Nomogram predicting overall and cancer specific prognosis for poorly differentiated lung adenocarcinoma after resection based on SEER cohort analysis.

The prognosis of poorly differentiated lung adenocarcinoma (PDLA) is determined by many clinicopathological factors. The aim of this study is identifying prognostic factors and developing reliable nomogram to predict the overall survival (OS) and cancer-specific survival (CSS) in patients with PDLA. Patient data from the Surveillance, Epidemiology and End Results (SEER) database was collected and analyzed. The SEER database was used to screen 1059 eligible patients as the study cohort. The whole cohort was randomly divided into a training cohort (n = 530) and a test cohort (n = 529). Cox proportional hazards analysis was used to identify variables and construct a nomogram based on the training cohort. C-index and calibration curves were performed to evaluate the performance of the model in the training cohort and test cohorts. For patients with PDLA, age at diagnosis, gender, tumor size were independent prognostic factors both for overall survival (OS) and cancer-specific survival (CSS), while race and number of nodes were specifically related to OS. The calibration curves presented excellent consistency between the actual and nomogram-predict survival probabilities in the training and test cohorts. The C-index values of the nomogram were 0.700 and 0.730 for OS and CSS, respectively. The novel nomogram provides new insights of the risk of each prognostic factor and can assist doctors in predicting the 1-year, 3-year and 5-year OS and CSS in patients with PDLA.

Anaplastic Lymphoma Kinase (ALK)-Negative Anaplastic Large Cell Non-Hodgkin Lymphoma as a Rare Differential Diagnosis of Lung Cancer: A Case Report.

Anaplastic large cell lymphomas (ALCL) are a group of sporadic malignancies that generally have an aggressive clinical course, especially the subtype of anaplastic lymphoma kinase (ALK)-negative ALCL. The appropriate diagnostic study modalities must be chosen to make an accurate diagnosis and promptly initiate specific treatment. We present the clinical case of a 72-year-old male patient with dyspnea on small efforts accompanied by diaphoresis and a weight loss of 10 kg in two months. Physical examination revealed adenopathy in the cervical region and bilateral pleural effusion. The pleural and lung biopsies revealed poorly differentiated metastatic adenocarcinomas. A multidisciplinary analysis was carried out; the typical clinical-radiographic presentation of adenocarcinoma was ruled out with immunohistochemistry, thus determining a diagnosis of ALK-negative anaplastic large cell non-Hodgkin's lymphoma. This case represented a diagnostic and therapeutic challenge since it is a rare entity with a poor prognosis, and there are only a few studies about the choice of appropriate chemotherapy in these patients.

Paraneoplastic Hypereosinophilia in Poorly Differentiated Adenocarcinoma of the Lung.

It is well-documented that lung and bronchus cancers are the leading cause of cancer death in the United States in both male and female patients, with lung adenocarcinoma accounting for the highest prevalence of lung cancers. Significant eosinophilia in the setting of lung adenocarcinoma has been documented in a few reports, being described as a rare paraneoplastic syndrome. We report on an 81-year-old female with hypereosinophilia-associated lung adenocarcinoma. A chest film showed a right lung mass, which was not apparent on a chest film 1 year prior, in the setting of significant leukocytosis of 27.90 x 103/mm3 with eosinophilia of 6.40 x 103/mm3. A computed tomography (CT) chest, obtained during admission, demonstrated significant right lower lobe mass enlargement since the previous study completed 5 months prior, with new occlusion of bronchi and pulmonary vessels to the region of the mass. Our observations are consistent with prior reports showing that the presence of eosinophilia in lung cancers may indicate rapid disease progression.