78

291

Comparison of cbesst x-ray Glms, computerized tomography of thorax, bronchoscopic results, and operative Gndings in patients

with suspected lung aodlor mediastinal lesions.

Ugur GnilIIll, Noman Nomanoglu, 6mer Altuntag, ismail Sava~.

&em bdemir, Doganay Alper, Medical School of Ankara University, Turkey.

We studied 2.4 patients with long and/or mediastinal mass(a)

admined to our Chest Diseases Depariment, Medical School of Ankara University. AU patients were followed up to their operations. We

compared plain chest x-ray films, CT findings and bronchoscopic manifes~aiions of each patients with the operative results.

We could obtain the diagnosis in patients with carcinoid toners and squamous cell long cancers unlike benign lesions by performing bronchoscopy.

Chest x-ray films could not give detailed information about mediastinal lesions.

Thoracic CT could not reveal the invasion of gxat vessels end thoracic wall involvement as much detail as in operative fmdings.

In our study, we found ihat inuabronchial masses originared from large bronchi could be seen readily in thorax CT. We showed cystic lesions in thorax CT much easier than chest x-ray films.

Thoracic CT was not able 10 show hilar lymph node involvement accurately compared with operative findings.

Cf could not differentiate the metestatic lymph nodes from benign lymph nodes.

CT did not give extra information except staging about tumors

locared major bronchi however it guided 10 select diagnostic bronchoscopic method for the lesion in cases with negative bronchoscopic results.

298

TOTAL SL4LlC ACID, LIPID-BOUND SIALIC ACID, CERULOPL4SMIN, AND FIBRINOGEN LEVELS IN

MALIGN AND BENIGN PLEURAL DISEASES

Dr.Numan Numanoglu, Dr.Turan Karayrlanoglu, Dr.Ugur Giiniillii. Dr.i%lem &demir, Dr.Yddo Atakwt. Dr.Doganay Alper.

Dept. of Chest Diseases and Biostatistics, Medical School of Ankara University, Turkey.

We detected the levels of sialic acid (%A), lipid-bound sialic acid

(LSA), ceroloplasmin, and fibrinogen in sewn and pleural effosions of 32 caseswith pleural diseases to differentiate benign effosions from malign ones. In addition to the patients, we also measured the same

markers in the serum of 30 healthy subjects as a conrrol group. Thirieen of total cases had malignant disease, while the remaining cases had benign patho1ogie.s. We found sewn and pleural effusion levels of TSA and EGA in cases with malignant pleurisy significantly higher ihan the levels of cases with benign pleurisy @cO.Mll). Serum levels of TSA and LSA of malignant pleurisy cases and TSA levels of benign pleurisy cases were significantly above the levels of control group @<O.oOl). Semm ceruloplasmin levels 01 malipant pleurisy cases were higher than the ceruloplasmin levels of benign pleurisy cases and control group @<O.Ol). Correlation was found between serum levels of TSA and LSA in cases with malignanf pleural effusion (1=0.905).

THE VALUE OF CYTOGENETIC ANALYSIS IN THE DIAGNOSIS

OF MALIGNANT PLEURAL EFFUSIONS f.Savag,N.fmirzal~oglu,B.S.~ayl~,N.Numano~lu,U. GSniillii,O.Ozdemir,D.Alper,H.Giirses. Departments of Chest Diseases and Genetics,Faculty of Medicine, University of Ankara;Department of Genetics,Giilhane Military Medical School,Tiirkiye

We examined 34 cases with pleural effusions.Following thoracentesis,chromosomal analysis of G-banded metaphase plates by direct and culture methods have been performed. Pleural effusions of 11 patients wsre found to be benign and the remaining malignant. No diagnosis was made in 2 cases.1" these instances,no chromosomal abnormality was found in some and culture was not positive in others. The results of chromosomal analjsis were consistent with the diagnosis in benign effusions. In general,diagnostic rate of cytology was 52% and histopathologic examination 42% in malignant effusions. When the chromosomal analysis was added,the diagnostic rate reached 71%. Chromosomal analysis was not very effective in the diagnosis of metastatic cases while results were contributive for lymphomas.Chromosomal analysis in lung adenocarcinoma were consistent with the cytology while it was negative for squamous cell carcinoma.These (-) results might be due to paramalignant effusions and/or technical reasons. We believe that if chromosomal analysis is combined with cytology,mdre information can be gained.

IMAGING OF SHALL CELL TlJ!JjURS WITH THE RADIOLABELLED SOMATOSTATIN ANALOCUE. IN-PENTETRBOTIDB. K.J. O'Byme, J.T. Ennis, P.J. Freyne, L.J. Clancy, J.S. Prichard, D.N. Carney. Depts. of Oncology & Radiology, Mater Hospital, & Depts. of Diagnostic Imaging & Respiratory Medicine, St. James's Hospital, Dublin, Ireland.

Recent work suggests that between 50-75X of small cell lung cancer (SCLC) turnours have specific high affinity binding sites for somatostatin. This study evaluated the ypjjential role of the radiolabelled somatostatin analogue,

In-pentetreotide, in the detection of SCLC and extra- pulmonary small cell turnours (EPSCC) in patients (pts) prior to and after chemotherapy (CT) using scintigraphic imaging techniques. Results were compared to standard imaging techniques. In all 25 pts were studied. The primary site of disease was detected in 22/23 pts with SCLC and l/2 pts with EPSCC. Furthermore 9/M known meta- static sites of disease were localized in the SCLC pts. Thirteen of the SCLC pts were evaluated prior to CTlll Following standard staging 6 pts had LD and 7 ED. Ill- pentetreotide imaging led to the detection of all primary sites of disease including a primary site of disease not detectable with chest x-ray or CT thorax. All sites of metsstatic disease detected by standard staging, were imaged in 50% of cases. This included an asymptomatic cerebellar metastasis detected in a pt thought to have LD. Following CT scintigraphic imaging of 6 pts detected residual disease in 2/j with complete remissions and in all 3 pts with a partial re~y~nse on standard staging. These results suggest that In-pentetreotide imaging may have a role to play in the clinical evaluation of pts with SCLC and EPSCC. Specifically, this technique may be of particular value in detecting residual intrathoracic disease in pts with SCLC thought to have a complete remission by conventional staging methods.