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Lung biopsy

Zhi Guo, Hong Shi, Wentao Li, Dongmei Lin, Changli Wang, Chen Liu, Min Yuan, Xia Wu, Bin Xiong, Xinhong He, Feng Duan, Jianjun Han, Xueling Yang, Haipeng Yu, Tongguo Si, Linfeng Xu, Wenge Xing, Huang Jinhua, Yingjuan Wang, Hui Xie, Li Cui, Wei Gao, Dongfeng He, Changfu Liu, Zhou Liu, Chunhua Ma, Jie Pan, Haibo Shao, Qiang Tu, Li Yong, Yan Xu, Zhang Weihao, Zou Qiang, Sen Wang
Biopsy has been used to diagnose thoracic diseases for more than a century. Percutaneous needle biopsy plays a crucial role in the diagnosis, staging, and treatment planning for tumors in the lungs, thoracic wall, hilum, and mediastinum. With the continuous improvement in imaging techniques, the range of clinical applications for percutaneous needle biopsy is also expanding. It has become important to improve Chinese professionals' and technicians' understanding of percutaneous transthoracic needle biopsy (PTNB) in order to standardize operating procedures and to strengthen perioperative management...
September 17, 2018: Thoracic Cancer
Adrien Costantini, Catherine Julie, Coraline Dumenil, Zofia Hélias-Rodzewicz, Julie Tisserand, Jennifer Dumoulin, Violaine Giraud, Sylvie Labrune, Thierry Chinet, Jean-François Emile, Etienne Giroux Leprieur
Immune checkpoint inhibitors, as nivolumab, are used in advanced non-small cell lung cancer (NSCLC). However, no associated biomarker is validated in clinical practice with this drug. We investigated herein immune-related blood markers in patients with advanced NSCLC treated with nivolumab. Plasma of 43 consecutive patients were prospectively collected at time of the diagnosis of cancer, at the initiation of nivolumab and at the first tumour evaluation (2 months). Concentrations of PD-L1 (sPD-L1), soluble PD-L2 (sPD-L2), Interleukine-2 (sIl-2), Interferon-gamma (sIFN-γ), and Granzyme B (sGranB) were quantified by ELISA...
2018: Oncoimmunology
Lakshmi Saladi, Sai Mounica Maddu, Masooma Niazi, Ajsza Matela
Recent advances in imaging techniques led to an increase in the incidence of synchronous and metachronous primary lung cancers due to early detection. Management of these patients is challenging and prognosis depends on the stage of the tumor at initial diagnosis and histological type. A 68-year-old African American male patient with medical history of hypertension and diabetes mellitus presented to our emergency department with right sided chest pain, worsening dyspnea and dry cough of 2-week duration. He also reported significant weight loss and was a smoker with 25 pack-years smoking history...
August 2018: World Journal of Oncology
G Faviez, E Bousquet, A Rabeau, I Rouquette, S Collot, C Goumarre, N Meyer, G Prevot, J Mazieres
INTRODUCTION: Immune checkpoint inhibitors are becoming a standard treatment for many different cancers. Their toxicities are variable and include organ-specific dysimmune injuries and the development of systemic diseases. CASE REPORT: We report 3 cases of sarcoid-like granulomatosis that occurred during treatment of various types of primary cancer by immune checkpoint inhibitors: lung adenocarcinoma, small cell lung cancer and melanoma. The clinical presentation, radiologic pattern and severity of this toxicity were variable...
September 13, 2018: Revue des Maladies Respiratoires
Xing Wang, Qiming Chen, Jian Meng
Extrapulmonary small cell neuroendocrine carcinoma (SNEC) is an extremely rare and highly malignant tumor with a poor prognosis. Multiple metastases of SNEC are even more rare, and patients with locally advanced and metastatic disease generally face a poor outcome. To date, only a few cases of SNEC have been reported. Here, we describe a rare case of a 70-year-old female patient with SNEC of the tonsil who presented with multiple metastases and had achieved a complete response (CR) of the primary lesion and cervical lymph nodes for more than 1 year after receiving palliative chemotherapy...
2018: OncoTargets and Therapy
Nobuhiro Kanaji, Nariyasu Nakashima, Takuya Inoue, Emi Ibuki, Makiko Murota, Norimitsu Kadowaki
A 34-year-old Japanese woman exhibited a 35×25-mm solitary multiloculated mass shadow in the left lower lobe mimicking lung adenocarcinoma. On computed tomography, the mass resembled a lotus torus. A transbronchial lung biopsy and mediastinal lymph node biopsy led to the diagnosis of sarcoidosis. This lotus torus-like mass regressed spontaneously. This is the second reported case of pulmonary cavitary sarcoidosis with a 'lotus torus-like' appearance. We propose several findings regarding the lotus torus-like appearance by comparing the findings to those of lung adenocarcinoma...
September 12, 2018: Internal Medicine
Jhanelle E Gray, Alberto Chiappori, Charlie C Williams, Tawee Tanvetyanon, Eric B Haura, Ben C Creelan, Jongphil Kim, Theresa A Boyle, Mary Pinder-Schenck, Farah Khalil, Soner Altiok, Rebecca Devane, David Noyes, Melanie Mediavilla-Varela, Renee Smilee, Emily L Hopewell, Linda Kelley, Scott J Antonia
The GM.CD40L vaccine, which recruits and activates dendritic cells, migrates to lymph nodes, activating T cells and leading to systemic tumor cell killing. When combined with the CCL21 chemokine, which recruits T cells and enhances T-cell responses, additive effects have been demonstrated in non-small cell lung cancer mouse models. Here, we compared GM.CD40L versus GM.CD40L plus CCL21 (GM.CD40L.CCL21) in lung adenocarcinoma patients with ≥ 1 line of treatment. In this phase I/II randomized trial (NCT01433172), patients received intradermal vaccines every 14 days (3 doses) and then monthly (3 doses)...
September 12, 2018: Cancer Immunology, Immunotherapy: CII
Honorata Marczak, Edyta Heropolitańska-Pliszka, Renata Langfort, Danuta Roik, Katarzyna Grzela
Nijmegen breakage syndrome (NBS) is a rare autosomal recessive disease characterized by microcephaly, growth retardation, severe immunodeficiency, and predisposition to lymphoid malignancy. In this report, we describe a case of a 9-year-old boy, previously diagnosed with NBS and symptoms of dyspnea, dry cough, and fever. Despite initial recognition of pneumonia, there was no response to broad spectrum antimicrobial treatment, negative results from microbiological tests, and unclear changes in lung imaging were observed...
September 12, 2018: Pediatrics
Paula P M van Lümig, Marcel C Pasch
A 37-year-old woman presented with progressive longitudinal erythronychia and onychorrhexis of the toenails. She had a history of sarcoidosis of the lung and nose, which was silent without treatment at the time of presentation. Histopathological examination of a nail matrix biopsy revealed granulomas with palisading histiocytes in the connective tissue and a lymphocytic infiltrate in and around the granulomas without necrosis. Based on the clinical presentation, medical history, and histopathological examination, the diagnosis of nail sarcoidosis was made...
August 2018: Skin Appendage Disorders
Yong-Sub Na, Sang-Gon Park
BACKGROUND: Inflammatory myofibroblastic tumor is a rare benign neoplasm that frequently involves the lung and abdominopelvic region, and is found mainly in children and young adults. Inflammatory myofibroblastic tumor tends to be locally invasive or recurrent, and rarely metastasizes. CASE PRESENTATION: A 76-year-old Korean man presented with a history of upper back pain for 2 months and motor weakness in both lower extremities for 2 days. Contrast-enhanced computed tomography of his chest and abdomen showed a large heterogeneous pleural mass involving the right fifth rib and vertebral body and a mass infiltrating the right renal hilum...
September 9, 2018: Journal of Medical Case Reports
Fiona Blackhall, Kristopher K Frese, Kathryn Simpson, Elaine Kilgour, Ged Brady, Caroline Dive
Small-cell lung cancer (SCLC) is an aggressive tumour that seeds metastases early with dismal outcomes. As expected from a disease that is closely associated with smoking, mutation burden in SCLC is high. Intratumoral and intertumoral heterogeneity is a substantial obstacle to successful treatment and the SCLC genomic landscape reveals few targets that are readily druggable. Chemotherapy elicits responses in most patients with SCLC, but their effects are short lived. Multiple clinical trials have been unsuccessful in showing positive survival outcomes and biomarkers to select patients and monitor responses to novel targeted treatments have been lacking, not least because acquisition of tumour biopsies, especially during relapse after chemotherapy, is a substantial challenge...
September 2018: Lancet Oncology
Sarah Khan, Jolie Guevara, Ana Barbosa, Awista Ayuby, Fred Bien-Aime, Larissa Verda, Nancy Glick, Vikas Mehta
AIDS-related Kaposi sarcoma (KS) is a vascular malignancy that usually presents with mucocutaneous lesions. Bronchopulmonary involvement as an initial manifestation is a rare phenomenon. This case describes a young male presenting with pulmonary symptoms mimicking HIV-related opportunistic infection who was eventually diagnosed with primary pulmonary KS. The aim of this report is to emphasize that KS should be recognized as a differential diagnosis in AIDS patients presenting with pulmonary symptoms. Making the diagnosis may be a difficult task, at times, requiring invasive procedures such as lung biopsy...
2018: IDCases
Johannes G Reiter, Alvin P Makohon-Moore, Jeffrey M Gerold, Alexander Heyde, Marc A Attiyeh, Zachary A Kohutek, Collin J Tokheim, Alexia Brown, Rayne M DeBlasio, Juliana Niyazov, Amanda Zucker, Rachel Karchin, Kenneth W Kinzler, Christine A Iacobuzio-Donahue, Bert Vogelstein, Martin A Nowak
Metastases are responsible for the majority of cancer-related deaths. Although genomic heterogeneity within primary tumors is associated with relapse, heterogeneity among treatment-naïve metastases has not been comprehensively assessed. We analyzed sequencing data for 76 untreated metastases from 20 patients and inferred cancer phylogenies for breast, colorectal, endometrial, gastric, lung, melanoma, pancreatic, and prostate cancers. We found that within individual patients, a large majority of driver gene mutations are common to all metastases...
September 7, 2018: Science
Paul A VanderLaan
Lung cancer diagnosis and ancillary testing are increasingly relying on cytology and small biopsy specimens obtained via minimally invasive means. Paired with traditional immunohistochemical characterization of tumors, biomarker testing and comprehensive genomic profiling are becoming essential steps in the workup of lung cancer to identify targetable alterations and guide optimal therapy selection. Recent advances in immune checkpoint inhibitor therapy have led to an increasingly complex and unresolved landscape for tumor PD-L1 testing...
September 2018: Surgical Pathology Clinics
Benjamín Herreros, Isabel Plaza, Rebeca García, Marta Chichón, Carmen Guerrero, Emilio Pintor
An immunocompetent 82-year-old female was admitted to our hospital due to fever without clear origin and hyponatremia. In the following days, an acute and bilateral pulmonary infiltrate appeared with a progressive worsening in respiratory function. Chest x-ray and CT (Computed tomography) showed bilateral reticulonodular infiltrates. Bronchoscopic aspiration and bronchoalveolar lavage (BAL), and transbronchial lung biopsy (TBBX) studies did not reveal microbiological and histopathological diagnosis. Broad-spectrum antibiotics were non-effective, and the patient died due to respiratory failure...
September 5, 2018: Pathogens
Nathalie Foray, Taylor Stone, Alexander Johnson, Mirza Ali, Shreedhar Kulkarni, John Gao, Rajagopal Sreedhar
Background: Cushing's syndrome due to ectopic ACTH secretion has been associated with many cancers; most commonly small cell carcinoma of the lung and bronchial carcinoid tumors. Usually, patients who confer this diagnosis have poor prognosis. Case presentation: A 66-year-old female presented with worsening shortness of breath and weakness over three days. Initial laboratory derangements included severe hypokalemia and metabolic alkalosis. Treatment included high amounts of potassium chloride and acetazolamide...
2018: Respiratory Medicine Case Reports
Masahiro Nemoto, Satoshi Noma, Ayumu Otsuki, Kei Nakashima, Koichi Honma, Takeshi Johkoh, Junya Fukuoka, Masahiro Aoshima
Myeloperoxidase antineutrophil cytoplasmic autoantibody (MPO-ANCA) is well-known as a serological marker for small-vessel vasculitis. However, when a smoker with interstitial lung disease (ILD) exhibits serum ANCA positivity without systemic vasculitis, diagnosis is a matter of debate; the relationship between smoking and ANCA is unknown. We report a case of combined pulmonary fibrosis and emphysema (CPFE) with elevated MPO-ANCA. Surgical lung biopsy showed emphysema and fibrotic interstitial pneumonia without vasculitis...
2018: Respiratory Medicine Case Reports
Li Liao, Xiaoyu Ji, Mengxi Ge, Qiong Zhan, Ruofan Huang, Xiaohua Liang, Xinli Zhou
Brain metastasis (BM) is the primary contributor to mortality in non-small cell lung cancer (NSCLC) patients. Although the findings of NSCLC genetic sequencing studies suggest the potential for personalizing therapeutic approaches, the genetic profiles and underlying mechanisms of BM progression remain poorly understood. Here, we investigated the genetic profiles of brain metastases from NSCLC in six patients with primary tumors and corresponding BM samples via whole exome sequencing and targeted panel sequencing...
September 2018: FEBS Open Bio
Xing Ding, Gengyun Sun, Guanghe Fei, Xuexin Zhou, Luqian Zhou, Ran Wang
Pulmonary actinomycosis is a chronic, suppurative, granulomatous disease caused by Actinomyces israelii , an obligate anaerobe. The clinical manifestations and imaging characteristics of pulmonary actinomycosis lack specificity and can lead to confusion with tuberculosis and lung cancer. The present study reported a case of pulmonary actinomycosis diagnosed by transbronchoscopic lung biopsy and reviewed the literature on the disease. The clinical characteristics, signs, laboratory findings as well as progression, diagnosis and treatment in the case of pulmonary actinomycosis were analyzed...
September 2018: Experimental and Therapeutic Medicine
Rouslan Kotchetkov, Robert El-Maraghi, Leena Narsinghani
A 74-year-old male with a history of chronic lymphocytic leukemia (CLL) previously treated with fludarabine/cyclophosphamide/rituximab (FCR) 5 years ago, presented with progressive fatigue, mucocutaneous bleeding, and cytopenias (hemoglobin 51 g/L, platelets 8.0 × 109 /L, lymphocytes 0.4 × 109 /L). He had normal respiratory findings, and no lymphadenopathy or hepatosplenomegaly. Further workup revealed a small spiculated lung nodule and multiple sclerotic bony lesions. Due to bleeding/profound thrombocytopenia, lung biopsy was not feasible...
May 2018: Case Reports in Oncology
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