[Diagnosis and surgical treatment of bronchial adenoma]

Twenty one patients with bronchial adenoma, treated surgically in our hospital, include three different neoplasms: carcinoid, cylindroma and mucoepidermoid adenoma. In this series, clinical characteristics were: bronchial obstruction when the tumor protrudes into the lumen and infection, first in the bronchus (bronchitis or bronchiectasis) then in the parenchyma (acute, recurrent or chronic pneumonia, tension abscess). Ball-valve action of the tumor may result in lobar or segmental emphysema. Preoperatively, most of the patients had been misdiagnosed as bronchitis, carcinoma of lung, bronchiectasis or acute tension abscess. In our series, all the patients were alive in a follow up of 2-8 years. Yet one patient is living with local recurrence and distant metastasis. To our experience, pneumonia recurring in the same area of the lung, localized wheezing, with or without endocrine symptoms, lobar or segmental emphysema may suggest bronchial adenoma. Tomography and endoscopy are important for diagnosis. For the treatment, sleeve resection of the main bronchus was done in 2, bronchoplastic lobectomy in 7, lobectomy in 10, and pneumonectomy in 2. Sleeve resection of the main bronchus or bronchoplastic lobectomy is recommended as a reliable procedure for this disease.

[Primary bone and joint tumor--statistical analysis of 571 cases]

This paper analyses 571 cases of primary bone and joint tumors diagnosed by histopathology, excluding the tumor-like lesions. They were divided into two groups: the benign (412 cases, 72.15%) and the malignant (159 cases, 27.85%). The susceptible ages were between 15-29 years and the susceptible location of these tumors were femur and tibia often on the right side. There were more males than the females. The frequencies in the two groups are as follows: In the benign group, osteoma had the highest incidence and then, with decreasing frequencies: osteochondroma, chondroma, synovioma, giant cell tumor, ossifying fibroma, osteoid osteoma, chondromyxoid fibroma. In the malignant group, the highest incidence was in the osteosarcoma, and then synoviosarcoma, chondrosarcoma, malignant giant cell tumor, Ewing's tumor, fibrosarcoma, osteomyeloma. The sequence of the incidence was basically similar to that reported abroad and at home. The pathogenesis of several kinds of bone tumor are discussed.

Significance of residual tumor at the esophageal stump after resection for carcinoma

Residual tumor at the esophageal stump was found in 103, or 14.3%, of a series of 719 resected esophageal specimens for carcinoma. The residual tumor pathologically presented as basal epithelial-cell carcinomatous change in 16 (15.5%), carcinoma in situ in 26 (25.5%), invasive carcinoma in 51 (49.5%), and cancerous emboli in 6 (5.8%) cases. A follow-up study of the 719 patients showed that the long-term survival rate of those with residual tumor was significantly lower than that of those without. Factors of occurrence besides inadequate resection were analyzed, and indications of surgical treatment were recommended. The presence of residual tumor is not an important factor in the development of anastomotic leakage.