Excellent Prognosis of Patients With Invasive Lung Adenocarcinomas During Surgery Misdiagnosed as Atypical Adenomatous Hyperplasia, Adenocarcinoma In Situ, or Minimally Invasive Adenocarcinoma by Frozen Section.

BACKGROUND: Our previous study revealed that intraoperative frozen section (FS) analysis could differentiate invasive lung adenocarcinoma (LUAD) accurately from preinvasive lesions. However, few articles have analyzed the clinical impact of FS errors such as underestimation of invasive adenocarcinomas (IACs), and whether complementary therapy is needed remains controversial. RESEARCH QUESTION: What is the prognosis of patients undergoing limited resection for invasive LUAD misdiagnosed as atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), or minimally invasive adenocarcinoma (MIA) by intraoperative FS analysis? STUDY DESIGN AND METHODS: From 2012 through 2018, data on 3031 patients undergoing sublobar resection of AAH, AIS, or MIA diagnosed by FS analysis were collected. The concordance rate between FS analysis and final pathologic results was evaluated. To assess the clinical significance of a discrepancy between FS and final pathologic results, patients with final pathologic results of IAC were identified for prognostic evaluation. RESULTS: When AAH, AIS, and MIA were classified together as a group, the overall concordance rate between FS and final pathologic results was 93.7%, and 192 patients (6.3%) received an upgraded diagnosis from the final pathologic results. Misdiagnosed IACs consisted of 94 patients (48.9%) with lepidic-predominant adenocarcinoma, 77 patients (40.1%) with acinar predominant adenocarcinoma, 19 patients (9.9%) with papillary predominant adenocarcinoma, one patient with solid predominant adenocarcinoma, and one patient with invasive mucinous adenocarcinoma. Among these patients, no positive N1 or N2 lymph node findings were observed. Moreover, the 5-year recurrence-free survival was still 100%, although the final pathologic results turned out to be IAC. INTERPRETATION: Patients undergoing limited resection of invasive LUAD misdiagnosed as AAH, AIS, or MIA by FS analysis showed excellent prognoses. Sublobar resection guided by FS diagnosis would be adequate for these underestimated cases of invasive LUAD.

[Bronchioloalveolar adenoma associated with bronchiolitis obliterans and leishmaniasis with lung involvement in acquired immunodeficiency syndrome]. / Adenoma bronquioloalveolar asociado a bronquiolitis obliterante y leishmaniasis pulmonar en el sida.

Visceral leishmaniasis is not unusual in patients with acquired immunodeficiency syndrome (AIDS), but lung infiltration is uncommon. Leishmaniasis involving the lung often manifests as interstitial pneumonitis. We report a case in which the discovery of amastigotes in the transbronchial biopsy led to a diagnosis of leishmaniasis. However, the findings from x-rays and study of the bronchoalveolar lavage fluid were consistent with bronchiolitis obliterans, possibly caused by the AIDS virus. In addition, the transbronchial biopsy findings were consistent with a diagnosis of bronchioloalveolar adenoma with radiographic evidence of multiple nodules.

Pregnancy complicated by acute pulmonary lymphangitic adenomatosis, metastasis and disseminated intravascular coagulation. A case report.

BACKGROUND: The association of pregnancy and cancer is a rare event, occurring in less than 1 case per 5,000 pregnancies, and is a cause of maternal mortality in about 5% of cases. CASE: A 33-year-old, Japanese woman presented at the end of pregnancy with clinical manifestations of pneumonia and developed fatal disseminated intravascular coagulation in the postpartum period. The pathologic findings suggested the existence of a primary cancer in the gastrointestinal tract with pulmonary and placental metastases. CONCLUSION: The biologic course of malignancies in pregnancy is complex. In gastrointestinal cancer, normal pregnancy symptoms can mask and delay the diagnosis. As in this patient, very rare presentations are possible.

Adenomatose pulmonar ("jaagsiekte") em ovino no Rio Grande do Sul / Pulmonary adenomatosis (\"jaagsiekte\") in sheep from southern Brazil

Descreve-se, no Rio Grande do Sul, o primeiro caso de adenomatose pulmonar ("jaagsiekte") em um ovino da raça Karakul, fëmea de 2 anos, filha de pais importados da Alemanha. O ovino morreu de acidose lática por sobrecarga alimentar e as lesöes pulmonares representaram achados incidentais. Macroscopicamente encontraram-se duas áreas esbranquiçadas nodulares com aproximadamente 4 e 6cm de diâmetro respectivamente, com bordos irregulares que, microscopicamente, correspondiam a tumoraçäo epitelial bem diferenciada, formando projeçöes papilares para o interior do lúmem alveolar e bronquiolar. Näo foram encontrados indícios de associaçäo com Maedi/Visna através dos achados sorológicos e histopatológicos. O diagnóstico de adenomatose pulmonar, baseou-se na histopatologia.

Malformación adenomatosa quística del pulmón: diagnóstico prenatal / Cystic adenomatoid malformation of the lung: antenatal diagnosis

Presentamos un caso clínico de diagnóstico antenatal de malformación adenomatosa quística del pulmón. Se realiza una revisión de la literatura y se discute el manejo perinatal