This report describes the case of a 58-year-old man presenting with haemoptysis. Chest X-ray and CT scans showed a solitary pulmonary mass in the right lower lobe without radiographic signs of malignancy. Definitive histology following thoracoscopic wedge resection showed the distinctive findings of an alveolar adenoma, a very rare benign tumour of the lung of unknown histogenesis. Its existence was first described in 1986 with less than 30 cases published to this day. Alveolar adenoma usually presents as a peripheral solitary lesion in asymptomatic, older patients. Its histological features, the benign proliferation of alveolar epithelium and septal mesenchyme, allow for its distinction from other benign lesions of the lung. Complete excision is considered curative on the basis of current knowledge.

From 1967 to 1979, 40 patients with the diagnosis of congenitally corrected transposition of the great arteries (C-TGA) have been followed. Associated cardiac defects were present in all but one patient, most frequently ventricular septal defect (80%), and pulmonary stenosis (70%). Left sided atrio-ventricular valve dysfunction developed in 25%, third degree atrio-ventricular block (at least intermittently) in 33% of the patients. Twenty-eight patients were operated: palliative procedures were done in 6, corrective operations in 22 patients. Ten of the 40 patients have died during a mean observation period of 4 years: 4 early postoperatively, 3 late postoperatively and 3 non-operated patients. Sudden unexplained cardiac arrest has been the most frequent cause of death (2 late postoperative and 2 non-operated patients). The incidence of residual ventricular septal defects and residual pulmonary stenosis after corrective surgery has been relatively high owing to the complex anatomy in these patients. Also reconstruction of the atrio-ventricular valves has been difficult because of severe deformities, particularly of the left side. It is concluded that in C-TGA the pacemaker should be implanted early, at the first sign of AV-conduction disturbance. Since the relief of the pulmonary stenosis is difficult, the operation should be deferred until an adequate-sized conduit can be implanted.

28, a = 26, V = 32 mmHg 1,86 l/rnin/m2 373 dyn sec/cm5 0340-1 61 8/80 0732-0094 $03.00 0 1980 Georg Thieme Verlag, Stuttgart New York Heruntergeladen von: NYU. Urheberrechtlich geschützt.

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