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1.
Article in Chinese | WPRIM | ID: wpr-922155

ABSTRACT

The concept of spread through air spaces (STAS) was first proposed in the World Health Organization (WHO) Classification of Tumors of the Lung, Pleura, Thymus and Heart (version 2015). STAS is defined as the micropapillary clusters, solid nests or single cells of tumor that exist in the air spaces of the surrounding lung parenchyma beyond the edge of the main tumor. Meanwhile, apart from the traditional invasion modes of lung adenocarcinoma (interstitial, visceral pleura and lym-phovascular invasion), STAS has been identified as the fourth invasion mode of lung adenocarcinoma. In recent years, the research on STAS has been a hot spot in the field of lung adenocarcinoma. The existence of STAS is related to lung cancer histopathology, gene mutation and other factors, and many studies have also confirmed that it can be used as an independent factor for tumor recurrence and prognosis. However, according to some studies, human factors can cause morphological artifacts of STAS, which still needs to be distinguished in clinical work. This paper reviews the research progress of STAS classification, related pathological features, genetic status changes, and human factors that may cause STAS artifacts.
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Subject(s)
Adenocarcinoma of Lung/pathology , Humans , Lung Neoplasms/pathology , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Neoplasm Staging , Prognosis , Retrospective Studies
2.
Chinese Journal of Lung Cancer ; (12): 673-676, 2021.
Article in Chinese | WPRIM | ID: wpr-922240

ABSTRACT

Lung cancer is a malignant tumor with high incidence rate and mortality rate in China and even the whole world, of which non-small cell lung cancer accounts for about 80%. Anaplastic lymphoma kinase (ALK) gene mutation accounts for about 5%. Alectinib, ALK-tyrosine kinase inhibitor (ALK-TKI), has great performance in clinical. The early detection and treatment of adverse drug reactions can greatly improve clinical benefits. This paper reports a patient of ALK positive non-small cell lung cancer was admited to Baotou Central Hospital in April 2020. The diagnosis and treatment was retrospectively analyzed, and the literature was reviewed.
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Subject(s)
Anaplastic Lymphoma Kinase/genetics , Antineoplastic Agents/therapeutic use , Carbazoles/therapeutic use , Carcinoma, Non-Small-Cell Lung/secondary , Humans , Lung Neoplasms/pathology , Mutation , Piperidines/therapeutic use , Pleural Neoplasms/secondary , Protein Kinase Inhibitors/therapeutic use , Retrospective Studies , Tomography, X-Ray Computed
3.
Chinese Journal of Lung Cancer ; (12): 632-645, 2021.
Article in Chinese | WPRIM | ID: wpr-922238

ABSTRACT

BACKGROUND@#Lung cancer is the leading cause of cancer-related death, of which non-small cell lung cancer (NSCLC) is the most common type. Immune checkpoint inhibitors (ICIs) have now become one of the main treatments for advanced NSCLC. This paper retrospectively investigated the effect of peripheral blood inflammatory indexes on the efficacy of immunotherapy and survival of patients with advanced non-small cell lung cancer, in order to find strategies to guide immunotherapy in NSCLC.@*METHODS@#Patients with advanced non-small cell lung cancer who were hospitalized in The Affiliated Cancer Hospital of Nanjing Medical University from October 2018 to August 2019 were selected to receive anti-PD-1 (pembrolizumab, sintilimab or toripalimab) monotherapy or combination regimens. And were followed up until 10 December 2020, and the efficacy was evaluated according to RECIST1.1 criteria. Progression-free survival (PFS) and overall survival (OS) were followed up for survival analysis. A clinical prediction model was constructed to analyze the predictive value of neutrophil-to-lymphocyte ratio (NLR) based on NLR data at three different time points: before treatment, 6 weeks after treatment and 12 weeks after treatment (0w, 6w and 12w), and the accuracy of the model was verified.@*RESULTS@#173 patients were finally included, all of whom received the above treatment regimen, were followed up for a median of 19.7 months. The objective response rate (ORR) was 27.7% (48/173), the disease control rate (DCR) was 89.6% (155/173), the median PFS was 8.3 months (7.491-9.109) and the median OS was 15.5 months (14.087-16.913). The chi-square test and logistic multi-factor analysis showed that NLR6w was associated with ORR and NLR12w was associated with ORR and DCR. Further Cox regression analysis showed that NLR6w and NLR12w affected PFS and NLR0w, NLR6w and NLR12w were associated with OS.@*CONCLUSIONS@#In patients with advanced non-small cell lung cancer, NLR values at different time points are valid predictors of response to immunotherapy, and NLR <3 is often associated with a good prognosis.


Subject(s)
Aged , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Biomarkers/blood , Carcinoma, Non-Small-Cell Lung/pathology , Female , Humans , Immunotherapy/methods , Inflammation/blood , Leukocyte Count , Lung Neoplasms/pathology , Lymphocytes , Male , Middle Aged , Neutrophils , Predictive Value of Tests , Prognosis , Retrospective Studies , Survival Analysis , Treatment Outcome
4.
Chinese Journal of Lung Cancer ; (12): 753-755, 2021.
Article in Chinese | WPRIM | ID: wpr-922142

ABSTRACT

The International Agency for Research on Cancer (IARC) published the World Health Organization (WHO) classification of thoracic tumors (5th edition) in May 2021, only six years after the 4th edition of WHO Classification. With the application of low-dose spiral computed tomography (CT) as an early screening method for lung tumors in recent years, lung adenocarcinoma has become the main type of disease in many hospital surgical treatments. The WHO classification serves as the authoritative guide for pathological diagnosis, and any slight change in the classification is at the heart of pathologists, clinicians and patients. Adenocarcinoma in situ is a newly added type of adenocarcinoma diagnosis in the 4th edition of the WHO classification, and it is also the focus of clinical treatment and research at home and abroad in recent years. Because its catalog position has been adjusted in the 5th edition of the WHO classification, there has been a huge controversy and discussion among clinicians and patients that "adenocarcinoma in situ was excluded from the category of malignant tumors". This article will briefly explain the origin of the diagnosis of lung adenocarcinoma in situ, the adjustment of the new classification catalog, and whether adenocarcinoma in situ is benign or malignant.
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Subject(s)
Adenocarcinoma in Situ/pathology , Adenocarcinoma of Lung/diagnostic imaging , Humans , Lung Neoplasms/pathology , Neoplasm Staging
5.
Chinese Medical Journal ; (24): 127-136, 2021.
Article in English | WPRIM | ID: wpr-921227

ABSTRACT

Lung cancer continues to be the leading cause of cancer-related death in the world, which is classically subgrouped into two major histological types: Non-small cell lung cancer (NSCLC) (85% of patients) and small-cell lung cancer (SCLC) (15%). Tumor location has been reported to be associated with the prognosis of various solid tumors. Several types of cancer often occur in a specific region and are more prone to spread to predilection locations, including colorectal cancer, prostate cancer, gastric cancer, ovarian cancer, cervical cancer, bladder cancer, lung tumor, and so on. Besides, tumor location is also considered as a risk factor for lung neoplasm with chronic obstructive pulmonary disease/emphysema. Additionally, the primary lung cancer location is associated with specific lymph node metastasis. And the recent analysis has shown that the primary location may affect metastasis pattern in metastatic NSCLC based on a large population. Numerous studies have enrolled the "location" factor in the risk model. Anatomy location and lobe-specific location are both important in prognosis. Therefore, it is important for us to clarify the characteristics about tumor location according to various definitions. However, the inconsistent definitions about tumor location among different articles are controversial. It is also a significant guidance in multimode therapy in the present time. In this review, we mainly aim to provide a new insight about tumor location, including anatomy, clinicopathology, and prognosis in patients with lung neoplasm.


Subject(s)
Carcinoma, Non-Small-Cell Lung/pathology , Humans , Lung Neoplasms/pathology , Lymphatic Metastasis , Male , Neoplasm Staging , Prognosis , Retrospective Studies
6.
Neumol. pediátr. (En línea) ; 16(4): 172-176, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1362265

ABSTRACT

El sarcoma sinovial primario de pulmón (SSPP) localizado en bronquio, es una entidad no reportada en la edad pediátrica. Se presenta el caso de un niño de siete años con antecedente de aparentes neumonías recurrentes derechas de siete meses de evolución; en la evaluación por neumología pediátrica se destaca en las radiografías de tórax, la presencia de atelectasias recurrentes en lóbulo medio e inferior derecho, por lo que se realiza broncoscopia, donde se observa una masa obstruyendo el 100% de la luz del bronquio fuente derecho y se sospecha tumor carcinoide. Se realiza extirpación de masa endobronquial con fines diagnósticos y terapéuticos, incluyendo resección segmentaria bronquial y anastomosis término-terminal. El respectivo análisis inmunohistoquímico muestra hallazgos sugestivos de sarcoma sinovial monofásico. Se descarta compromiso tumoral extrapulmonar, por lo que se diagnostica como tumor primario de bronquio. Se administraron 7 ciclos de quimioterapia y 31 sesiones de radioterapia. Actualmente en control, sin evidencia de metástasis, tumores residuales o recidivas.


Primary Synovial Sarcoma of Lung (PSSL) located in the bronchus is an unreported entity in pediatric age. We present the case of a 7-year-old child with a history of apparent recurrent right pneumonia of 7 months of evolution; in the evaluation by pediatric pulmonology, the presence of recurrent atelectasis in the middle and lower right lobe is highlighted on chest X-rays, so bronchoscopy is performed, where a mass is observed obstructing 100% of the right bronchus lumen and carcinoid tumor is suspected. Endobronchial mass resection is performed for diagnostic and therapeutic purposes, including bronchial segmental resection and termino-terminal anastomosis. The respective immunohistochemical analysis shows suggestive findings of monophasic synovial sarcoma. Extrapulmonary tumor involvement is ruled out, so it is diagnosed as a primary bronchial tumor. 7 cycles of chemotherapy and 31 sessions of radiation therapy are given. Currently in control, with no evidence of metastasis, residual tumors, or recurrence.


Subject(s)
Humans , Male , Child , Sarcoma, Synovial/surgery , Sarcoma, Synovial/diagnosis , Lung Neoplasms/surgery , Lung Neoplasms/diagnosis , Bronchoscopy , Radiography, Thoracic , Sarcoma, Synovial/pathology , Lung Neoplasms/pathology
7.
J. bras. pneumol ; 47(4): e20200584, 2021. tab, graf
Article in English | LILACS | ID: biblio-1279298

ABSTRACT

ABSTRACT Objective: EBUS-TBNA cytological sampling is routinely performed for pathological diagnosis, mediastinal staging, and molecular testing in lung cancer patients. EBUS-TBNA samples are not formally accepted for testing programmed death-ligand 1 (PD-L1) expression. The objective of the study was to compare the feasibility, reproducibility, and accuracy of PD-L1 expression assessment in cytological specimens and histological samples. Methods: We prospectively collected histological (transbronchial forceps biopsy) and cytological (EBUS-TBNA) samples from peribronchial neoplastic lesions during an endoscopic procedure at the same target lesion for the pathological diagnosis and molecular assessment of stage IV non-small cell lung cancer (NSCLC). Results: Fifteen patients underwent the procedure. Adequate cytological samples (at least 100 neoplastic cells) were obtained in 12 cases (92.3%). Assessment of PD-L1 expression was similar between histological and cytological samples (agreement rate = 92%). Sensitivity and diagnostic accuracy of EBUS-TBNA cytological specimens were 88.9% and 100%, respectively. Conclusions: The evaluation of PD-L1 expression in EBUS-TBNA cytological specimens is feasible and presents good reproducibility when compared with routine histological samples. EBUS-TBNA cytological samples could be used for the assessment of PD-L1 expression in patients with NSCLC as a minimally invasive approach in stage IV NSCLC cancer patients.


RESUMO Objetivo: A amostragem citológica por meio de EBUS-TBNA é realizada rotineiramente para diagnóstico anatomopatológico, estadiamento mediastinal e teste molecular em pacientes com câncer de pulmão. As amostras obtidas por meio de EBUS-TBNA não são formalmente aceitas para testar a expressão da proteína programmed death-ligand 1 (PD-L1, ligante de morte celular programada 1). O objetivo do estudo foi comparar a viabilidade, reprodutibilidade e precisão da avaliação da expressão de PD-L1 em espécimes citológicos e amostras histológicas. Métodos: Foram coletadas prospectivamente amostras histológicas (obtidas por meio de biópsia transbrônquica com pinça) e citológicas (obtidas por meio de EBUS-TBNA) de lesões neoplásicas peribrônquicas durante um procedimento endoscópico na mesma lesão-alvo para o diagnóstico anatomopatológico e avaliação molecular de câncer pulmonar de células não pequenas (CPCNP) em estágio IV. Resultados: Quinze pacientes foram submetidos ao procedimento. Amostras citológicas adequadas (pelo menos 100 células neoplásicas) foram obtidas em 12 casos (92,3%). A expressão de PD-L1 nas amostras histológicas e citológicas foi semelhante (taxa de concordância = 92%). A sensibilidade e precisão diagnóstica das amostras citológicas obtidas por meio de EBUS-TBNA foram de 88,9% e 100%, respectivamente. Conclusões: A avaliação da expressão de PD-L1 em espécimes citológicos obtidos por meio de EBUS-TBNA é viável e apresenta boa reprodutibilidade quando comparada com amostras histológicas rotineiras. Amostras citológicas obtidas por meio de EBUS-TBNA podem ser usadas para avaliar a expressão de PD-L1 como uma abordagem minimamente invasiva em pacientes com CPCNP em estágio IV.


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Pilot Projects , Prospective Studies , Reproducibility of Results , B7-H1 Antigen , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Neoplasm Staging
8.
J. bras. pneumol ; 47(3): e20200378, 2021. tab, graf
Article in English | LILACS | ID: biblio-1154705

ABSTRACT

ABSTRACT Objective: Adjuvant chemotherapy (AC) improves survival of patients with resected non-small cell lung cancer (NSCLC). However, the cisplatin-vinorelbine regimen has been associated with a significant risk of clinically relevant toxicity. We sought to evaluate the effectiveness, safety, and feasibility of AC for NSCLC patients in a real-world setting. Methods: This was a single-center, retrospective cohort study of patients with stage I-III NSCLC undergoing surgery with curative intent between 2009 and 2018. AC was administered at the discretion of physicians. The patients were divided into two groups: AC group and no AC (control) group. Study outcomes included overall survival (OS) and recurrence-free survival (RFS), as well as the safety profile and feasibility of the cisplatin-vinorelbine regimen in a real-world setting. Results: The study involved 231 patients, 80 of whom received AC. Of those, 55 patients received the cisplatin-vinorelbine regimen. Survival analyses stratified by tumor stage showed that patients with stage II NSCLC in the AC group had better RFS (p = 0.036) and OS (p = 0.017) than did those in the no AC group. Among patients with stage III NSCLC in the AC group, RFS was better (p < 0.001) and there was a trend toward improved OS (p = 0.060) in comparison with controls. Of those who received the cisplatin-vinorelbine regimen, 29% had grade 3-4 febrile neutropenia, and 9% died of toxicity. Conclusions: These results support the benefit of AC for NSCLC patients in a real-world setting. However, because the cisplatin-vinorelbine regimen was associated with alarming rates of toxicity, more effective and less toxic alternatives should be investigated.


RESUMO Objetivo: A quimioterapia adjuvante melhora a sobrevida de pacientes com câncer pulmonar de células não pequenas (CPCNP) ressecado. No entanto, o esquema cisplatina-vinorelbina está relacionado com risco significativo de toxicidade clinicamente relevante. Nosso objetivo foi avaliar a eficácia, segurança e viabilidade da quimioterapia adjuvante para pacientes com CPCNP em um cenário de mundo real. Métodos: Estudo retrospectivo de coorte realizado em um único centro com pacientes com CPCNP em estágio I-III submetidos a cirurgia com intuito curativo entre 2009 e 2018. A quimioterapia adjuvante foi administrada a critério dos médicos. Os pacientes foram divididos em dois grupos: quimioterapia adjuvante e sem quimioterapia adjuvante (grupo controle). Os desfechos estudados foram sobrevida global (SG) e sobrevida livre de recidiva (SLR), bem como o perfil de segurança e viabilidade do esquema cisplatina-vinorelbina em um cenário de mundo real. Resultados: O estudo envolveu 231 pacientes, 80 dos quais receberam quimioterapia adjuvante. Destes, 55 receberam o esquema cisplatina-vinorelbina. As análises de sobrevida estratificadas pelo estágio do tumor mostraram que os pacientes com CPCNP em estágio II que receberam quimioterapia adjuvante apresentaram melhor SLR (p = 0,036) e SG (p = 0,017) do que os do grupo controle. Entre os pacientes com CPCNP em estágio III que receberam quimioterapia adjuvante, a SLR foi melhor (p < 0,001) e houve uma tendência a melhor SG do que no grupo controle (p = 0,060). Dos que receberam o esquema cisplatina-vinorelbina, 29% apresentaram neutropenia febril de grau 3-4, e 9% morreram em virtude de toxicidade. Conclusões: Os resultados confirmam o efeito benéfico da quimioterapia adjuvante em pacientes com CPCNP em um contexto real. No entanto, o esquema cisplatina-vinorelbina relacionou-se com taxas alarmantes de toxicidade e alternativas mais eficazes e menos tóxicas devem ser investigadas.


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/pathology , Lung Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Retrospective Studies , Cisplatin/adverse effects , Chemotherapy, Adjuvant , Vinorelbine/therapeutic use , Neoplasm Staging
9.
J. bras. pneumol ; 47(1): e20190426, 2021. tab, graf
Article in English | LILACS | ID: biblio-1143154

ABSTRACT

ABSTRACT Objective: To evaluate the evolution of clinical and epidemiological data, as well as data related to diagnosis, staging, treatment, and survival, among patients undergoing curative surgery for lung cancer at a tertiary referral center in the city of São Paulo, Brazil. Methods: This was a retrospective study of cases in the International Association for the Study of Lung Cancer database. We selected only cases of patients undergoing curative surgery between January of 2011 and April of 2018. We determined overall and disease-free survival at 36 months and compared the data between two periods (2011-2014 and 2015-2018). Results: Comparing the two periods (N = 437 cases), we observed trends toward increases in the number of female patients, as well as in the proportions of former smokers (44.09% vs. 53.59%), of patients diagnosed with adenocarcinoma (52.21% vs. 59.72%), and of patients diagnosed at an earlier pathological stage, together with a decrease in 30-day mortality (4.05% vs. 2.39%). There were significant increases in the proportions of cases diagnosed at an earlier clinical stage (p = 0.002) or incidentally (p = 0.003). Although lobectomy was the main surgical technique employed, there was a proportional increase in segmentectomies (2.67% vs. 7.11%; p = 0.026). Overall and disease-free survival rates were 79.4% (95% CI: 74.0-83.9%) and 75.1% (95% CI: 69.1-80.1%), respectively. The difference in overall survival between the periods lost statistical significance when adjusted for pathological stage, the only factor that affected survival (log-rank: p = 0.038 to p = 0.079). Conclusions: The clinical and epidemiological evolution presented in this study corroborates global trends. The decrease in 30-day mortality was probably due to better patient selection and improved surgical techniques.


RESUMO Objetivo: Avaliar a evolução de dados clínicos e epidemiológicos, assim como dados sobre diagnóstico, estadiamento, tratamento e sobrevida em pacientes submetidos a tratamento cirúrgico curativo de câncer de pulmão em uma instituição terciária na cidade de São Paulo (SP). Métodos: Estudo retrospectivo baseado nos casos inseridos no banco de dados da International Association for the Study of Lung Cancer submetidos à cirurgia curativa entre janeiro de 2011 e abril de 2018. Determinamos a sobrevida global e livre de doença em 36 meses e comparamos os dados em dois períodos (2011-2014 e 2015-2018). Resultados: Comparando-se os dois períodos (N = 437 casos), houve uma tendência de aumento no número de pacientes do sexo feminino, ex-tabagistas (44,09% vs. 53,59%), com diagnóstico de adenocarcinoma (52,21% vs. 59,72%) e em estádio patológico mais precoce, assim como queda da mortalidade em 30 dias (4,05% vs. 2,39%). Houve aumento significativo de casos em estádio clínico mais precoce (p = 0,002) e diagnosticados incidentalmente (p = 0,003). A lobectomia foi a principal técnica cirúrgica; entretanto, houve aumento de segmentectomias (2,67% vs. 7,11%; p = 0,026). As sobrevidas global e livre de doença foram de 79,4% (IC95%: 74,0-83,9%) e 75,1% (IC95%: 69,1-80,1%), respectivamente. Houve perda de significância estatística na sobrevida global entre os períodos quando ajustada por estadiamento patológico, o único fator a impactar a sobrevida (log-rank: p = 0,038 para p = 0,079). Conclusões: A evolução clínica e epidemiológica apresentada neste estudo corrobora tendências mundiais. A diminuição da mortalidade em 30 dias provavelmente ocorreu devido a melhor seleção de pacientes e melhora da técnica cirúrgica.


Subject(s)
Humans , Female , Lung Neoplasms/surgery , Lung Neoplasms/pathology , Brazil/epidemiology , Survival Rate , Retrospective Studies , Tertiary Care Centers , Neoplasm Staging
10.
Clinics ; 76: e2251, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153972

ABSTRACT

OBJECTIVES: Lung cancer is the leading cause of cancer-related deaths worldwide. However, factors associated with the survival of patients with advanced non-small-cell lung cancer (NSCLC) who received only hospice care are largely unclear. In this study, we aimed to determine the prognostic factors correlated with survival in patients with advanced NSCLC who had undergone hospice care only. METHODS: A total of 102 patients with recurrent stage III/IV NSCLC after traditional treatment failure were investigated. Survival was measured from the date of enrollment to December 2019 or the time of death. Tumor tissues were collected, and DNA sequencing was performed to identify somatic mutations. Data on clinical factors of patients were collected and analyzed by univariate and multivariate analyses. Overall survival analysis was conducted using the Kaplan-Meier method. RESULTS: The 6-month, 1-year, and 2-year overall survival rates of the 102 patients with metastatic NSCLC were 17.65%, 3.92%, and 0.98%, respectively. The median overall survival of the 102 patients was 3.15 months. Tumor location in the peripheral lung, epidermal growth factor receptor (EGFR) inhibitor history, low tumor mutation load, adenocarcinoma, and poor performance status score were associated with prolonged survival compared with tumor location in the central lung, no EGFR inhibitor history, high tumor mutation load, squamous cell carcinoma, and good performance status score (p=0.045, p=0.003, p=0.045, p=0.021, and p=0.0003, respectively). CONCLUSIONS: EGFR inhibitor treatment history and tumor mutation load are risk factors for the overall survival of patients with stage III/IV NSCLC who have undergone only hospice care. These results provide a critical clinical basis for further study of nontraditional anti-tumor responses induced by EGFR inhibitors.


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Lung Neoplasms/drug therapy , Prognosis , Retrospective Studies , Protein Kinase Inhibitors/therapeutic use , ErbB Receptors/genetics , Mutation , Neoplasm Staging
11.
Rev. colomb. cancerol ; 24(2): 88-91, abr.-jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144325

ABSTRACT

Resumen El carcinoma de célula pequeña (CPCP) o microcítico de pulmón es un subtipo de cáncer de pulmón que típicamente se ha asociado al tabaquismo y que se caracteriza por su agresividad y mal pronóstico a corto plazo. Como entidad, puede metastatizar en cualquier órgano, siendo las metástasis pancreáticas raras y la mayoría de las veces asintomáticas. Por ello, la presencia de una pancreatitis neoplásica, como en el caso presentado, es excepcional, y aún más cuando presenta refractariedad al tratamiento médico convencional y responde al tratamiento citotóxico sistémico. Por todo ello, se expone esta experiencia clínica y se debate la presencia de esta rara entidad y su manejo.


Abstract Small-cell lung carcinoma is a subtype of neoplasm that has been typically associated with smoking; it is characterized by its aggressiveness and poor prognosis in the short term. As an entity, it can metastasize in any organ, but pancreatic metastases are rare and most of the time asymptomatic. Therefore, the presence of neoplastic pancreatitis as in our case is exceptional; even more when it presents refractoriness to conventional medical treatment, responding instead to systemic cytotoxic treatment. Therefore, we expose our clinical experience and discuss the presence of this rare entity and its management.


Subject(s)
Humans , Male , Middle Aged , Pancreatic Neoplasms/secondary , Pancreatitis/etiology , Small Cell Lung Carcinoma/pathology , Lung Neoplasms/pathology , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/diagnostic imaging , Tobacco Use Disorder/complications , Acute Disease , Cisplatin/therapeutic use , Etoposide/therapeutic use , Small Cell Lung Carcinoma/drug therapy , Small Cell Lung Carcinoma/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/diagnostic imaging , Antineoplastic Agents/therapeutic use
12.
Medicina (B.Aires) ; 80(2): 173-176, abr. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1125061

ABSTRACT

El cáncer de pulmón es la principal causa de muerte por cáncer en todo el mundo. Los nódulos pulmonares ubicados en proximidad al mediastino, retrocardíacos, cercanos a grandes vasos o por delante de la columna vertebral pueden resultar de difícil acceso por vía percutánea o broncoscópica. La punción aspiración/biopsia con aguja fina guiada por ecoendoscopía transesofágica (EUS-FNA/FNB) es un método mini invasivo con baja morbilidad que permitiría acceder a estas localizaciones. Presentamos el caso de un paciente con nódulo pulmonar solitario, en el que se obtuvo el diagnóstico de cáncer de pulmón mediante EUS-FNA/FNB.


Lung cancer is one of the leading causes of death worldwide. Pulmonary nodules located in the vicinity of the mediastinum, retrocardiac, near the aorta or pulmonary vessels, and in front of the spine, may be difficult to access through a percutaneous or bronchoscopic approach. Fine needle aspiration/biopsy guided by transesophageal echoendoscopy (EUS-FNA/FNB) is a minimally invasive method with low morbidity that could allow access to lesions in these places. We present the case of a patient with a solitary pulmonary nodule, in which the diagnosis of lung cancer was obtained by EUS-FNA/FNB.


Subject(s)
Humans , Male , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods , Lung Neoplasms/pathology , Carcinoma, Squamous Cell/radiotherapy , Tomography, X-Ray Computed , Endosonography , Biopsy, Fine-Needle , Lung Neoplasms/radiotherapy
13.
Int. j. morphol ; 38(2): 247-251, abr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056430

ABSTRACT

Nine tumor and various potential biomarkers were measured and combined the information to diagnose disease, all patients accepted fiber bronchoscopy brush liquid based cytologyand histopathology examination in order to reliably detect lung cancer. The samples from 314 Chinese lung cancer patients were obtained and CK5/6, P63, P40, CK7, TTF-1, NapsinA CD56, Syn and CgA were measured with the immunohistochemical SP method and analyzed correlation of the expression of these markers with pathological and clinical features of squamous cell carcinoma, adenocarcinoma, and small cell lung carcinoma. Squamous cell carcinoma, adenocarcinoma and small cell carcinoma were 61 cases, 114 cases and 139 cases,CK5/6 and P63 expression were more frequent in squamous cell carcinoma, with sensitivity and specificity of 77.05 % and 96.44 %, 83.61 % and 88.93 %,and compared with adenocarcinoma and small cell carcinoma difference was statistically significant (P<0.05), The incidences of a positive P40 expression were 100 % in squamous cell carcinoma, with specificity of 98.81 %.CK7, TTF-1 and NapsinA expression were more frequent in adenocarcinoma, with sensitivity and specificity of 85.09 % and 78.69 %, 79.82 % and 93.44 %, 56.14 % and 95.08 %, and compared with squamous cell carcinoma and small cell carcinoma difference was statistically significant (P<0.05). TTF-1, Syn, CgA and CD56 expression were more frequent in adenocarcinoma, with sensitivity and specificity of 86.33 % and 93.44 %, 89.21 % and 98.36 %, 74.10 % and 100 %, 96.40 % and 96.72 %. The combined detection of CK5/6, P63 and P40 were more useful and specific in differentiating squamous cell carcinoma. CK7, TTF-1 and NapsinA were more useful and specific in differentiating lung adenocarcinoma. The impaired CD56, TTF-1, Syn and CgA reflects the progression of small cell lung cancer.


Se midieron tumores y utilizaron nueve biomarcadores potenciales y se analizó la información para diagnosticar la enfermedad. A todos los pacientes se les realizó citología en líquido con broncoscopía de fibra y examen histopatológico para detectar de manera confiable el cáncer pulmonar. Se obtuvieron muestras de 314 pacientes chinos con cáncer de pulmón y CK5 / 6, P63, P40, CK7, TTF-1, Napsina A, CD56, Syn y CgA se midieron a través de histoquímica SP y analizaron la correlación de la expresión de estos marcadores con características patológicas y clínicas de carcinoma de células escamosas, adenocarcinoma y carcinoma de células pequeñas en el cáncer de pulmón. El carcinoma de células escamosas, el adenocarcinoma y el carcinoma de células pequeñas fueron 61 casos, 114 casos y 139 casos, respectivamente, la expresión de CK5 / 6 y P63 fueron más frecuentes en el carcinoma de células escamosas, con una sensibilidad y especificidad del 77,05 % y 96,44 %, 83,61 % y 88,93 %, y en comparación con el adenocarcinoma y el carcinoma de células pequeñas, la diferencia fue estadísticamente significativa (P <0,05). La incidencia de ap la expresión positiva P40 fue del 100 % en el carcinoma de células escamosas, con una especificidad del 98,81 %. La expresión de CK7, TTF-1 y NapsinA fueron más frecuentes en el adenocarcinoma, con una sensibilidad y especificidad del 85,09 % y 78,69 %, 79,82 % y 93,44 %, 56,14 % y 95,08 %, y en comparación con el carcinoma de células escamosas y la diferencia de carcinoma de células pequeñas fue estadísticamente significativa (P <0,05) .TTF-1, Syn, CgA y la expresión de CD56 fueron más frecuentes en adenocarcinoma, con sensibilidad y especificidad de 86.33 % y 93.44 %, 89.21 % y 98.36 %, 74.10 % y 100 %, 96.40 % y 96.72 %. La detección combinada de CK5 / 6, P63 y P40 fue más útil y específica en la diferenciación del carcinoma de células escamosas. CK7, TTF-1 y NapsinA fueron más útiles y específicos para diferenciar el adenocarcinoma de pulmón. El deterioro de CD56, TTF-1, Syn y CgA refleja la progresión del cáncer de pulmón de células pequeñas.


Subject(s)
Humans , Carcinoma/metabolism , Carcinoma/pathology , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Peptide Fragments/metabolism , Transcription Factors/metabolism , Immunohistochemistry , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Adenocarcinoma/metabolism , Adenocarcinoma/pathology , Biomarkers, Tumor/metabolism , Aspartic Acid Endopeptidases/metabolism , Sensitivity and Specificity , Carcinoma, Small Cell/metabolism , Carcinoma, Small Cell/pathology , CD56 Antigen/metabolism , Tumor Suppressor Proteins/metabolism , Keratins, Type II/metabolism , Keratin-7/metabolism , Thyroid Nuclear Factor 1/metabolism
14.
Rev. argent. cir ; 112(1): 51-54, mar. 2020. ilus
Article in English, Spanish | LILACS | ID: biblio-1125781

ABSTRACT

El schwannoma es un tumor neurogénico que se presenta más frecuentemente en el ángulo costovertebral del mediastino posterior, pero también en otras localizaciones dentro del tórax. Habitualmente suele ser una masa única, encapsulada, bien definida, con un tamaño aproximado 2 a 10 cm. Presentamos el caso de un paciente de 66 años, derivado a nuestro hospital por una masa de 13 cm localizada en el hemitórax inferior izquierdo. Se realizó una biopsia, y la resonancia magnética corroboró el diagnóstico de un tumor mediastínico gigante de la vaina neural. Se procedió a su resección completa sin complicaciones.


Schwannomas are neurogenic tumors, commonly located in the costovertebral angle of the posterior mediastinum, but with many intrathoracic locations. They usually present as a solitary, well-circumscribed and encapsulated mass with a size between 2 and 10 cm. We report a case of a 66-year-old male, referred to our hospital for a mass located at the left lower hemithorax with 13 cm in size. A percutaneous biopsy was performed, and magnetic resonance imaging confirmed the diagnosis of a resectable giant mediastinal nerve sheath tumor. Surgery was performed without complications.


Subject(s)
Humans , Male , Aged , Lung Neoplasms/pathology , Neurilemmoma/diagnostic imaging , Thorax/diagnostic imaging , Thoracotomy , Magnetic Resonance Spectroscopy/methods , Positron-Emission Tomography/methods , Electrocardiography
15.
An. bras. dermatol ; 95(1): 67-70, Jan.-Feb. 2020. graf
Article in English | LILACS | ID: biblio-1088720

ABSTRACT

Abstract Erythroderma as the first manifestation of a solid organ malignancy is rare. The underlying cancer is a challenging condition to diagnose. There are a few cases of erythroderma in cancer patients reported in the literature. We here describe the case of a 70-year-old man who presented with asthenia, weight loss, dry cough and total body erythema with desquamation over the past month. A chest computed tomography scan showed a nodular lesion, which was finally diagnosed as a squamous cell lung carcinoma. To our knowledge, as an erythroderma presentation, only 13 cases have been reported in the literature. This case report demonstrates the need to search for a neoplasm in patients presenting with erythroderma, particularly in the presence of accompanying debilitating symptoms.


Subject(s)
Humans , Male , Aged , Dermatitis, Exfoliative/pathology , Neoplasms, Squamous Cell/pathology , Lung Neoplasms/pathology , Paraneoplastic Syndromes/pathology , Biopsy , Tomography, X-Ray Computed , Dermatitis, Exfoliative/etiology , Neoplasms, Squamous Cell/complications , Erythema/pathology , Lung Neoplasms/complications
16.
Autops. Case Rep ; 10(3): e2020199, 2020. tab, graf
Article in English | LILACS | ID: biblio-1131830

ABSTRACT

We present the autopsy findings and differential diagnosis in a 42year old male who presented with fever and rapidly progressive respiratory symptoms like breathlessness, nonproductive cough and right sided chest pain. Initial imaging workup done at our hospital revealed a large unilateral tumor with tracheal shift. While being evaluated patient developed facial puffiness, tachypnea suggestive of superior vena cava obstruction. Antemortem biopsy of lung mass was attempted twice and that suggested malignant lesion. Unfortunately, the individual had a rapid downhill course following admission. Post mortem examination was conducted that on opening the thoracic cavity revealed total replacement of right lung tissue by a necrotic growth which was deeply adherent to the rib cage. The contralateral lung as well as all other visceral organs were unremarkable grossly. Histopathology confirmed primary Ewing sarcoma of the lung. We hereby, report a rare case of primary lung Ewing sarcoma diagnosed at autopsy.


Subject(s)
Humans , Male , Adult , Sarcoma, Ewing/pathology , Bone Neoplasms/pathology , Neuroectodermal Tumors/pathology , Lung Neoplasms/pathology , Autopsy , Fatal Outcome , Diagnosis, Differential
18.
Braz. j. med. biol. res ; 53(6): e8694, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1132522

ABSTRACT

Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignant tumors. Ethanol extract of Antrodia cinnamomea (EEA) has been widely studied for its health benefits including anticancer effects. The purpose of this study was to assess the effects of EEA on HNSCC. Cell proliferation, transwell, and wound healing assays were performed. The impact of EEA on tumor growth was investigated using a xenograft model. Expressions of migration-related proteins (MMP-2, MMP-9, TIMP-1, and TIMP-2) and apoptosis-related proteins (cleaved caspase-9 and cleaved PARP) were determined using western blot analysis. The results indicated that EEA significantly inhibited the capacities of proliferation, invasion, and migration of HNSCC cells in a dose-dependent manner. Cleaved caspase-9 and cleaved PARP expressions were increased in cells treated with an increasing concentration of EEA, which suggested that EEA induced apoptosis of HNSCC. MMP-2 and MMP-9 were downregulated when cells were administered EEA, while TIMP-1 and TIMP-2 were not affected, which uncovered the mechanisms mediating the EEA-induced inhibition on cell invasion and migration. The animal experiment also suggested that EEA inhibited tumor growth. Our study confirmed the inhibitive effects of EEA on cell proliferation, invasion, and migration of HNSCC in vitro and in vivo, providing the basis for further study of the application of EEA as an effective candidate for cancer treatment.


Subject(s)
Humans , Animals , Female , Rabbits , Biological Products/pharmacology , Ethanol/pharmacology , Antrodia/chemistry , Squamous Cell Carcinoma of Head and Neck/pathology , Lung Neoplasms/pathology , Time Factors , Blotting, Western , Apoptosis/drug effects , Cell Line, Tumor , Cell Proliferation/drug effects , Ethanol/isolation & purification , Squamous Cell Carcinoma of Head and Neck/drug therapy , Lung Neoplasms/drug therapy , Mice, Inbred BALB C
19.
Article in Chinese | WPRIM | ID: wpr-878684

ABSTRACT

Rapid on-site evaluation(ROSE),an auxiliary sampling quality evaluation technology,can be used to evaluate the adequacy and diagnostic category of samples,judge the histological type of lung cancer,and optimize the gene type of lung cancer.Applying ROSE to endobronchial ultrasound-guided transbronchial needle aspiration of suspected lung cancer can improve the puncture success rate and diagnostic rate and reduce complications and puncture attempts.Rose performed via remote cytopathology technology or by trained respiratory specialists may become the future trends.


Subject(s)
Bronchoscopy , Cytodiagnosis/methods , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Humans , Lung Neoplasms/pathology
20.
Chinese Journal of Oncology ; (12): 1063-1077, 2020.
Article in Chinese | WPRIM | ID: wpr-877493

ABSTRACT

Non-small cell lung cancer (NSCLC) is the most common histological type of lung cancer, accounting for more than 80% of primary lung cancer. Platinum-based chemotherapy is the traditional standard for the treatment of advanced NSCLC, but the 5-years survival rate is still very low, less than 5%. Angiogenesis plays an important role in the growth, proliferation and metastasis of solid tumors. Angiogenesis inhibitors affect the tumor microenvironment, degenerate existing tumor blood vessels and inhibit tumor angiogenesis. Angiogenesis inhibitors are now one of the indispensable treatments for patients with advanced NSCLC through continuous development of new angiogenesis inhibitor and improvement of drug accessibility. This consensus is based on the "Expert consensus on anti-angiogenic drug therapy for advanced non-small cell lung cancer in China (2019 Edition)" , combines with clinical research evidence published in the past years and clinical experience. The consensus-writing group compiles a consensus of guiding clinical departments related to lung cancer treatment to use anti-angiogenic drugs in a standardized manner, and further improves the level of standardized diagnosis and treatment of lung cancer.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Carcinoma, Non-Small-Cell Lung/pathology , China , Consensus , Humans , Lung Neoplasms/pathology , Neoplasm Staging
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