Morphological characterization and molecular profiling of malignant pericardial effusion in patients with pulmonary adenocarcinoma

Context: Malignant pericardial effusions (MPCEs) is a common complication observed in advanced pulmonary adenocarcinoma. In such cases, investigating molecular alterations can have significant therapeutic implication in determining anticancer drugs. Aim: The objective was to evaluate the significance of cell block technique in the diagnosis of MPCE and further investigate the morphological and molecular profiles of MPCE in patients with pulmonary adenocarcinoma. Setting and Design: Cytopathological and molecular profiles of 19 MPCE cases in patients with pulmonary adenocarcinoma were retrospectively analyzed. The control group consisted of 14 malignant pleural effusion (MPE) cases in patients with pulmonary adenocarcinoma. Materials and Methods: Anaplastic lymphoma kinase (ALK) and tyrosine-protein kinase Met (C-MET) expression was evaluated by fluorescence in situ hybridization (FISH). Epithelial growth factor receptor (EGFR) and K-Ras (KRAS) mutations were detected by ARMS real-time polymerase chain reaction (RT-PCR). Statistical Analysis Used: Associations between MPCE and MPE were analyzed using Fisher's exact test. Results: MPCE was found to have micropapillary and solid pattern predominant with mucin secretion compared to acinar patterns, as seen in MPE. Seventeen MPCE cases (89.5%) and all MPE cases (100%) underwent molecular analysis. Mutations in EGFR and KRAS, ALK rearrangement, and C-MET amplification were observed in MPCE and MPE with statistical differences. Additionally, two MPCE cases demonstrated EGFR T790M mutation and multiple insertions at L858. Conclusions: MPCE shows micropapillary and solid cytological patterns predominant with mucin secretion. MPCE are suitable to analyze oncogenic mutations and to develop targeted therapy for patients with pulmonary adenocarcinoma. Further molecular investigations may reveal novel molecular alterations.

Síndrome de compresión medular como manifestación de un carcinoma de células no pequeñas / Spinal cord compression syndrome as a manifestation of a non-small cell carcinoma

Resumen Una complicación importante que ocurre entre 5 y 10% de los pacientes con cáncer es el síndrome de compresión medular que representa una urgencia oncológica. Existe relación entre el cáncer pulmonar y el síndrome de compresión medular, porque puede ocurrir infiltración del cáncer a la columna vertebral. Sin embargo, no es frecuente que ocurra como manifestación inicial. Se comunica el caso de un paciente de 40 años de edad diagnosticado con adenocarcinoma pulmonar que tuvo como manifestación inicial una paraplejía.

Abstract An important complication that occurs between 5 and 10% of patients with cancer is spinal cord compression syndrome that represents an oncological emergency. There is a relationship between lung cancer and spinal cord compression syndrome, because cancer can infiltrate the spine. However, it is not common to occur as an initial manifestation. We report the case of a 40-year-old patient diagnosed with pulmonary adenocarcinoma who had paraplegia as an initial manifestation.

A visualization study of deep convolutional neural network to classify the pathological type of sub-soild pulmonary adenocarcinoma of ≤3 cm based on CT images / 上海交通大学学报（医学版）

Objective: To investigate the feasibility of deep convolutional neural network (CNN) to classify the pathological type of sub-soild pulmonary adenocarcinoma of ≤3 cm based on CT images, and to visualize the medical imaging features derived from the activation area of CNN. Methods: A total of 200 sub-solid lung nodules, which were confirmed as adenocarcinoma by immunohistochemical staining, were classified as preinvasive lesions (including atypical adenomatous hyperplasia and adenocarcinoma in situ), microinvasive adenocarcinoma and invasive adenocarcinoma, in which 160 (80%) were used to train the inception v3 CNN architecture, and the other 40 (20%) were used to test the model and visualize the activation area. The characteristics of the activated area were defined as 14 CT signs. Results: The CNN yielded an accuracy of 87.5% to classify three categories of lung nodules. The visualization study found that the CNN activation area mainly focused on the non-solid component (43.0%) and smooth margin (20.2%) of the preinvasive lesions, on the spiculated margin (18.3%) of the microinvasive adenocarcinoma, and on the solid component (18.9%) and the spiculated margin (14.1%) of the invasive adenocarcinoma. Conclusion: CNN can classify the pathological type of lung adenocarcinoma based on CT images. The visualization of activation area of CNN indicates the medical imaging characteristics of diagnosis.

Risk factors analysis for pleural invasion in small nodular typeⅠA lung adenocarcinoma / 中国胸心血管外科临床杂志

@#Objective    To explore and analyze the risk factors of pleural invasion in patients with small nodular type stage ⅠA pulmonary adenocarcinoma. Methods    From June 2016 to December 2017, 168 patients with small nodular type stage ⅠA pulmonary adenocarcinoma underwent surgical resection in the First Affiliated Hospital of Nanjing Medical University. There were 59 males and 109 females aged 58.7±11.5 years ranging from 28 to 83 years. The clinical data were analyzed retrospectively. Single factor Chi-square test and multivariate logistic regression were used to analyze the independent risk factors of pleural invasion. Results    Among 168 patients, 20 (11.9%) were pathologically confirmed with pleural invasion and 148 (88.1%) with no pleural invasion. Single factor analysis revealed significant differences (P<0.05) in nodule size, nodule status, pathological type, relation of lesion to pleura (RLP), distance of lesion to pleura (DLP), epidermal growth factor receptor (EGFR) mutation between patients with and without pleural invasion in stage ⅠA pulmonary adenocarcinoma. Logistic multivariate regression analysis showed that significant differences of nodule size, nodule status, RLP, DLP and EGFR mutation existed between the two groups (P<0.05), which were independent risk factors for pleural invasion. Conclusion    Imageological-pathological-biological characteristics of patients with small nodular type stage ⅠA pulmonary adenocarcinoma are closely related to pleural invasion. The possibility of pleural invasion should be evaluated by combining these parameters in clinical diagnosis and treatment.

Supervivencia de pacientes con adenocarcinoma pulmonar y mutación en el receptor del factor de crecimiento epidérmico / Survival of patients with pulmonary adenocarcinoma and mutation in the epidermal growth factor receptor

Resumen Introducción El carcinoma pulmonar es la causa mayor de muertes por cáncer en el mundo; la expresión del receptor del factor de crecimiento epidérmico (EGFR) en tejido de carcinoma pulmonar se presenta en la estirpe adenocarcinoma. La utilización de inhibidores de tirosina cinasa que actúan sobre dicho receptor ha incrementado la supervivencia mayor de dos años en pacientes EGFR mutados. Objetivo Conocer el efecto de los inhibidores tirosina cinasa en la supervivencia de pacientes con adenocarcinoma pulmonar y receptor del factor de crecimiento epidérmico mutado. Material y métodos Se realizó un estudio observacional, analítico, retrospectivo y transversal en un periodo de dos años (2013 al 2015); fueron incluidos pacientes con diagnóstico confirmado de cáncer pulmonar y la presencia de EGFR mutado realizado por FISH (siglas del inglés fluorescent in situ hybridization). La supervivencia se evaluó mediante prueba de Kaplan-Meier, Logrank o regresión de Cox, considerando una significancia estadística asociada a un valor de p ≤ 0.005. Resultados Fueron incluidos 13 pacientes; su edad promedio fue de 66.77 ± 9.356 años, con una mediana de 67 años; 46.2% fueron mujeres y 53.8% hombres. El tipo de deleción más común fue del exón 19 (en un 61.5%); la segunda fue de L858R (en 38.5%). Tres (23%) pacientes eran fumadores y 10 (77%) reportaron no serlo; ocho (61%) presentaron la deleción del exón 19 y cinco (39%) la deleción de L858R. Al final del estudio, seis pacientes habían sobrevivido (46%) y siete murieron (54%). El método de Kaplan-Meier arrojó 21.95 meses (IC 95% 17.3-26.61) de supervivencia.

Abstract Introduction Pulmonary carcinoma is the leading cause of cancer deaths in the world; the expression of the epidermal growth factor receptor in lung carcinoma tissue occurs in the adenocarcinoma lineage. The use of tyrosine kinase inhibitors that act on said receptor has increased survival beyond two years in mutated EGFR patients. Objective To know the effect of tyrosine kinase inhibitors in the survival of patients with pulmonary adenocarcinoma, mutated EGFR. Material and methods An observational, analytical, retrospective, transversal study was conducted over a period of two years (2013 to 2015), including patients with a confirmed diagnosis of lung cancer and the presence of the mutated EGFR performed by FISH (fluorescent in situ hybridization). The survival was evaluated by Kaplan-Meier test/Cox regression, considering a statistical significance associated with a p ≤ 0.005. Results Thirteen patients were included; their average age was 66.77 ± 9.356 years, with a median of 67 years; 46.2% were women and 53.8% men. The most common type of deletion was of exon 19 (in 61.5%); the second was of L858R (in 38.5%). Three (23%) patients were smokers and 10 (77%) reported not to be; eight (61%) presented deletion of exon 19 and five (39%) deletion of L858R. By the end of the study, six patients had survived (46%) and seven died (54%). The Kaplan-Meier method showed 21.95 months of survival (95% CI 17.3-26.61).

Differentiation of pulmonary mucosa-associated lymphoid tissue lymphoma and pulmonary adenocarcinoma by radiomics / 中华放射学杂志

Objective To differentiate between pulmonary mucosa-associated lymphoid tissue lymphoma (MALT) and adenocarcinoma by radiomics, and then evaluate the diagnostic value of this novel approach. Methods We retrospectively analyzed CT images of pulmonary MALT lymphoma (n=16) and invasive pulmonary adenocarcinoma (n=41) and all these cases were confirmed by pathology in the Second Affiliated Hospital of Zhejiang University School of Medicine from June 2012 to June 2017. After we delineated the lesions as region of interest (ROI), sixty-one radiomics features were extracted from each individual's CT images by Radcloud 1.0. All cases in each group were randomly divided into training set (70％cases) and testing set(30％cases), with 7 features (Wilcoxon test) of which showed group differences and were used to train and validate a support vector machine (SVM) classifier. Results Seven of 61 radiomics features showed differences between the two groups, i.e. 10th percentile, mean, median, minimum, total energy, run length non uniformity, gray level non uniformity. Using these 7 features, the resulted SVM successfully differentiated two diseases. The SVM showed high performance with 90％precision, recall 0.89, F1-score 0.87, ROC 0.75. Conclusions Pulmonary MALT and adenocarcinoma differ in radiomics features and machine learning can utilize these features to differentiate between pulmonary MALT and adenocarcinoma. Combination of radiomics and machine learning is promising in the differential diagnosis of these two diseases.

Driver Genes Mutation and Survival Analysis in 200 Patients with Pulmonary Adenocarcinoma Brain Metastasis / 昆明医科大学学报

Objective To investigate the relationship between the driver genes mutation and the survival in patients with pulmonary adenocarcinoma brain metastasis. Methods We enrolled 200 patients with pulmonary adenocarcinoma brain metastasis confirmed histologically from Jan 2013 to Dec 2015, and tested EGFR, KRAS, ALK, Her-2 gene mutation, analyzed the relationship between EGFR gene mutation and clinicopathological data and prognosis of the patients.Results The mutation rates of EGFR, KRAS, ALK and Her-2 gene mutation were 48.5％, 5.5％, 6.5％, 3.5％, respectively. Compared with EGFR gene mutation patients, the sex, age, BMI, differentiation were significant different (P＜0.05), however, the smoking was not significant different (P＞0.05). Patients with EGFR gene mutation who received targeted therapy survived longer than who did not receive targeted therapy, (28.0 ±4.5) months vs (11.2 ±1.4) months. By Log Rank (Mantel-Cox), the median survival time between the two groups was statistically significant (P＜0.05).Conclusions The mutation rate of EGFR gene mutation was high in patients with pulmonary adenocarcinoma brain metastasis, and the patients will survivel longer by targeted therapy.

Expression of miRNA-193a and its significance in pulmonary adenocarcinoma / 国际检验医学杂志

Objective To explore the diagnostic value of the quantitative detection of serum miRNA-193a in pulmonary adenocarcinoma.Methods 40 pulmonary adenocarcinoma patients and 40 healthy people were recruited to receive quantitative detection of serum miRNA-193a and CEA.And then the relationship between the concentration of miRNA-193a and CEA was analyze by spearman correlation analysis.12 of the 40 patients underwent operation and the different levels of miRNA-193a expression among pulmonary adenocarcinoma tissues,adjacent tissues and normal tissues was detected by qRT-PCR.The different miRNA-193a levels were compared among groups of by t-test.The diagnostic performance of miRNA-193a was evaluated with receiver operating characteristic curves(ROC) and the area under the curve (AUC) and its 95%CI were calculated.Results The relative expressions of miRNA-193a in pulmonary adenocarcinoma tissues,adjacent tissues and normal tissues were 1.07±0.16;0.80±0.10;0.11±0.07.miRNA-193a expression in pulmonary adenocarcinoma tissues was significantly lower than that in other two groups(P<0.05).The expression of serum miRNA-193a in pulmonary adenocarcinoma group was significantly lower than that in healthy group(P<0.05).There was no correlation between miRNA-193a and CEA(r=0.079,P=0.618).The detection of miRNA-193a yielded a ROC AUC of 0.829(0.741-0.917) in discriminating pulmonary adenocarcinoma from healthy group.Conclusion The relative expression of miRNA-193a in pulmonary adenocarcinoma was significantly lower than that in healthy controls no matter in tissue or serum,serum miRNA-193a may prove to be a non-invasive biomarker for the auxiliary diagnosis of pulmonary adenocarcinoma.

Role of EGFR mutation status in patients with advanced lung adenocarcinoma treated with pemetrexed / 中国肿瘤临床

Objective:To assess the role of EGFR mutations on pemetrexed response in patients with advanced lung adenocarcino-ma. Method: Forty pulmonary adenocarcinoma patients with evaluable lesions were retrospectively screened .They had been treated with pemetrexed-included chemotherapy and had EGFR gene test results. The evaluation endpoints were overall response rate,disease control rate and progression free survival. Result:No significant statistical difference was seen in overall response rate(ORR) (44.4%VS 31.8%, respectively) and disease control rate(DCR) (88.9%VS 81.8%, respectively ) between EGFR wild group and EGFR muta-tion group, but patients in EGFR wild group had longer progression free survival(PFS) ( 8.9 months VS 5.3 months;P=0.046). Conclu-sion:EGFR mutation status can influence the efficacy of pemetrexed.

Effect of EGFR mutation on radiation-induced DNA repair in pulmonary adenocarcinoma cells / 中华放射医学与防护杂志

Objective To observe the effect of EGFR mutation on radiation induced DNA repair in pulmonary adenocarcinoma ceils.Methods A549 cells with wild-type EGFR and H1975 cells with mutated-type of EGFR were irradiated by 4 Gy of 6 MV X-rays.After irradiation,the formation of nuclear γ-H2AX foci was assayed with immunostaining method,the level of DNA-PKcs-EGFR interaction was detected with coimmunoprecipitation,and nuclear RAD51 expression and EGFR nuclear translocation were detected using Western blot.Results DNA repair in the H1975 cells was significantly lower than that in A549 cells.In the irradiated H1975 cells,there was no EGFR translocation with further nuclear DNA-PKcs binding,and the expression of nucleus RAD51 was not altered.But in the irradiated A549 cells,EGFRDNA-PKcs interaction and nucleus RAD51 were increased.Conclusions Lung adenocarcinoma cell line with mutations in the tyrosine kinase domain (TKD) of EGFR exhibits a high radiosensitivity due to the reduction of the non-homologous end-joining (NHEJ) and homologous recombination (HR) DNA DSB repair kinetics.

The Impact of Cigarette Smoking on the Frequency of and Qualitative Differences in KRAS Mutations in Korean Patients with Lung Adenocarcinoma

PURPOSE: This study was designed to determine the relationship of cigarette smoking to the frequency and qualitative differences among KRAS mutations in lung adenocarcinomas from Korean patients. MATERIALS AND METHODS: Detailed smoking histories were obtained from 200 consecutively enrolled patients with lung adenocarcinoma according to a standard protocol. EGFR (exons 18 to 21) and KRAS (codons 12/13) mutations were determined via direct-sequencing. RESULTS: The incidence of KRAS mutations was 8% (16 of 200) in patients with lung adenocarcinoma. KRAS mutations were found in 5.8% (7 of 120) of tumors from never-smokers, 15% (6 of 40) from former-smokers, and 7.5% (3 of 40) from current-smokers. The frequency of KRAS mutations did not differ significantly according to smoking history (p=0.435). Never-smokers were significantly more likely than former or current smokers to have a transition mutation (G-->A or C-->T) rather than a transversion mutation (G-->T or G-->C) that is known to be smoking-related (p=0.011). In a Cox regression model, the adjusted hazard ratios for the risk of progression with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) were 0.24 (95% CI, 0.14-0.42; p<0.001) for the EGFR mutation and 1.27 (95% CI, 0.58-2.79; p=0.537) for the KRAS mutation. CONCLUSION: Cigarette smoking did not influence the frequency of KRAS mutations in lung adenocarcinomas in Korean patients, but influenced qualitative differences in the KRAS mutations.

Effect of ionizing radiation on invasiveness of pulmonary adenocarcinoma cells A549 and its mechanism / 中华放射医学与防护杂志

Objective To investigate the effect of ionizing radiation on the invasion of the pulmonary adenocarcinoma cell line A549.Methods The invasiveness of A549 cells irradiated with 2 and 4 Gy doses of γ-rays was detected by using transwell invasion assay.The expression levels of matrix metalloproteinase (MMP)-2 mRNA and protein and phosphorylated signal transducers and activators of transcription 3 ( STAT3 ) protein were detected by reverse transcription PCR and Western blot.Results After irradiation with 2 or 4 Gy, the invasiveness of A549 cells increased by 200.0% ( F = 111.7, P ＜ 0.01 ) and 390.9% ( F = 593.7, P ＜ 0.01 ), respectively, compared with that in untreated A549 cells.Furthermore, the transcription and protein expression of MMP-2 24 h after irradiation and the phosphorylation of STAT3 12 h after irradiation were promoted.The irradiation-induced elevation of MMP-2 protein expression was suppressed using STAT3 phosphorylation specific inhibitor (AG490).Moreover,compared with 4 Gy of irradiation alone, treatment with 4 Gy of irradiation plus AG490 decreased the number of invasive cells by 76.1% ( F = 555.9, P ＜ 0.01 ), and the number of invasive cells in 4 Gy of irradiation plus AG490 group made up only 117.8% of that in untreated group ( F = 3.6, P ＞ 0.05 ).Conclusions Ionizing radiation could activate STAT3, which triggers the transcription of MMP-2, and then promote the invasiveness of A549 cells.

Adenocarcinoma pulmonar em um bovino / Pulmonary adenocarcinoma in a bovine

Um bovino Guzerá, fêmea, adulto, com histórico de insuficiência cardíaca congestiva direita de duração de duas semanas, morreu durante o transporte ao hospital veterinário. À necropsia, o lobo pulmonar cranial esquerdo estava moderadamente aumentado de tamanho e firme. O parênquima do lobo afetado era branco e continha múltiplas áreas de 0,3 a 1,5cm de diâmetro, amareladas e caseosas. Alterações semelhantes foram observadas nos linfonodos mediastínicos e brônquicos, no pericárdio parietal, no epicárdio e na adventícia da artéria pulmonar. Histologicamente, a massa tecidual do lobo pulmonar era constituída por células epiteliais neoplásicas de padrão acinar, com duas ou mais camadas celulares, algumas com projeções papilares intraluminais. A anisocariose era acentuada, e o índice mitótico, moderado (dois a três por campo de maior aumento). Envolvendo as neoformações, observava-se abundante tecido conjuntivo fibroso. Focos de necrose e mineralização eram multifocais moderados. Alterações histológicas semelhantes foram observadas nos linfonodos brônquicos, nos mediastínicos, nos pericárdios visceral e parietal e na adventícia da artéria pulmonar. Com exceção do fígado com congestão generalizada crônica, não foram observadas alterações macro e microscópicas em outros órgãos. Os achados histológicos foram compatíveis com adenocarcinoma pulmonar, com metástases regionais. O quadro de insuficiência cardíaca congestiva direita provavelmente foi decorrente do impedimento da drenagem linfática pelas metástases.

An adult Guzera cow, dysplaying for two weeks signs of right-sided congestive heart failure died during the transport to the veterinary hospital. At necropsy, the left cranial lung lobe was moderately increased in volume and firm. The parenchyma of the affected lung lobe was white and contained multiple 0.3 to 1.5cm in diameter, yellow, dry, friable nodules. Similar changes were observed in bronchial and mediastinal lymph nodes, parietal pericardium, epicardium, and adventitia of the pulmonary artery. Microscopically, the pulmonary tissue mass was composed of neoplastic epithelial cells arranged in acini lined by two or more layers, some with intraluminal papillary projections. Anisokaryosis was marked, and mitotic index was moderate (2-3 mitosis in high field). Abundant fibrous connective tissue surrounded the neoplastic cell aggregates. Foci of necrosis and mineralization were moderate. Similar microscopic changes were observed in bronchial and mediastinal lymph nodes, visceral and parietal pericardium and adventitia of the pulmonary artery. With liver chronic generalized congestion exception, no other macro or microscopic lesions were observed. Microscopic findings were consistent with pulmonary adenocarcinoma with regional metastases. The right-sided congestive heart failure was probably due to obstruction of lymphatic drainage by metastases.

Expression of AC133 and EpCAM in human pulmonary adenocarcinoma and isolation of their double positive cells / 第二军医大学学报

Objective: To determine the expression of AC133 and EpCAM in human pulmonary adenocarcinoma by dual immunofluorescent labeling technique and to isolate AC133+ EpCAM+ cells by flow cytometry, so as to provide a basis for further investigation of human pulmonary adenocarcinoma stem cells. Methods: The human lung adenocarcinoma tissues were obtained and subjected to cryosection and dual immunofluorescent staining. AC133+ EpCAM+ cells in human pulmonary adenocarcinoma were identified by using laser confocal microscopy. The fresh adenocarcinoma tissues were prepared into single cell suspension with the collagen and red blood cell removed. AC133 and EpCAM were used to label cells and the AC133+ EpCAM+ cells were isolated by flow cytometry. ResuIts:AC133+ EpCAM + cells were found in human pulmonary adenocarcinoma and they could be isolated by flow cytometry. Conclusion:The existence of AC133+ EpCAM+ cells has been confirmed in the lung adenocarcinoma tissues; the double positive cells can be isolated by flow cytometry, which provides a basis for further investigation of lung cancer stem cells.

Cloning and Sequence Analysis of Genome from the Inner Mongolia Strain of the Endogenous Betaretroviruses (enJSRV) / 中国病毒学·英文版

In order to amplify the complete genome of enJSRV from the strain of Inner Mongolia (enJSRV-NM), we used enJSRV-specific and JSRV-specific DNA probes in dot blot hybridization. Seven pairs of primers were designed based on Genbank sequences. Seven fragments were obtained by PCR and were cloned into the PMD19- T vectors. The recombinant plasmids were sequenced and analyzed. The results showed that the genome was 7 942 bp in length and contained four overlapping open reading frames corresponding to the gag, pro, pol and env genes as well as an additional open reading frame (orf-x) that overlaps the 3' end of the pol gene. The nucleotide acid sequences of the enJSRV-NM loci were compared with the sequences of South Africa enJS56A1 strain (Accession No. AF153615) and USA JSRV21 strain (Accession No. AF105220). The nucleotide acid identities were 99.2% and 92.3% respectively. Two zinc fingers were found in the NC region in the predicted amino acid sequence. However, the YXXM motif, which is a reliable molecular marker for the infectious exogenous virus, was not found in the TM region. It was found that the enJSRV-NM region was 90%-98% identical at the amino acid level to its exogenous infectious counterparts in most of the retroviral genome. This is the first nucleotide sequence of enJSRV reported in P.R China. The resource work has provided a wide range of information useful not only for expression genomics and annotation of genomic DNA sequence, but also for further research on the clinical diagnosis of OPA.

Adenocarcinoma primario de pulmón metastásico a schwannoma: un caso de metástasis de tumor a tumor / Tumor-to-tumor metastasis: pulmonary adenocarcinoma metastatic to Schwannoma

The coexistence of multiple primary malignant tumors in the same host is not unusual; however, tumor-to-tumor metastasis is rare. According to previous publications, the most common recipient tumor is renal cell carcinoma, and lung carcinoma is the most frequent donor site. According our bibliographic search we are presenting the first published case of primary pulmonary moderately differentiated adenocarcinoma metastatic to a schwannoma, demonstrated with Thyroid Transcription Factor 1 (TTF-1); immunostaining has become an important tool for guiding diagnosis of adenocarcinoma.

La coexistencia de múltiples tumores malignos primarios en un huésped no es un evento infrecuente. Sin embargo, la presencia de una neoplasia con metástasis en otra neoplasia (metástasis de tumor a tumor) es una entidad inusual, según lo publicado en la literatura el tumor receptor más frecuente es el carcinoma de células renales y el donante el carcinoma de pulmón. En el siguiente reporte se presenta un caso de adenocarcinoma moderadamente diferenciado metastásico a schwannoma, donde por inmunomarcaje con el Factor 1 de Transcripción Tiroidea (TTF-1) se demostró el origen pulmonar de la lesión, este correspondería al primer caso según nuestra revisión bibliográfica.

A Cavitary Lesion Changed to Pulmonary Nodule / 결핵

We have experienced a case of pulmonary adenocarcinoma looked like cavitary lesion of pulmonary tuberculosis in 49-year-old male patient. He has taken antituberculous medication for 5 months under the impression of pulmonary tuberculosis with cavity at local hospital. The cavitary lesion was changed nodular mass on follow-up chest X-ray. Transthoracic fine needle aspiration was done and cytologic specimen suggested squamous cell carcinoma. Right middle lobectomy was performed. The nodular mass, which was confirmed as adenocarcinoma on microscopic examination, had central cavity filled with hemorrhage.

Pulmonary Adenocarcinoma of Fetal Type: Report of a case

Adenocarcionma of fetal type is in lung is a newly recognized malignant tumor sharing morphologic features with the epithelial component of the pulmonary blastoma devoid of sarcomatous component. We present a case of adenocarcinoma of fetal type in a 28-year-old female, consisting of numerous branching tubules or glands and morula-like epithelial complexes. Histologically, the tubules and glands were composed of glycogne-rich nonciliated epithelial cells showing in part argyrophilia. Some of tubular and morula-like epithelial cells revealed immunoreactivity for neuron-specific enolase. We report this case with a review of literatures with special references on the histogenisis. This report is the pathologically confirmed second case of the pulmonary adenocarcinoma of fetal type in Korea, following the report of Cho and Lee, 1990.