• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5899-5902
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• 2015

Background: To compare the current histologic distribution of lung cancer in Lebanon to the worldwide trends, according to the 2004 WHO Classification. Materials and Methods: 1,760 patients with a pulmonary pathology examination at Hotel-Dieu de France University Hospital between July 2009 and July 2014 were included. Results: Some 676 out of the total investigated patients (38.4%) had a lung tumor. In 665 (98.4%) the tumors were malignant, with a mean age at diagnosis of 63.8 years and a male/female (M/F) sex ratio of 1.7:1. Among the malignant tumors, 86.2% were epithelial tumors with a mean age at diagnosis of 64.8 years and an M/F sex ratio of 1.9. Other malignant tumors consisted of metastatic tumors (10.2%), lymphoproliferative tumors (2.1%) and mesenchymal tumors (1.5%). Most common carcinoma subtypes were adenocarcinoma (48.0%), squamous cell carcinoma (23.0%) and small cell carcinoma (13.3%). Carcinoid tumors were the only carcinoma subtype with an M/F sex ratio below 1 (0.7). Salivary gland tumors were the carcinoma with lowest mean age at diagnosis (45.5 years). Conclusions: The histologic distribution of lung tumors in Lebanon is similar to that in developed countries. We believe this resemblance is due to common smoking habits, known to be responsible for the increase of lung adenocarcinoma at the expense of other subtypes.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.208-211
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• 2005

Primary lung cancer is unusual in children; the squamous cell variant is extremely rare. Lung cancer is classified by histologic types into small-cell lung cancer, non-small cell lung caner, carcinoid, mucoepidermoid carcinoma, and adenoid cystic carcinoma. Furthermore, non-small cell lung cancer is subclassified into adenocarcinoma, large-cell carcinoma, and squamous cell carcinoma. The incidence of lung cancer is influenced by smoking, especially in squamous cell carcinoma, and large cell carcinoma. The present treatments for these tumors are chemotherapy, radiation therapy, and surgical resection depending on their histologic types or stages, but yield very poor survival rates. In this article, we report a case of basaloid squamous cell lung carcinoma in an 11-year-old boy who had symptoms of both leg weakness and back pain radiating to both legs. We confirmed the primary lung carcinoma cells by percutaneous transthoracic needle biopsy. The metastatic carcinoma cells were identified at the bone marrow and lumbar spine. We treated with a combination chemotherapy and radiation therapy. However, he expired 4 months after the onset of disease.

• The Korean Journal of Cytopathology
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• v.2 no.2
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• pp.90-97
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• 1991

Liver is generally known as an organ which is most commonly involved by the metastic tumors. According to the tendency of using fine needle aspiration in the diagnosis of hepatic tumors, the differentital diagnosis between hepatocellular carcinoma and metastatic carcinoma frequently has been a main issue in the poorly differentitated cases, especially to the pathologists of Korea, an endemic area of hepatocellular carcinoma. Until now the problem has been usually solved by the comparison of cytologic characteristics of their tumor cells but not by background cytologic features which rarely have been studied. We observed the background cytologic features helpful for the differential diagnosis through the analysis of 20 cases who had confirmed primary cancer and were diagnosed as metastatic carcinomas in the liver by fine needle aspiration cytology. Twenty cases included 9 adenocarcinomas, 7 spuamous cell carcinomas, 1 small cell carcinoma, 1 carcinoid, 1 adenoid cystic carcinoma, and 1 renal cell cacinoma. Analysis of background cytologic features revealed that 77% of adenocacinoma cases showed benign mesenchymal components and hepatocytes and spuamous cell carcinoma cases disclosed benign mesenchymal tissue (71%) and necrosis (57%), Remaining cases showed variable combinations of benign mesenchymal component, necrosis, hepatocytes, and bile duct epithelial cells. No case revealed atypical hepatocytic naked nuclei, a useful cytologic finding of hepatocellular carcinoma. In summary, the background cytologic features more commonly observed in metastatic carcinomas than in the hepatocellular carcinoma were benign mesenchymal components, hepatocytes, necrosis, and bile duct epithelium. The endothelial cells and hepatocytic naked nuclei, two relatively specific findings of hepatocellular carcinoma were not observed except for renal ceil carcinoma. Above background cytologic features are thought to be helpful for the differential diagnosis between the hepatocellular carcinoma and various metastatic carcinomas in the poorly differentiated cases.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.68-73
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• 2008

Background: The presence of infiltrated mediastinal lymph nodes is a crucial factor for the prognosis of lung cancer. The aim of our study is to investigate the pattern of metastatic non-small cell lung cancer that spreads to the mediastinal lymph nodes, in relation to the primary tumor site, in patients who underwent major lung resection with complete mediastinal lymph node dissection. Material and Method: We retrospectively. studies 293 consecutive patients [mean age $63.0{\pm}8.3$ years (range $37{\sim}88$) and 220 males (75.1%)] who underwent major lung resection due to non-small cell lung cancer from January 1998 to December 2005. The primary tumor and lymph node status was classified according to the international TNM staging system reported by Mountain. The histologic type of the tumors was determined according to the WHO classification. Fisher's exact test was used; otherwise the chi-square test of independence was employed. A p-value < 0.05 was considered significant. Result: Lobectomy was carried out in 180 patients, bilobectomy in 50, sleeve lobectomy in 10 and pnemonectomy in 53. The pathologic report revealed 124 adenocarcinomas, 138 squamous-cell tumors, 14 adenosquamous tumors, 1 carcinoid tumor, 8 large cell carcinomas, 1 carcinosarcoma, 2 mucoepidermoid carcinomas and 5 undifferentiated tumors. The TNM stage was IA in 51 patients, IB in 98, IIB in 41, IIIA in 71, IIIB in 61 and IV in 6. 25.9 % of the 79 patients had N2 tumor. Most common infiltrated mediastinal lymph node was level No.4 in the right upper lobe, level No. 4 and 5 in the left upper lobe and level No. 7 in the other lobes, but no statistically significant difference was observed. Thirty-six patients (12.3%) presented with skip metastasis to the mediastinum. Conclusion: Mediastinal lymph node dissection is necessary for accurately determining the pTNM stage. It seems that there is no definite way that non-small cell lung cancer spreads to the lymphatics, in relation to the location of the primary cancer. Further, skip metastasis to the mediastinal lymph nodes was present in 12.3% of our patients.

• Journal of Oriental Neuropsychiatry
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• v.2 no.1
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• pp.3-18
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• 1991

Serotonin was chemically identified as 5-hydrowytryptamin which occurs in plants, animals, and human beings. The end product of metabolism was excreted as 5-HIAA in urine. Many scientists, specially biochemist and psychiatrist reported that the change of serotonin concentration caused mental disorder and pathological condiions such as schizophrenia and carcinoid. This study was carried out to observe the urinary 5-HIAA excretion rates changed by three recipes treatment (Kamisoyosan, Ondamtang, kalgunhaegitang) according to the classification of endogenous, exogenous and non-exo-endogenous, causes of disease. The urinary 5-HIAA excretion rates before and after three recipes treatment on normal groups divided into three groups on the basis of physical constitutional differences and on patients groups, divided into three groups according to the causal factor were measured. The results were as follows; 1. The urinary 5-HIAA volume of patients groups appeared non-exoendogenous, endogenous, exogenous causes of disease in order of three causative classification. 2. The urinary 5-HIAA volume of Normal groups was $2.50{\pm}088mg/24hrs$(range $0.30{\sim}6.90mg/24hrs$) 3. Thr urinary 5-HIAA volume was $3.70{\pm}0.89mg/24hrs$(range $0.90{\sim}6.50mg/24hrs$) before kamisoyosan treatment and $3.20{\pm}0.72mg/24hrs$ (range $0.80{\sim}6.20mg/24hrs$) after the treatment. 4. The value was $2.60{\pm}0.10mg/24hrs$ (range $0.60{\sim}6.50mg/24hrs$) before Ondamtange treatment and $2.00{\pm}0.12mg/24hrs$(range $0.20{\sim}6.10mg/24hrs$) after the treatment. 5. The value was $4.30{\pm}0.75mg/24hrs$(range $0.92{\sim}6.50mg/24hrs$) before kalgunhaegitang treatment and $3.10{\pm}0.10mg/24hrs$(range $0.80{\sim}5.80mg/24hrs$) after the treatment. Considering the above-mentioned the study on the changes of urinary 5-HIAA volume will make a significant contribution to the diagnosis and the evaluation of therapeutic effect successive research and modified application will be in need.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.802-804
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• 2007

Although intrathoracic liver in association with a congenital diaphragmatic hernia has been well documented, the finding of intrathoracic ectopic liver tissue in the presence of an intact diaphragm is an extremely rare congenital anomaly. We have experienced a case of intrathoracic ectopic liver without any diaphragmatic hernia. A 37-year-old woman was admitted for the treatment of an incidentally detected right lung mass, A chest computed tomography scan revealed a right lower lobe lung mass close to the diaphragm, and this was suspicious for bronchial carcinoid tumor. Upon surgery, 2 round solid masses $3.5{\times}3.5 cm$ and a $2.0{\times}2.0 cm$ in size were noted, with their bottoms attached to the diaphragm dome. The masses were completely resected. Histologically, they were confirmed to be intrathoracic ectopic livers. The patient had an uncomplicated postoperative course.

• Journal of Gastric Cancer
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• v.8 no.2
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• pp.104-109
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• 2008

Purpose: To investigate the clinicopathlogical characteristics and the surgical methods for gastric submucosal tumors in Korea, the Information Committee of the Korean Gastric Cancer Association performed a nationwide survey. Materials and Methods: Data on 878 patients who underwent resection from 2005 to 2006 were collected from medical records obtained from 47 institutes. Diagnosis, demographics, symptoms, tumor factors (location, size, degree of malignancy) and operative factors (surgicalmethod and approach, mortality) were analyzed. Results: Gastrointestinal stromal tumors (GISTs) were the most common cancers (n=586, 66.8%), followed by leiomyomas (n=97, 11.1%), schwannomas (n=70, 8.0%), ectopic pancreas (n=67, 7.8%) and carcinoids (n=16, 1.8%). The mean age of patients was 56.0 years and the male to female ratio was 1:1.18. Only 40.9% of the patients had symptoms at the time of diagnosis, such as abdominal pain, dyspepsia and bleeding. Gastric submucosal tumors were most frequently located in the upper third of the stomach and 55.4% of the GISTs (n=319) and 84.5% of the leiomyomas (n=84.5%) were located in the upper third of the stomach. Wedge resection (n=726, 82.8%) was the most common operative method, and laparoscopic surgery was performed in 388 patients (44.2%). Only one patient (0.1%) died within 30 days of surgery. A total of 115 patients withGISTs (21.1%, 115/544) had a high risk of malignancy and 41 patients (8.3%, 45/495) received adjuvant imatinib mesylate therapy. Conclusion: The survey showed that about two-thirds of the patients with a gastric submuscoal tumor (SMT) had a GIST, and about one-half of the patients underwent laparoscopic resection. These data presented in the nationwide survey could be used as a fundamental resource for gastric submucosal tumors in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6469-6475
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• 2015

Background: Diffusion-weighted magnetic resonance imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. It is uncertain whether DWI is more useful than positron emission tomography-computed tomography (PET-CT) for distinguishing benign from malignant mediastinal tumors and mass lesions. Materials and Methods: Sixteen malignant mediastinal tumors (thymomas 7, thymic cancers 3, malignant lymphomas 3, malignant germ cell tumors 2, and thymic carcinoid 1) and 12 benign mediastinal tumors or mass lesions were assessed in this study. DWI and PET-CT were performed before biopsy or surgery. Results: The apparent diffusion coefficient (ADC) value ($1.51{\pm}0.46{\times}10^{-3}mm^2/sec$) of malignant mediastinal tumors was significantly lower than that ($2.96{\pm}0.86{\times}10^{-3}mm^2/sec$) of benign mediastinal tumors and mass lesions (P<0.0001). Maximum standardized uptake value (SUVmax) ($11.30{\pm}11.22$) of malignant mediastinal tumors was significantly higher than that ($2.53{\pm}3.92$) of benign mediastinal tumors and mass lesions (P=0.0159). Using the optimal cutoff value (OCV) $2.21{\times}10^{-3}mm^2/sec$ for ADC and 2.93 for SUVmax, the sensitivity (100%) by DWI was not significantly higher than that (93.8%) by PET-CT for malignant mediastinal tumors. The specificity (83.3%) by DWI was not significantly higher than that (66.7%) for benign mediastinal tumors and mass lesions. The accuracy (92.9%) by DWI was not significantly higher than that (82.1%) by PET-CT for mediastinal tumors and mass lesions. Conclusions: There was no significant difference between diagnostic capability of DWI and that of PET-CT for distinguishing mediastinal tumors and mass lesions. DWI is useful in distinguishing benign from malignant mediastinal tumors and mass lesions.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6493-6499
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• 2013

Background: Non-epithelial malignant ovarian tumors and clear cell carcinomas, Brenner tumors, transitional cell tumors, and carcinoid tumors of the ovary are rare ovarian tumors (ROTs). In this study, our aim was to determine the clinicopathological features of ROT patients and prognostic factors associated with survival. Materials and Methods: A total of 167 patients with ROT who underwent initial surgery were retrospectively analyzed. Prognostic factors that may influence the survival of patients were evaluated by univariate and multivariate analyses. Results: Of 167 patients, 75 (44.9%) were diagnosed with germ-cell tumors (GCT) and 68 (40.7%) with sex cord-stromal tumors (SCST); the remaining 24 had other rare ovarian histologies. Significant differences were found between ROT groups with respect to age at diagnosis, tumor localization, initial surgery type, tumor size, tumor grade, and FIGO stage. Three-year progression-free survival (PFS) rates and median PFS intervals for patients with other ROT were worse than those of patients with GCT and SCST (41.8% vs 79.6% vs 77.1% and 30.2 vs 72 vs 150 months, respectively; p=0.01). Moreover, the 3-year overall survival (OS) rates and median OS times for patients with both GCT and SCST were better as compared to patients with other ROT, but these differences were not statistically significant (87.7% vs 88.8% vs 73.9% and 170 vs 122 vs 91 months, respectively; p=0.20). In the univariate analysis, tumor localization (p<0.001), FIGO stage (p<0.001), and tumor grade (p=0.04) were significant prognostic factors for PFS. For OS, the univariate analysis indicated that tumor localization (p=0.01), FIGO stage (p=0.001), and recurrence (p<0.001) were important prognostic indicators. Multivariate analysis showed that FIGO stage for PFS (p=0.001, HR: 0.11) and the presence of recurrence (p=0.02, HR: 0.54) for OS were independent prognostic factors. Conclusions: ROTs should be evaluated separately from epithelial ovarian cancers because of their different biological features and natural history. Due to the rarity of these tumors, determination of relevant prognostic factors as a group may help as a guide for more appropriate adjuvant or recurrent therapies for ROTs.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.516-523
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• 1996

The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(1 adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), 1 false positive(hepatocellular carcinoma) and 3 false negatives(1 recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.