ABSTRACT
Benign fibrous histiocytomas (BFH) are uncommon pulmonary tumours. These lesions usually present as slow-growing, solid masses. We report the rare case of a young man with cavitary BFH. The 20-year-old patient, a non-invasive drug abuser, had suffered from hemoptysis for two months. The chest X-ray showed a solitary pulmonary nodule with a diameter of 2 cm in the left lower lobe with central cavitation. Fiberoptic bronchoscopy showed a normal bronchial system, biopsies were not diagnostic and no acid fast bacilli were found. Considering the patient's history and the cavitary process, a non-specific abscess was suspected and an antimicrobial treatment was started. Since no treatment effect was observed, biopsies from a second bronchoscopy were suspicious of a malignant mesenchymal tumour. Lower lobe resection with lymphadenectomy revealed a benign fibrous histiocytoma. This is--to our knowledge--the first reported case of a BFH presenting with cavitation.
Subject(s)
Histiocytoma, Benign Fibrous/diagnosis , Lung Neoplasms/diagnosis , Adult , Biopsy , Diagnosis, Differential , Hemoptysis/etiology , Histiocytoma, Benign Fibrous/diagnostic imaging , Histiocytoma, Benign Fibrous/surgery , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Lymph Node Excision , Male , Radiography, Thoracic , Treatment OutcomeABSTRACT
Previous studies suggested that the characteristics of young female lung cancer patients may differ from those of other patients. Using the cancer registry at the Lungenklinik Heckeshorn hospital, all female patients under the age of 46 yrs with primary lung cancer 1986-1995 were identified. The clinical records were reviewed for risk factors, stage, histology, therapy, and survival. The data were compared with those of other patients. Of the 4,939 patients 96 (1.9%) were females aged <46 yrs. The percentage of young females doubled within ten years from 1 to 2% of all patients (p=0.03). The main risk factor in young females was smoking. Adenocarcinoma and carcinoids were overrepresented, whereas squamous cell and small cell carcinoma were significantly rarer in the young female group. Young females and young males were more likely to have advanced disease and underwent surgery and/or combined treatment significantly more often than older patients. The overall survival was only moderately better in younger patients. The clinical features of young female patients differed from those of young males and older females, the prognosis likewise depended on tumour stage and therapy.
Subject(s)
Lung Neoplasms/pathology , Lung Neoplasms/therapy , Adolescent , Adult , Age Distribution , Combined Modality Therapy , Female , Humans , Lung Neoplasms/epidemiology , Lung Neoplasms/etiology , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Distribution , Smoking/adverse effects , Survival AnalysisABSTRACT
Lung cancer in young adults has been differently described in publications from various regions of the world, in respect of relative incidence, distribution of morphology and stages, and prognosis of the disease. We analysed retrospectively the data from the cancer registry of the Lungenklinik Heckeshorn in Berlin between 1986 and 1995 with regard to this topic. 106/4939 patients were 40 years old or younger (2.1%). The proportion of female patients was higher in the younger group (42 vs. 29%). Adenocarcinoma was the leading subtype in young patients (33 vs. 24%). The younger group showed a higher proportion of inoperable stages IIIB and IV for non-small cell lung cancer (71 vs. 46%). Younger patients with operable stages I to IIIA non-small cell lung cancer underwent surgery much more often than patients older than 40 years (90 vs. 49%), but for all patients with this morphology there was no difference in survival between younger and older patients (302 vs. 314 patients). We conclude that lung cancer presents a clearly different clinical picture in younger patients but not a better prognosis.
