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Clinical Features of Bronchogenic Carci- noma in Libya.

Akhtar, S.S., Haranath, K., Habbash, K.E., Salim, K., Haq, I.U. Alfateh University, Central Hospital Tripoli, Libya.

A retrospective study, first ever in Libya, was made of 124 patients seen in the Oncology Clinic with proven bronchogenic cancer. The median age at presentation was 52.2 years. The male to female ratio (14.5:1) was one of the highest in the world. Amongst males 86% were heavy smokers, 52% smoked for more than 20 years. The common- est symptoms were cough (63.7%), chest pain (37.9%) and haemoptysis (37.9%). Mean du- ration of symptoms was 4.8 months, being shortest in undifferentiated and small cell anaplastic (SCC) carcinomas.

Commonest clinicoradiological presen- tation was a mass lesion (78%). Right lung involvement was 53.2% whereas bronchosco- pically upper lobe was most frequently (48%) involved. The three major histolo- gical types accounted for 84.7% of the ca- ses, 45.7% epidermoid, 18% SCC and 21% adenocarcinoma. Commonest pressure symptoms (seen in 23 subjects) were superior vena caval (9) and Horner's (8) syndromes. Coincidental chronic bronchitis was seen in 33% patients.

Our patients presented late and only one case (0.86%) could be subjected to curative surgery.

Widespread Invasion into Pulmonary Circu- lation and Central Venous System. Mieno, T., Ishihara, T., Matsuoka, R., Kuratomi, U., Kobayashi, J., Okada, M., Aoki, S., Kira, S. Jichi Medical School, Tochigi, Japan.

Based on 148 autopsied cases with lung cancer, the invasion into pulmonary cir- culation and central venous system was analysed anatomically.

It was confirmed that invasion into pe- ricardium (42 cases, 29%) and superior vena cava or bilateral brachiocephalic veins (23 cases, 16%) were most frequent. However, simultaneous invasion into peri- cardium and superior vena cava, pericardi- um and inferior vena cava, and bilateral main pulmonary arteries were also noted in 8 cases (5%), 2 cases (1%) and 2 cases (1%) respectively.

The routes of spread of lung cancer into these mediastinal compartments were either direct invasion from the primary site of cancer, invasion from the metastatic medi- astinal lymph nodes or combination of both.

The evidence that simultaneous invasion into these intramediastinal structures by lung cancer can happen fairly frequently is not exceptional because these structu- res are located closely each other within

an unicompartment of the mediastinum, and

the opportunity to see these patients may in- crease in future because patients in far advan- ced stage may survive longer than presently

expected with introduction of the effective treatment. Therefore, it is quite necessary to pay attention even from clinical viewpoint to how far the mediastinum is involved by lung cancer.

A Computerized Dispaly of the Staging of Lung Cancer. Zeldin, R., Math, B. University of Toronto, Toronto, Canada.

Bronchogenic carcinoma is a leading cause of cancer deaths worldwide. Uniform nomenclature is necessary in describing various tumors and patterns of spread. The TNM classification (RNMC) achieves this goal but can be cumber- some and difficult to learn and recall. In or- der to teach and remember it concisely, effi- ciently and accuretely a computer program has been devised to better illustrate the details of the various tumors, characteristics of lymph node spread and possible routes of metastatic involvement.

Using computer-generated graphics and ani- mation techniques on a microcomputer the user is guided through the different tumors and staging patterns. One progresses through the stages at his own pace and may review features poorly understood repeatedly. As well the user may read the descriptions of the pictorial displays from the screen or listen as the com- puter, using speech synthesis techniques, "talks" to the user. At any time throughout the session one may request a printed version of the dis- play currently being viewed. Thus a useful summary of the TNMC is provided for permanent reference.

This method os presenting the TNMC offers the advantages of the written word, pictorial and animated display plus voice enhancement. The user is truly taught using a myriad of au- diovisual techniques that can be reviewed over and over. Only computer technology can provide this variety in presentation.

The Non-Metastatic Neuro-Muscular Disorders Associated with Carcinoma of the Lung. Gomm, S.A., Cumming, W.J.K., Barber, P.V., Thatcher, N. Manchester Lung Tumour Group, Wythenshawe Hospital, Manchester 23, U.K.

Among malignant neoplasms lung carcinoma has the highest incidence of non-metastatic neuro-muscular syndromes. (Cross & Wilkinson, Brain 88, 427, 1965). Their aetiology and pa- thogenesis remain largely unknown. They have been classified into four clinico-pathological groups: polymyopathy, "cachectic", (type I and II muscle Fibre atrophy)and "proximal" (type II and Fibre atrophy); myaesthenic syndrome: myositis (muscle necrosis) and endocrine myo- pathies (Henson & Urich, Cancer & the Nervous System, 406, 1982).

The clinical incidence of neuro-muscular