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1.
BMJ Case Rep ; 14(10)2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598972

RESUMEN

A 62-year-old man presents with breathlessness 6 months following right pneumonectomy for lung adenocarcinoma. Previous investigations had not yielded a diagnosis and his symptoms were progressing. The patient described worsened symptoms when stood up (platypnoea), with profound hypoxia until laid supine (orthodeoxia). Platypnoea-orthodeoxia syndrome due to a right-to-left interatrial shunt was diagnosed on contrast-enhanced transoesophageal echocardiography with the patient undergoing successful percutaneous patent foramen ovale closure. Patent foramen ovale is often asymptomatic with a population prevalence of around 20%-30%. Anatomical shifts postpneumonectomy can open, or worsen a previously closed interatrial communication leading to right-to-left shunting of blood. Platypnoea-orthodeoxia is under-recognised, impairing quality of life and patient outcome. Investigations can be falsely reassuring, or poorly sensitive for the causative pathology. Percutaneous closure is safe with high success rates and this case highlights the need for a high index of suspicion for shunts, particularly in postpneumonectomy patients.


Asunto(s)
Neoplasias Pulmonares , Neumonectomía , Disnea/etiología , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Calidad de Vida , Síndrome
2.
Folia Biol (Praha) ; 67(2): 62-69, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34624938

RESUMEN

Hypoxia leads to post-treatment metastasis and recurrences of cancer via the epithelial-mesenchymal transition (EMT). Radiotherapy itself may also contribute to the acquisition of EMT phenotypes. Despite extensive studies on the EMT driven by either hypoxia or radiation stimuli, the molecular mechanisms characterizing these EMT events remain unclear. Thus, we aimed to evaluate the differences in the molecular pathways between hypoxia-induced EMT (Hypo-EMT) and radiation-induced EMT (R-EMT). Further, we investigated the therapeutic effects of HIF-1α inhibitor (LW6) on Hypo-EMT and R-EMT cells. A549 cells, lung adenocarcinoma cell line, acquired enhanced wound-healing activity under both hypoxia and irradiation. Localization of E-cadherin was altered from the cell membrane to the cytoplasm in both hypoxia and irradiated conditions. Of note, the expression levels of vimentin, one of the major EMT markers, was enhanced in irradiated cells, while it decreased under hypoxia condition. Importantly, LW6 significantly blocked EMT-related malignant phenotypes in both Hypo-EMT cells and R-EMT cells with concomitant re-location of E-cadherin onto the cell membrane. Moreover, LW6 deflected stress responsive signalling, JNK, activated sustainably under hypoxic condition, and the blockage of JNK impaired EMT phenotypes. Together, this work demonstrated the molecular events underlying Hypo-EMT and R-EMT, and highlighted HIF-1α as a therapeutic target not only in Hypo- EMT, but also in R-EMT.


Asunto(s)
Hipoxia de la Célula , Transición Epitelial-Mesenquimal , Factor 1 Inducible por Hipoxia/metabolismo , Neoplasias Pulmonares , Células A549 , Antígenos CD , Cadherinas , Transición Epitelial-Mesenquimal/efectos de la radiación , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia
3.
BMJ Case Rep ; 14(10)2021 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-34649854

RESUMEN

Conventional lung cancer treatments include surgery, chemotherapy and radiotherapy; however, these treatments are often poorly tolerated by patients. Cannabinoids have been studied for use as a primary cancer treatment. Cannabinoids, which are chemically similar to our own body's endocannabinoids, can interact with signalling pathways to control the fate of cells, including cancer cells. We present a patient who declined conventional lung cancer treatment. Without the knowledge of her clinicians, she chose to self-administer 'cannabidiol (CBD) oil' orally 2-3 times daily. Serial imaging shows that her cancer reduced in size progressively from 41 mm to 10 mm over a period of 2.5 years. Previous studies have failed to agree on the usefulness of cannabinoids as a cancer treatment. This case appears to demonstrate a possible benefit of 'CBD oil' intake that may have resulted in the observed tumour regression. The use of cannabinoids as a potential cancer treatment justifies further research.


Asunto(s)
Cannabidiol , Cannabinoides , Neoplasias Pulmonares , Femenino , Humanos , Neoplasias Pulmonares/tratamiento farmacológico
4.
Sensors (Basel) ; 21(19)2021 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-34640976

RESUMEN

Lung cancer is the leading cause of cancer death and morbidity worldwide. Many studies have shown machine learning models to be effective in detecting lung nodules from chest X-ray images. However, these techniques have yet to be embraced by the medical community due to several practical, ethical, and regulatory constraints stemming from the "black-box" nature of deep learning models. Additionally, most lung nodules visible on chest X-rays are benign; therefore, the narrow task of computer vision-based lung nodule detection cannot be equated to automated lung cancer detection. Addressing both concerns, this study introduces a novel hybrid deep learning and decision tree-based computer vision model, which presents lung cancer malignancy predictions as interpretable decision trees. The deep learning component of this process is trained using a large publicly available dataset on pathological biomarkers associated with lung cancer. These models are then used to inference biomarker scores for chest X-ray images from two independent data sets, for which malignancy metadata is available. Next, multi-variate predictive models were mined by fitting shallow decision trees to the malignancy stratified datasets and interrogating a range of metrics to determine the best model. The best decision tree model achieved sensitivity and specificity of 86.7% and 80.0%, respectively, with a positive predictive value of 92.9%. Decision trees mined using this method may be considered as a starting point for refinement into clinically useful multi-variate lung cancer malignancy models for implementation as a workflow augmentation tool to improve the efficiency of human radiologists.


Asunto(s)
Neoplasias Pulmonares , Humanos , Pulmón , Neoplasias Pulmonares/diagnóstico por imagen , Sensibilidad y Especificidad , Tórax , Rayos X
5.
BMC Neurol ; 21(1): 397, 2021 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-34641815

RESUMEN

BACKGROUND: Hypereosinophilia (HE) is caused by various conditions, including solid and hematologic tumors. Nonetheless, there exist no reports on cerebral infarctions caused by HE associated with lung cancer metastasis to the bone marrow. CASE PRESENTATION: We report a case of a 67-year-old man with multiple cerebral infarctions associated with HE. His white blood cell and eosinophil counts were 38,900/µL and 13,600/µL, respectively, at 4 weeks before admission. During treatment for HE, he presented with dysarthria and walking difficulties. Magnetic resonance imaging of the brain showed multiple small infarcts in regions such as the bilateral cortex, watershed area, and cerebellum. Chest computed tomography showed small nodes in the lung and enlargement of the left hilar lymph nodes. Bronchoscopic biopsy did not reveal a tumor; however, bone marrow biopsy showed infiltration of tumor cells. We considered a diagnosis of lung cancer metastasizing to the bone marrow, which induced HE and later caused cerebral infarctions. CONCLUSIONS: This case report demonstrates that metastatic cancer in the bone marrow can induce HE, which can consequently cause multiple cerebral infarctions. Clinicians should consider HE as a cause of multiple cerebral infarctions in patients with cancer.


Asunto(s)
Neoplasias Pulmonares , Anciano , Encéfalo , Infarto Cerebral/complicaciones , Infarto Cerebral/diagnóstico por imagen , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos X
6.
Acta Oncol ; 60(11): 1407-1412, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34643168

RESUMEN

BACKGROUND: The aim is to quantify and analyse tumour motion during a course of treatment for lung SBRT patients. MATERIAL AND METHODS: Peak-to-peak motion of 483 tumours in 441 patients treated with peripheral lung SBRT at a single institution over a two year period was measured on planning CT and at all treatment fractions. Planning 4D-CT scans were analysed using our clinical workflow involving deformable propagation of the delineated target to all phases. Similarly, acquisition of the 4D-CBCT data followed the clinical workflow based on XVI 5.0 available on Elekta linacs. Differences and correlations of the peak-to-peak motion on the planning CT and at treatment were analysed. RESULTS: On the planning CT, a total of 81.4% of the tumours had a peak-to-peak motion <10 mm, and 96.1% had <20 mm. The largest motion was observed in the CC direction, with largest amplitude for tumours located in the caudal posterior part of the lung. The difference in amplitude in CC between planning CT and first fraction had a mean and standard deviation of 0.3 mm and 3.5 mm, respectively, and the largest differences were observed in the caudal posterior part of the lung. Patients with a difference in tumour motion amplitude exceeding two standard deviations (>7 mm) at the first fraction were evaluated individually, and they all had poor 4DCT image quality. The difference between the first and second/third fractions had a mean and standard deviation of 0.4 mm/0.5 mm and 2.0 mm/1.9 mm. CONCLUSION: Tumour motion at first treatment was similar to motion at planning, and motion at subsequent treatments was very similar to motion at first treatment. Large tumour motions are located towards the caudal posterior tumour locations. Patients with poor 4D-CT image quality should be closely followed at the first treatment to verify the motion.


Asunto(s)
Neoplasias Pulmonares , Radiocirugia , Tomografía Computarizada Cuatridimensional , Humanos , Pulmón , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Planificación de la Radioterapia Asistida por Computador
7.
J Int Med Res ; 49(10): 3000605211049653, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34605301

RESUMEN

OBJECTIVE: To investigate the clinical significance of serum S100 calcium-binding protein A10 (S100A10) levels in lung cancer. METHODS: This prospective study enrolled patients with lung cancer, patients with benign lung nodules and healthy control subjects. Serum S100A10 levels and three biomarkers were measured and compared between the groups. Associations between serum S100A10 and clinical characteristics in patients with lung cancer were investigated. The diagnostic efficacy of serum S100A10 and carcinoembryonic antigen for lung cancer was calculated. RESULTS: The study enrolled 82 patients with lung cancer, 21 with benign lung nodules and 50 healthy controls. Serum S100A10 levels were significantly higher in patients with lung cancer compared with patients with benign lung nodules and healthy control subjects. Serum S100A10 levels of patients with advanced lung cancer were significantly higher than those with early stage disease. Patients with lymph node metastases had significantly higher serum S100A10 levels than patients without lymph node metastases. The cut-off serum S100A10 value for lung cancer detection was 1.34 ng/ml, which had a sensitivity of 48.2%, a specificity of 76.2% and an area under the curve of 0.63. CONCLUSION: Serum S100A10 was significantly correlated with disease stage and lymph node metastasis. It has the potential to be a tumour biomarker for lung cancer.


Asunto(s)
Biomarcadores de Tumor , Neoplasias Pulmonares , Voluntarios Sanos , Humanos , Neoplasias Pulmonares/diagnóstico , Metástasis Linfática , Estudios Prospectivos
8.
J Int Med Res ; 49(10): 3000605211042988, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34605304

RESUMEN

Several clinical trials have proven that immunotherapy can improve survival and benefit non-small cell lung cancer (NSCLC) patients. In patients who progress after chemotherapy, immune checkpoint inhibitor (ICI) monotherapy can prolong overall survival compared with patients receiving single-agent chemotherapy. A 61-year-old man diagnosed with advanced NSCLC and without driver variants received first-line chemotherapy but experienced recurrence. During subsequent treatment, the disease progressed rapidly, and his general condition deteriorated; therefore, toripalimab monotherapy was initiated. Surprisingly, he responded well, and symptoms were relieved after several treatment cycles despite pseudoprogression, shown in chest images. For driver gene-negative NSCLC patients who progress after chemotherapy and who develop poor performance status (PS), ICIs are an option to alleviate symptoms and improve survival. Furthermore, immunotherapy in patients with pseudoprogression may also provide a survival benefit.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Anticuerpos Monoclonales Humanizados , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia
9.
Khirurgiia (Mosk) ; (10): 68-74, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34608782

RESUMEN

OBJECTIVE: To present an experience of adapting the accelerated rehabilitation protocol at the thoracic surgery department of the Moscow City Clinical Oncology Hospital No. 1. MATERIAL AND METHODS: An effectiveness of the accelerated rehabilitation program in the city oncology hospital was retrospectively analyzed for the period from February to December 2019. Lung resections were performed in 252 patients with median age 66 (59; 71) years and an equal ratio of men and women (124/128). Primary non-small cell lung cancer was noted in 194 (77%) patients, secondary malignant neoplasms of lungs - in 58 (23%) cases. ASA grading system of anesthetic risk was applied (American Society of Anesthesiologists): grade II - 56 (22.2%) patients, grade III - 203 (75.2%) patients, grade IV - 7 (2.8%) patients. RESULTS: Lobectomy was performed in 147 patients, segmentectomy - in 32, bilobectomy, pneumonectomy and marginal resection - in 1, 3 and 69 cases, respectively. Endoscopic operations made up 13.6% (n=20), 12.5% (n=4) and 78% (n=54). Postoperative 30-day complications occurred in 19 (7.5%) out of 252 patients (95% CI 4.9-11.5). Postoperative 30-day mortality was 1.98% (5 out of 252 patients, 95% CI 0.9-4.6). Median postoperative hospital-stay was 7 (6; 8) days. CONCLUSION: Implementation of fast track protocol requires time and the first results can be assessed after 6-12 months. Continuous monitoring of implementation of the protocol elements by all members of multidisciplinary team, analysis of complications and long-term results are required to realize all potential benefits of this program.


Asunto(s)
Neoplasias Pulmonares , Cirugía Torácica , Anciano , Femenino , Humanos , Tiempo de Internación , Neoplasias Pulmonares/cirugía , Masculino , Neumonectomía , Estudios Retrospectivos , Cirugía Torácica Asistida por Video
10.
Am J Case Rep ; 22: e933867, 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34611123

RESUMEN

BACKGROUND The pathophysiology of pulmonary tumor thrombotic microangiopathy (PTTM) was recently revealed by autopsy. Considered rare, we suggest that this fatal disease is not rare, but has not been diagnosed pre-mortem. Some patients with pulmonary thromboembolism with unknown thrombus source or with sudden death have been treated for malignant carcinoma. We report a patient with PTTM who was successfully rescued acutely by treatment with soluble guanylate cyclase (sGC), resulting in appropriate palliative care. CASE REPORT An 80-year-old Japanese woman was transferred to our emergency room for severe dyspnea owing to type I respiratory failure. Her clinical findings indicated pulmonary thromboembolism, but we found no thrombus in either the pulmonary artery or inferior vena cava. However, we incidentally found gallbladder cancer with peritoneal metastases. These findings raised the suspicion of PTTM. We began concurrent sGC and direct oral anticoagulant (DOAC) on the assumption that PTTM had occurred, while performing peripheral pulmonary artery sampling for cytology, and pulmonary perfusion scintigraphy. Cytology revealed several aplastic cells; consequently, we finally diagnosed PTTM. Because she did not wish to undergo examination and active treatment for carcinoma, we initiated palliative care while continuing sGC. She was able to spend time with her family for more than 100 days, without dyspnea. CONCLUSIONS We must recognize PTTM, which is a lesser-known disease, and introduce diagnostic therapy with a pulmonary vasodilator, such as sGC, immediately, when we suspect PTTM, leading to appropriate clinical care.


Asunto(s)
Neoplasias Pulmonares , Embolia Pulmonar , Microangiopatías Trombóticas , Anciano de 80 o más Años , Femenino , Humanos , Pulmón , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamiento farmacológico , Microangiopatías Trombóticas/diagnóstico , Microangiopatías Trombóticas/tratamiento farmacológico , Microangiopatías Trombóticas/etiología , Vasodilatadores
11.
Am J Case Rep ; 22: e933396, 2021 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-34606491

RESUMEN

BACKGROUND As use of immune checkpoint inhibitors consistently grows, so does knowledge of immune-related adverse events. Pleural complications from PD-L1 inhibitors such as atezolizumab have never been reported. We describe the first reported case of biopsy-proven pleuritis manifesting as recurrent pleural effusion in a patient treated with atezolizumab. CASE REPORT A 66-year-old woman with history of extensive-stage small cell lung cancer presented with a new pleural effusion. She was previously treated with carboplatin, etoposide, and atezolizumab followed by atezolizumab maintenance, but this later was stopped due to pneumonitis. She had been on no systemic therapy for 6 months prior; radiation to the chest was completed 1 year earlier. Thoracentesis revealed an exudate with eosinophilia but no malignancy. She underwent medical thoracoscopy, which showed normal pleura with no evidence of radiation changes. Random pleural biopsies revealed only chronic pleuritis. Given normal-appearing pleura, radiation pleuritis was ruled out. It was felt that the chemotherapy had occurred too long ago to be a present cause of her pleuritis. As such, after extensive workup, the eosinophilic pleural effusion was felt to be due to pleuritis from atezolizumab. The effusion has ultimately recurred 5 times over 1 year, and cytology remains negative for malignancy. CONCLUSIONS Patients with prior cancer presenting with a new pleural effusion should undergo an extensive workup to evaluate for recurrence. When other causes have been ruled out, ongoing immune-related effects of immunotherapy should be considered. Pleural complications from PD-L1 inhibitors have not been reported; we present a possible case of chronic pleuritis and recurrent effusion due to atezolizumab.


Asunto(s)
Neoplasias Pulmonares , Derrame Pleural , Pleuresia , Carcinoma Pulmonar de Células Pequeñas , Anciano , Anticuerpos Monoclonales Humanizados , Exudados y Transudados , Femenino , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Derrame Pleural/inducido químicamente , Pleuresia/inducido químicamente
12.
Khirurgiia (Mosk) ; (10): 52-58, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34608780

RESUMEN

Lung surgeries following pneumonectomy using veno-venous extracorporeal membrane oxygenation (V-V ECMO) are described in the literature. The authors report a 62-year-old man with bilateral metachronous primary multiple lung cancer after previous extended lower lobectomy combined with sublobar resection of the upper lobe for squamous cell carcinoma of the left lung. Despite satisfactory functional status and heart function, the patient had poor lung function. Therefore, we decided to increase safety of resection using extracorporeal respiratory support. Extended right lower lobectomy was carried out under V-V ECMO. Surgery was followed by intrapleural bleeding that required urgent surgical hemostasis with completion of perioperative V-V ECMO. Postoperative ventilation lasted for 33 days but the patient was discharged later in a satisfactory condition.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Oxigenación por Membrana Extracorpórea , Neoplasias Pulmonares , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Humanos , Pulmón , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Neumonectomía
13.
Acta Gastroenterol Belg ; 84(3): 513-515, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34599579

RESUMEN

Erythema multiforme is an immune-mediated mucocutaneous disorder. Mucosal involvement usually affects the oral region, the genitals or the eyes. We report a case of esophagitis caused by erythema multiforme in a patient diagnosed with lung cancer. Esophageal manifestation in erythema multiforme is rarely seen. Besides esophagitis it can lead to esophageal strictures. Erythema multiforme is mostly triggered by infection or drugs but the association with malignancy has been described.


Asunto(s)
Eritema Multiforme , Estenosis Esofágica , Esofagitis , Neoplasias Pulmonares , Eritema Multiforme/diagnóstico , Eritema Multiforme/etiología , Esofagitis/complicaciones , Esofagitis/diagnóstico , Humanos
14.
Kyobu Geka ; 74(11): 910-914, 2021 Oct.
Artículo en Japonés | MEDLINE | ID: mdl-34601472

RESUMEN

We present a case of a 67-year-old woman who was pointed out a 1.8 cm nodule in the left inferior lobe by chest computed tomography( CT). Lung cancer was suspected and the surgery was scheduled. Before surgery, perioperative oral care was performed and gingival tumor doubtful of metastatic lesion was found. After the resection of the lung tumors, the diagnosis of pleomorphic carcinoma with pleural dissemination and gingival metastasis was established. Because high programmed cell death 1 ligand 1 (PD-L1) expression was demonstrated in the specimen of the lung, she was treated with pembrolizumab as an initial treatment, which led to a complete response. Twenty months after initiating of pembrolizumab therapy, she is doing well without recurrence of pleomorphic carcinoma.


Asunto(s)
Carcinoma , Neoplasias Pulmonares , Anciano , Anticuerpos Monoclonales Humanizados , Femenino , Humanos , Pulmón , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Recurrencia Local de Neoplasia
15.
Kyobu Geka ; 74(11): 915-919, 2021 Oct.
Artículo en Japonés | MEDLINE | ID: mdl-34601473

RESUMEN

A 61-year-old woman was found to have multiple ground-glass nodules( GGNs) in both lungs by chest computed tomography (CT) scan. The lesion of the right S2 contained a partial solid component and was suspected to be minimally invasive adenocarcinoma. Three-dimensional CT showed two anomalous V2s descending dorsally to the intermediate bronchus and draining into the inferior pulmonary vein. Thoracoscopic segmentectomy of the right S2 was performed safely. The pathological diagnosis was adenocarcinoma in situ. Since aberrant pulmonary vessels increases the surgical risk during video-assisted thoracoscopic anatomical lung resection, preoperative three-dimensional CT is useful in performing safe surgical procedure.


Asunto(s)
Adenocarcinoma , Neoplasias Pulmonares , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/cirugía , Drenaje , Femenino , Humanos , Pulmón , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
16.
Kyobu Geka ; 74(11): 972-975, 2021 Oct.
Artículo en Japonés | MEDLINE | ID: mdl-34601485

RESUMEN

Ciliated muconodular papillary tumor( CMPT) is a rare true pulmonary tumor consisting of bronchiolar cellular elements. Although this tumor cannot be classified as benign or malignant, it is mostly believed to be a benign bronchiolar adenoma. Recently, CMPT has been divided into two subtypes: proximal and distal. Herein, we report a case of a proximal type of CMPT containing abundant mucus cells in a 70-year-old woman. Thoracoscopic resection of the tumor in the left lower lobe was successfully performed, and the patient has been well without recurrence or metastasis for more than three years after surgery.


Asunto(s)
Adenoma , Carcinoma Papilar , Neoplasias Pulmonares , Anciano , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Recurrencia Local de Neoplasia
17.
J Nepal Health Res Counc ; 19(2): 411-413, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34601540

RESUMEN

We report cases of vertebral body enhancement in patients with superior vena cava and brachiocephalic venous obstruction appearing as sclerotic metastases in post-contrast CT.A 58-year-old male presented with right lung mass compressing the superior vena cava.Sclerotic areas seen involving few vertebrae in post-contrast scans.Another patient, 64-year-old female with right lung mass and narrowing of left brachiocephalic vein, sclerosis of lower cervical and upper dorsal vertebrae were seen in contrast studies. In both cases after resolution of pathology following treatment showed no enhancement in post contrast scan which was attributed to the collaterals arising due to obstruction, obviously not seen in metastases. Keywords: Brachiocephalic vein obstruction; computed tomography CT; superior vena cava SVC; vertebral enhancement; venous collaterals.


Asunto(s)
Neoplasias Pulmonares , Vena Cava Superior , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Nepal , Esclerosis , Columna Vertebral
19.
Anal Chim Acta ; 1184: 339011, 2021 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-34625248

RESUMEN

Three-dimensional (3D) multicellular tumor spheroids (MCTS) that mimic the complex tumor microenvironment provide a good platform for in vitro study of drug and endogenous metabolites. Hydroxychloroquine (HCQ) has shown anti-tumor activity in a variety of tumor models. However, the effect of the drug on the alteration of lipid metabolism spatial composition and distribution in the MCTS model is not clear. Herein, we utilized matrix-assisted laser desorption/ionization-mass spectrometry imaging (MALDI-MSI) in the analysis of A549 lung cancer multicellular spheroids to investigate the in situ spatial distribution of HCQ and its effect on lipid metabolism. We have successfully observed the spatial variations of HCQ in the inner region of the spheroid at different drug-treated time points. The MSI results also demonstrated that HCQ treatment altered the spatial composition of lipids in the inner and outer regions of treated spheroids. Furthermore, the lipidomic results showed that the identified phosphatidylcholines (PC), lysophosphatidylcholines (LPC), phosphatidylethanolamines (PE), lysophosphatidylethanolamines (LPE), phosphatidylinositols (PI), ceramides (Cer), glucosylceramides (CerG), and diglycerides (DG) were significantly up-regulated, and phosphatidylglycerol (PG) and triglycerides (TG) were remarkable down-regulated. MSI method combined with LC-MS/MS profiling of endogenous metabolites can obtain more detailed information about how spheroids respond to drug and spatial distribution information, thus fostering a better understanding of the relationship between drug-altered lipid metabolism and cancer microenvironment.


Asunto(s)
Neoplasias Pulmonares , Esferoides Celulares , Cromatografía Liquida , Humanos , Hidroxicloroquina/farmacología , Fosfatidilcolinas , Espectrometría de Masas en Tándem , Microambiente Tumoral
20.
BMC Infect Dis ; 21(1): 1052, 2021 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-34627188

RESUMEN

BACKGROUND: Schizophyllum commune is a basidiomycete that lives in the environment and can cause infections, mainly those of the respiratory system. Although S. commune is increasingly reported as a cause of allergic bronchopulmonary mycosis and sinusitis, cases of fungal ball formation are extremely uncommon. Identification of S. commune is difficult using routine mycological diagnostic methods, and in clinically suspicious cases, internal transcribed spacer sequencing should be used for diagnosis. Here, we report a first case of lung cancer with a fungal ball formation of S. commune, confirmed by analyzing the internal transcribed spacer. CASE PRESENTATION: A 76-year-old man with diabetes and hypertension was admitted to the hospital with a chief complaint of hemosputum, which he had for about 19 months. A computed tomography image of the patient's chest showed a cavity and internal nodule in the left upper lobe of his lung. A left upper lobectomy was performed, and histopathological examination revealed squamous cell carcinoma of the lung and a fungal ball. The isolate from the surgical specimen was identified as S. commune by analyzing the internal transcribed spacer. The patient had no recurrence of the infection during 5 months of follow-up. CONCLUSIONS: Only three cases of lung fungal balls caused by S. commune have been previously reported, and this is the first case of lung cancer cavity with a fungal ball formation. In cases of fungal ball formation in the lung, S. commune should be considered a possible causative microorganism.


Asunto(s)
Aspergilosis Pulmonar Invasiva , Neoplasias Pulmonares , Schizophyllum , Tuberculosis Pulmonar , Anciano , Humanos , Masculino , Recurrencia Local de Neoplasia , Schizophyllum/genética
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