Pleomorphic Carcinoma Showing Rapid Growth, Multiple Metastases, and Intestinal Perforation
|
|
- Marybeth Potter
- 5 years ago
- Views:
Transcription
1 doi: /atcs.cr Case Report Pleomorphic Carcinoma Showing Rapid Growth, Multiple Metastases, and Intestinal Perforation Hidefumi Koh, MD, PhD, 1 Atsushi Chiyotani, MD, PhD, 1 Toshiki Tokuda, MD, 1 Hirofumi Suzumura, MD, 1 Nobufumi Kamiishi, MD, 1 Hidenori Takahashi, MD, PhD 1 and Shigemichi Hirose, MD, PhD 2 Pleomorphic carcinoma is a rare and very aggressive subtype of lung cancer that tends to grow rapidly and invade adjacent structures. Here we report a case of pleomorphic carcinoma with rapid growth, multiple metastases, and intestinal perforation. A 46-year-old man was admitted to our hospital because of lung abscess. Several antibiotics were administered for 2 weeks, but his condition did not improve. F18-fluorodeoxyglucose positron emission tomography revealed high uptake in the right lung, stomach, and pancreas. CT-fluoroscopic lung biopsy was performed, and a diagnosis of pleomorphic carcinoma was made. His performance status worsened each day, and the lung tumor grew within 1 month. In addition, sudden severe abdominal pain and tenderness developed 10 days after lung biopsy. He was diagnosed with gastrointestinal perforation, and he underwent surgery. However, he died 2 weeks after the surgery. Autopsy revealed the presence of an enormous tumor in the right lung and multiple metastases in the stomach, duodenum, intestine, bilateral kidneys, pancreas, gallbladder, right adrenal gland and thyroid. Keywords: lung cancer, pleomorphic carcinoma, gastrointestinal metastases, intestinal perforation Introduction Pulmonary pleomorphic carcinoma (PC) is rare, with an incidence rate ranging from 0.1% to 0.3% of all lung cancers. Pulmonary PC has a more aggressive clinical 1 Division of Pulmonary Medicine, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan 2 Department of Pathology, Keio University School of Medicine, Tokyo, Japan Received: July 3, 2013; Accepted: September 25, 2013 Corresponding author: Hidefumi Koh, MD, PhD. Division of Pulmonary Medicine, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Takebayashimachi, Utsunomiya, Tochigi , Japan hdfmkoh@yahoo.com 2014 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery. All rights reserved. course and worse prognosis than other types of non-small cell lung cancers (NSCLCs). Early recurrence is common, and effective adjuvant treatment is necessary to improve prognosis. A few serial case reports on PC have been published, but PC showing rapid growth has rarely been reported. Case Report A 46-year-old man was admitted to the medical unit of our hospital in May 2011 with lung abscess. One month prior to admission, he experienced high-grade fever. Two weeks prior to admission, he was diagnosed with lung abscess at a local clinic. He was treated with antibiotics for 1 week, but no improvement was observed. The patient was subsequently referred to our hospital for further evaluation. He had no additional past history, other than the 1
2 Koh H, et al. (C) (D) Fig. 1 Chest X-ray obtained on admission demonstrated a large mass in the right lung field. F18-fluorodeoxyglucose positron emission tomography (FDG-PET) scan showed high uptake in the right lung, stomach, and pancreas. (C) Microscopic analysis of the lung biopsy specimen revealed large polygonal malignant tumor cells with eosinophilic cytoplasm, varying in size and shape; hyperchromatic nuclei; and numerous multinucleated giant tumor cells. Hematoxylin-eosin staining (HE, original magnification, 400). (D) Chest X-ray obtained 1 month after admission revealed rapid growth of the lung tumor. fact that he had smoked four packets of cigarettes per day for 27 years. He occasionally drank alcohol and did not use illicit drugs. Physical examination revealed a temperature of 38.4 C, blood pressure of 92/60, pulse of 92 beats/min, and an oxygen saturation level of 97% in ambient air. Examination of the palpebral conjunctiva indicated anemia. Breath sounds diminished in the right upper lung field. The results of other general physical and detailed neurological examinations were normal. Laboratory tests revealed a leukocyte count of 15530/µl, with 85% neutrophils. Hemoglobin, hematocrit, and C-reactive protein levels were 6.8 g/dl, 21.2%, and mg/dl, respectively. Although NSE level was slightly elevated, tests for other tumor markers such as CEA, SCC, CYFRA, SLX, and ProGRP were negative. Cultures for blood, sputum, and urine showed no growth. Tests for urinary antigens for Streptococcus pneumoniae and Legionella were also negative. Electrocardiography revealed a sinus rhythm and no other abnormal findings. Chest X-ray revealed a large mass with a cavity occupying the right upper lung field (Fig. 1A). An initial diagnosis of lung abscess was made, and several antibiotics were administered. Despite antibiotic treatment for 2 weeks, the patient s condition, including laboratory data and chest X-ray, did not improve. To determine the cause of the mass in the lung, F18-fluorodeoxyglucose positron emission tomography (FDG-PET) was performed, revealing high uptake in the right lung, stomach, and pancreas (Fig. 1B). The standardized uptake value (SUV) of the lung, stomach and pancreas were 21.18, 11.35, and 12.38, respectively. Secondary, bronchoscopy was performed, but transbronchial lung biopsy was difficult due to severe bronchial stenosis. Computed tomography (CT)-fluoroscopic lung biopsy was therefore performed. Microscopic examination of the lung biopsy specimen revealed large polygonal malignant tumor cells with eosinophilic cytoplasm, varying in size and shape; 2
3 Ann Thorac Cardiovasc Surg Advance Published Date: February 4, 2014 Rapidly Progressing Pleomorphic Carcinoma Fig. 2 Macroscopic features of resected intestinal tumor, which caused central perforation. Microscopic examination demonstrated large polygonal malignant tumor cells with eosinophilic cytoplasm similar to that of lung biopsy (HE, original magnification, 400). (C) (D) Fig. 3 (E) acroscopic features of the autopsy specimen. Arrow show metastatic tumors. Large tumor in the M right lung; multiple metastases in the stomach; (C) multiple metastases in the intestine. Microscopic features at autopsy. (D) Large polygonal malignant tumor cells with eosinophilic cytoplasm, varying in size and shape, which were consistent with PC (HE, original magnification, 400). (E) Tumor cells stained strongly with pankeratin (original magnification, 400). hyperchromatic nuclei; and numerous multinucleated giant tumor cells. Necrosis was also detected (Fig. 1C). Based on these findings, a diagnosis of PC was made. Although chemotherapy was considered, the patient s general condition worsened each day (performance status: 4). Chest X-ray, 1 month, after admission showed rapid progression of the lung tumor (Fig. 1D). Sudden severe abdominal pain and tenderness developed 10 days after the lung biopsy. Abdominal CT led to a diagnosis of gastroint estinal perforation. Emergency surgery revealed intestinal 3
4 Koh H, et al. tumor as the cause of central perforation (Fig. 2A). Microscopic analysis of the surgical specimen demonstrated large polygonal malignant tumor cells with eosinophilic cytoplasm similar to those of the lung biopsy specimen (Fig. 2B). Best supportive care was recommended, and the patient was moved to the hospice ward of our hospital. Death occurred 2 weeks after the surgery, which had been performed 49 days after admission. Macroscopic features of the autopsy specimen showed a large tumor in the right lung (Fig. 3A) and multiple metastases in the stomach (Fig. 3B), duodenum, intestine (Fig. 3C), bilateral kidneys, pancreas, gallbladder, right adrenal gland, and thyroid. Microscopic analysis of the autopsy specimen showed large polygonal malignant tumor cells with eosinophilic cytoplasm, varying in size and shape, which were consistent with PC (Fig. 3D and 3E). Discussion PC is a poorly differentiated NSCLC, namely squamous cell carcinoma, adenocarcinoma, or large cell carcinoma. It contains at least 10% spindle cells and/or giant cells, or more commonly, a mixture of these cell types. Spindle cells and giant cells are often associated with other more common histological subtypes of lung carcinoma, supporting the concept that lung cancers are derived from a pluripotent stem cell that can exhibit differentiation into any potential combination (spindle cell, giant cell, squamous cell, small cell, and adenocarcinoma). Spindle cell and giant cell subtypes are most frequently found to coexist. 1) PC is considered to be rare, with an incidence rate ranging from 0.1% to 0.3% of all lung cancers. The male:female ratio of PC varies from 3:1 to 6:1, with the median age of presentation being 59 years. 2) Chest X-ray shows PC as round or oval masses, often lobulated, and usually located at the lung periphery. However, chest X-ray fails to reveal any characteristic features of PC that help in discriminating it from other primary lung malignancies. Chest CT can provide some clues into the presence of PC. A central low attenuation area is depicted within the tumor, which aggressively invades adjacent structures such as the chest wall or the pleura. Central low attenuation areas corresponding to regions of central necrosis are also frequently observed. 3) PC has a tendency to grow rapidly and invade adjacent structures in the early stage. According to Ito, et al., 4) recurrence after surgical treatment is common, and systemic metastases are frequently observed. In addition, response to chemotherapy is poor. The median survival time of the 22 patients enrolled in that study was 213 days. The median survival time of the 7 patients who did not undergo surgical treatment was 118 days. A few cases of PC showing rapid growth have been reported. 3 6) Wakisaka, et al. 5) reported a case in which local recurrence and multiple metastases were found only 45 days after surgery. The patient died 67 days after the surgery. Fujioka, et al. 6) described a case of PC that grew rapidly within 1 month, necessitating surgery. In their case, the tumor was mm on the first visit, but it had increased to mm within 1 month on chest CT. In our case, the tumor increased in size from mm to mm within 1 month on chest CT. In general, lung cancer metastasis to the stomach is very rare. Ioncica, et al. 7) reported a rare case of PC metastasis to the stomach and pancreas at first diagnosis. In our case, FDG-PET revealed high uptake in the stomach, but esophagogastroduodenoscopy was not performed because of poor performance status at the time of diagnosis. Aokage, et al. 8) reported two cases of resected gastric metastasis of pulmonary PC in which long survival times were recorded. After resection, these patients with gastric metastasis survived for 4 5 years with no other evidence of metastasis. They speculated that resection of gastric metastasis following pulmonary PC resection may be indicated if the metastasis is solitary. Furthermore, some cases of gastrointestinal perforation caused by metastatic PC have been reported. 9,10) In most cases, intestinal perforation was detected, but perforation also occurred in the colon 11) and appendix. 12) Kaira, et al. 13) reported epidermal growth factor receptor (EGFR) mutation in 3 (18%) of 17 patients in whom a carcinomatous element of adenocarcinoma was observed. In one patient treated with gefitinib, stable disease was achieved. This patient s overall survival was 8 months. The two other patients who were not treated with gefitinib survived 1 month and 5.5 months, respectively. In another report, 4) EGFR mutation was positive in 1 of 22 patients who received gefitinib as second-line therapy. The pathological subtype was adenocarcinoma with spindle cells, and partial response was achieved. EGFR mutation in our case was negative; therefore, no gefitinib was administered. Conclusion PC is a rare lung neoplasm with poorer prognosis than other NSCLCs. The clinicopathological character- 4
5 Rapidly Progressing Pleomorphic Carcinoma istics of PC are still not well known. Therefore, morecases of PC should be reported to establish optimal management. Acknowledgement We thank Dr. Morimoto, Dr. Sasakura, and Dr. Kase for their contributions to the surgery. Disclosure Statement The authors have no conflicts of interest to declare. References 1) Travis WD, Colby TV, Corrin B, et al. Histological typing of lung and pleural tumors, 3rd ed. Berlin: Springer, ) Rossi G, Cavazza A, Sturm N, et al. Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases. Am J Surg Pathol 2003; 27: ) Kim TH, Kim SJ, Ryu YH, et al. Pleomorphic carcinoma of lung: comparison of CT features and pathologic findings. Radiology 2004; 232: ) Ito K, Oizumi S, Fukumoto S, et al. Clinical characteristics of pleomorphic carcinoma of the lung. Lung Cancer 2010; 68: ) Fujioka S, Nakamura H, Adachi Y, et al. Pleomorphic carcinoma of the lung in which the sarcomatous element grew rapidly: a case report. Ann Thorac Cardiovasc Surg 2009; 15: ) Wakizaka K, Otani Y, Aiyama T, et al. Pulmonary pleomorphic carcinoma with rapid growth causing death in a short period after surgery; report of a case. Kyobu Geka 2012; 65: (in Japanese) 7) Ioncica AM, Atiq M, Lee JH, et al. Gastric and pancreatic metastases from pleomorphic lung carcinoma. Endoscopy 2011; 43 Suppl 2 UCTN: E ) Aokage K, Yoshida J, Ishii G, et al. Long-term survival in two cases of resected gastric metastasis of pulmonary pleomorphic carcinoma. J Thorac Oncol 2008; 3: ) Burnette RE, Ballard BR. Metastatic pleomorphic carcinoma of lung presenting as abdominal pain. J Natl Med Assoc 2004; 96: ) Baldassarre E, Maggi P, Ramieri MT, et al. Jejunal perforation secondary to metastatic sarcomatoid carcinoma of the lung. Minerva Gastroenterol Dietol 2008; 54: ) Tsushima M, Matsuo K, Mizuta M, et al. Pleomorphic carcinoma of the lung with uncommon initial manifestation of intestinal perforation. Nihon Kokyuki Gakkai Zasshi 2009; 47: (in Japanese) 12) Tamura T, Nishimura H, Takamatsu Y, et al. A case of appendiceal metastasis from pleomorphic carcinoma of the lung. Jpn J Gastroenterol Surg 2011; 44: ) Kaira K, Horie Y, Ayabe E, et al. Pulmonary pleomorphic carcinoma: a clinicopathological study including EGFR mutation analysis. J Thorac Oncol 2010; 5:
Pleomorphic carcinoma of the lung: which CT findings predict poor prognosis?
Pleomorphic carcinoma of the lung: which CT findings predict poor prognosis? Poster No.: C-1887 Congress: ECR 2015 Type: Scientific Exhibit Authors: A. Fujisaki, T. Aoki, S. Kinoshita, Y. Hayashida, Y.
More informationSurgical resection of solitary omental metastasis from non small cell lung cancer: Report of three cases
ONCOLOGY LETTERS 11: 563-567, 2016 Surgical resection of solitary omental metastasis from non small cell lung cancer: Report of three cases YASUHIRO MATSUDA, YOSHIYUKI FUJIWARA, KENTARO KISHI, JIRO OKAMI,
More informationPrimary Pulmonary Colloid Adenocarcinoma: How Can We Obtain a Precise Diagnosis?
doi: 10.2169/internalmedicine.1153-18 Intern Med 57: 3637-3641, 2018 http://internmed.jp CASE REPORT Primary Pulmonary Colloid Adenocarcinoma: How Can We Obtain a Precise Diagnosis? Shinsuke Ogusu 1, Koichiro
More informationPrimary enteric adenocarcinoma with predominantly signet ring features of the lung: A case report with clinicopathological and molecular findings
CASE REPORT Primary enteric adenocarcinoma with predominantly signet ring features of the lung: A case report with clinicopathological and molecular findings Makoto Nagashima 1, Ayako Moriyama 1, Yasuo
More informationCase Report Five-Year Survival after Surgery for Invasive Micropapillary Carcinoma of the Stomach
Case Reports in Surgery Volume 2013, Article ID 560712, 4 pages http://dx.doi.org/10.1155/2013/560712 Case Report Five-Year Survival after Surgery for Invasive Micropapillary Carcinoma of the Stomach Shigeo
More informationCase Report Pulmonary Pleomorphic Carcinoma Detected as a Result of Pneumothorax and the Subsequent Occurrence of Multiple Cystic Metastases
Case Reports in Medicine, Article ID 219273, 4 pages http://dx.doi.org/10.1155/2014/219273 Case Report Pulmonary Pleomorphic Carcinoma Detected as a Result of Pneumothorax and the Subsequent Occurrence
More informationCombined Large Cell Neuroendocrine Carcinoma and Spindle Cell Carcinoma of the Lung
Case Reports Jpn J Clin Oncol 2011;41(6)797 802 doi:10.1093/jjco/hyr034 Advance Access Publication 16 March 2011 Combined Large Cell Neuroendocrine Carcinoma and Spindle Cell Carcinoma of the Lung Taichiro
More informationCT Findings of Surgically Resected Pleomorphic Carcinoma of the Lung in 30 Patients
Kim et al. CT of Pleomorphic Carcinoma of the Lung Chest Imaging Clinical Observations Tae Sung Kim 1 Joungho Han 2 Kyung Soo Lee 1 Yeon Joo Jeong 1 Seo Hyun Kwak 1 Hong Sik Byun 1 Myung Jin Chung 1 Hojoong
More informationWell-differentiated Papillary Mesothelioma of the Pleura Diagnosed by Video-Assisted Thoracic Surgical Pleural Biopsy : A Case Report
Showa Univ J Med Sci 25 1, 67 72, March 2013 Case Report Well-differentiated Papillary Mesothelioma of the Pleura Diagnosed by Video-Assisted Thoracic Surgical Pleural Biopsy : A Case Report Yuri TOMITA
More informationSleeve lobectomy for lung adenocarcinoma treated with neoadjuvant afatinib
Case Report Sleeve lobectomy for lung adenocarcinoma treated with neoadjuvant afatinib Ichiro Sakanoue 1, Hiroshi Hamakawa 1, Reiko Kaji 2, Yukihiro Imai 3, Nobuyuki Katakami 2, Yutaka Takahashi 1 1 Department
More informationBreast metastasis of pulmonary pleomorphic carcinoma: a case report
Fujita et al. Surgical Case Reports (2017) 3:25 DOI 10.1186/s40792-017-0302-6 CASE REPORT Open Access Breast metastasis of pulmonary pleomorphic carcinoma: a case report Tomoyuki Fujita 1*, Hajime Nishimura
More informationEndobronchial Ultrasound-guided Transbronchial Needle Aspiration in a Patient with Pericardial Mesothelioma
CASE REPORT Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in a Patient with Pericardial Mesothelioma Hironori Ashinuma 1, Masato Shingyoji 1, Yasushi Yoshida 1, Meiji Itakura 1, Fumihiro
More informationEsophageal Cancer Initially Thought to be Accompanied by a Solitary Metastasis to an Intrathoracic Paraaortic Lymph Node
2012 66 5 417 421 Esophageal Cancer Initially Thought to be Accompanied by a Solitary Metastasis to an Intrathoracic Paraaortic Lymph Node a b* a a a a a a a b ʼ 418 Horio et al. Acta Med. Okayama Vol.
More informationA Rare Case of Recurrent Alphafetoprotein-producing. without Re-elevation of Serum AFP
The Journal of International Medical Research 2006; 34: 109 114 A Rare Case of Recurrent Alphafetoprotein-producing Gastric Cancer without Re-elevation of Serum AFP K TOMIYAMA 1, M TAKAHASHI 2, T FUJII
More informationIntrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1
Intrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1 Jae-Hoon Lim, M.D., Jin Woong Kim, M.D., Suk Hee Heo, M.D., Yong Yeon Jeong, M.D., Heoung Keun Kang, M.D. A 53-year-old
More informationInflammatory Pseudotumor Suspected of Lung Cancer Treated by Thoracoscopic Resection
Ann Thorac Cardiovasc Surg 2011; 17: 48 52 Case Report Inflammatory Pseudotumor Suspected of Lung Cancer Treated by Thoracoscopic Resection Shinji Hirai, MD, 1 Tatsuya Katayama, MD, 1 Naru Chatani, MD,
More informationA nonresponding small cell lung cancer combined with adenocarcinoma
Case Report A nonresponding small cell lung cancer combined with adenocarcinoma Hongyang Lu 1,2, Shifeng Yang 3 1 Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung
More informationBasaloid Carcinoma of the Lung: A Really Dismal Histologic Variant?
Carcinoma of the Lung: A Really Dismal Histologic Variant? Dae Joon Kim, MD, Kil Dong Kim, MD, Dong Hwan Shin, MD, Jae Y Ro, MD, and Kyung Young Chung, MD Departments of Thoracic and Cardiovascular Surgery,
More informationAbstracting Upper GI Cancer Incidence and Treatment Data Quiz 1 Multiple Primary and Histologies Case 1 Final Pathology:
Abstracting Upper GI Cancer Incidence and Treatment Data Quiz 1 Multiple Primary and Histologies Case 1 A 74 year old male with a history of GERD presents complaining of dysphagia. An esophagogastroduodenoscopy
More informationImaging in gastric cancer
Imaging in gastric cancer Gastric cancer remains a deadly disease because of late diagnosis. Adenocarcinoma represents 90% of malignant tumors. Diagnosis is based on endoscopic examination with biopsies.
More informationDiagnostic challenge: Sclerosing Hemangioma of the Lung. Department of Medicine, Division of Pulmonary and Critical Care, Lincoln Medical and
Diagnostic challenge: Sclerosing Hemangioma of the Lung. S. Arias M.D, R. Loganathan M.D, FCCP Department of Medicine, Division of Pulmonary and Critical Care, Lincoln Medical and Mental Health Center/Weill
More informationDiagnosis and Staging of Non-Small Cell Lung Cancer Carlos Eduardo Oliveira Baleeiro, MD. November 18, 2017
Diagnosis and Staging of Non-Small Cell Lung Cancer Carlos Eduardo Oliveira Baleeiro, MD November 18, 2017 Disclosures I do not have a financial interest/arrangement or affiliation with one or more organizations
More informationRespiratory Tract Cytology
Respiratory Tract Cytology 40 th European Congress of Cytology Liverpool, UK Momin T. Siddiqui M.D. Professor of Pathology and Laboratory Medicine Director of Cytopathology Emory University Hospital, Atlanta,
More informationPrimary pulmonary cancer colliding with metastatic choriocarcinoma
Case Report Primary pulmonary cancer colliding with metastatic choriocarcinoma Zheng Wang 1, Jingwen Si 2, Jingwei Liu 1 1 Department of Thoracic Surgery, 2 Department of Pathology, Peking University First
More informationThe right middle lobe is the smallest lobe in the lung, and
ORIGINAL ARTICLE The Impact of Superior Mediastinal Lymph Node Metastases on Prognosis in Non-small Cell Lung Cancer Located in the Right Middle Lobe Yukinori Sakao, MD, PhD,* Sakae Okumura, MD,* Mun Mingyon,
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our
More informationThoracic CT pattern in lung cancer: correlation of CT and pathologic diagnosis
19 th Congress of APSR PG of Lung Cancer (ESAP): Update of Lung Cancer Thoracic CT pattern in lung cancer: correlation of CT and pathologic diagnosis Kazuma Kishi, M.D. Department of Respiratory Medicine,
More informationBrief History. Identification : Past History : HTN without regular treatment.
Brief History Identification : Name : 陳 x - Admission : 94/10/06 Gender : male Age : 75 y/o Chief Complaint : Urinary difficulty for months. Past History : HTN without regular treatment. Brief History
More informationCase # nd Annual SEVPAC May 17, Kathy-Anne Clarke
Case # 10 42 nd Annual SEVPAC May 17, 2014 Kathy-Anne Clarke Google images Babu Babu is 10 year old spayed female French Bulldog Chronic weight loss over 4 months Febrile and lethargic at the referring
More informationCancers of unknown primary : Knowing the unknown. Prof. Ahmed Hossain Professor of Medicine SSMC
Cancers of unknown primary : Knowing the unknown Prof. Ahmed Hossain Professor of Medicine SSMC Definition Cancers of unknown primary site (CUPs) Represent a heterogeneous group of metastatic tumours,
More informationBronchial carcinosarcoma
Bronchial carcinosarcoma Carolina Carcano 1*, Edward Savage 2, Maria Julia Diacovo 3, Jacobo Kirsch 1 1. Division of Radiology, Cleveland Clinic Florida, Weston, Fl, USA 2. Department of Thoracic and Cardiovascular
More informationUnexpectedly long intravenous and intracardiac extension of a small-sized pulmonary pleomorphic carcinoma
Case Report Unexpectedly long intravenous and intracardiac extension of a small-sized pulmonary pleomorphic carcinoma Aya Ishii 1, Tokuhiro Kimura 1, Koshiro Moritani 2, Dan Cui 1, Shinsuke Tanaka 3, Hiroo
More informationRadiology Pathology Conference
Radiology Pathology Conference Nadia F. Yusaf, M.D. PGY-3 1/29/2010 Presentation material is for education purposes only. All rights reserved. 2010 URMC Radiology Page 1 of 90 Case 1 60 year- old man presents
More informationImmunohistochemical Profile of Lung Tumors in Image Guided Biopsies
Original Article DOI: 10.21276/APALM.1342 Immunohistochemical Profile of Lung Tumors in Image Guided Biopsies T. Pavithra 1 *, A. Dhanalakshmi 1, C. Lalitha 1, K.B. Lavanya 1 and S. Shifa 2 Department
More informationTitle. CitationLung Cancer, 68(2): Issue Date Doc URL. Type. File Information. Clinical characteristics of pleomorphic carcinoma of
Title Clinical characteristics of pleomorphic carcinoma of Ito, Kenichiro; Oizumi, Satoshi; Fukumoto, Shinichi; Author(s) Kojima, Tetsuya; Yokouchi, Hiroshi; Nishimura, Masah CitationLung Cancer, 68(2):
More informationUniversity Journal of Pre and Para Clinical Sciences
ISSN 2455 2879 Volume 2 Issue 1 2016 Metaplastic carcinoma breast a rare case report Abstract : Metaplastic carcinoma of the breast is a rare malignancy with two distinct cell lines described as a breast
More informationMetastatic mechanism of spermatic cord tumor from stomach cancer
Int Canc Conf J (2013) 2:191 195 DOI 10.1007/s13691-013-0-9 CANCER BOARD CONFERENCE Metastatic mechanism of spermatic cord tumor from stomach cancer Masahiro Seike Yoshikazu Kanazawa Ryuji Ohashi Tadashi
More informationPresentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98
Presentation material is for education purposes only. All rights reserved. 2011 URMC Radiology Page 1 of 98 Radiology / Pathology Conference February 2011 Brooke Koltz, Cytopathology Resident Presentation
More informationCase Scenario 1: Thyroid
Case Scenario 1: Thyroid History and Physical Patient is an otherwise healthy 80 year old female with the complaint of a neck mass first noticed two weeks ago. The mass has increased in size and is palpable.
More informationSakamoto et al. Journal of Medical Case Reports (2018) 12:136
Sakamoto et al. Journal of Medical Case Reports (2018) 12:136 https://doi.org/10.1186/s13256-018-1671-6 CASE REPORT Open Access Successful resection of a slow-growing synchronous pulmonary metastasis from
More informationA Case of Colon Cancer Metastasizing to the Spleen
Jpn. J. Clin. Oncol. J984, 14 (3), 425 ~ 430 A Case of Colon Cancer Metastasizing to the Spleen SEISHIRO INABA, M.D., TSUGUO TANAKA, M.D., H1SAKAZU YAMAGISHI, M.D., KIMIO IGUCHI, M.D., HIDEAKI KURIOKA,
More informationA Proposed Strategy for Treatment of Superficial Carcinoma. in the Thoracic Esophagus Based on an Analysis. of Lymph Node Metastasis
Kitakanto Med J 2002 ; 52 : 189-193 189 A Proposed Strategy for Treatment of Superficial Carcinoma in the Thoracic Esophagus Based on an Analysis of Lymph Node Metastasis Susumu Kawate,' Susumu Ohwada,'
More informationEndometriosis of the Appendix Resulting in Perforated Appendicitis
27 Endometriosis of the Appendix Resulting in Perforated Appendicitis Toru Hasegawa a Koichi Yoshida b Kazuhiro Matsui c a Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama,
More informationPleomorphic carcinoma is a rare epithelial malignant. Personal Experience in Surgical Management of Pulmonary Pleomorphic Carcinoma
Personal Experience in Surgical Management of Pulmonary Pleomorphic Carcinoma Federico Raveglia, MD, Maurizio Mezzetti, MD, Tiziana Panigalli, MD, Simone Furia, MD, Luigi Giuliani, MD, Serena Conforti,
More information101 spots: Find the primary site
www.edoriumjournals.com CLINICAL IMAGES PEER REVIEWED OPEN ACCESS 101 spots: Find the primary site Geraldine Bera, Gabriel Malouf, Nathanaëlle Yeni, Charlotte Lepoutre-Lussey ABSTRACT Abstract is not required
More informationcame from a carcinoma and in 12 from a sarcoma. Ninety lesions were intrapulmonary and the as the chest wall and pleura. Details of the primary
Thorax 1982;37:366-370 Thoracic metastases MARY P SHEPHERD From the Thoracic Surgical Unit, Harefield Hospital, Harefield ABSTRACI One hundred and four patients are reviewed who were found to have thoracic
More informationCitation Auris, nasus, larynx (2011), 38(3):
TitleManagement of metastasis to the thy Author(s) Ishikawa, Masaaki; Hirano, Shigeru; Citation Auris, nasus, larynx (2011), 38(3): Issue Date 2011-06 URL http://hdl.handle.net/2433/139807 Right 2010 Elsevier
More informationRelationship between FDG uptake and the pathological risk category in gastrointestinal stromal tumors
270 ORIGINAL Relationship between FDG uptake and the pathological risk category in gastrointestinal stromal tumors Yoichi Otomi, Hideki Otsuka, Naomi Morita, Kaori Terazawa, Kaori Furutani, Masafumi Harada,
More informationNeuroendocrine Tumor of Unknown Primary Accompanied with Stomach Adenocarcinoma
J Gastric Cancer 2011;11(4):234-238 http://dx.doi.org/10.5230/jgc.2011.11.4.234 Case Report Neuroendocrine Tumor of Unknown Primary Accompanied with Stomach Adenocarcinoma Ho-Yeun Kim, Sung-Il Choi 1,
More informationCASE REPORT. Abstract. Introduction. Case Report
SE REPORT n utopsy ase of Two Distinct, cquired Drug Resistance Mechanisms in Epidermal Growth Factor Receptor-mutant Lung denocarcinoma: Small ell arcinoma Transformation and Epidermal Growth Factor Receptor
More information췌장의단일종괴형태로재발해원발성췌장암으로오인된재발성폐암
Case Report The Korean Journal of Pancreas and Biliary Tract 2018;23:172-176 https://doi.org/10.15279/kpba.2018.23.4.172 pissn 1976-3573 eissn 2288-0941 췌장의단일종괴형태로재발해원발성췌장암으로오인된재발성폐암 대구가톨릭대학교의과대학내과학교실
More informationPleomorphic Carcinoma of the Lung: Relationship Between CT Findings and Prognosis
Cardiopulmonary Imaging Original Research Fujisaki et al. CT of Pleomorphic Carcinoma of the Lung Cardiopulmonary Imaging Original Research Akitaka Fujisaki 1 Takatoshi Aoki 1 Takahiko Kasai 2,3 Shunsuke
More informationLung Cancer in Women: A Different Disease? James J. Stark, MD, FACP
Lung Cancer in Women: A Different Disease? James J. Stark, MD, FACP Medical Director, Cancer Program and Director of Palliative Care Maryview Medical Center Professor of Medicine Eastern Virginia Medical
More informationRadiology Pathology Conference
Radiology Pathology Conference Sharlin Johnykutty,, MD, Cytopathology Fellow Sara Majewski, MD, Radiology Resident Friday, August 28, 2009 Presentation material is for education purposes only. All rights
More informationLUNG CANCER PATHOLOGY: UPDATE ON NEUROENDOCRINE LUNG TUMORS
LUNG CANCER PATHOLOGY: UPDATE ON NEUROENDOCRINE LUNG TUMORS William D. Travis, M.D. Attending Thoracic Pathologist Memorial Sloan Kettering Cancer Center New York, NY PULMONARY NE TUMORS CLASSIFICATION
More informationCytological Sub-classification of Lung Cancer: Morphologic and Molecular Characteristics. Mercè Jordà, University of Miami
Cytological Sub-classification of Lung Cancer: Morphologic and Molecular Characteristics Mercè Jordà, University of Miami Mortality Lung cancer is the most frequent cause of cancer incidence and mortality
More informationMucosal Esophageal Squamous Cell Carcinoma With Intramural Gastric Metastasis Invading Liver and Pancreas: A Case Report
Int Surg 2014;99:458 462 DOI: 10.9738/INTSURG-D-13-00069.1 Case Report Mucosal Esophageal Squamous Cell Carcinoma With Intramural Gastric Metastasis Invading Liver and Pancreas: A Case Report Nobuhiro
More informationSmall Bowel Metastatic Cancer Observed With Double Balloon Enteroscopy in a Patient With a Past History of Multiple Cancers
CASE REPORT ISSN 1598-9100(Print) ISSN 2288-1956(Online) http://dx.doi.org/10.5217/ir.2015.13.4.350 Intest Res 2015;13(4):350-354 Small Bowel Metastatic Cancer Observed With Double Balloon Enteroscopy
More informationManagement of Neck Metastasis from Unknown Primary
Management of Neck Metastasis from Unknown Primary.. Definition Histologic evidence of malignancy in the cervical lymph node (s) with no apparent primary site of original tumour Diagnosis after a thorough
More informationLos Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010
Los Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010 Self Assessment Module on Nuclear Medicine and PET/CT Case Review FDG PET/CT IN LYMPHOMA AND MELANOMA Submitted
More informationCase Presentation. Maha Akkawi, MD, Fatima Obeidat, MD, Tariq Aladily, MD. Department of Pathology Jordan University Hospital Amman, Jordan
Case Presentation Maha Akkawi, MD, Fatima Obeidat, MD, Tariq Aladily, MD Department of Pathology Jordan University Hospital Amman, Jordan The 25th Annual Congress of the ADIAP The 8/11/2013 1 5th International
More informationPulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of 51 cases
Huang et al. World Journal of Surgical Oncology 2013, 11:252 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Pulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of
More informationThree Cases With a Lung Abscess and Bronchial Inflammatory Polyps
Elmer Press Case Report Three Cases With a Lung Abscess and Bronchial Inflammatory Polyps Yoshiyuki Kurose a, Norio Kodaka a, Kumiko Kashiwa a, Yuuki Kamata a, Haruhi Kouno a, Chihiro Nakano a, Kayo Sugawa
More informationUnusual Osteoblastic Secondary Lesion as Predominant Metastatic Disease Spread in Two Cases of Uterine Leiomyosarcoma
49 Unusual Osteoblastic Secondary Lesion as Predominant Metastatic Disease Spread in Two Cases of Uterine Leiomyosarcoma Loredana Miglietta a Maria Angela Parodi b Luciano Canobbio b Luca Anselmi c a Medical
More informationThe Significant Antitumor Activity of Nivolumab in Lung Adenocarcinoma with Choriocarcinomatous Features
doi: 10.2169/internalmedicine.0002-17 http://internmed.jp CASE REPORT The Significant Antitumor Activity of Nivolumab in Lung Adenocarcinoma with Choriocarcinomatous Features Mieko Ochi 1, Shingo Miyamoto
More informationInternational Journal of Medical and Health Sciences
International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Case Report Squamous Cell Carcinoma Of Renal Pelvis- A Rare Case Report S. S. Inamdar* 1, Sainath
More informationPET IMAGING (POSITRON EMISSION TOMOGRAPY) FACT SHEET
Positron Emission Tomography (PET) When calling Anthem (1-800-533-1120) or using the Point of Care authorization system for a Health Service Review, the following clinical information may be needed to
More informationCase Report A Case of Pulmonary Sarcoma with Significant Extension into the Right Lung
Case Reports in Medicine, Article ID 279374, 4 pages http://dx.doi.org/10.1155/2014/279374 Case Report A Case of Pulmonary Sarcoma with Significant Extension into the Right Lung Yoshiaki Inoue, 1 Yotaro
More informationIn the mid 1970s, visceral pleural invasion (VPI) was included
ORIGINAL ARTICLE Tumor Invasion of Extralobar Soft Tissue Beyond the Hilar Region Does Not Affect the Prognosis of Surgically Resected Lung Cancer Patients Hajime Otsuka, MD,* Genichiro Ishii, MD, PhD,*
More informationLung Tumor Cases: Common Problems and Helpful Hints
Lung Tumor Cases: Common Problems and Helpful Hints Brandon T. Larsen, MD, PhD Senior Associate Consultant Department of Laboratory Medicine and Pathology Mayo Clinic Arizona Arizona Society of Pathologists
More informationLung cancer pleural invasion was recognized as a poor prognostic
Visceral pleural invasion classification in non small cell lung cancer: A proposal on the basis of outcome assessment Kimihiro Shimizu, MD a Junji Yoshida, MD a Kanji Nagai, MD a Mitsuyo Nishimura, MD
More informationUse of Integrated PET CT in the Clinical Staging of Non Small Cell Lung Cancer
November 2010 Use of Integrated PET CT in the Clinical Staging of Non Small Cell Lung Cancer Laura Myers, Harvard Medical School, Year III Clinical Presentation 79yo woman with cough productive of green
More informationCase report Serous cystadenocarcinoma of the mesentery in a man: case report and review of literature
Gastroenterology Report 2 (2014) 306 310, doi:10.1093/gastro/gou019 Advance access publication 7 April 2014 Case report Serous cyst of the mesentery in a man: case report and review of literature Toru
More informationCentral Poorly Differentiated Adenocarcinoma of the Maxilla: Report of a Case
Kobe J. Med. Sci., Vol. 49, No. 2, pp. 45-49, 2003 Central Poorly Differentiated Adenocarcinoma of the Maxilla: Report of a Case MASAHIRO UMEDA 1), SATOSHI YOKOO 1), YASUYUKI SHIBUYA 1), TAKAHIDE KOMORI
More informationCase Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms
Hindawi Publishing Corporation Volume 2015, Article ID 153932, 5 pages http://dx.doi.org/10.1155/2015/153932 Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Shiuan-Li
More informationPrimary Malignant Melanoma of the Esophagus: A Case Report and Review of the Literature
ISSN 1941-5923 DOI: 10.12659/AJCR.894041 Received: 2014.03.07 Accepted: 2015.04.13 Published: 2015.07.27 Primary Malignant Melanoma of the Esophagus: A Case Report and Review of the Literature Authors
More informationITO, Yasuhiro ; FUJII, Mizue ; SHIBUYA, Takashi ; UEHARA, Jiro ; SATO, Katsuhiko ; IIZUKA, Hajime
Journal of Dermatology (2011) 38(5):515-517. Granulocyte colony stimulating factor-producing squamous cell carcinoma of the skin ITO, Yasuhiro ; FUJII, Mizue ; SHIBUYA, Takashi ; UEHARA, Jiro ; SATO, Katsuhiko
More informationEarly View Article: Online published version of an accepted article before publication in the final form.
: Online published version of an accepted article before publication in the final form. Journal Name: International Journal of Case Reports and Images (IJCRI) Type of Article: Clinical Images Title: Urinary
More informationCase Scenario 1. Discharge Summary
Case Scenario 1 Discharge Summary A 69-year-old woman was on vacation and noted that she was becoming jaundiced. Two months prior to leaving on that trip, she had had a workup that included an abdominal
More informationGastric Metastasis of Lung Cancer Mimicking an Adrenal Tumor
Published online: March 13, 2014 1662 0631/14/0081 0077$39.50/0 This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC)
More informationImaging of Gastrointestinal Stromal Tumors (GIST) Amir Reza Radmard, MD Assistant Professor Shariati hospital Tehran University of Medical Sciences
Imaging of Gastrointestinal Stromal Tumors (GIST) Amir Reza Radmard, MD Assistant Professor Shariati hospital Tehran University of Medical Sciences Describe the typical imaging findings of GIST at initial
More informationRatio of maximum standardized uptake value to primary tumor size is a prognostic factor in patients with advanced non-small cell lung cancer
Original Article Ratio of maximum standardized uptake value to primary tumor size is a prognostic factor in patients with advanced non-small cell lung cancer Fangfang Chen 1 *, Yanwen Yao 2 *, Chunyan
More informationMetastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report
Kimura et al. Surgical Case Reports (2018) 4:47 https://doi.org/10.1186/s40792-018-0455-y CASE REPORT Open Access Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy:
More informationCase Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms
Case Reports in Pathology Volume 2015, Article ID 153932, 5 pages http://dx.doi.org/10.1155/2015/153932 Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Shiuan-Li
More informationPerigastric Lymph Node Metastasis from Papillary Thyroid Carcinoma in a Patient with Early Gastric Cancer: The First Case Report
J Gastric Cancer 2014;14(3):215-219 http://dx.doi.org/10.5230/jgc.2014.14.3.215 Perigastric Lymph Node Metastasis from Papillary Thyroid Carcinoma in a Patient with Early Gastric Cancer: The First Gui-Ae
More informationColor Codes Pathology and Genetics Medicine and Clinical Pathology Surgery Imaging
Saturday, November 5, 2005 8:30-10:30 a. m. Poorly Differentiated Endocrine Carcinomas Chairman: E. Van Cutsem, Leuven, Belgium 9:00-9:30 a. m. Working Group Sessions Pathology and Genetics Group leaders:
More informationManagement of Rare Liver Tumours
Gian Luca Grazi Hepato-Biliary-Pancreatic Surgery National Cancer Institute Regina Elena Rome Fibrolamellar Carcinoma Mixed Hepato Cholangiocellular Carcinoma Hepatoblastoma Carcinosarcoma Primary Hepatic
More informationFour Cases of Large Cell Neuroendocrine Carcinoma of the Stomach: Findings on CT and Barium Studies 1
Four Cases of Large Cell Neuroendocrine Carcinoma of the Stomach: Findings on CT and arium Studies 1 Hee Jung Kim, M.D., Dongil Choi, M.D., Soon Jin Lee, M.D., Won Jae Lee, M.D., Sung Kim, M.D. 2, Jae
More informationSarcomatoid Carcinoma of the Small Intestine: A Case Report and Review of the Literature 1 소장에생긴육종성암 : 증례보고및문헌고찰 1
Case Report pissn 1738-2637 / eissn 2288-2928 J Korean Soc Radiol 2013;69(4):295-299 http://dx.doi.org/10.3348/jksr.2013.69.4.295 Sarcomatoid Carcinoma of the Small Intestine: A Case Report and Review
More informationManagement of an Appendiceal Mass - Approach to acute presentation of appendiceal neoplasms
Management of an Appendiceal Mass - Approach to acute presentation of appendiceal neoplasms Dr. Claudia LY WONG, Department of Surgery, Kwong Wah Hospital Joint Hospital Surgical Grand Round Presentation,
More informationSESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, :30am - 11:30am FACULTY COPY
SESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, 2008 9:30am - 11:30am FACULTY COPY GOAL: Describe the basic morphologic (structural) changes which occur in various pathologic conditions.
More informationA Case of Pancreatic Carcinoma with Bilateral Hilar
Shinshu Med J, 66⑵:151~155, 2018 A Case of Pancreatic Carcinoma with Bilateral Hilar 18 F-FDG and 67 Ga Hyperaccumulation Satoshi Kawakami 1 )*, Yasunari Fujinaga 1), Shin Yanagisawa 1) Masumi Kadoya 1),
More information1/25/13 Right partial nephrectomy followed by completion right radical nephrectomy.
History and Physical Case Scenario 1 45 year old white male presents with complaints of nausea, weight loss, and back pain. A CT of the chest, abdomen and pelvis was done on 12/8/12 that revealed a 12
More informationEsophageal seeding after endoscopic ultrasound-guided fine-needle aspiration of a mediastinal tumor
Esophageal seeding after endoscopic ultrasound-guided fine-needle aspiration of a mediastinal tumor Authors Kensuke Yokoyama 1,JunUshio 1,NorikatsuNumao 1, Kiichi Tamada 1, Noriyoshi Fukushima 2, Alan
More informationCase Report Ovarian Metastasis from Lung Cancer: A Rare Entity
Case Reports in Obstetrics and Gynecology Volume 2013, Article ID 378438, 4 pages http://dx.doi.org/10.1155/2013/378438 Case Report Ovarian Metastasis from Lung Cancer: A Rare Entity Huseyin Cengiz, Fükrü
More informationSuperior and Basal Segment Lung Cancers in the Lower Lobe Have Different Lymph Node Metastatic Pathways and Prognosis
ORIGINAL ARTICLES: Superior and Basal Segment Lung Cancers in the Lower Lobe Have Different Lymph Node Metastatic Pathways and Prognosis Shun-ichi Watanabe, MD, Kenji Suzuki, MD, and Hisao Asamura, MD
More informationDisclosure of Relevant Financial Relationships
Disclosure of Relevant Financial Relationships USCAP requires that all faculty in a position to influence or control the content of CME disclose any relevant financial relationship WITH COMMERCIAL INTERESTS
More informationCase Report Intramucosal Signet Ring Cell Gastric Cancer Diagnosed 15 Months after the Initial Endoscopic Examination
Hindawi Publishing Corporation Case Reports in Medicine Volume 2015, Article ID 479625, 5 pages http://dx.doi.org/10.1155/2015/479625 Case Report Intramucosal Signet Ring Cell Gastric Cancer Diagnosed
More information