Core Microbiota in Central Lung Cancer With Streptococcal Enrichment as a Possible Diagnostic Marker / Núcleo de microbiota en el cáncer de pulmón central con enriquecimiento estreptocócico como posible marcador de diagnóstico

Background: Dysbiosis in lung cancer has been underexplored. The aim of this study was to define the bacterial and fungal microbiota of the bronchi in central lung cancer and to compare it with that of the oral and intestinal compartments. Methods: Twenty-five patients with central lung cancer and sixteen controls without antimicrobial intake during the previous month were recruited. Bacterial and fungal distribution was determined by massive sequencing of bronchial biopsies and saliva and faecal samples. Complex computational analysis was performed to define the core lung microbiota. Results: Affected and contralateral bronchi of patients have almost identical microbiota dominated by Streptococcus, whereas Pseudomonas was the dominant genera in controls. Oral and pulmonary ecosystems were significantly more similar in patients, probably due to microaspirations. Streptococcal abundance in the bronchi differentiated patients from controls according to a ROC curve analysis (90.9% sensitivity, 83.3% specificity, AUC=0.897). The saliva of patients characteristically showed a greater abundance of Streptococcus, Rothia, Gemella and Lactobacillus. The mycobiome of controls (Candida) was significantly different from that of patients (Malassezia). Cancer patients’ bronchial mycobiome was similar to their saliva, but different from their contralateral bronchi. Conclusions: The central lung cancer microbiome shows high levels of Streptococcus, and differs significantly in its composition from that of control subjects. Changes are not restricted to tumour tissue, and seem to be the consequence of microaspirations from the oral cavity. These findings could be useful in the screening and even diagnosis of this disease. (AU)

Antecedentes: La disbiosis en cáncer pulmonar no ha sido suficientemente estudiada. Los objetivos de este estudio fueron definir la microbiota bacteriana y fúngica de bronquios con cáncer central de pulmón, y compararla con la del compartimento intestinal en heces y saliva. Métodos: Se reclutaron 25 pacientes con cáncer central de pulmón y 16 controles sin exposición antibiótica durante el mes anterior. Se determinó la composición de bacterias y hongos en biopsias de bronquio, saliva y heces. Se realizó un análisis computacional para definir el núcleo de microbiota del pulmón. Resultados: Los bronquios afectados y contralaterales de pacientes presentaron una microbiota similar dominada por Streptococcus, mientras que Pseudomonas destacó en los controles. Los ecosistemas orales y pulmonares fueron significativamente más parecidos en pacientes, probablemente debido a microaspiraciones. La abundancia bronquial de estreptococos permitió diferenciar a los pacientes de los controles mediante una curva ROC (90,9% de sensibilidad, 83,3% de especificidad, AUC=0,897). La saliva de los pacientes presentó mayor abundancia de Streptococcus, Rothia, Gemella y Lactobacillus. El micobioma de los controles (Candida) fue significativamente diferente al de los pacientes (Malassezia), con los bronquios afectados por el cáncer similares a su saliva, pero diferentes de sus bronquios contralaterales. Conclusiones: En el cáncer de pulmón central hay enriquecimiento de Streptococcus, y su composición es significativamente diferente de sujetos control. Las alteraciones no se limitan al tejido tumoral, y parecen ser consecuencia de microaspiraciones desde la cavidad oral. Estos hallazgos podrían ser útiles para la detección e incluso el diagnóstico de esta patología. (AU)

Core Microbiota in Central Lung Cancer With Streptococcal Enrichment as a Possible Diagnostic Marker.

BACKGROUND: Dysbiosis in lung cancer has been underexplored. The aim of this study was to define the bacterial and fungal microbiota of the bronchi in central lung cancer and to compare it with that of the oral and intestinal compartments. METHODS: Twenty-five patients with central lung cancer and sixteen controls without antimicrobial intake during the previous month were recruited. Bacterial and fungal distribution was determined by massive sequencing of bronchial biopsies and saliva and faecal samples. Complex computational analysis was performed to define the core lung microbiota. RESULTS: Affected and contralateral bronchi of patients have almost identical microbiota dominated by Streptococcus, whereas Pseudomonas was the dominant genera in controls. Oral and pulmonary ecosystems were significantly more similar in patients, probably due to microaspirations. Streptococcal abundance in the bronchi differentiated patients from controls according to a ROC curve analysis (90.9% sensitivity, 83.3% specificity, AUC=0.897). The saliva of patients characteristically showed a greater abundance of Streptococcus, Rothia, Gemella and Lactobacillus. The mycobiome of controls (Candida) was significantly different from that of patients (Malassezia). Cancer patients' bronchial mycobiome was similar to their saliva, but different from their contralateral bronchi. CONCLUSIONS: The central lung cancer microbiome shows high levels of Streptococcus, and differs significantly in its composition from that of control subjects. Changes are not restricted to tumour tissue, and seem to be the consequence of microaspirations from the oral cavity. These findings could be useful in the screening and even diagnosis of this disease.

Core Microbiota in Central Lung Cancer With Streptococcal Enrichment as a Possible Diagnostic Marker.

BACKGROUND: Dysbiosis in lung cancer has been underexplored. The aim of this study was to define the bacterial and fungal microbiota of the bronchi in central lung cancer and to compare it with that of the oral and intestinal compartments. METHODS: Twenty-five patients with central lung cancer and sixteen controls without antimicrobial intake during the previous month were recruited. Bacterial and fungal distribution was determined by massive sequencing of bronchial biopsies and saliva and faecal samples. Complex computational analysis was performed to define the core lung microbiota. RESULTS: Affected and contralateral bronchi of patients have almost identical microbiota dominated by Streptococcus, whereas Pseudomonas was the dominant genera in controls. Oral and pulmonary ecosystems were significantly more similar in patients, probably due to microaspirations. Streptococcal abundance in the bronchi differentiated patients from controls according to a ROC curve analysis (90.9% sensitivity, 83.3% specificity, AUC=0.897). The saliva of patients characteristically showed a greater abundance of Streptococcus, Rothia, Gemella and Lactobacillus. The mycobiome of controls (Candida) was significantly different from that of patients (Malassezia). Cancer patients' bronchial mycobiome was similar to their saliva, but different from their contralateral bronchi. CONCLUSIONS: The central lung cancer microbiome shows high levels of Streptococcus, and differs significantly in its composition from that of control subjects. Changes are not restricted to tumour tissue, and seem to be the consequence of microaspirations from the oral cavity. These findings could be useful in the screening and even diagnosis of this disease.

Acinic Cell Carcinoma of the Parotid Gland with Four Morphological Features.

Acinic cell carcinoma arising in salivary glands is a rare tumor, accounting for 2% to 5% of the primary neoplasms of the parotid gland. When these tumors are well-differentiated, the neoplasia has innocuous aspect, due to the similarity to normal parotid tissue. This makes the diagnosis difficult. Initially the malignancy of this tumor was uncertain; however, recent studies have declared it as malignant. The female / male ratio is 3:2. The nodule usually presents as solitary and well defined shape. Several authors have used different terms to describe histomorphological patterns of these tumors. Four descriptive categories (solid, microcystic, papillary-cystic and follicular) are useful for pathologists. Here we report a case of a 49 yr old man with a left parotid nodule of 5 cm. Parotidectomy was performed at the Hospital Universitario Miguel Servet, in Zaragoza (Spain). The microscopy showed a tumor with acinic semblance, having the four morphologic patterns previously described. The morphological and immunohistochemical study was consistent with the diagnosis of acinic cell carcinoma.

[Endometriosis in a laparotomic scar after cesarean section: report of two cases]. / Endometriosis en la cicatriz de una cesárea.

Extrapelvic endometriosis in an abdominal wall surgical scar is a rare entity that is difficult to diagnose. However, it should be suspected in any woman of childbearing age complaining of a cyclic painful nodule in a scar from a previous obstetric or gynecologic procedure, after excluding other conditions such as incisional hernia, late abscess, or suture granuloma. Fine-needle aspiration biopsy provides an accurate preoperative diagnosis. Imaging studies such as ultrasound, computed tomography, or magnetic resonance imaging are non-specific, but may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions. We present two cases of endometriosis in an abdominal wall scar that developed after cesarean section performed 7 years previously. In both patients, preoperative diagnosis, based on clinical suspicion in the first patient and aspiration cytology in the second, was correct. Wide local excision was curative in both patients.

Endometriosis en la cicatriz de una cesárea / Endometriosis in a laparotomic scar after cesarean section: Report of two cases

La endometriosis extrapelviana, localizada en incisiones de la pared abdominal, es una entidad poco frecuente que puede plantear dificultades diagnósticas. No obstante, en la población femenina premenopáusica, la presencia de un nódulo cíclicamente doloroso y situado en el espesor de una cicatriz laparotómica, por anteriores procedimientos obstétricos o ginecológicos, debe resultar sospechoso de dicha complicación, una vez excluidos otros procesos más comunes como eventraciones, abscesos tardíos o granulomas por suturas. El diagnóstico de certeza preoperatorio puede hacerse mediante punción-aspiración con aguja fina del nódulo, mientras que la mayoría de pruebas de imagen sólo contribuyen a su localización anatómica y al cribado de hernia incisional. Presentamos 2 casos de endometriosis de pared abdominal desarrollados 7 años después de cesárea. En ambos se orientó el diagnóstico preoperatorio, por sospecha clínica en el primero y por examen citológico del aspirado en el segundo. La extirpación quirúrgica, con márgenes de resección suficientes, fue resolutiva (AU)

Extrapelvic endometriosis in an abdominal wall surgical scar is a rare entity that is difficult to diagnose. However, it should be suspected in any woman of childbearing age complaining of a cyclic painful nodule in a scar from a previous obstetric or gynecologic procedure, after excluding other conditions such as incisional hernia, late abscess, or suture granuloma. Fine-needle aspiration biopsy provides an accurate preoperative diagnosis. Imaging studies such as ultrasound, computed tomography, or magnetic resonance imaging are non-specific, but may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions. We present two cases of endometriosis in an abdominal wall scar that developed after cesarean section performed 7 years previously. In both patients, preoperative diagnosis, based on clinical suspicion in the first patient and aspiration cytology in the second, was correct. Wide local excision was curative in both patients (AU)