• Journal of Chest Surgery
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• v.37 no.11
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• pp.937-941
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• 2004

Epithelioid hemangioendothelioma, originating from the vascular endothelium, is a very rare and low-grade malignancy. World-wide, about 50 cases of pulmonary epithelioid hemangioendothelioma have been reported. This is more common in female and is usually shown as multiple nodules in both lung fields. A 41-year-old male, who had suffered from right pleuritic chest pain for 3 months, was initially diagnosed as adenocarcinoma under bronchofiberscopic biopsy. At that time, the stage of tumor according to the TNM staging was llla. He received bronchoscopic biopsy again during follow-up period and it was diagnosed as hamartoma. After surgery, the final diagnosis was pulmonary epithelioid hemangioendothelioma.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.63 no.1
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• pp.83-87
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• 2007

Idiopathic pulmonary fibrosis (IPF) is strongly associated with lung cancer compared with the general population. However, other types of idiopathic interstitial pneumonia (IIP) are rarely associated with lung cancer. We describe a case of a primary lung cancer associated with IIP other than IPF, which was considered to be nonspecific interstitial pneumonia (NSIP), and NSIP disappeared spontaneously after treating the primary lung cancer.

• Korean Journal of Veterinary Research
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• v.44 no.4
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• pp.621-624
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• 2004

A 13-year-old female Miniature Pincher was euthanized after suffering from respiratory insufficiency and seizure. At necropsy, firm tan masses approsimately 4 to 5 cm in diameter were noted at the right caudal love and left cranial lobe of the lung. On cross sections of the cerebellum and the verebrum, several compressive firm round masses, 0.5 to 1 cm in diameter, were noted. similar looking nodules were also present in the mediastinal lymph nodes. Histopathologically, the neoplastic masses consisted of cuboidal shape epithelial cells that form glandular structure. The neoplastic cells have hyperchromatic nuclei with prominent nucleoli and moderate amount of cytoplasm. The degree of mitosis was high (4-6/400X). Multiple areas of necrosis, hemorrhage, and tumor emboli were also noted. Metastasis to the mediastinal lymph nodes, pancreas, and brain was confirmed. Based on the gross and histopathologic examinations, a diagnosis of primary metastatic pulmonary adenocarcinoma was made. Clinicaly recognized neurological signs were therefore due to brain metastasis.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1044-1047
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• 1997

Pulmonary blastoma are a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or emb yonal in appearance. We report a pulmonary blastoma occurring in a 31 years old man. An abnormal shadow was detected in the right lower lung field in a routine chest X-ray film. The preoperative imaging films showed about a 5cm sized well circumscribed solid tumor of the right lung. A preoperative clinical diagnosis of primary lung cancer was considerd. The operative field showed that the hard, round mass, 6$\times$5$\times$4cm in diameter was localized in middle lobe of the right lung, and partially adhered to the upper lobe, pericardium and diaphragm. Right middle lobe lobectomy, right upper lobe wedge resection, partial pericardiectomy and diaphragm resection with plication was performed with radical Iymph node dissection. Histopathologic diagnosis was pulmonary blastoma (Biphasic blastoma). It is considered that the prognosis of biphasic blastoma is worse than WDFA(well differentiated fetal adenocarcinoma). There are no other available treatments except for surgical resection. It is suggeste that it is necessary to collect as many cases as possible, to make definite classifications and to examine the clinical course and prognosis of pulmonary blastoma.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.149-155
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• 1995

Background: Cytokeratin 19 is 40KD acidic molecule whose distribution is restricted to simple or pseudo-stratified epithelia, such as the epithelial layer of the bronchial tree. Immunohistochemical study have shown that cytokeratin 19 is overexpressed in lung carcinoma tissue. An immunoradiometric assay, CYFRA 21-1 has been developed using two monoclonal antibody, BM 19-21 and KS 19-1, reactive to different epitopes on cytokeratin 19. We studied the diagnostic value of CYFRA 21-1 in lung cancer. Method: The serum CYFRA 21-1 level using immunoradiometric kit(ELSA-CYFRA 21-1) was measured in 54 patients who admit to Yeungnam University Hospital from April, 1993 to August, 1994. Lung cancer group was 39 primary lung cancer patients(19 patients with squamous cell carcinoma, 11 patients with adenocarcinoma and 9 patients with small cell carcinoma). Control group was 15 patients with non malignant lung diseases(8 patients with pulmonary tuberculosis, 3 patients with chronic obstructive pulmonary disease, 2 patients with pneumonia and 2 patients with chronic obstructive pulmonary disease combined with pulmonary tuberculosis). Results: The mean serum value of CYFRA 21-1 was $20.2{\pm}4.7ng/ml$ in squamous cell carcinoma, $7.2{\pm}1.6ng/ml$ in adenocarcinoma and $15.5{\pm}4.7ng/ml$ in non-small cell lung cancer. The serum value of CYFRA 21-1 in control group was $1.7{\pm}0.5ng/ml$. All of the serum values of 3 histologic types were significantly higher than that of control group(p<0.01). The serum value of CYFRA 21-1 of squamous cell carcinoma was significantly higher than that of adenocarcinoma(p <0.05). Serum value of CYFRA 21-1 in small cell lung cancer was $2.9{\pm}0.9ng/ml$ and not significantly different compared with control group. Using cut off value of 3.3ng/ml, sensitivity and specificity was 11.1%, 65.2% in small cell lung cancer, 70.0%, 62.5% in non-small cell lung cancer, 73.7%, 75% in squamous cell carcinoma and 63.6%, 78.9% in adenocarcinoma, respectively. Conclusion: The serum levels of CYFRA 21-1 may be useful in diagnosis of non-small cell lung carcinoma, especially in squamous cell carcinoma with its high specificity.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4629-4635
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• 2014

Background: Diffusion-weighted imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. However, it is uncertain whether DWI has advantages over FDG-PET for distinguishing malignant from benign pulmonary nodules and masses. Materials and Methods: One hundred-forty-three lung cancers, 17 metastatic lung tumors, and 29 benign pulmonary nodules and masses were assessed in this study. DWI and FDG-PET were performed. Results: The apparent diffusion coefficient (ADC) value ($1.27{\pm}0.35{\times}10^{-3}mm^2/sec$) of malignant pulmonary nodules and masses was significantly lower than that ($1.66{\pm}0.58{\times}10^{-3}mm^2/sec$) of benign pulmonary nodules and masses. The maximum standardized uptake value (SUVmax: $7.47{\pm}6.10$) of malignant pulmonary nodules and masses were also significantly higher than that ($3.89{\pm}4.04$) of benign nodules and masses. By using optimal cutoff values for ADC ($1.44{\times}10^{-3}mm^2/sec$) and for SUVmax (3.43), which were determined with receiver operating characteristics curves (ROC curves), the sensitivity (80.0%) of DWI was significantly higher than that (70.0%) of FDG-PET. The specificity (65.5%) of DWI was equal to that (65.5%) of FDG-PET. The accuracy (77.8%) of DWI was not significantly higher than that (69.3%) of FDG-PET for pulmonary nodules and masses. As the percentage of bronchioloalveolar carcinoma (BAC) component in adenocarcinoma increased, the sensitivity of FDG-PET decreased. DWI could not help in the diagnosis of mucinous adenocarcinomas as malignant, and FDG-PET could help in the correct diagnosis of 5 out of 6 mucinous adenocarcinomas as malignant. Conclusions: DWI has higher potential than PET in assessing pulmonary nodules and masses. Both diagnostic approaches have their specific strengths and weaknesses which are determined by the underlying pathology of pulmonary nodules and masses.

• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.182-186
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• 2012

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.

• Tuberculosis and Respiratory Diseases
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• v.46 no.2
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• pp.281-284
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• 1999

The lung is one of the most frequent sites of metastasis for extrathoracic tumors. Certain malignancies show a particular tendency to metastasize to lung, and in 15 to 25% of these cases, lung involvement is the only manifestation of metastatic disease. The most common presentation is the form of multiple bilateral nodules or masses of varying sizes. Lymphangitic metastasis is comprising 6 to 8% of all pulmonary metastasis. A striking variant of parenchymal involvement occures when dyscohesive tumor cells fill alveoli to produce a tumoral pneumonia. Carcinomatous lymphangitis of prostate origin is infrequent and usually carries a poor prognosis, and tumoral pneumonia of it is extremely rare. We report herein a case of prostate carcinoma metastasizing to lung, simulates atypical pneumonia, and disclosed by acute chest illness.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6799-6804
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• 2014

Background: Chemotherapy is the mainstay of treatment for the majority of patients with advanced non-small cell lung cancer (NSCLC) without driver mutations and many receive therapies beyond first-line. Second-line chemotherapy has been disappointing both in terms of response rate and survival and we know relatively little about the prognostic factors. Materials and Methods: One thousand and eight patients with advanced NSCLC who received second-line chemotherapy after progression were reviewed in Shanghai Pulmonary Hospital, China, from September 2005 to July 2010. We analyzed the effects of potential prognostic factors on the outcomes of second-line chemotherapy (overall response rate, ORR; progression free survival, PFS; overall survival, OS). Results: The response and progression free survival of first-line chemotherapy affects the ORR, PFS and OS of second-line chemotherapy (ORR: CR/PR 15.4%, SD 10.1%, PD2.3%, p<0.001; PFS: CR/PR 3.80 months, SD 2.77 months, PD 2.03 months, p<0.001; OS: CR/PR 11.60 months, SD 10.33 months, PD 6.57 months, p=0.578, p<0.001, p<0.001, respectively). On multivariate analysis, better response to first-line therapy (CR/PR: HR=0.751, p=0.002; SD: HR=0.781, p=0.021) and progression within 3-6 months (HR=0.626, p<0.001), together with adenocarcinoma (HR=0.815, p=0.017), without liver metastasis (HR=0.541, p=0.001), never-smoker (HR=0.772, p=0.001), and ECOG PS 0-1 (HR=0.745, p=0.021) were predictors for good OS following second-line chemotherapy. Conclusions: Patients who responded to first-line chemotherapy had a better outcome after second-line therapy for advanced NSCLC, and the efficacy of first-line chemotherapy, period of progression, histology, liver metastasis, smoking status and ECOG PS were independent prognostic factors for OS.