Pleuropulmonary Blastoma: A Single-center Case Series of 6 Patients.

Pleuropulmonary blastoma (PPB) is a rare malignancy of childhood which when left untreated often shows pathologic progression resulting in a more aggressive neoplasm with an increasingly poor prognosis. Because of this it is important to diagnose and initiate treatment early. However, early stage PPB can appear as a cystic lung lesion on imaging and can be easily misdiagnosed given the rarity of the malignancy. Moreover, current therapeutic guidelines for these lesions are not well established, making treatment decisions and management difficult for clinicians. DICER1 mutations are known to be present in a majority of PPBs with or without a germline mutation and may be part of a familial tumor predisposition syndrome. The clinical, pathologic, and genetic data of 6 patients are summarized here. Two patients with type I PPB and 4 patients with type II PPB underwent surgical and chemotherapeutic treatment and all are alive and without recurrence 1 to 13 years after treatment. With increasing awareness of PPB, it is important for clinicians to consider this malignant entity in the evaluation and treatment of patients presenting with a cystic lung abnormality, especially in cases with a history strongly suggestive of a DICER1 mutation.

Sapwood temperature gradients between lower stems and the crown do not influence estimates of stand-level stem CO(2) efflux.

Temperature plays a critical role in the regulation of respiration rates and is often used to scale measurements of respiration to the stand-level and calculate annual respiratory fluxes. Previous studies have indicated that failure to consider temperature gradients between sun-exposed stems and branches in the crown and shaded lower stems may result in errors when deriving stand-level estimates of stem CO(2) efflux. We measured vertical gradients in sapwood temperature in a mature lowland podocarp rain forest in New Zealand to: (1) estimate the effects of within-stem temperature variation on the vertical distribution of stem CO(2) efflux; and (2) use these findings to estimate stand-level stem CO(2) efflux for this forest. Large within-stem gradients in sapwood temperature (1.6 +/- 0.1 to 6.0 +/- 0.5 degrees C) were observed. However, these gradients did not significantly influence the stand-level estimate of stem CO(2) efflux in this forest (536 +/- 42 mol CO(2) ha(-1) day(-1)) or the vertical distribution of stem CO(2) efflux, because of the opposing effects of daytime warming and nighttime cooling on CO(2) efflux in the canopy, and the small fraction of the woody biomass in the crowns of forest trees. Our findings suggest that detailed measurements of within-stand temperature gradients are unlikely to greatly improve the accuracy of tree- or stand-level estimates of stem CO(2) efflux.

Sap flow rates and sapwood density are critical factors in within- and between-tree variation in CO2 efflux from stems of mature Dacrydium cupressinum trees.

Measurements of CO2 efflux from stems and branches, sap velocity, and respiratory activity of excised wood cores were conducted in Dacrydium cupressinum trees that differed in diameter, age, and canopy emergence. The objective of this study was to determine if consistent linkages exist among respiratory production of CO2 within stems, xylem transport of CO2, and the rate of CO2 diffusing from stem surfaces. Stem CO2 efflux was depressed during periods of sap flow compared with the efflux rate expected for a given stem temperature and was positively correlated with sapwood density. By contrast, no significant relationships were observed between CO2 efflux and the respiratory activity of wood tissues. Between 86 and 91% of woody tissue respiration diffused to the atmosphere over a 24-h period. However, at certain times of the day, xylem transport and internal storage of CO2 may account for up to 13-38% and 12-18%, respectively, of woody tissue respiration. These results demonstrate that differences in sap flow rates and xylem anatomy are critically important for explaining within- and between-tree variation in CO2 efflux from stems.