Question: Hi ,
I am 76 years old and I had the following results from a histopathology exam:
1.     Can you please let me know what this mean?
2.     Can you please let me know what treatment you recommend, knowing that I do also issues with high blood pressure and I do have heart diseases (cardio ischemia)?
Regards,
XXXXXX
Bulletin histopathology


Imunohistchimice stains were performed on the block 9020/13 Santomar:
AE1/AE3 CK highly +
15% CD56 + cells intensely
CK 7 + highly
Intense TTF1 +
Histology and IHC panel suggests a large cell neuroendocrine carcinoma.

Disease code 8014/3 code location 34

Thank you Dr. Indranil,
The tumor is on Right Lung , but I did have diarrhea also for 6 months now ; I lost 20 kg ; I am not fit at all ;
I did a CT

CT
Chest CT
The examination was performed in axial sequences, coronal and sagittal;
results:
Tumor 58 mm diam applied dr, covered the mediastinal pleura, fat infiltrated the posterior mediastinum without adjacent bone on incentives;
No mediastinal lymphadenopathy and pulmonary changes observed;
No issues found pleural effusion.
The liver has normal size and structure. No changes observed biliary or portal;
Gallbladder is inhabited;
SR glands were normal appearance;
Kidneys, bilateral cortical index and normal in size;
Pronounced dorsal kyphosis;
Conclusion: Formation TU LASD T3N0M0

Do You know what stage the cancer is ?
How long do I still have to live ?
Regards,
XXXXXX

Hi Dr. Indranil,
here are the final results from oncologist :

1. Do you agree with the treatment the oncologist just started ? do you see another better way to treat this?
2. what results we should expect and in how long time we'll see improvements in patient health ?
Regards,

Epicrisis
Diagnosis: BP LSD applied T4 carcinoma (posterior mediastinum) N0M0, stage III B. Damage LSD post TBC.
76 years old patient presents to the diagnosis of carcinoma onclologie LSD applied BP T4 (posterior mediastinum) N0M0, stage III B, confirmed by bronchoscopy with biopsy.
Ex. HP: large cell neuroendocrine carcinoma TTF1 item
Ex. CT Chest 16.04.2013 :
The examination was performed in axial sequences, coronal and sagittal;
results:
Tumor 58 mm diam applied dr, covered the mediastina pleura, fat infiltrated the posterior mediastinum without adjacent bone on incentives;
No mediastina lymphadenopathy and pulmonary changes observed;
No issues found pleural effusion.
The liver has normal size and structure. No changes observed biliary or portal;
Gallbladder is inhabited;
SR glands were normal appearance;
Kidneys, bilateral cortical index and normal in size;
Pronounced dorsal kyphosis;
Conclusion: Formation TU LASD T3N0M0
Ex. Bronchoscopy 15.04.2013:
Trachea free. Tracheal Pintenele normal. Free bilateral bronchial tree. No signs neoplastic; mucosa has the appearance of chronic bronchitis, acutazita, scarring TBC antracotic deposit br. LSD. No signs cancer;

It has decide to start chemotherapy Navelbine 25mg/mp + Carboplatin 5AUC, day 1, 8.
RGR chest PA and LL law - opacity unorganized, located at the top of the right lung on LL; opacity appears projected in the middle lung field. Hili increased in volume.
Biological therapeutic limits.
It is administrated Chemotherapy antiemetic and antiallergic protection without actute reactions.
The patient returns for continuing chemotherapy on 22/05/2013.

Recommendations:
In case of nausea - metoclopramide 1 tablet every 8 hours for 5 days;
In the event of diarrhea - Imodium diarrhea stool 2 tablets after the first 4 hours and then 1 tablet after each other diarrheal stool, maximum 6-8 cpr / day;
In case of temperature> 38 Celsius - Augment 1 gr 1 tablet in 12 hours and Ciprofloxacin 500 mg every 12 hours for 7 days if the fever does not respond within 48 hours will harvest blood counts and will address the Territorial oncology service management of febrile aplasia periodically.