Respiration; international review of thoracic diseases
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Bronchogenic cysts are congenital cystic lesions of foregut origin, usually intra-pulmonary or mediastinal in location. Peri-oesophageal bronchogenic cysts are rare, while intra-oesophageal cysts are almost always considered as enterogenous owing to their location and their composition. ⋯ Despite the fact that the cyst was completely embedded in the oesophageal wall, the pathological findings revealed the respiratory origin of the cyst. An extramucosal excision of the cyst was performed establishing the diagnosis and alleviating all our patient's symptoms.
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Chemical pleurodesis is an effective treatment of malignant pleural effusions, but indications must be individualised to optimise its results. The aim of the present study was to investigate the relationship of various prognostic features with both the response rate to pleurodesis and the probability of patient survival. A non-concurrent cohort study was carried out in which 120 evaluable patients with malignant pleural effusion underwent pleurodesis. ⋯ Pleural fluid glucose (< 60 mg/dl), Karnofsky performance status (< 70), size of the effusion in chest radiographs (massive effusion), pleural fluid pH (< 7.20), presence of concomitant alterations in chest radiographs, and pleural lactic acid dehydrogenase levels (> 600 U/l) showed a significant association with the probability of failure. Patients with these features, along with those having non-chemosensitive tumours (in particular, non-small cell lung cancer), had a significantly worse actuarial survival. This study confirms that some pretreatment clinical data and pleural fluid parameters can predict both the outcome of pleurodesis and the survival of patients with malignant pleural effusion.