ABSTRACT
BACKGROUND/AIM: Pleomorphic carcinoma (PC) of the lung is a rare tumor that usually has an aggressive clinical course and a poor prognosis. Clinical and pathological features remain unclear. The aim of this study was to determine whether tumor angiogenesis of PC is up-regulated compared to that in adenocarcinoma (AD). MATERIALS AND METHODS: We collected 55 cases of PC and AD in which the patients had undergone either lung resection or autopsy and immunohistochemically examined the expression of vascular endothelial growth factor (VEGF), hypoxia-inducible factor (HIF)-1α and microvessel density (MVD) in tissue specimens. RESULTS: VEGF was expressed in many cases of both PC and AD with no significant differences between the groups. In contrast, the expression of HIF-1α and MVD were significantly greater in PC than AD. Median survival time of the PC group was 14.7 months and significantly shorter than that of the AD group. CONCLUSION: MVD and expression of HIF-1α are associated with angiogenesis in PC and confer a poorer prognosis. Tumor angiogenesis provides significant prognostic information regarding clinical outcome in patients with PC.
Subject(s)
Adenocarcinoma/blood supply , Lung Neoplasms/blood supply , Neovascularization, Pathologic/metabolism , Adenocarcinoma/metabolism , Adenocarcinoma/mortality , Adult , Aged , Aged, 80 and over , Angiogenic Proteins/metabolism , Female , Humans , Kaplan-Meier Estimate , Lung Neoplasms/metabolism , Lung Neoplasms/mortality , Male , Middle Aged , Multivariate Analysis , Neovascularization, Pathologic/mortality , Prognosis , Proportional Hazards ModelsABSTRACT
A 69-year-old man was hospitalized for fever and cough. He was diagnosed with and treated for an abscess in the left lower jaw and pneumonia by an otolaryngologist, but the pneumonia persisted with no improvement. Chest computed tomography revealed the presence of a heterogeneous torose lesion in the inlet of the left upper bronchus, and bronchoscopy revealed an endobronchial tumor with a smooth surface. An episode of sudden dyspnea occurred and was resolved after the patient changed his sitting position. We concluded that this symptom occurred because the tumor was incarcerated in the left lower lobe bronchus. The tumor was excised by bronchofi berscopic snare resection under tracheal intubation. It was found to be a pleomorphic carcinoma, and left upper lobectomy was performed. There has been no recurrence during the 3 years since the operation.
Subject(s)
Airway Obstruction/surgery , Bronchial Neoplasms/surgery , Bronchoscopy , Carcinoma, Non-Small-Cell Lung/surgery , Pneumonectomy , Aged , Airway Obstruction/diagnosis , Airway Obstruction/etiology , Biopsy , Bronchial Neoplasms/complications , Bronchial Neoplasms/diagnosis , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/diagnosis , Chemotherapy, Adjuvant , Dyspnea/etiology , Humans , Intubation, Intratracheal , Male , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Adipose Tissue/diagnostic imaging , Carcinoma, Squamous Cell/diagnostic imaging , Hernia, Diaphragmatic/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Pleural Effusion, Malignant/diagnostic imaging , Aged , Carcinoma, Squamous Cell/surgery , Diagnosis, Differential , Humans , Lung Neoplasms/surgery , Male , RadiographyABSTRACT
Gorham's disease is a rare disorder characterized by a non-malignant proliferation of thin-walled lymphatic vessels that result in progressive bony destruction and often extend into the surrounding soft tissues. Chylothorax is a common complication in cases of mediastinal involvement. Here we report a case of a 22-year-old male with Gorham's syndrome complicated by chyloma of the chest wall, but without chylothorax. To our knowledge, this is the first report demonstrating an abnormality of the parietal pleura prior to the clinical development of the chylothorax.
Subject(s)
Chylothorax/etiology , Osteolysis, Essential/complications , Thoracic Wall/pathology , Adult , Humans , Male , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/surgery , Osteolysis/pathology , Osteolysis/surgery , Osteolysis, Essential/pathology , Osteolysis, Essential/surgery , Postoperative Complications/etiology , Thoracic Surgery, Video-Assisted , Thoracic Vertebrae/pathology , Thoracic Vertebrae/surgery , Thoracic Wall/surgeryABSTRACT
OBJECTIVE AND METHODS: In order to clarify the utility of video-assisted thoracoscopic surgery (VATS) for mediastinal disease, we analyzed retrospectively 34 thoracoscopic surgical cases (seven lymph node, nine thymic, eight cystic and 10 cases with solid lesions that excluded thymic diseases) between February 1993 and July 2002. RESULTS: In lymph node disease, adequate specimens were obtained in all cases; pathologic diagnoses were three sarcoidosis, two tuberculosis, and two other tumors. In thymic disease, all cases underwent thoracoscopic partial resection of the thymus. Conversion to thoracotomy or mediansternotomy was necessary in two cases of epithelial thymic tumors. In cases of cystic diseases, complete resections of the cysts were performed in five cases. Final diagnoses of these cysts were four bronchogenic, three pericardial, and one parathyroid cyst. In solid diseases, nine tumors were completely resected. Final diagnoses of these tumors were six neurogenic, and four other tumors. CONCLUSION: VATS is an effective and reliable approach for managing mediastinal diseases. Cases of small lesions surrounded by thymic tissue, cystic lesions excluding lymphatic duct origin, and neurogenic tumors without evidence of intraspinal invasion are good indications for VATS.
