Clinical and characteristic features of surgically treated endobronchial hamartoma cases: analysis of twenty-two cases.

PURPOSE: Endobronchial hamartomas are tumors originating from peribronchial mesenchymal tissues. Generally, endobronchial methods are used in the treatment of these tumors, which are usually benign. Surgery is used in cases of endobronchial hamartoma that cannot be fully treated with endobronchial methods, or that developed parenchyma destruction due to bronchial obstruction. The objective of this study is to assess clinical and characteristic features of surgically treated cases of endobronchial hamartoma. MATERIALS AND METHODS: Twenty-two patients who underwent anatomic resection between 1988 and 2011 in our clinic were diagnosed with hamartoma. Clinical and characteristic features of these patients (17 males and 5 females) were assessed retrospectively via patient records. RESULTS: Patients were aged between 43 and 72 (average 54.4). Fifteen patients underwent lobectomy (lobectomy for 13 patients, bilobectomy for 1), 6 patients underwent bronchotomy, 1 patient underwent tracheotomy and 1 underwent pneumonectomy. Pathologic diagnosis was chondromatosis hamartoma for 9 patients and lipomatosis hamartoma for 6 patients; dominant cell type was not detected for 7 patients. No surgery-related mortality was observed. No recurrence was observed for patients after the surgery. CONCLUSIONS: Endoscopic treatment methods yield successful results in endobronchial hamartomas. However, surgery is required in cases that develop irreversible parenchymal destruction due to chronic obstruction and suppuration, or those that cannot be treated via endobronchial methods.

Clinical significance of the expression of alpha-methylacyl-CoA racemase in squamous cell carcinoma and adenocarcinoma of the lung.

BACKGROUND: The role of alpha-methylacyl-CoA racemase (AMACR) in pathogenesis and diagnosis of different types of cancer has been investigated during last decade. This study is conducted to investigate AMACR expression in adenocarcinoma and squamous cell carcinoma (SCC) of lung and its correlation with clinical characteristics and survival. METHODS: The clinicopathologic characteristics of 146 patients who underwent a potentially curative surgical resection between June 2000-2009 in our clinic were reviewed retrospectively. The patients who were given adjuvant chemotherapy and/or radiotherapy, with an evidence of residual tumor at resection margin and who died due to postoperative mortality and due to reasons not related to lung cancer were excluded. Data from remaining 67 patients were analyzed for survival. For the correlation between progression and AMACR immunoreactivity, data from 62 patients who had postoperative follow up in our center were analyzed. RESULTS: AMACR immunoreactivity was observed more frequently in adenocarcinoma group than SCC group (p = 0,046). The samples with invasive adenocarcinoma--lepidic predominant pattern also showed high rates of positive staining (73%). We could not show a statistically significant correlation between AMACR immunostaining and degree of differentiation, age, gender, pathologic T status, N status, or stage. We failed to show a statistically meaningful effect of AMACR on overall and progression-free survival. CONCLUSION: Adenocarcinoma had higher rates of positive immunostaining for AMACR than SCC (p = 0,046). But the presence of AMACR expression did not have a statistically meaningful effect on overall and progression-free survival in adenocarcinoma and SCC of lung.

MUC1 and bcl-2 expression in preinvasive lesions and adenosquamous carcinoma of the lung.

BACKGROUND: Adenosquamous carcinoma of the lung involves both adenocarcinoma and squamous cell carcinoma, each comprising at least 10% of the tumor. Atypical adenomatous hyperplasia (ADH), bronchiolar columnar cell dysplasia (BCCD), basal cell dysplasia (BCD), columnar cell dysplasia (CCD), bronchial epithelial dysplasia with transitional differentiation (BEDT) and squamous dysplasia (SD) are preinvasive lesions. The aim of this study is to define the preinvasive lesions and evaluate the role of MUC1, bcl-2, and the preinvasive and invasive components of adenosquamous carcinoma. METHODS: A group of 31 patients with adenosquamous carcinoma of the lung were selected. The ratio of squamous to glandular differentiation, the associated preinvasive lesions, the features of peritumoral tissue, the stroma of the tumor, necrosis, perineural and vascular invasion were analyzed. For the immunohistochemical study, blocks containing squamous cell carcinoma, adenocarcinoma and preinvasive lesions were selected. MUC1 and bcl-2 analyses were performed by the immunoperoxidase method using the avidin-biotin complex. RESULTS: Associated preinvasive lesions amd SD, BCCD, BEDT, AAH and CCD were observed in 24, 6, 3, 1 and 6 cases, respectively. Expression for MUC1 was positive in the squamous component of 30 cases, the adenocarcinoma component of 27 cases and in 34 preinvasive lesions. A strong correlation was found between MUC-1 expression in the squamous component and tumor localization (p = 0,01). The positive expression of Bcl-2 in the adenocarcinomatous component was correlated with the presence of preinvasive lesions (p = 0,01). CONCLUSIONS: Squamous dysplasia was the most frequent preinvasive lesion of adenosquamous carcinomas. MUC1 and bcl-2 expression levels were strongly associated with preinvasive lesions in adenosquamous carcinomas.