Walter S, Cook D, Troyan S, Gritlith L et al. hfcA4osler

Univ. Health Sciences C&. I200 Main Sneer West, Hamdron, Ont. Lgh: 321 Chest 1995;107:116-9.

Objective: To measure the reliability of the assessment of media&al lymph node size in computed tomographic (CT) scans of the thorax. Design: Observer agreement study in which radiologists, blinded to one anothers’ interpretation. were randomized to read 30 scans each. Population. Sixty scans from patients wtth apparently operable non-small cell carcinoma of the lung were read by radiologists responsible for clinical interpretation (clinical radiologists) and four radiologists with a special interest in thoracic CT (study radiologists). MeaJuremenfi Radiologists measured the size of left and right superior media&al nodes, aortic nodes. and the subcarinal nodes and, on the basis of whether any nodes accessible to mcdiastinoscopy were greater than I cm, recommended whether mediastinoscopy be undertaken. Agreement was quantified using kappa. a measure of chance- corrected agreement. Results: Among all radiologists. agreement on whether there were any nodes larger than I cm for right superior mediastinal nodes was 0.68; for letl superior medlastinal nodes it was 0.28. for amtic pulmonary nodes it was 0.62; for subarinal nodes it was 0.58; and for any node greater than I cm and accessible to mediastinoscopy It was 0.61. The agreement was very similar when the analysns was restricted to the study radiologists. Conclusion: Although the good level of overall agreement suggests that CT provides useful information in the evaluation of media&al lymph node size, the disagreement was sufficient that it likely contributes to suboptimal sensitivity and specificity of CT in dctccting tumor spread reported m prcvwus studies.

Mation between a c@MromeP450 CYPIAI gcno(ype and incidence of lung cancer Okada T, Kawashima K, Fukushi S, Minakuchi T, Nishimura S. Biology Dwision. Nar. Cancer Cenrer Research InsI., Tokyo 104. Pharmacogenetics 1994:4:333- 40.

We analysed 267 samples from patients with lung cancer and 54 samples from patients with pancreatic cancer and classified them into three types (A. B and C) based on their WSOCYPIAl genotypes. This was performed by restriction fragment length polymorphism (RFLP) analysis ofDNA (that had been amplitied) using the polymerwe chain reaction @‘CR). Our results rccontirmcd previous studies with RFLP analyses by revealing significantly higher frequencies of C type in lung cancer patients, particularly light smokers with squamous cell carcinoma (p < 0.001). Also when WC compared the appearance rate of P45OCYPIAl genotype in lung cancer patients between metastasis group and no metastasis group, lymph node or distant metastasis was more frequently observed among the patients of squamous cell carcinoma, especially the light smoking group, with C genotypes (p < 0.05). These results suggested that this genotype is not only associated with the etiology of lung cancer but also with the status of metastasis. Furthermore, genotyping could be useful in predicting the incidence of lung cancer in the smokers and the general population as well as the prognosis of individuals who develop this dwasc.

Small cell lungcareinoma in a young patient of only 17 years old A case report Robinet G, Gown S. Lc Reste N, Leroy JP, Brambdla E, Clawer J Service de

Pneumologie, Oncofogie Broncho-Pulmonaire, CHU Morvan. F 29609 Bresi Cedex. Rev h4al Respir 1994, I 1:607-9.

We report a case of small cell lung cancer in B 17 year-old man. He was admitted to our unit suffering from a two month history of pain letl shoulder Chest X-rays showed a large round mass in the lefi upper lobe The chest CT scan revealed a tumor with evidence of first lctt rib involvement. Ihstological examination, after surgical biopsy revealed small cell carcinoma, continned by hvo indepcndant pathological physicians. Small cell lung carcinoma is very rare in the under 20 year age group and we compare this case with other types of lung cancer in young patients described in the literstun.