technetium-tc-99m-sulfur-colloid and Carcinoma--Small-Cell

Application of the sentinel node concept to lung cancer is still controversial. Patients with peripheral small lung cancers would gain the most benefit from this concept, if it were valid. We sought to determine whether it is possible to choose between limited lymph node sampling and systematic lymphadenectomy from the distribution of sentinel lymph nodes in patients with node-negative disease on the basis of imaging.. Sixty-five consecutive patients with cT1 N0 M0 non-small cell lung cancer were enrolled. A radioisotope tracer (4 mCi of technetium-99m tin colloid, 2.0 mL) was injected in the vicinity of the tumor before surgical intervention with computed tomographic guidance. The radioactivity of each resected lymph node was measured separately with a hand-held gamma probe after complete tumor resection. Sentinel nodes were identified, and the accuracy of sentinel node mapping was examined. Whether the location of the sentinel node depended on the site of the primary tumor was also examined.. Of the 65 patients, 3 were excluded because of the final pathologic results. Successful radionuclide migration occurred in 39 (62.9%) of the 62 patients. There was 1 (2.6%) false-negative result among 39 patients with a sentinel node, and therefore the sensitivity was 90%, and the specificity was 100%. The most common sentinel lymph nodes were at level 12 (46.7%), followed by level 11 (18.3%), the mediastinum (16.7%), and level 10 (11.7%).. The sentinel node concept is valid in patients with cT1 N0 M0 lung cancer. The lobar lymph nodes were identified as sentinel nodes more frequently than other lymph nodes. We need to make further efforts to increase the sentinel node identification rate. However, we believe that if sentinel nodes are identified, sentinel node mapping can allow the accurate intraoperative diagnosis of pathologic N0 status in patients with cT1 N0 M0 lung cancer.

Topics: Aged; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; False Negative Reactions; Female; Forced Expiratory Volume; Humans; Japan; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Predictive Value of Tests; Radioisotopes; Radiopharmaceuticals; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Vital Capacity

Assessment of sentinel nodes to predict metastases in a regional nodal basin is valuable for staging patients with melanoma and breast carcinoma. This study tested whether injection of isosulfan blue and technetium-99 could identify mediastinal sentinel nodes in patients with lung carcinoma and determine whether sentinel node histology predicts distal nodal metastases.. Isosulfan blue and technetium-99 were injected into the tumor and pulmonary resection performed. The hilum and mediastinum were assessed visually and with the gamma probe, and a mediastinal nodal dissection was performed.. Thirty-one patients were evaluated. Three patients had positive sentinel nodes and positive distal mediastinal nodes. Twenty-two patients had negative sentinel nodes and negative distal nodes. No sentinel node was identified in 6 patients and 2 patients had two sentinel nodes.. These data demonstrate that this rapid, simple technique can identify sentinel nodes in the mediastinum and that the sentinel node is an accurate predictor of distal nodal metastases in patients with lung cancer.

Topics: Aged; Carcinoid Tumor; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Female; Humans; Injections, Intralesional; Lung Neoplasms; Lymph Node Excision; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Pneumonectomy; Prognosis; Rosaniline Dyes; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid

A case of a primary lung carcinoma involving the left pulmonary hilum serendipitously detected utilizing hepatic imaging is presented. Malignant stimulation of the reticuloendothelial system resulted in diffuse pulmonary uptake of Tc-99m sulfur colloid, however, only the right lung was visualized. Subsequently, a chest radiograph and computed tomography of the chest demonstrated massive malignant involvement of the left pulmonary hila, adjacent mediastinum, and left atrium. Transbronchial biopsy revealed anaplastic small cell carcinoma.

Topics: Adult; Carcinoma, Small Cell; Female; Humans; Liver; Lung Neoplasms; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

The concentration of granulocyte-macrophage colonies in culture (CFU-c) in bone marrow cells was estimated, and bone marrow radionuclide scans were performed in a group of 15 cancer patients prior to bone marrow harvest for autologous transplantation. Preharvest CFU-c counts on iliac-crest bone marrow aspirates correlated very well with CFU-c counts from fresh and frozen-thawed bone marrows. Technetium-99m-sulfur colloid radionuclide scans showed that the distribution of total-body bone marrow and increased peripheral radionuclide uptake correlated with higher preharvest and harvest CFU-c counts. Bone marrow scan results were available in 1 h, whereas CFU-c counts took 14 days to obtain. Bone marrow scans may facilitate the clinical estimation of hemopoietic activity in patients under consideration for autologous bone marrow transplantation.

Topics: Bone Marrow; Breast Neoplasms; Carcinoma, Small Cell; Colony-Forming Units Assay; Hematopoiesis; Humans; Leukemia; Lung Neoplasms; Lymphoma; Male; Neoplasms; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Testicular Neoplasms

One hundred fifty-seven consecutive patients with small cell lung cancer seen at the National Cancer Institute over a four-year period underwent a series of pretherapy liver staging procedures to determine optimal means of detection and prognostic implications of hepatic metastases. Liver evaluation included physical examination, liver function tests, and liver scan (radionuclide or computerized tomography [CT]), as well as percutaneous and/or peritoneoscopy-directed liver biopsy when possible (74%). Liver metastases were detected in 26% of patients. Peritoneoscopy was the most sensitive method of liver evaluation and increased the detection of liver metastases when done in a sequential fashion after percutaneous liver biopsy from 18 to a total of 27 patients. Of the noninvasive procedures, radionuclide and CT liver scan were the most accurate concurring with liver biopsy in 87% of patients but permitting correct discrimination of stage in excess of 96% of patients. The accuracy of this noninvasive procedure was enhanced by an algorithm combining the results of radionuclide liver scan with liver function tests to detect patients with high or low likelihood of liver involvement. The survival and response of patients with liver metastases was significantly worse than those without such metastases with no three-year disease-free survivors among patients with liver metastases.

Topics: Actuarial Analysis; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Carcinoma, Small Cell; Female; Humans; Liver Function Tests; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Topics: Bronchial Neoplasms; Carcinoma, Small Cell; Cell Count; Cell Movement; Hot Temperature; Humans; Indium; Leukemia, Lymphoid; Liver; Lung; Lymphocytes; Radioisotopes; Spleen; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid