Wilson IB Onuigbo
Medical Foundation & Clinic, 8 Nsukka Lane, Enugu, Nigeria.
*Corresponding author: Wilson IBOnuigbo, Medical Foundation & Clinic, 8 Nsukka Lane, Enugu, Nigeria, Tel: 2348037208680; E-mail: firstname.lastname@example.org
Received Date: 3April, 2017; Accepted Date:2May, 2017; Published Date:9 April, 2017
It is common knowledge that lung cancer
(i) is supremely situated with reference to its draining easily into the pulmonary vein, and (ii) gains easy access to the heart and aorta. Moreover, quantitation has shown that millions of these cells circulate in the system. Therefore, both easy entrance and ready colonization should go together. However, an important factor creeps in, i.e., anomaly, which means the occurrence of the unexpected. Elsewhere, I demarcated 10 anomalies. One of them is that of expansive lung cancer, named as “bulky.” Accordingly, it is the purpose of this paper to exemplify historical cases in my collection, and to hypothesize that bulky lung cancers constitute a distinct group that is worthyof attentionin the field of stem cell research and therapy.
Keywords: Anomaly; Bulky; Lung Cancer; Research; Stokes; Stem Cells
Lung cancer normally gains ready access into the pulmonary vein . On this account, it enters the left atrium and subsequently the cardiac chambers as well as the aorta. Moreover, it has been calculated that millions of these cells circulate in the blood stream .Little wonder that their fate necessarily required research . However, one of the surprises is that a large tumor, defined precisely as one over 10 cm across , tends not to be associated with extrathoracic metastases [5,6].
Is this a new idea? Or one that had been described in the 19th Century? It was the famous eponymous William Stokes who provided the required data.
A man, aged 43, was admitted to Guy’s Hospital, laboring under cough with associated hemorrhage. Extreme dyspnea led to death. The dissection was as follows:
The right pleura was universally and strongly adherent; the entire of right lung, except a small portion at its apex, was converted into a fungoid mass, which was generally white and pallaceous, except near the center, where it was of a pink color, and reduced to a diffluent pulp; and opposite the scapula, near the surface, where there was an irregularly shaped cavity, containing little or no fluid. In the bronchial tubes was much viscid secretion, and the mucous membrane was slightly congested. The left pleura was partially adherent from old disease; but the lung and the bronchial tubes on this side were healthy. Several bronchial glands were much enlarged, but did not appear to have assumed any of the characters of the malignant disease. The right auricle of the heart appeared considerably flattened, and the entire organ was pushed considerably to the left side, by the pulmonary tumour. There was nothing remarkable in the abdomen, except, that at the head of the pancreas was an enlarged gland, about the size of an orange, which contained a straw-colored fluid.
Let us make use of the expansive review of the eponymous giant, William Stokes. By 1842 ,he was the Regius Professor of Physic in the University of Dublin and Secretary to the Pathological Society of Dublin. He was quite expansive in his survey of lung cancer literature. In particular, listen to him: “I propose, in the present paper, to examine into the actual state of our knowledge of the history of thoracic cancer, and to examine how far its diagnosis, direct or indirect, can be considered to be established.”
The problems encountered were summarized thus:
I will now give the general conclusions to which we have arrived, marking with an asterisk those which I already stated in my work on the diseases of the chest, and with two asterisks those which have been modified.
Indeed, he referred extensively to the works of Laennec, Morgagni, Van Sweiten and Bayle. Altogether, he collected 15 cases. Perhaps, it is desirable to quote fully the contrast provided by thenumerous colonies detected in a woman aged 50 years who had also died at Guy’s Hospital as follows:
The left pleura was slightly adherent; the left lung was crepitant throughout, and partially emphysematous; the right pleura was universally firmly adherent, and superiorly altered in texture by a white, flaky, malignant deposit; the entire upper part of the right lung was converted into a mass of medullary fungus, the cut surface of which exhibited a dead white, cheesy substance, intersected with bands of cellular tissue. By slight pressure a creamy fluid exuded, together with portions of soft, brain-like matter, from cells, varying in size from a pin’s head to a marble. The middle lobe contained some portions of the malignant growth, appearing like elongations or processes of the diseased mass above them, from being clearly connected with and traceable into it, and separated from each other by the intervention of healthy, or simply compressed lung.
The inferior lobe contained a few small detached masses of fungoid matter, and was posteriorly firm, dark-coloured, and lacerable, probably from gravitation. In the branch of the right pulmonary artery, going to the upper lobe, there was a small pedunculated medullary tubercle, and another on its external surface. The heart and pericardium were healthy.
The liver had the nutmeg character, and presented one patch of malignant disease. Both kidneys and renal capsules presented small masses of medullary matter, and near the os uteri were found three pea-like scirrhous tubercles. The gland in the axilla was clearly affected with the same disease.
Interestingly, words like tubercle, medullary matter, scirrhous tubercles, medullary tubercle, malignant disease, and fungoid matter are strewn all over the old scripts. However, I have shown elsewhere  that they constituted, as the saying goes, much ado about nothing! The title was fully as follows:“Some nineteenth century ideas on links between tuberculous and cancerous diseases of the lung.” Be that as it may, I am persuaded that much of the descriptive pathology of cancer was historically sound !
Coming back to the single depicted bulky cancer, it constituted 6.7% of the entire series of Stokes. Curiously, my Glasgow series of 60 cases revealed 4 examples, i.e., 6.7%! In all probability, this unique class is in keeping with the visionary views of the medical masters of yester years . In sum, in order to hypothesize, now that Stem Cell research is growing [11-13],let this verifiable field be selected for replicative researches whose breakthroughs may lead to thattarget therapy which could conduce to cancer cure.
Citation: Onuigbo WIB (2017)Can Stem Cell Research Benefit from William Stokes’ 1842 Review of 15 Lung Cancers Which Included One Case with Local Extensive Replacement but Without Bodily Deposits. J Oncol Res Ther: JONT-123. DOI: 10.29011/2574-710X.000022