Ivan Vollmer - Academia.edu (original) (raw)
Papers by Ivan Vollmer
ABSTRACT
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Anales de Pediatría
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Neurologia (Barcelona, Spain)
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PURPOSE/AIM The purpose of this exhibit is: 1. To review the staging of Hodgkin Disease (HD). 2. ... more PURPOSE/AIM The purpose of this exhibit is: 1. To review the staging of Hodgkin Disease (HD). 2. To show typical images on CT and Chest X-ray of thoracic involvement in HD. 3. To show atypical X-ray, CT, PET-CT and MRi findings in thoracic HD. CONTENT ORGANIZATION 1. Staging of HD. 2. Review of imaging findings in thoracic HD: a. Mediastinal adenopathies. b. Lungs (direct extension, nodules, masses). c. Pleural (effusions, solid pleural masses). d. Heart and pericardium (cardiac masses and pericardial effusion). e. Thymus (thymic enlargement, thymic cysts). f. Chest wall (involvement of paraesternal soft tissues, internal mammary nodes, masses between pectoral muscles). SUMMARY The major teaching points of this exhibit are: 1. To emphasize about the typical findings in thoracic HD as mediastinal adenopathies, direct extension to lung, pleural effusions, chest wall involvement and thymic enlargement. 2. To show atypical findings that may suggest thoracic HD involvement. Radiologist h...
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Revista Clínica Española
Bronchoscopic identification of an endobronchial foreign body is an unexpected finding in adults.... more Bronchoscopic identification of an endobronchial foreign body is an unexpected finding in adults. Modern imaging techniques such as computerised tomography (CT) may identify bronchial obstruction but not the cause. Moreover, images may be suggestive of other pathologies, especially when the previous aspiration cases are unknown. The most common CT findings in this setting are atelectasis, lung hyperlucency, localised bronchiectases and lobar consolidation. CT diagnosis of false endobronchial tumors in patients who have swallowed a foreign body is rarely described in the bibliography. In view of the potential adverse outcome in the case of wrong diagnosis we consider it is of interest to report two cases of endobronchial tumors diagnosed by CT in which flexible bronchoscopy allowed identification and extraction of an endobronchial foreign body.
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PURPOSE/AIM The purposes of this exhibit is: 1. To review the classification of non-Hodgkin lymph... more PURPOSE/AIM The purposes of this exhibit is: 1. To review the classification of non-Hodgkin lymphomas (NHL) 2. To show typical images on CT and Chest X-ray of thoracic involvement in (NHL). 3. To show atypical X-ray, CT, PET-CT and MRi findings in thoracic NHL. CONTENT ORGANIZATION 1. Classification of NHL. 2. Review of imaging findings in thoracic NHL: -Mediastinal adenopathies. -Thymus (thymic enlargement). -Thyroid (primary thyroid lymphoma). -Lungs (nodular, bronchovascular and alveolar patterns, MALT lymphoma). -Pleural (effusions, solid pleural masses). -Pericardium (pericardial effusion). -Heart (primary cardiac lymphoma). -Chest wall. -NHL arising in patients with Lymphocytic Interstitial Pneumonia. -Airways (endobronchial lymphoma). SUMMARY The major teaching points of this exhibit are: 1. To emphasize about the typical findings in thoracic NHL as mediastinal adenopathies, lung nodules, pleural effusion and chest wall involvement. 2. To show atypical findings that may sugge...
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AJR. American journal of roentgenology, 2015
The objectives of this article are to review the imaging findings of left ventricular noncompacti... more The objectives of this article are to review the imaging findings of left ventricular noncompaction (LVNC) at echocardiography, cardiac MRI, and MDCT; to discuss diagnostic criteria for and the advantages and limitations of these imaging techniques; and to describe pitfalls that can lead to misinterpretation of findings of LVNC. LVNC is a cardiac disease of emerging importance, and imaging has a key role in its diagnosis. Accordingly, radiologists should be familiar with LVNC imaging findings to realize an accurate diagnosis.
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Archivos de Bronconeumología, 2014
Disease stage is the most important prognostic factor in lung cancer, and optimal staging is impo... more Disease stage is the most important prognostic factor in lung cancer, and optimal staging is important to determine the best therapeutic option. FDG-PET/CT has demonstrated its value in early stage non-small cell lung cancer (NSCLC) but there is still insufficient data to define its role in other stages. Information provided by FDG-PET/CT has an impact on the therapeutic management of patients with NSCLC. A retrospective review was made of patients who underwent FDG-PET/CT between January 2008 and December 2010 for the diagnosis of NSCLC. Clinical stage before and after FDG-PET/CT and information about any change in therapeutic decision due to information provided by FDG-PET/CT were collected. Using pathologic evaluation as the gold standard, sensitivity, specificity, and positive and negative predictive values for CT and FDG-PET/CT were calculated. Of the 522 patients diagnosed of NSCLC, FDG-PET/CT was performed in 246 (47.1%). In 85 cases (34.6%) FDG-PET/CT led to stage migration. Treatment was modified in 60 patients (24.4% of all FDG-PET/CT performed), avoiding a futile thoracotomy in 13 cases (5.2%), and allowing treatment with curative intent in 26 (10.5%). Out of 90 patients (36.5%) evaluated as stage iii by CT staging, FDG-PET/CT modified the therapeutic approach in 36 (40%). For the 133 cases (54%) with pathological assessment of the mediastinal lymph nodes, sensitivity, specificity, positive predictive value and negative predictive value were 0.57, 0.64, 0.48 and 0.72 for CT, and 0.68, 0.86, 0.75 and 0.81 for FDG-PET/CT. Our data support previous reports that FDG-PET/CT is essential in the staging process not only for patients with potentially operable NSCLC but also for stage iii patients, as demonstrated by our data.
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Revista Española de Patología, 2011
... b Servei d'Anatomia Patològica, Hospital del Mar-Parc de Salut Mar, Universitat Autò... more ... b Servei d'Anatomia Patològica, Hospital del Mar-Parc de Salut Mar, Universitat Autònoma de Barcelona, Universitat Pompeu Fabra, Barcelona, España. c Servei de Pneumologia, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, España. ...
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Respiratory Medicine, 2010
The potential role of decreased respiratory muscle mass, if any, in mediating the susceptibility ... more The potential role of decreased respiratory muscle mass, if any, in mediating the susceptibility to exacerbation in COPD patients has not been determined. We hypothesized that a decrease in respiratory muscle mass is associated with increased risk of multiple hospital admissions due to acute exacerbations of the disease. Eligible cases and controls (n=20) were identified from records of our department's pulmonary clinic. Ten subjects diagnosed with COPD (males, 66+/-7yr, Body Mass Index (BMI)=26+/-4kg/m(2)) were identified as fragile patients. Fragility was defined as four or more admissions in the previous year due to severe exacerbations of the disease. Fragile patients were matched with 10 non-fragile controls, defined as COPD patients who had required only one admission due to exacerbation of the disease. Criteria for 1:1 matching included ethnicity, gender, age, BMI, degree of airflow obstruction (i.e., FEV(1)), comorbidity and chronic treatment. Multiple computed tomography (CT) scan slices were obtained to assess area and attenuation coefficients of multiple upper limb, thorax, abdomen and lower limb muscles. CSA of intercostal and abdominal muscles was significantly decreased in fragile COPD patients (right side intercostals, mean relative difference (MRD)=-14%, p=0.010; OR (95% CI)=2.2 (1.1-4.8), p=0.021; left side, MRD=-13%, p=0.007; OR=2.2 (1.1-4.5), p=0.027). CSA and attenuation coefficients of all other muscle compartments showed no statistical differences between the two study groups but showed the same trend. Strength of the inspiratory and expiratory muscles did not differ between the two study groups. This study shows that the risk for multiple admissions due to a COPD exacerbation associates with a marked decrease in the CSA of the intercostal muscle compartment.
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Journal of Thoracic Oncology, 2014
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Archivos de Bronconeumología, 2010
The diaphragm is the principal respiratory muscle. Its special characteristics have made it diffi... more The diaphragm is the principal respiratory muscle. Its special characteristics have made it difficult to design instruments capable of performing a non-invasive evaluation of its structure and function in humans. The present study was designed to evaluate the potential use of echography as a non-invasive method to fulfil these objectives. The study consisted of three phases: (1) echographic study in autopsy samples (n=10) of a segment of the thoracic-abdominal wall, from the bottom to the parietal peritoneum (i.e., thoracic wall, diaphragm, pleura and peritoneum structures), (2) static echographic study of the previous structures and the diaphragm in healthy subjects (n=10) to standardised lung volumes; and (3) dynamic echographic study of the contraction-relaxation of the diaphragm in the same subjects, calculating its maximum velocity of relaxation (MVrdi, mm/sec) during a specific inspiratory resistance test. The echography enabled the pleural and peritoneal limits of the diaphragm to be identified, and quantitate its thickness (Tdi), both ex-vivo and in-vivo, in all cases. The dynamic study of the Tdi showed a linear increase directly associated with the lung volume measurement, as well as a cyclical increase during inspiratory movements at rest. In the resistance test, the MVrdi was maximal with low loads and gradually decrease until reaching a minimum nadir (Δ≈-70% of the initial value) in claudication (fatigue). The MVrdi has a high precision in diagnosing claudication. Transthoracic echography of the diaphragm is a non-invasive method that gives promising results in the structural and functional evaluation (i.e. fatigue risk) of that muscle. These findings are of pathophysiological interest and could be of use in the clinical care context.
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Archivos de Bronconeumología, 2009
Transbronchial needle aspiration (TBNA) is a bronchoscopic technique that has been shown to be us... more Transbronchial needle aspiration (TBNA) is a bronchoscopic technique that has been shown to be useful for sampling enlarged mediastinal lymph nodes. The yield of this technique can be increased by using endobronchial ultrasound (EBUS) to guide needle placement. The aim of the present study was to compare the yield of radial EBUS-guided TBNA to that of conventional TBNA in the analysis of mediastinal lymph nodes. All patients undergoing either EBUS-guided or conventional TBNA for the diagnosis of mediastinal lymph nodes between January 2006 and May 2007 were studied consecutively. Histology results were used as a reference standard in the patients treated surgically. In cases in which surgery was not indicated, the results of cytology or of clinical follow-up of at least 6 months duration were used. TBNA was performed in 117 patients, and a total of 143 lymph nodes were punctured (mean shortest [SD] diameter, 17.9 [8]mm). The samples obtained were diagnostic in 58 patients (49.6%) and in 70 lymph nodes (49.0%). For paratracheal and hilar stations, the yield of radial EBUS-guided TBNA was superior to that of conventional TBNA (59.2% compared to 34.1%, P=.02). Radial EBUS guidance increases the diagnostic yield of TBNA in paratracheal and hilar lymph node stations.
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Archivos de Bronconeumología, 2011
In non-small cell lung cancer, the EGFR gene mutations identify a patient sub-population with dif... more In non-small cell lung cancer, the EGFR gene mutations identify a patient sub-population with different clinical characteristics and treatment responses to those that do not have these mutations. There are mutations that derive in increased sensitive to EGFR targeted therapy, as well as mutations that result in resistance. The determination of EGFR mutations involves a change in the therapeutic approach to lung cancer patients in current clinical practice. In this article we present a case of a patient suffering from a metastatic lung adenocarcinoma with an activating mutation on diagnosis, initially responding to treatment with erlotinib, who subsequently developed a secondary resistance due to acquiring the T790M mutation in exon 20 of the EGFR gene.
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Archivos de Bronconeumología, 2010
Chest ultrasonography is a useful tool for assessing disease activity in the peripheral lung pare... more Chest ultrasonography is a useful tool for assessing disease activity in the peripheral lung parenchyma, pleura, chest wall, diaphragm, and mediastinum. Ultrasound imaging also provides highly useful guidance in invasive diagnostic and therapeutic procedures. The main advantages of this imaging technology are the absence of ionizing radiation and the possibility of real-time bedside applications. The chief indications and limitations of chest ultrasonography and the principal sonographic signs are reviewed.
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Archivos de Bronconeumología, 2014
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Archivos de Bronconeumología, 2014
Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary le... more Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary lesions (PPL), but the diagnostic yield varies widely among studies. Endobronchial ultrasound (EBUS) can increase the diagnostic yield of bronchoscopic diagnosis of PPL. To compare the diagnostic yield of fluoroscopy-guided bronchoscopy and EBUS with fluoroscopy-guided bronchoscopy in the study of PPL. All patients who underwent bronchoscopy to study PPL from January 2009 to December 2012 were prospectively included. 145 consecutive patients were randomly distributed in two groups: EBUS and fluoroscopy (50 patients, 71.3 ± 8.2 years) or fluoroscopy alone (95 patients, 68 ± 10.5 years). The mean diameter of the lesions was 41.97 ± 19.22 mm. Cytological brushing and transbronchial biopsies were obtained. All procedures were performed under fluoroscopic guidance with intravenous conscious sedation. EBUS was performed using an endoscopic ultrasound system equipped with a 20-MHz radial miniprobe introduced via a guide-sheath. Bronchoscopist, cytologist, study protocol, techniques and tools were the same throughout the whole study. 129 (89%) patients had malignant disease. A diagnosis with bronchoscopy was established in 105 (72.4%) patients. EBUS plus fluoroscopy obtained a diagnostic yield in 78% of patients and fluoroscopy alone in 69.5% (non-significant). In contrast, for lesions smaller than 30 mm, EBUS plus fluoroscopy guidance provided significantly greater diagnostic performance than fluoroscopy alone (90 vs. 52%; P=.05). Bronchoscopy under EBUS plus fluoroscopy guidance is a technique that has become useful for the diagnostic of LPPs, especially those smaller than 30 mm in diameter.
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Oncotarget, Jan 30, 2014
We have previously shown that Met activation through the hepatocyte growth factor (HGF) increases... more We have previously shown that Met activation through the hepatocyte growth factor (HGF) increases tumorogenesis, induces epithelial-to-mesenchymal transition (EMT) and chemoresistance in SCLC. We sought to evaluate circulating HGF levels in SCLC patients and assess correlation with outcome and EMT features in the tumor. Serum samples from patients with SCLC were prospectively obtained at diagnosis, response evaluation and progression. HGF serum (sHGF) was quantified by ELISA. EMT markers and p-Met/Met were assayed by immunohistochemistry in tumor samples. Clinical data were prospectively recorder. One-hundred twelve patients were included. High baseline levels of sHGF were associated with shorter overall survival (p=0.006) and remained independently associated with survival in the multivariate analysis (p=0.016). For stage IV patients, an increase of sHGF levels at response evaluation (p=0.042) and at progression (p=0.003) were associated with poor outcome. sHGF levels were associat...
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ABSTRACT
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Anales de Pediatría
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Neurologia (Barcelona, Spain)
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PURPOSE/AIM The purpose of this exhibit is: 1. To review the staging of Hodgkin Disease (HD). 2. ... more PURPOSE/AIM The purpose of this exhibit is: 1. To review the staging of Hodgkin Disease (HD). 2. To show typical images on CT and Chest X-ray of thoracic involvement in HD. 3. To show atypical X-ray, CT, PET-CT and MRi findings in thoracic HD. CONTENT ORGANIZATION 1. Staging of HD. 2. Review of imaging findings in thoracic HD: a. Mediastinal adenopathies. b. Lungs (direct extension, nodules, masses). c. Pleural (effusions, solid pleural masses). d. Heart and pericardium (cardiac masses and pericardial effusion). e. Thymus (thymic enlargement, thymic cysts). f. Chest wall (involvement of paraesternal soft tissues, internal mammary nodes, masses between pectoral muscles). SUMMARY The major teaching points of this exhibit are: 1. To emphasize about the typical findings in thoracic HD as mediastinal adenopathies, direct extension to lung, pleural effusions, chest wall involvement and thymic enlargement. 2. To show atypical findings that may suggest thoracic HD involvement. Radiologist h...
Bookmarks Related papers MentionsView impact
Revista Clínica Española
Bronchoscopic identification of an endobronchial foreign body is an unexpected finding in adults.... more Bronchoscopic identification of an endobronchial foreign body is an unexpected finding in adults. Modern imaging techniques such as computerised tomography (CT) may identify bronchial obstruction but not the cause. Moreover, images may be suggestive of other pathologies, especially when the previous aspiration cases are unknown. The most common CT findings in this setting are atelectasis, lung hyperlucency, localised bronchiectases and lobar consolidation. CT diagnosis of false endobronchial tumors in patients who have swallowed a foreign body is rarely described in the bibliography. In view of the potential adverse outcome in the case of wrong diagnosis we consider it is of interest to report two cases of endobronchial tumors diagnosed by CT in which flexible bronchoscopy allowed identification and extraction of an endobronchial foreign body.
Bookmarks Related papers MentionsView impact
PURPOSE/AIM The purposes of this exhibit is: 1. To review the classification of non-Hodgkin lymph... more PURPOSE/AIM The purposes of this exhibit is: 1. To review the classification of non-Hodgkin lymphomas (NHL) 2. To show typical images on CT and Chest X-ray of thoracic involvement in (NHL). 3. To show atypical X-ray, CT, PET-CT and MRi findings in thoracic NHL. CONTENT ORGANIZATION 1. Classification of NHL. 2. Review of imaging findings in thoracic NHL: -Mediastinal adenopathies. -Thymus (thymic enlargement). -Thyroid (primary thyroid lymphoma). -Lungs (nodular, bronchovascular and alveolar patterns, MALT lymphoma). -Pleural (effusions, solid pleural masses). -Pericardium (pericardial effusion). -Heart (primary cardiac lymphoma). -Chest wall. -NHL arising in patients with Lymphocytic Interstitial Pneumonia. -Airways (endobronchial lymphoma). SUMMARY The major teaching points of this exhibit are: 1. To emphasize about the typical findings in thoracic NHL as mediastinal adenopathies, lung nodules, pleural effusion and chest wall involvement. 2. To show atypical findings that may sugge...
Bookmarks Related papers MentionsView impact
AJR. American journal of roentgenology, 2015
The objectives of this article are to review the imaging findings of left ventricular noncompacti... more The objectives of this article are to review the imaging findings of left ventricular noncompaction (LVNC) at echocardiography, cardiac MRI, and MDCT; to discuss diagnostic criteria for and the advantages and limitations of these imaging techniques; and to describe pitfalls that can lead to misinterpretation of findings of LVNC. LVNC is a cardiac disease of emerging importance, and imaging has a key role in its diagnosis. Accordingly, radiologists should be familiar with LVNC imaging findings to realize an accurate diagnosis.
Bookmarks Related papers MentionsView impact
Archivos de Bronconeumología, 2014
Disease stage is the most important prognostic factor in lung cancer, and optimal staging is impo... more Disease stage is the most important prognostic factor in lung cancer, and optimal staging is important to determine the best therapeutic option. FDG-PET/CT has demonstrated its value in early stage non-small cell lung cancer (NSCLC) but there is still insufficient data to define its role in other stages. Information provided by FDG-PET/CT has an impact on the therapeutic management of patients with NSCLC. A retrospective review was made of patients who underwent FDG-PET/CT between January 2008 and December 2010 for the diagnosis of NSCLC. Clinical stage before and after FDG-PET/CT and information about any change in therapeutic decision due to information provided by FDG-PET/CT were collected. Using pathologic evaluation as the gold standard, sensitivity, specificity, and positive and negative predictive values for CT and FDG-PET/CT were calculated. Of the 522 patients diagnosed of NSCLC, FDG-PET/CT was performed in 246 (47.1%). In 85 cases (34.6%) FDG-PET/CT led to stage migration. Treatment was modified in 60 patients (24.4% of all FDG-PET/CT performed), avoiding a futile thoracotomy in 13 cases (5.2%), and allowing treatment with curative intent in 26 (10.5%). Out of 90 patients (36.5%) evaluated as stage iii by CT staging, FDG-PET/CT modified the therapeutic approach in 36 (40%). For the 133 cases (54%) with pathological assessment of the mediastinal lymph nodes, sensitivity, specificity, positive predictive value and negative predictive value were 0.57, 0.64, 0.48 and 0.72 for CT, and 0.68, 0.86, 0.75 and 0.81 for FDG-PET/CT. Our data support previous reports that FDG-PET/CT is essential in the staging process not only for patients with potentially operable NSCLC but also for stage iii patients, as demonstrated by our data.
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Revista Española de Patología, 2011
... b Servei d'Anatomia Patològica, Hospital del Mar-Parc de Salut Mar, Universitat Autò... more ... b Servei d'Anatomia Patològica, Hospital del Mar-Parc de Salut Mar, Universitat Autònoma de Barcelona, Universitat Pompeu Fabra, Barcelona, España. c Servei de Pneumologia, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, España. ...
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Respiratory Medicine, 2010
The potential role of decreased respiratory muscle mass, if any, in mediating the susceptibility ... more The potential role of decreased respiratory muscle mass, if any, in mediating the susceptibility to exacerbation in COPD patients has not been determined. We hypothesized that a decrease in respiratory muscle mass is associated with increased risk of multiple hospital admissions due to acute exacerbations of the disease. Eligible cases and controls (n=20) were identified from records of our department's pulmonary clinic. Ten subjects diagnosed with COPD (males, 66+/-7yr, Body Mass Index (BMI)=26+/-4kg/m(2)) were identified as fragile patients. Fragility was defined as four or more admissions in the previous year due to severe exacerbations of the disease. Fragile patients were matched with 10 non-fragile controls, defined as COPD patients who had required only one admission due to exacerbation of the disease. Criteria for 1:1 matching included ethnicity, gender, age, BMI, degree of airflow obstruction (i.e., FEV(1)), comorbidity and chronic treatment. Multiple computed tomography (CT) scan slices were obtained to assess area and attenuation coefficients of multiple upper limb, thorax, abdomen and lower limb muscles. CSA of intercostal and abdominal muscles was significantly decreased in fragile COPD patients (right side intercostals, mean relative difference (MRD)=-14%, p=0.010; OR (95% CI)=2.2 (1.1-4.8), p=0.021; left side, MRD=-13%, p=0.007; OR=2.2 (1.1-4.5), p=0.027). CSA and attenuation coefficients of all other muscle compartments showed no statistical differences between the two study groups but showed the same trend. Strength of the inspiratory and expiratory muscles did not differ between the two study groups. This study shows that the risk for multiple admissions due to a COPD exacerbation associates with a marked decrease in the CSA of the intercostal muscle compartment.
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Journal of Thoracic Oncology, 2014
Bookmarks Related papers MentionsView impact
Archivos de Bronconeumología, 2010
The diaphragm is the principal respiratory muscle. Its special characteristics have made it diffi... more The diaphragm is the principal respiratory muscle. Its special characteristics have made it difficult to design instruments capable of performing a non-invasive evaluation of its structure and function in humans. The present study was designed to evaluate the potential use of echography as a non-invasive method to fulfil these objectives. The study consisted of three phases: (1) echographic study in autopsy samples (n=10) of a segment of the thoracic-abdominal wall, from the bottom to the parietal peritoneum (i.e., thoracic wall, diaphragm, pleura and peritoneum structures), (2) static echographic study of the previous structures and the diaphragm in healthy subjects (n=10) to standardised lung volumes; and (3) dynamic echographic study of the contraction-relaxation of the diaphragm in the same subjects, calculating its maximum velocity of relaxation (MVrdi, mm/sec) during a specific inspiratory resistance test. The echography enabled the pleural and peritoneal limits of the diaphragm to be identified, and quantitate its thickness (Tdi), both ex-vivo and in-vivo, in all cases. The dynamic study of the Tdi showed a linear increase directly associated with the lung volume measurement, as well as a cyclical increase during inspiratory movements at rest. In the resistance test, the MVrdi was maximal with low loads and gradually decrease until reaching a minimum nadir (Δ≈-70% of the initial value) in claudication (fatigue). The MVrdi has a high precision in diagnosing claudication. Transthoracic echography of the diaphragm is a non-invasive method that gives promising results in the structural and functional evaluation (i.e. fatigue risk) of that muscle. These findings are of pathophysiological interest and could be of use in the clinical care context.
Bookmarks Related papers MentionsView impact
Archivos de Bronconeumología, 2009
Transbronchial needle aspiration (TBNA) is a bronchoscopic technique that has been shown to be us... more Transbronchial needle aspiration (TBNA) is a bronchoscopic technique that has been shown to be useful for sampling enlarged mediastinal lymph nodes. The yield of this technique can be increased by using endobronchial ultrasound (EBUS) to guide needle placement. The aim of the present study was to compare the yield of radial EBUS-guided TBNA to that of conventional TBNA in the analysis of mediastinal lymph nodes. All patients undergoing either EBUS-guided or conventional TBNA for the diagnosis of mediastinal lymph nodes between January 2006 and May 2007 were studied consecutively. Histology results were used as a reference standard in the patients treated surgically. In cases in which surgery was not indicated, the results of cytology or of clinical follow-up of at least 6 months duration were used. TBNA was performed in 117 patients, and a total of 143 lymph nodes were punctured (mean shortest [SD] diameter, 17.9 [8]mm). The samples obtained were diagnostic in 58 patients (49.6%) and in 70 lymph nodes (49.0%). For paratracheal and hilar stations, the yield of radial EBUS-guided TBNA was superior to that of conventional TBNA (59.2% compared to 34.1%, P=.02). Radial EBUS guidance increases the diagnostic yield of TBNA in paratracheal and hilar lymph node stations.
Bookmarks Related papers MentionsView impact
Archivos de Bronconeumología, 2011
In non-small cell lung cancer, the EGFR gene mutations identify a patient sub-population with dif... more In non-small cell lung cancer, the EGFR gene mutations identify a patient sub-population with different clinical characteristics and treatment responses to those that do not have these mutations. There are mutations that derive in increased sensitive to EGFR targeted therapy, as well as mutations that result in resistance. The determination of EGFR mutations involves a change in the therapeutic approach to lung cancer patients in current clinical practice. In this article we present a case of a patient suffering from a metastatic lung adenocarcinoma with an activating mutation on diagnosis, initially responding to treatment with erlotinib, who subsequently developed a secondary resistance due to acquiring the T790M mutation in exon 20 of the EGFR gene.
Bookmarks Related papers MentionsView impact
Archivos de Bronconeumología, 2010
Chest ultrasonography is a useful tool for assessing disease activity in the peripheral lung pare... more Chest ultrasonography is a useful tool for assessing disease activity in the peripheral lung parenchyma, pleura, chest wall, diaphragm, and mediastinum. Ultrasound imaging also provides highly useful guidance in invasive diagnostic and therapeutic procedures. The main advantages of this imaging technology are the absence of ionizing radiation and the possibility of real-time bedside applications. The chief indications and limitations of chest ultrasonography and the principal sonographic signs are reviewed.
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Archivos de Bronconeumología, 2014
Bookmarks Related papers MentionsView impact
Archivos de Bronconeumología, 2014
Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary le... more Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary lesions (PPL), but the diagnostic yield varies widely among studies. Endobronchial ultrasound (EBUS) can increase the diagnostic yield of bronchoscopic diagnosis of PPL. To compare the diagnostic yield of fluoroscopy-guided bronchoscopy and EBUS with fluoroscopy-guided bronchoscopy in the study of PPL. All patients who underwent bronchoscopy to study PPL from January 2009 to December 2012 were prospectively included. 145 consecutive patients were randomly distributed in two groups: EBUS and fluoroscopy (50 patients, 71.3 ± 8.2 years) or fluoroscopy alone (95 patients, 68 ± 10.5 years). The mean diameter of the lesions was 41.97 ± 19.22 mm. Cytological brushing and transbronchial biopsies were obtained. All procedures were performed under fluoroscopic guidance with intravenous conscious sedation. EBUS was performed using an endoscopic ultrasound system equipped with a 20-MHz radial miniprobe introduced via a guide-sheath. Bronchoscopist, cytologist, study protocol, techniques and tools were the same throughout the whole study. 129 (89%) patients had malignant disease. A diagnosis with bronchoscopy was established in 105 (72.4%) patients. EBUS plus fluoroscopy obtained a diagnostic yield in 78% of patients and fluoroscopy alone in 69.5% (non-significant). In contrast, for lesions smaller than 30 mm, EBUS plus fluoroscopy guidance provided significantly greater diagnostic performance than fluoroscopy alone (90 vs. 52%; P=.05). Bronchoscopy under EBUS plus fluoroscopy guidance is a technique that has become useful for the diagnostic of LPPs, especially those smaller than 30 mm in diameter.
Bookmarks Related papers MentionsView impact
Oncotarget, Jan 30, 2014
We have previously shown that Met activation through the hepatocyte growth factor (HGF) increases... more We have previously shown that Met activation through the hepatocyte growth factor (HGF) increases tumorogenesis, induces epithelial-to-mesenchymal transition (EMT) and chemoresistance in SCLC. We sought to evaluate circulating HGF levels in SCLC patients and assess correlation with outcome and EMT features in the tumor. Serum samples from patients with SCLC were prospectively obtained at diagnosis, response evaluation and progression. HGF serum (sHGF) was quantified by ELISA. EMT markers and p-Met/Met were assayed by immunohistochemistry in tumor samples. Clinical data were prospectively recorder. One-hundred twelve patients were included. High baseline levels of sHGF were associated with shorter overall survival (p=0.006) and remained independently associated with survival in the multivariate analysis (p=0.016). For stage IV patients, an increase of sHGF levels at response evaluation (p=0.042) and at progression (p=0.003) were associated with poor outcome. sHGF levels were associat...
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