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We present the case of a 50-year-old woman with stage IV invasive ER+/PR-/HER2-ductal breast carcinoma who was admitted to the intensive care unit (ICU) with obstructive shock and hypoxic respiratory failure due to pulmonary tumor thrombotic microangiopathy (PTTM), which significantly improved with chemotherapy. Upon presentation, her heart rate was 145 beats/min, her blood pressure was 86/47 mmHg, her respiratory rate was 25 breaths/min, and her oxygen saturation was 80% in room air. She underwent a broad non-diagnostic infectious evaluation, received fluid resuscitation, and was placed on broad-spectrum antibiotics. Transthoracic echocardiography showed evidence of severe pulmonary hypertension with a pulmonary arterial systolic pressure (PASP) of 77 mmHg. She initially required oxygen via a high-flow nasal cannula (HFNC) at 40 liters/minute and 80% FiO2 and was subsequently placed on inhaled nitric oxide (iNO) at 40 parts per million (PPM) as well as norepinephrine and vasopressin drips for acute decompensated right heart failure. Despite her poor performance status, she was started on chemotherapy with carboplatin and gemcitabine. Over the ensuing week, she was weaned off supplemental oxygen, vasoactive agents, and iNO and discharged home. Repeat echocardiography performed 10 days after the initiation of chemotherapy demonstrated marked improvement in her pulmonary hypertension with a PASP of 34 mmHg. This case highlights the potential role of chemotherapy in altering the course of PTTM in select patients with metastatic breast cancer.

Objective: To explore the mulyi-slice computed tomograpy (MSCT) imaging characteristics of pulmonary mucosa-associated lymphoma tissue. Methods: The clinical data and MSCT findings of eight cases of pulmonary MALT lymphoma confirmed by pathology in our hospital from February 2014 to July 2022 were analyzed retrospectively. The causes of misdiagnosis were also analyzed. Results: Five patients underwent plain and enhanced chest CT scans, and three underwent plain chest CT scans alone. Among the eight patients, four had a single focus, four had multiple foci, and seven showed large patches of high-density shadows. All patients showed air bronchogram, and one showed mixed density patches. CT enhancement showed moderate enhancement in four cases, slight enhancement in one case, and angiography sign in four cases. Conclusion: Primary MALT lymphoma of the lung is an inert tumor with low-grade malignancy. The MSCT findings have certain characteristics. Therefore, it is necessary to obtain diseased tissues in time for pathological examination and immunohistochemistry to make a clear diagnosis.

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Abstract Background In this study, we aimed to summarize the extremely important lesson and experience in the whole process of surgical treatments of lung tumors for the benefit of steps taken to prevent against unplanned reoperation. Methods Demographical and clinical information of 7732 patients were retrospectively retrieved and reviewed, who were diagnosed with pulmonary tumor and underwent surgical treatments from January 2016 to March 2021. Those patients who underwent unplanned reoperation for the treatment of severe complications were focused carefully and analyzed meticulously. Results A total of forty-one patients (41/7732) received 44 unplanned reoperations. Among them, eight and thirty-three patients were diagnosed with benign and malignant tumor, respectively. The incidence of unplanned reoperations seemed to be similar on both sides (Left vs. Right: 12/3231 vs. 29/4501, p = 0.103). Lobectomy plus segmentectomy is prone to reoperation (2/16, 12.5%) as compared to the other types of surgery. The complications leading to reoperation was hemothorax, including active hemorrhage (23/44, 52.3%) and clotted hemothorax (6/44, 13.6%), chylothorax (8/44, 18.2%), and the others (7/44, 15.9%) including bronchopleural fistula, torsion, or injury of right middle bronchus and pulmonary bulla rupture. The morbidity and mortality after unplanned reoperation were 17.1% (7/41) and 12.2% (5/41), respectively. Conclusions Bronchi or vessel stumps, the surgical edges of the lung parenchyma, and pleural adhesions should be checked to avoid postoperative bleeding. Prophylactic ligation of the thoracic duct should be recommended in case of the suspected oily-like exudation in the lymph node bed. Smooth expansion of the middle lobe is important to avoid narrowing and torsion before transection of the bronchus.

Background: In this study, we aimed to summarize the extremely important lesson and experience in the whole process of surgical treatments of lung tumors for the benefit of steps taken to prevent against unplanned reoperation. Methods: Demographical and clinical information of 7732 patients were retrospectively retrieved and reviewed, who were diagnosed with pulmonary tumor and underwent surgical treatments from January 2016 to March 2021. Those patients who underwent unplanned reoperation for the treatment of severe complications were focused carefully and analyzed meticulously. Results: A total of forty-one patients (41/7732) received 44 unplanned reoperations. Among them, eight and thirty-three patients were diagnosed with benign and malignant tumor, respectively. The incidence of unplanned reoperations seemed to be similar on both sides (Left vs. Right: 12/3231 vs. 29/4501, p = 0.103). Lobectomy plus segmentectomy is prone to reoperation (2/16, 12.5%) as compared to the other types of surgery. The complications leading to reoperation was hemothorax, including active hemorrhage (23/44, 52.3%) and clotted hemothorax (6/44, 13.6%), chylothorax (8/44, 18.2%), and the others (7/44, 15.9%) including bronchopleural fistula, torsion, or injury of right middle bronchus and pulmonary bulla rupture. The morbidity and mortality after unplanned reoperation were 17.1% (7/41) and 12.2% (5/41), respectively. Conclusions: Bronchi or vessel stumps, the surgical edges of the lung parenchyma, and pleural adhesions should be checked to avoid postoperative bleeding. Prophylactic ligation of the thoracic duct should be recommended in case of the suspected oily-like exudation in the lymph node bed. Smooth expansion of the middle lobe is important to avoid narrowing and torsion before transection of the bronchus. [ABSTRACT FROM AUTHOR]

Purpose: To determine the influence of isoginkgetin on the progression of pulmonary carcinogenesis. Methods: A549 cells exposed to isoginkgetin were transfected with miR-27a-5p mimetic and suppressor, as well as short hairpin RNA against apurinic/apyrimidinic endo-deoxyribonuclease 1 (sh- APEX1) for 24 h. Then, the proliferative, migration and invasive potential of A549 cells were determined using CCK-8, wound healing and Transwell assays, respectively. The association between miR-27a-5p and APEX1 was determined by dual-luciferase reporter assay. Results: Isoginkgetin significantly suppressed A549 cell proliferative, migration and invasive activities (p < 0.05). Moreover, isoginkgetin significantly increased miR-27a-5p expression. Furthermore, miR- 27a-5p suppressor annulled the influence of isoginkgetin on lung cancer progression. More importantly, the inhibitor directly targeted APEX1, and negatively modulated APEX1 expression (p < 0.05). However, APEX1 knockdown annulled the enhancing effect of miR-27a-5p inhibitor on A549 cell viability, migration and invasion (p < 0.05). Conclusion: Isoginkgetin exerts an anti-lung cancer effect via miR-27a-5p/APEX1 axis. Thus, it is a potential therapy for the management of lung cancer; however, clinical studies are required to validate these findings of this study. [ABSTRACT FROM AUTHOR]

Pulmonary inflammatory myofibroblastic tumor (IMT) is a rare condition in the normal population and specifically in the pediatric population. We reported a 9‐year‐old male child who presented with cough and intermittent fever and weight loss that was most suggestive of the infectious process. We reviewed the consideration of diagnosis and treatment. Pulmonary IMT is a rare pulmonary mass that might be asymptomatic or manifest by hemoptysis, cough, constitutional symptoms, and pneumonia. It should be in the mind that IMT might mimic neoplasms, by history, radiology, and clinical aspects. [ABSTRACT FROM AUTHOR]

Objective: Sublobar resection is considered the gold standard for selected patients with pulmonary metastasis or who are compromised in some way. However, an unfavorable outcome after sublobar resection is local/margin recurrence. The aim of this study was to evaluate the clinical reliability of a new rapid-stapler lavage immunocytochemistry (ICC) technique for assessing margin malignancy. The method uses non-contact alternating current (AC) mixing to achieve more stable staining. Methods: Twenty-one patients who underwent sublobar resection, including 16 wedge resections, for pulmonary metastasis or lung cancer in a compromised host between September 2016 and December 2017 were retrospectively reviewed. All margin specimens were intraoperatively evaluated with HE staining of frozen sections and stapler lavage cytology using Papanicolaou staining and rapid-ICC. Results: Rapid-stapler lavage ICC can be used to diagnose surgically safe margins within 20 min during sublobar resections. Although in all cases margins were diagnosed as cancer free based on HE staining of frozen sections, two of four patients diagnosed with malignant-positive margins based on rapid ICC experienced local/margin recurrence. Conclusions: Rapid-stapler lavage ICC with AC mixing could potentially serve as a clinical tool for prompt determination of margin malignant status after pulmonary sublobar resection. [ABSTRACT FROM AUTHOR]

Abstract Pulmonary inflammatory myofibroblastic tumor (IMT) is a rare condition in the normal population and specifically in the pediatric population. We reported a 9‐year‐old male child who presented with cough and intermittent fever and weight loss that was most suggestive of the infectious process. We reviewed the consideration of diagnosis and treatment.

Extraskeletal Ewing Sarcoma is a rare tumor of the soft tissues. Primary Ewing Sarcoma of the lung is an exceedingly uncommon variant of Extraskeletal Ewing Sarcoma, with only a small number of cases reported in the literature. We present a case of a 43-year-old woman who presented with a locally invasive mass of the right lung, biopsy-proven to be Ewing Sarcoma., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Primary pulmonary Hodgkin's lymphoma (PPHL) is an uncommon condition that accounts for less than 1% of all lymphomas. The clinical and radiological presentation of PPHL is nonspecific. This case report aimed to highlight the misleading presentation of PPHL, which initially manifested as a pulmonary cavitary lesion. The presented case report describes a perplexing presentation of PPHL in a 24-year-old female patient. Initially suspected to have necrotizing pneumonia or pulmonary tuberculosis due to symptoms including cough, hemoptysis, and weight loss, the patient underwent various diagnostic procedures, including bronchoscopy and CT-guided biopsy, which failed to provide a definitive diagnosis. Surgical resection was eventually pursued, leading to the conclusive identification of PPHL. This case highlights the diagnostic challenges associated with PPHL, emphasizing the importance of considering this rare entity in the differential diagnosis of pulmonary nodular or cavitary lesions. Prompt recognition and accurate diagnosis are essential for optimal management and improved patient outcomes. PPHL is an infrequent neoplasm that often presents diagnostic dilemmas. It requires consideration within the appropriate clinical framework to ensure timely diagnosis and intervention., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Razouq et al.)

Background Radiofrequency ablation and microwave ablation are frequently prescribed for thoracic cancer. However, few writers have been able to draw on any systematic research into the differences between the two ablation methods. Methods A literature search was carried out using Embase, PUBMED, Web of Science, Cochrane Library, and CNKI databases, with additional searches carried out manually using terms associated with thoracic cancer and thermal ablation. Then we used Google Scholar for a complementary search. Data were extracted from studies of patients that underwent radiofrequency ablation or microwave ablation, and the investigator carried out efficacy evaluation and follow up. The data obtained from the literature were summarized and analyzed using Cochrane Revman software Version 5.3 and SPSS 22.0. Results There were seven comparative studies, but no randomized studies identified for data extraction; 246 patients received radiofrequency ablation therapy and 319 controls received microwave ablation. There was no significant difference in the six‐month, one‐year, two‐year, and three‐year survival rates, and adverse reactions were found in the two treatments. For patients’ long‐term survival rate, the two treatments can achieve a similar survival time. Conclusion In the treatment of thoracic cancer, microwave ablation can achieve the same efficacy as radiofrequency ablation.

EWSR1‐CREM gene fusions were recently discovered in several mesenchymal and epithelial tumors, including myxoid mesenchymal tumors of the central nervous system, rare cases of soft tissue clear cell sarcoma and angiomatoid fibrous histiocytoma, and hyalinizing clear cell carcinoma, which implicates the potential phenotypic diversities of tumors harboring an EWSR1‐CREM fusion. We herein present an exceedingly indolent pulmonary mesenchymal tumor showing distinctive clinicopathological features. This tumor histologically displayed a small nest and alveolar pattern consisting of monomorphic clear cells intermingled with dilated anastomosing vasculature. Immunophenotypically, tumor cells were positive for vimentin and focally positive for synaptophysin, but negative for many immunohistochemical panels including keratins, EMA, desmin, mesothelial markers, melanotic markers, smooth muscle actin, inhibin and S‐100 protein. Interestingly, RNA sequencing identified an in‐frame EWSR1‐CREM fusion, which was confirmed by subsequent real‐time/reverse transcription polymerase chain reaction and fluorescence in situ hybridization assay. Clinical follow‐up showed no evidence of recurrence and metastasis. Our pathological findings further expand the phenotypic spectrum of tumors associated with EWSR1‐CREM fusions, implying the emergence of a possible novel tumor entity. [ABSTRACT FROM AUTHOR]

Background: The aim of the study is to evaluate the technique, safety, efficacy, and clinical value of computed tomography (CT)-guided percutaneous coaxial biopsy combined with microwave ablation (MWA) therapy for pulmonary tumors.Materials and Methods: CT-guided percutaneous coaxial biopsy combined with MWA was performed on 27 tumors in 23 patients who received treatment at our hospital from August 2014 to November 2017. The patients were followed up from 2 to 42 months. The outcomes were evaluated with plain and contrast spiral CT scans.Results: After treatment, lower density and lower CT values than baseline values were observed in the ablated area. The positive rate of biopsy was 81.48%. Seventeen patients had complete remission, four had partial remission, and two had progressive disease, with an effective rate of 91.3%. Until February 2018, 14 patients survived. Seven patients with metastatic lung cancer died of primary tumor progression. Two patients with primary lung cancer also died; one died of a lung infection and the other of cerebral hemorrhage. The 1-year local control rate was 88.9%, and the median progression-free survival was 33 months. The 1-, 2-, and 3-year survival rates were 91.3%, 69.6%, and 60.9%, respectively.Conclusion: CT-guided percutaneous coaxial biopsy combined with MWA can improve the quality of life of patients, prolong survival, and improve the survival rate. It is currently one of the most promising interventional treatments. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency ablation and microwave ablation are frequently prescribed for thoracic cancer. However, few writers have been able to draw on any systematic research into the differences between the two ablation methods. Methods: A literature search was carried out using Embase, PUBMED, Web of Science, Cochrane Library, and CNKI databases, with additional searches carried out manually using terms associated with thoracic cancer and thermal ablation. Then we used Google Scholar for a complementary search. Data were extracted from studies of patients that underwent radiofrequency ablation or microwave ablation, and the investigator carried out efficacy evaluation and follow up. The data obtained from the literature were summarized and analyzed using Cochrane Revman software Version 5.3 and SPSS 22.0. Results: There were seven comparative studies, but no randomized studies identified for data extraction; 246 patients received radiofrequency ablation therapy and 319 controls received microwave ablation. There was no significant difference in the six‐month, one‐year, two‐year, and three‐year survival rates, and adverse reactions were found in the two treatments. For patients' long‐term survival rate, the two treatments can achieve a similar survival time. Conclusion: In the treatment of thoracic cancer, microwave ablation can achieve the same efficacy as radiofrequency ablation. [ABSTRACT FROM AUTHOR]

Background: Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is associated with poor prognosis, and its treatment strategy is still controversial, especially regarding chemotherapy regimens. Case report: We present the case of a 49-year-old Chinese male with primary pulmonary LCNEC treated with neoadjuvant and adjuvant chemotherapy with cisplatin plus pemetrexed. A suspected quasi-circular mass in the left lower pulmonary lobe and an enlarged mediastinal lymph node were found. The patient was diagnosed with adenocarcinoma with neuroendocrine differentiation based on computerized tomography-guided percutaneous lung biopsy. An EGFR gene mutation test showed negative results. Cisplatin and pemetrexed were administered as the neoadjuvant chemotherapy regimen. The primary lesion had reduced markedly, and the enlarged mediastinal lymph node had disappeared after two cycles of neoadjuvant chemotherapy. A left lower lobectomy and mediastinal lymph node dissection were performed. The lesion was confirmed as LCNEC based on postoperative histopathological analysis and immunohistochemical results. The patient underwent four cycles of adjuvant chemotherapy with cisplatin and pemetrexed for a month postoperatively, followed by postoperative adjuvant radiotherapy. The patient was still alive after a follow-up of 24 months, with no evidence of tumor recurrence. Conclusion: Cisplatin combined with pemetrexed is effective and safe for patients with pulmonary LCNEC. [ABSTRACT FROM AUTHOR]

We report a case of a huge solitary non-endobronchial pulmonary tumor in a 76-year-old male smoker. The tumor measured 11 × 10 × 8 cm. It was ill-defined, and it was located periphery of the right lower lobe with the subpleural cystic spaces. He underwent right lower lobectomy with mediastinal lymph node dissection and is free from tumor 30 months after surgery. Microscopically, it was composed of a proliferation of squamous and ciliated columnar epithelial cells with a few mucous cells. These cells were arranged in a papillary growth fashion extending along the fibrously thickened alveolar septa together with metaplastic bronchiolar and squamous epithelia displaying an usual interstitial pneumonia-pattern. Although the histologic features of the tumor were that of a mixed squamous cell and glandular papilloma (MSCGP), it was peripherally located and showed a lepidic growth, and it was much larger than previously reported MSCGPs. It is possible that the tumor developed in association with bronchial metaplasia in the periphery of the lung, and then extended along the surface of the reconstructed air spaces, which resulted in its unique histologic appearance. Further investigations of respiratory papilloma are needed to clarify the pathogenesis of these lesions. [ABSTRACT FROM AUTHOR]

Chondroid hamartomas are rare benign tumors of the lung which show predominantly cartilage. Usually, they are small, solitary, and asymptomatic lesions. They are detected incidentally on chest X-ray or at the time of autopsy. Occasionally, large pulmonary hamartomas are encountered. We present a case of a 60-year-old male patient with a 6-month history of cough. His X-ray and computed tomography (CT) scan of the chest revealed a well-defined soft-tissue density lesion with popcorn calcification measuring 6.5 cm × 4.8 cm in the left lung upper lobe. A presumptive diagnosis of chondroid hamartoma was made in CT-guided percutaneous biopsy. A posterolateral thoracotomy and left upper lobectomy were done. There was a spherical gray-white firm mass noted in the resected lobectomy specimen. Postoperative histopathological examination confirmed the diagnosis of pulmonary chondroid hamartoma. This is an additional case of large chondroid hamartoma.

The feasibility and clinical application of single-hole video-assisted thoracoscope in pulmonary peripheral tumors was examined. From March, 2011 to March, 2015, we retrospectively analyzed the clinical data obtained from 32 patients with pulmonary peripheral tumor that received single-hole thoracoscopic surgery. We completed the surgery via a 1.5-cm incision on the seventh or eighth rib in midaxillary line as the observation hole, and a 4.0-5.0-cm incision in the lateral margin of pectoralis major in the fourth or fifth rib in midaxillary line as the operation hole. All the patients had completed the tumor-reductive surgery under single-hole thoracoscope successfully. None required second operation hole or needed a transfer to thoracotomy. Operation time was 40-100 min with an average of 65.78±15.87 min. Intraoperative blood loss was 20-100 ml, with an average of 47.19±26.91 ml. Post-operative chest drainage time was 3-6 days, with an average of 4.22±0.87 days. Hospitalization time after operation was 5-7 days, with an average hospitalization time of 5.97±0.82 days. No patient received a second surgery for pulmonary leak or bleeding and no patient had any complication. All the cases recovered without any problem. In conclusion, for patients with pulmonary peripheral tumor, single-hole video-assisted thoracoscope could further reduce their surgical trauma. The operation was safe and feasible and worthy of wide application. [ABSTRACT FROM AUTHOR]

Introduction Glomangiomas are rare soft tissue tumors originating from the perivascular tissue. The most common localization is in the dermis of the extremities, with a few reports of respiratory tract involvement. Case presentation We present the case of a 48-year-old Caucasian female patient with a glomangioma in her left lung. It was diagnosed incidentally as a coin lesion in a chest X-ray performed during preoperative work-up for a gastric Roux-en-Y bypass for alimentary obesity. A computed tomography scan of her chest revealed a lesion in her upper left lung lobe 31mm in diameter. After resection, a histopathological examination presented typical signs of a glomangioma, originating from the pulmonary parenchyma. Conclusion Glomangiomas of the lung are extremely rare. However, whenever incidental lesions in the lung parenchyma are found, glomangioma should be taken into diagnostic consideration. To the best of our knowledge, signs of malignancy have not previously been reported in the literature. In fact, this tumor entity shows benign behavior, with a low potential for recurrence after complete resection. [ABSTRACT FROM AUTHOR]