1/30. lung transplantation for advanced bronchioloalveolar carcinoma confined to the lungs.BACKGROUND: Bronchioloalveolar carcinoma (BAC) is a well-differentiated lung adenocarcinoma that has a tendency to spread chiefly within the confines of the lung by aerogenous and lymphatic routes and may therefore be amenable to local therapy. However, a high rate of local recurrence after lung transplantation was recently reported. We describe two patients with unresectable and recurrent extensive BAC limited to the lung parenchyma who underwent lung transplantation with curative intent. methods: patients were chosen to receive lung transplants for BAC if they met the following criteria: (1) recurrent or unresectable BAC limited to the lung parenchyma without nodal involvement and (2) suitable candidate for lung transplantation. RESULTS: The first patient relapsed in the lungs at 9 months after transplantation. The pattern of disease suggested contamination of the new lungs at the time of implantation. Repeat lung transplantation was performed, with cardiopulmonary bypass and irrigation of the remaining upper airway. This patient has had no evidence of local or systemic tumor recurrence at more than 4 years since the second transplantation. The second patient underwent transplantation using the modified technique and expired 16 months after transplantation of other causes. An autopsy showed no evidence of recurrent BAC in the lungs or of metastatic lesions at any site. CONCLUSIONS: lung transplantation may be an option for unresectable or recurrent BAC confined to the lungs. Isolation of the diseased lungs and the use of cardiopulmonary bypass during surgery may be important in this disease and should be studied further.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/30. Bronchioloalveolar carcinoma mimicking miliary tuberculosis.A case of bronchioloalveolar carcinoma, with widespread dissemination to both lungs and miliary mottling on chest X-ray is reported in a 40 year old male.- - - - - - - - - - ranking = 7.8504059274027keywords = chest (Clic here for more details about this article) |
3/30. Evaluation of the clonality of multilobar bronchioloalveolar carcinoma of the lung: case report.A case of multilobar bronchioloalveolar carcinoma (BAC) is reported. To investigate the clonality of BAC, immunohistochemical staining as well as genetic analysis were performed. To investigate point mutations of the p53 gene, we used the polymerase chain reaction and fluorescence-based single strand conformation polymorphism analysis method. The BAC tissues of the right upper lobe, right lower lobe, and the other lobes were considered to be multiclonal. This case suggests that multilobar BAC might occur with multiclonality.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
4/30. Multiple atypical adenomatous hyperplasia with synchronous multiple primary bronchioloalveolar carcinomas.We report a case of multiple atypical adenomatous hyperplasia (AAH) associated with synchronous multiple primary bronchioloalveolar carcinomas (BACs). A 58-year-old man was visited for bronchial asthma. A chest computed tomography (CT) scan revealed small, multiple nodules with ground glass attenuation (GGA) throughout both lungs, predominantly in the upper lobes. A high resolution CT (HRCT) scan disclosed well-defined nodules with uniform GGA. Thoracoscopic wedge lung biopsy confirmed the diagnosis. The patient was treated with chemotherapy and had stable disease for two years. It is important to recognize that multiple AAH associated with multiple BACs can present as diffuse, well-defined nodules with uniform GGA on HRCT.- - - - - - - - - - ranking = 8.8504059274027keywords = chest, upper (Clic here for more details about this article) |
5/30. Bronchioloalveolar carcinoma masked by gravity-dependent gradient on computed tomography.A 78-year-old woman was found to have a small bronchioloalveolar carcinoma with ground-glass attenuation in the gravity-dependent gradient in the left lower lobe during a preoperative chest computed tomography (CT) evaluation, which was performed for previously-diagnosed adenocarcinoma of the right upper lobe. To remove the gravitational effect of the CT, the patient underwent a thin section CT in the prone position. Then, a ground-glass attenuation was revealed clearly in the left lower lobe. Postoperative pathological diagnosis was synchronous multiple bronchioloalveolar carcinomas, stage IA. This case suggests that focal areas of ground-glass attenuations on a thin-section CT in patients with BAC would be considered to be multicentric development of BAC. CT with the patient in the prone position helps to exclude the gravitational effect and narrow the differential diagnosis of ground-glass opacity, including localized forms of BAC.- - - - - - - - - - ranking = 8.8504059274027keywords = chest, upper (Clic here for more details about this article) |
6/30. Combined bilateral lung resections and off-pump coronary artery bypass grafting.We report herein a 74 year old man with angina who had an abnormal chest roentgenogram. Computed tomography of the chest showed a solitary 1.0-cm peripheral, noncalcified lesion in the apical segment of the left lower lobe and a 1.5-cm peripheral lesion in the posterior basal segment of the right lower lobe. coronary angiography revealed the left anterior descending coronary artery to have a long 90% stenosis. We report here a case of a combined bilateral lung resection and off-pump coronary surgery though a midline sternotomy in a compromised lung function patient with both severe coronary artery disease and bilateral synchronous primary lung cancer.- - - - - - - - - - ranking = 15.700811854805keywords = chest (Clic here for more details about this article) |
7/30. Iatrogenic esophagobronchial fistula arising in irradiated Barrett's esophagus.A 47-yr-old male underwent a right upper lobectomy for stage IIB bronchoalveolar carcinoma followed by 4600 Gy of irradiation. One year later a fistula formed from an ulcerated region of Barrett's esophagus into the left main bronchus. Bronchotomy repair with onlay patch intercostal muscle flap and esophageal repair with serratus anterior muscle flap plus postoperative esophageal stent placement for stricture resulted in good functional results.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
8/30. A unique collision of epithelioid hemangioendothelioma and bronchioloalveolar carcinoma in a 54-year-old Japanese woman.We present a unique collision of epithelioid hemangioendothelioma and bronchioloalveolar carcinoma. A 54-year-old Japanese woman seen for a small nodular shadow on chest X-ray in December 1989 was found in chest computed tomography to have multiple small nodules in bilateral lung fields. At thoracotomy through a median sternotomy, 9 nodules from 0.3 cm to 1.2 cm in diameter detected were all resected. The pathological diagnosis was epithelioid hemangioendothelioma of the lung. A focus of bronchioloalveolar carcinoma 1.4 cm in diameter existed adjacent to the focus of epithelioid hemangioendothelioma in the lingular portion of the left lung. The initial surgical margin was not clear, and a complete lingulectomy was conducted through a left lateral thoracotomy. The patient is currently alive with no evidence of recurrence at 13 years after the first appearance.- - - - - - - - - - ranking = 15.700811854805keywords = chest (Clic here for more details about this article) |
9/30. bronchoalveolar lavage in the diagnosis of bronchiolo-alveolar carcinoma. A case report.Bronchiolo-alveolar carcinoma is usually localized to the terminal bronchioles and alveoli, and may present on chest X-ray as interstitial pulmonary disease with diffuse reticulonodular infiltrates. The cytological diagnosis is often difficult to obtain. This case demonstrates that bronchoalveolar lavage can be useful in the diagnostic evaluation of this type of malignancy, in conjunction with transbronchial lung biopsy.- - - - - - - - - - ranking = 7.8504059274027keywords = chest (Clic here for more details about this article) |
10/30. Alveolar cell carcinoma presenting as malignant pericardial effusion: diagnosis by electron microscopy.The cytologic, immunocytochemical, and ultrastructural findings in a 68-year-old man who presented with a malignant pericardial effusion are reported. Radiologic studies failed to identify a primary neoplasm over the next 6 months. Ultrastructural examination of a repeat pericardiocentesis fluid specimen revealed cells with intranuclear tubular inclusions and cytoplasmic lamellar bodies typical of alveolar cell carcinoma. review of the chest radiographs showed nonresolving patchy infiltrates in the upper lobe of the left lung clinically thought to represent pneumonia; in retrospect, however, these were consistent with the pneumonic form of alveolar cell carcinoma.- - - - - - - - - - ranking = 8.8504059274027keywords = chest, upper (Clic here for more details about this article) |
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