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In the gestational theory, choriocarcinoma originates from pregnancy or from a complete hydatidiform mole and is usually associated with genital bleeding, abnormally high levels of hCG, and pulmonary metastasis at diagnosis in most of the patients. However, the primary tumor regresses and disappears; only the lung metastases remain. Choriocarcinoma is a rare germ cell tumor that shows abnormally high levels of human chorionic gonadotropin (hCG) and often originates from the uterus during the perinatal period. [Extracted from the article]

The current 2015 World Health Organization (WHO) classification of lung tumors does not adequately categorize mucinous lung adenocarcinoma. Thus far, only two variants of mucinous adenocarcinoma have been studied: invasive mucinous adenocarcinoma and colloid adenocarcinoma. Moreover, common types of invasive adenocarcinoma when they produce mucin are yet to be elucidated, particularly epidermal growth factor receptor (EGFR)‐mutated mucinous adenocarcinoma. In this study, we extracted mucinous adenocarcinoma of both the common types and the two variants. Further, we immunohistochemically and molecular‐biologically examined their clinicopathological characteristics, mutation patterns, and expressions of thyroid transcription factor‐1 (TTF‐1), hepatocyte nuclear factor‐4 alpha (HNF‐4a) and mucins, particularly referring to EGFR‐mutated adenocarcinoma. Among 1159 surgically resected invasive adenocarcinomas, 189 mucinous adenocarcinomas (16%) were identified. Among these, 20%, 34% and 9.5% were EGFR mutated, KRAS mutated and ALK rearranged, respectively. Compared with EGFR‐mutated nonmucinous adenocarcinoma, EGFR‐mutated mucinous adenocarcinoma had no female predominance, lower grades of histological differentiation and lower TTF‐1 and higher HNF‐4a expressions. Moreover, for the first time, we indicated that mucin production was an independent prognostic factor for EGFR‐mutated adenocarcinomas and the mucin‐staining pattern of negative MUC5AC and positive MUC5B was characteristic in these adenocarcinomas. We suggest that EGFR‐mutated mucinous adenocarcinoma has a different tumorigenic pathway than nonmucinous EGFR‐mutated adenocarcinoma. [ABSTRACT FROM AUTHOR]

Calretinin, a mesothelioma marker, is sometimes expressed in lung cancer, which may complicate the differential diagnosis of mesothelioma. Here, the clinicopathological and immunohistochemical characteristics of calretinin-positive lung cancer were examined to reduce confusion with malignant mesothelioma. Calretinin expression in 307 consecutive cases of lung cancer was evaluated immunohistochemically. Survival was analyzed using the Kaplan-Meier method and log-rank test. Calretinin expression was identified in 67 (22%) tumors, including those with partial and weak expression [15% (37/250) of adenocarcinomas, 54% (25/46) of squamous cell carcinomas, 75% (3/4) of adenosquamous carcinomas, and 29% (2/7) of sarcomatoid carcinomas]. In calretinin-positive adenocarcinoma (n = 37), expression percentages of Wilms tumor-1, podoplanin, thyroid transcription factor-1, and claudin-4 were 6, 3, 52, 82%, respectively, whereas in calretinin-positive squamous cell carcinoma (n = 25) the percentages were 8, 12, 12, 68%, respectively, indicating that other mesothelial markers were only rarely expressed and that claudin-4 expression was common. Although not an independent marker, calretinin expression was associated with a poor prognosis for stage I tumors of adenocarcinoma (p < 0.001) and of all histological subtypes (p < 0.001). In conclusion, calretinin-positive lung tumors share characteristics with those of smokers and advanced stages and can be differentiated from mesothelioma with the use of other mesothelial and epithelial markers., Competing Interests: Declaration of Competing Interest All other authors declare no conflicts of interest., (Copyright © 2020. Published by Elsevier GmbH.)

A 50-year-old man with hemoptysis, given a diagnosis of left upper lobe pulmonary aspergilloma with cavity and fungus ball by computed tomography. He has a history of typeⅠ diabetes mellitus due to traumatic injury of pancreas and underwent diaphragm plasty. Despite of systemic anti-fungal medication, symptom and radiological findings were not progressed and surgical intervention was planned. Before surgery we performed intercostal artery embolization, in order to minimize bleeding on dissecting adhesion between the chest wall and the lobe with aspergilloma. Left upper lobectomy with muscle-flap prombage was done safely with a blood loss of 450 ml. Postoperative course was favorable. Intercostal artery embolization with N-butyl-2cyanoacrylate is an effective way to minimize hemorrhage during surgical resection for pulmonary aspergillosis with sever adhesion.