Thoracic endometriosis is a rare condition and occurs in females of reproductive age due to the presence of active endometrial tissue in tracheobronchial tree, lung parenchyma and lung pleura. A typical history of haemoptysis during menstrual periods and strong suspicion of the disease entity is important for the diagnosis and management of the case. Diagnosis of the disease is usually delayed. Serial CT thorax during menstrual period and in non-menstrual period supports the diagnosis. We present here a case of catamenial haemoptysis. The diagnosis was missed initially but later a detailed clinical history revealed the same. Serial computed tomography of thorax taken during menstrual and after menstrual period supported the diagnosis. Though bronchoscopy was able to reveal hyperemic tissue in the tracheobronchial tree, bronchial washing was inconclusive. The patient was treated successfully with danazol.
Malignant melanoma of the rectum is an extremely rare disease. It typically presents in the fifth or sixth decade of life with nonspecific complaints such as rectal bleeding or anal pain. A timely diagnosis of anal melanoma is made even more difficult by the fact that most of the lesions lack obvious pigmentation and are even histologically amelanotic. Prognosis is very poor. Anorectal malignant melanomas spread along submucosal planes and are often beyond complete resection at the time of diagnosis. We present the radiological and pathological features seen in a 43-year-old woman diagnosed with melanoma of the rectum.
Bronchial brushing (BB) and the more recent trans-bronchial needle aspiration (TBNA) are well established techniques performed using flexible fiberoptic bronchoscope, for sampling trachobronchial lesions suspected of malignancy. Our aim was to assess the efficacy of these two techniques in diagnosing carcinoma lung, when used individually as well as in combination, taking bronchial biopsy as the "Gold Standard" diagnostic test. Of all the cases of suspected lung cancer received between 1 st January 2003 to 30 th September 2004, 181 cases were selected where flexible bronchoscopic samples of BB, TBNA as well as bronchial biopsy were taken. Samples were processed as per standard procedures of cytology and histology. Squamous cell carcinoma was the most common lung cancer followed by small cell type. Sensitivity of BB was 81.5%; while that of TBNA was 62.5%. Specificity of BB and TBNA was 77.8% and 66.7%, respectively. Efficacy of BB was better than TBNA in diagnosing lung cancers. Combined use of BB and TBNA showed better sensitivity and accuracy than either techniques used individually. Bronchial brushing is a superior technique in the diagnosis of lung cancers than TBNA. Their combined use can further improve the chances of early detection of lung cancers.
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