[Experience with Secondary Pulmonary Lymphoma Diagnosed by Surgical Biopsy].

Pulmonary malignant lymphoma presents diverse imaging findings, thus making an imaging-based diagnosis difficult. Furthermore, because of the low histological diagnostic rate of approximately 30% based on transbronchial lung biopsy, there are difficulties in the early diagnosis of pulmonary malignant lymphoma. We report a case of pulmonary malignant lymphoma that was difficult to diagnose until a surgical biopsy was performed. A 72-year-old female was referred to our hospital with an abnormal chest shadow on a medical examination. Chest computed tomography(CT) scan demonstrated groundglass opacity and consolidation in both lung fields. Bronchoscopy was performed but a histological definitive diagnosis could not be obtained. We suspected organized pneumonia and initiated steroid therapy that resulted in improvement in the chest shadow. However, new multiple lung nodules and mediastinal lymphadenopathy were noticed on CT scan performed 9 months after the initiation of steroid therapy, and a lung biopsy and mediastinal lymph node biopsy were performed. Finally, the diagnosis was malignant lymphoma with pulmonary infiltrates.

Protective effects of intratracheally administered quercetin on lipopolysaccharide-induced acute lung injury.

BACKGROUND: Acute respiratory distress syndrome (ARDS) can result in a life-threatening form of respiratory failure, and established, effective pharmacotherapies are therefore urgently required. Quercetin is one of the most common flavonoids found in fruits and vegetables, and has potent anti-inflammatory and anti-oxidant activities. Quercetin has been demonstrated to exhibit cytoprotective effects through the induction of heme oxygenase (HO)-1. Here, we investigated whether the intratracheal administration of quercetin could suppress lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice as well as the involvement of HO-1 in quercetin's suppressive effects. METHODS: Mouse model of ALI were established by challenging intratracheally LPS. The wet lung-to-body weight ratio, matrix metalloproteinase (MMP)-9 activities, and pro-inflammatory cytokine productions, including tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6 in bronchoalveolar lavage fluid (BALF) were examined in ALI mice with or without quercetin pretreatment. We also examined the effects of quercetin on LPS stimulation in the mouse alveolar macrophage cell line, AMJ2-C11 cells. RESULTS: Intratracheal administration of quercetin decreased the wet lung-to-body weight ratio. Moreover, quercetin decreased MMP-9 activity and the production of pro-inflammatory cytokines in BALF cells activated by LPS in advance. We determined the expression of quercetin-induced HO-1 in mouse lung, e.g., alveolar macrophages (AMs), alveolar and bronchial epithelial cells. When AMJ2-C11 cells were cultured with quercetin, a marked suppression of LPS-induced pro-inflammatory cytokine production was observed. The cytoprotective effects were attenuated by the addition of the HO-1 inhibitor SnPP. These results indicated that quercetin suppressed LPS-induced lung inflammation, and that an HO-1-dependent pathway mediated these cytoprotective effects. CONCLUSIONS: Our findings indicated that quercetin suppressed LPS-induced lung inflammation, and that an HO-1-dependent pathway mediated these cytoprotective effects. Intratracheal administration of quercetin will lead to new supportive strategies for cytoprotection in these serious lung conditions.