RESUMO
A 54-year-old man was admitted to our hospital for further examination following a chest radiographic screening test. He was asymptomatic but had an elevated serum concentration of alpha-fetoprotein. Chest computed tomography (CT) and magnetic resonance imaging showed a posterior mediastinal mass in the left thoracic paravertebral region. CT-guided percutaneous needle biopsy was performed, and the histological findings confirmed nonseminomatous germ cell tumor (NSGCT). Gonadal examination and F-18 fluorodeoxyglucose positron emission tomography findings indicated the posterior mediastinum as the origin of the disease. Reports of primary NSGCT in the posterior mediastinum are extremely rare.
RESUMO
Although rare, gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. The asynchronous occurrence of other malignancies in patients with GIST during the clinical course is relatively common. However, the synchronous coexistence of GIST and lung cancer has only rarely been reported. We experienced a case of coincidental primary lung adenocarcinoma and intestinal GIST. The present case is not only of interest due to the rare coincidence of GIST and lung cancer, but also because there was an epidermal growth factor receptor gene mutation in the lung cancer and a c-kit mutation in the GIST.
Assuntos
Adenocarcinoma/diagnóstico , Neoplasias Gastrointestinais/diagnóstico , Tumores do Estroma Gastrointestinal/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Adenocarcinoma/genética , Adenocarcinoma/terapia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundário , Receptores ErbB/genética , Feminino , Neoplasias Gastrointestinais/genética , Neoplasias Gastrointestinais/terapia , Tumores do Estroma Gastrointestinal/genética , Tumores do Estroma Gastrointestinal/terapia , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/terapia , Pessoa de Meia-Idade , Mutação/genética , Neoplasias Primárias Múltiplas/genética , Neoplasias Primárias Múltiplas/terapia , Cuidados Paliativos , Proteínas Proto-Oncogênicas c-kit/genéticaRESUMO
Most mantle cell lymphoma patients show remarkable disseminated disease at the initial diagnosis. We describe two cases of mantle cell lymphoma mainly involving thoracic lesions at the initial presentation of the disease. The clinical presentations were right hilar lymphadenopathy in one case and right pleural thickness in the other. The diagnosis of mantle cell lymphoma was confirmed by immunohistochemistry, including CD5, CD20, and cyclin D1, and the presence of t(11 ; 14)(q13 ; q32) by fluorescence in situ hybridization. These thoracic manifestations at the initial diagnosis should be taken into consideration for the clinical spectrum of mantle cell lymphoma.
