• 제목/요약/키워드: Adenocarcinoma of the lung

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Clinical Characteristics of Patients with Bronchioloalveolar Carcinoma: A Retrospective Study of 44 Cases

  • Dirican, Nigar;Baysak, Aysegul;Cok, Gursel;Goksel, Tuncay;Aysan, Tulin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4365-4368
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    • 2013
  • Background: Bronchioloalveolar carcinoma (BAC) is considered a subtype of adenocarcinoma of the lung. Recently BAC has been variously termed adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant invasive adenocarcinoma, and invasive mucinous adenocarcinoma. The aim of the study was to analyze and detect prognostic factors of patients with BAC over a 7-year period. Materials and Methods: This retrospective single-center study included 44 patients with BAC. The impact on survival of fifteen variables (gender, age, smoking status, cough, dyspnea, hemoptysis, fever, chest pain, sputum, metastasis number, Karnofsky performance status, pT, pN, TNM stage, cytotoxic chemoterapy) were assessed. Results: Median age was 55 years (38-83). Most patients were male (63.6%) and stage IV (59.1%). Twenty-one patients (47.7%) received cytotoxic chemotherapy (platinum-based regimens) for metastatic disease. Objective response rate was 33.3% (4 partial, 3 complete responses). Stable disease was observed in nine in patients (42.8%). Disease progression was noted in 5 (23.8%). The median OS for all patients was 12 months (95%CI, 2.08-22.9 months). Independent predictors for overall survival were: Karnofsky performance status (HR:3.30, p 0.009), pN (HR:3.81, p 0.018), TNM stage (HR:6.49, p 0.012) and hemoptysis (HR:2.31, p 0.046). Conclusions: Karnofsky performance status, pN, TNM stage and hemoptysis appear to have significant impact on predicting patient survival in cases of BAC.

Fine Needle Aspiration Cytology of So-called Sclerosing Hemangioma of the Lung - Report of Two Cases - (폐의 '소위 경화성 혈관종'의 세침 흡인 세포학적 소견 -2예 보고 -)

  • Myong, Na-Hye;Ha, Chang-Won;Cho, Kyung-Ja;Jang, Ja-June
    • The Korean Journal of Cytopathology
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    • v.2 no.1
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    • pp.28-35
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    • 1991
  • So-called sclerosing hemangioma of the lung is a rare benign neoplasm which usually presents with a coin lesion detected through routine chest X-ray. We report two cases showing characteristic cytologic appearances which have been rarely reported. Both cases were young females with coin lesions in the lung. Fine needle aspiration of each case revealed unique but some different cytologic features. Case 1 showed bland-looking polygonal epithelial cells resembling bronchioloalveolar cells haying predominantly papillary configurations with loosely arranged solid sheets or isolated cells. Cytoplasms were plump, cyanophilic, and finely granular, with eccentric nuclei. The nuclei were usually monotonous, round-to-ovoid, and vesicular with a small but conspicuous nucleolus. In comparison to case 1, case 2 revealed largely loose pavement-like solid sheets or clusters rather than papillary patterns in the hemorrhagic background. The size of tumor cells were a little smaller than that of case 1. Bronchioloalveolar carcinoma and papillary adenocarcinoma of metastatic origin were considered to be one of the important differential diagnoses with these cytologic features. Histologically, both cases exhibited findings compatible with so-called sclerosing hemangioma of the lung.

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Pembrolizumab-related autoimmune hemolytic anemia in a patient with metastatic lung adenocarcinoma: a case report

  • Baek, Dong Won;Chae, Yee Soo
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.366-370
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    • 2021
  • Immune checkpoint inhibitors (ICIs) have become the main drugs for programmed cell death receptor-1 or ligand-1 expressing non-small cell lung cancer (NSCLC) combined with conventional chemotherapy. ICIs are generally more tolerable than cytotoxic chemotherapies in terms of toxicity, and ICI-related adverse events are mild and manageable. However, these drugs may lead to unexpected severe adverse events such as immune-related hematologic toxicities, which could be life-threatening. Here, a rare case of a pembrolizumab-related adverse event in a patient with NSCLC who showed early-onset hemolytic anemia and recovered by high-dose steroid and a series of plasma exchanges is reported.

Cytologic Features and Distribution of Primary Sites of Malignant Cells in Body Cavity Fluids (체강액내 암세포의 원발부위 및 세포학적 소견)

  • Suh, Kang-Suek;Lee, Chang-Hun;Kim, Hyun-Ok
    • The Korean Journal of Cytopathology
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    • v.8 no.1
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    • pp.35-46
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    • 1997
  • The authors reviewed 167 malignant effusions from 110 patients, of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm. Main factors analysed were the distribution of primary organs and the cytohistoiogic correlation of body cavity effusions. The 167 fluid specimens from 110 patients consisted of 90 cases(53.9%) of pleural, 68(40.7%) of peritoneal, and 9(5.4%) of pericardial origins. Histologically they consisted of 82 cases(74.5%) of adenocarcinoma, 8(7.3%) of malignant lymphoma, 6(5.5%) of squamous ceil carcinoma, and 3(2.7%) of small cell carcinoma. The most common site among the primary lesions was the stomach in 25 cases(22.7%) followed by the lung in 21(19.1%), ovary on 17(15.5%), and breast in 7(6.4%). As for the distribution of primary tumors in adenocarcinoma, the most common site was lung un 16 cases (48.5%) in pleural fluid and stomach in 22(48.9%) in peritoneal fluid. In pericardial effusions, all 5 cases were from the lung. As a whole, the cytologic findings of malignant effusion were fairly representative of histologic characteristics of primary lesions. Thus, when the primary lesion Is unknown, careful evaluation of effusion cytology is presumed to be a helpful tooi for tracing the primary tumor.

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Expression of TS, RRM1, ERCC1, TUBB3 and STMN1 Genes in Tissues of Non-small Cell Lung Cancer and its Significance in Guiding Postoperative Adjuvant Chemotherapy

  • Zou, Zhi-Qiang;Du, Yi-Ying;Sui, Gang;Xu, Shi-Ning
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3189-3194
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    • 2015
  • Background: To explore the expression of TS, RRM, ERCC1, TUBB3 and STMN1 genes in the tissues of patients with non-small cell lung cancer (NSCLC) and its significance in guiding the postoperative adjuvant chemotherapy. Materials and Methods: Real time polymerase chain reaction (PCR) was applied to detect the expression of TS, RRM, ERCC1, TUBB3 and STMN1 genes in the tissues of NSCLC patients so as to analyze the relationship between the expression of each gene and the clinical characteristics and to guide the postoperative individualized chemotherapy according to the detection results of NSCLC patients. Results: Expression of TS gene was evidently higher in patients with adenocarcinoma than those with non-adenocarcinoma (P=0.013) and so was the expression of ERCC1 (P=0.003). The expression of TUBB3 gene was obviously higher in NSCLC patients in phases I/II and IV than those in phase III ($P_1=0.021$; $P_2=0.004$), and it was also markedly higher in patients without lymph node metastasis than those with (P=0.008). The expression of STMN1 gene was apparently higher in patients in phase I/II than those in phase IV (P=0.002). There was no significant difference between the rest gene expression and the clinical characteristics of NSCLC patients (P>0.05). Additionally, the diseasefree survival (DFS) was significantly longer in patients receiving gene detections than those without (P=0.021). Conclusions: The selection of chemotherapeutic protocols based singly on patients' clinical characteristics has certain blindness. However, the detection of tumor-susceptible genes can guide the postoperative adjuvant chemotherapy and prolong the DFS of NSCLC patients.

Surgical Treatment of Primary Lung Cancer (원발성 폐암의 외과적 치료)

  • 곽문섭
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.87-100
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    • 1988
  • The authors evaluated 200 cases of primary carcinoma of lung in terms of the cell type, operability, resectability and survival rate, that proved by histopathologic examination at the Dept. of Thoracic and Cardiovascular Surgery, Catholic Medical College during the period of 11 years from Jan., 1977 to Dec., 1987. The results are as follows; 1] The peak incidence was observed in the 7th decade of life [34%] and followed by 6th [30%] 8 5th decade [25%]. Male to female ratio was 3.4:1. 2] Histopathologic classifications were squamous cell carcinoma 48% [96 cases], adenocarcinoma 27% [34 cases], small cell carcinoma 13%[26 cases], ;bronchioloalveolar cell carcinoma 5% [10 cases], large cell carcinoma 4.5% [9 cases], adenosquamous cell carcinoma 1.5% [3 cases] and adenoalveolar cell carcinoma 0.5% [1 case]. 3] Among 200 cases of primary lung cancer, the operability was 47.5% [95 cases], refusal of operation 6.0% [12 cases] and inoperability 46.5% [93 cases]. 4] Ninety five cases [47.5%] were operated. Of these, post-surgical stage I was 18.9% [18 cases], stage II 24.2% [23 cases] and stage III 56.8% [54 cases]. Among 54 cases of stage III, 32 cases were unresectable, while 22 cases were resectable. Consequently, the resectability was 31.5% [63 cases] from the total numbers of 200 cases, and the resectability for the operable 95 cases was 66.3% [63 cases]. 5] Surgical complications were empyema with bronchopleural fistula [4 cases], G-I bleeding [1 case], tedious pleural effusion [1 case] and acute respiratory insufficiency [1 case]. Operative mortality was 3.2% [2 cases], which caused by massive G-I bleeding [1 case] and respiratory insufficiency [1 case]. 6] On the long term follow-up of resectable 63 cases, overall 3 year survival rate was 35%, 5 year 22% and 9 year 2%. Five year survival rate was 39% in stage l, 30% in stage II and 0% in stage III. As for the cell types, the higher 5 year survival rate was observed in resectable squamous cell carcinoma [35%] as compared to adenocarcinoma [15%], alveolar cell carcinoma [14%], small cell carcinoma [0%] and large cell carcinoma [0%].

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Comparative Assessment of the Diagnostic Value of Transbronchial Lung Biopsy and Bronchoalveolar Lavage Fluid Cytology in Lung Cancer

  • Binesh, Fariba;Pirdehghan, Azar;Mirjalili, Mohammad Reza;Samet, Mohammad;Majomerd, Zahra Amini;Akhavan, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.201-204
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    • 2015
  • Background: This study was designed to determine the accuracy of bronchoalveolar lavage fluid cytology (BAL) using histopathologic examination of transbronchial biopsy specimens as the gold standard in diagnosis of lung carcinoma at our center. Materials and Methods: A retrospective study was conducted to investigate a total of 388 patients who were suspected of having lung cancer and had undergone fiberoptic bronchoscopy in Shahid Sadoughi hospital from 2006 to 2011. Lung masses were proven to be malignant by histology. Results: Transbronchial lung biopsy (TBLB) identified malignancy in 183 of the 388 cases, including 48 cases (26.2%) with adenocarcinoma, 4(2.1%) with bronchioloalveolar carcinoma, 47(25.6%)with squamous cell carcinoma, 34(18.5%) with well-diffentiated neuroendocrine carcinoma, 35(19.1%) with small cell carcinoma, 14 (7.6%) with non-small cell carcinoma, and 1 (0.54%) with large cell carcinoma. A total of 205 cases were correctly classified as negative. BAL was also performed in 388 patients; 86/103 cases were consistent with the final diagnosis of lung cancer and 188/285 cases were correctly classified as negative. The sensitivity of BAL was 46.9%(CI:41.9%, 51.8%)) and its specificity was 91.6%(CI:88.8%, 94.3%). BAL had a positive predictive value (PPV) of 83.4%(CI:79.7%, 87.1%) and a negative predictive value (NPV) of 65.8%(CI:61%, 70.5%). The overall accuracy of BAL was 70.5% and the exact concordance was 39%. Conclusions: Our findings suggest that BAL cytology is not sensitive but is a specific test for diagnosis of lung carcinoma. If transbronchial lung biopsy is combined with bronchoalveolar lavage, the positive diagnostic rate will be further elevated.

High Feasibility of Liquid-Based Cytological Samples for Detection of EGFR Mutations in Chinese Patients with NSCLC

  • Wu, Chun-Yan;Hou, Li-Kun;Ren, Sheng-Xiang;Su, Bo;Chen, Gang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7885-7889
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    • 2014
  • Background: Activating mutations of epidermal growth factor receptor (EGFR) could predict response to tyrosine kinase inhibitor (TKI) treatment in patients with non-small cell lung cancer (NSCLC). However, the detection of EGFR mutation is frequently challenging in clinical practice for the lack of tumor tissue. The aim of this study was to investigate the feasibility of performing EGFR mutation testing on various types of liquid-based cytology (LBC) samples. Materials and Methods: A total of 434 liquid-based cytology samples were collected from March 2010 and November 2013. Among them, 101 with diagnosis of lung adenocarcinoma had paired surgically resected specimens. The ADx Amplification Refractory Mutation System (ADx-ARMS) was used to determine EGFR mutation status both in LBC and resected samples. Results: All liquid-based cytology samples were adequate for EGFR mutation analysis. The mutation rate was 50.5% in the 434 NSCLC patients with LBC samples and the incidence rates of EGFR mutation were consistent among different specimens. We also detected EGFR positives in 52.5% (53/101) patients with paired histologic specimens. The concordance rate of EGFR mutation between LBC samples and paired histologic specimens was 92.1%. Conclusions: Our results suggest that liquid-based cytology samples are highly reliable for EGFR mutation testing in patients with NSCLC.

A Case of Non-Small Cell Lung Cancer in a Respiratory Bronchiolitis Associated Interstitial Lung Disease Patient (호흡 세기관지염 연관 간질성 폐질환환자에서 확인된 비소세포폐암 1예)

  • Jhun, Byung-Woo;Kim, Da-Min;Park, Ji-Hyeon;Jung, Hyun-Ae;Song, Lim-Hwa;Han, Joung-Ho;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.216-220
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    • 2011
  • Respiratory bronchiolitis-associated interstitial lung disease is one of the smoking-related interstitial lung diseases. Histopathologically, it shows respiratory bronchiolitis, which is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles, accompanying peribronchiolar inflammation. Clinically, it is presented with respiratory symptoms such as a cough, sputum and dyspnea on exertion. It is well known that the incidence of malignancy in interstitial lung disease is high, but in respiratory bronchiolitis-associated interstitial lung disease the report of accompanying malignancy is rare. Here we report a case of a 60-year-old male heavy smoker presented with a cough, sputum and clubbing finger. A chest computed tomography (CT) of the patient did not show any shadow suspected of malignancy, but adenocarcinoma was found on a transbronchial lung biopsy and on a surgical lung biopsy with respiratory bronchiolitis-associated interstitial lung disease.

Benzo[a]pyrene Alters the Expression of Genes in A549 Lung Cancer Cells and Cancer Stem Cells

  • Bak, Yesol;Jang, Hui-Joo;Seo, Ji-Hye;No, Su-Hyun;Chae, Jung-il;Hong, Jintae;Yoon, Do-Young
    • Journal of Microbiology and Biotechnology
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    • v.28 no.3
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    • pp.425-431
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    • 2018
  • Benzo[a]pyrene (B[a]P), a polycyclic aromatic hydrocarbon, is a principal component of cigarette smoke. B[a]P can cause lung carcinogenesis and plays a key role in lung cancer progression. The role of B[a]P has been reported in lung cancer, but its effects on lung cancer stem cells (CSCs) have not been investigated. Emerging evidence indicates that CSCs are associated with carcinogenesis, tumor initiation, relapse, and metastasis. Therefore, targeting CSCs to defeat cancer is a challenging issue in the clinic. This study explored whether B[a]P alters gene expression in lung cancer cells and CSCs. The lung adenocarcinoma A549 cell line was used to investigate the role of B[a]P on lung cancer cells and lung CSCs using microarray and quantitative PCR. B[a]P ($1{\mu}M$) provoked gene expression changes in A549 cancer cells and CSCs by deregulating numerous genes. Gene pathway analysis was performed using GeneMANIA and GIANT. We identified genes that were coexpressed and showed physical interactions. These findings improve our understanding of the mechanism of B[a]P in lung cancer and cancer stem cells and can be an attractive therapeutic target.