Cases reported "Lung Neoplasms"

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1/49. Carcinoid tumourlets associated with diffuse bronchiectasis and intralobar sequestration.

    Innumerable carcinoid tumourlets may develop within pulmonary lobes should there be scarring from intralobar sequestration; these tumourlets may, in turn, be the cause of chronic lung disease. This report documents the incidental detection of multifocal carcinoid tumourlets in the lung of a 65-year-old man who had repeated episodes of lung infection, progressive dyspnea and haemoptysis; he lived at high altitude. The left lower lobe of the lung was resected surgically, during which procedure an aberrant systemic arterial supply was noticed. The patient had diffuse bronchiectasis and intralobar sequestration. The latter implies the development of abnormal lung tissue located within lobar tissue--but which does not communicate with the bronchial tree; it is supplied with arterial blood from a branch of the aorta--arising either above or below the diaphragm. There was loss of demarcation between the sequestered lung and the surrounding lower lobe lung parenchyma. The proliferation of pulmonary neuroendocrine cells in the form of tumourlets, had probably occurred as an adaptive response to the chronic hypoxia experienced. The combination of intralobar sequestration, bronchiectasis and carcinoid tumourlets, although uncommon, may arise when intralobar sequestration of the lung has not been resected at an incipient stage.
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2/49. Primary pulmonary botryomycosis: a late complication of foreign body aspiration.

    Primary pulmonary botryomycosis is a rare cause of haemoptysis and can enter the differential diagnosis of a mass on the plain chest radiograph. The case history is presented of a 63 year old man with botryomycosis which was initially thought to be a bronchial carcinoma. When the diagnosis was made several years later it was found to be secondary to persisting vegetable material in the bronchial tree following previous aspiration.
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3/49. Paravertebral and diaphragmatic mass: an ectopic location of bronchogenic cyst.

    Bronchogenic cysts constitute one area of the broad spectrum of developmental anomalies of the primitive foregut. They arise from anomalous budding of the primitive tracheobronchial tube and are commonly located in the mediastinum or the lung parenchyma, closely related to the tracheobronchial tree. In rare cases, they can migrate to subpleural, pericardial, paravertebral and cervical locations, if embryological connections with their parent bronchus are lost. Plain chest radiography and computed tomography have been the primary imaging modalities used for diagnosis. Computed tomography is frequently associated with misleading information with respect to the cyst density. magnetic resonance imaging has been shown to be useful in the differential diagnosis of cystic mediastinal masses. We present a patient with two asymptomatic bronchogenic cysts found at a distance from the tracheobronchial tree.
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4/49. Foreign body in tracheal bronchus simulating bronchogenic cancer.

    A foreign body in the bronchial tree may mimic many pathological conditions. We present a case of a 62-year-old patient with a foreign body in the tracheal bronchus simulating bronchogenic cancer. After the removal of the foreign body, there has been a gradual regression of the foreign body induced inflammatory changes. To the best of our knowledge, a similar case has not been reported in the English medical literature.
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5/49. Endobronchial photodynamic therapy for the treatment of lung cancer.

    After 2 decades of basic research and clinical experience with endobronchial photodynamic therapy, clear indications for its use have arisen. PDT for the treatment of superficial NSCLC is a viable alternative for patients with inoperable lung cancer. Although early indications are that it may be used to spare operable patients an aggressive surgical procedure, this application still should be considered investigational. The standard of care remains surgical resection in the operable patient. PDT may be considered for the palliation of obstructing lesions of the tracheobronchial tree; however, the risk for prolonged sensitivity to sunlight limits its broad application in this patient population. As better screening techniques are introduced, the role of PDT will expand in the future management of superficial lung cancers. Future developments include new photosensitizers with decreased duration of sun sensitivity and greater choice of wavelength to affect depth of penetration, better dosimetry systems for more consistent light delivery and reporting of results, and better light delivery systems for more homogenous distribution of light.
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6/49. hemoptysis as an unusual presenting symptom of invasion of a descending thoracic aortic aneurysmal dissection by lung cancer.

    A 70-year-old woman with a known chronic dissecting aneurysm of the descending thoracic aorta presented with new-onset back pain and hemoptysis. The hemoptysis was thought to be the result of invasion of the bronchial tree by the aneurysm. During surgical repair, a lesion that appeared to be a pulmonary abscess was discovered to be adhering to the aortic tissue, and the patient underwent a localized pulmonary resection. The pathology report of the surgical specimens revealed squamous cell carcinoma of the lung with infiltration of the aortic wall. The patient died of lung cancer 6 months later. hemoptysis was an unusual presentation in a case of lung cancer that had invaded a stable chronic aortic aneurysm.
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7/49. Molecular changes track recurrence and progression of bronchial precancerous lesions.

    diagnosis of lung cancer is reached when the disease had grown to advanced stages in its natural history. Thus, novel molecular markers for early detection and risk assessment are needed. Here we performed a longitudinal study of 20 morphological lesions occurred in the bronchial tree of high-risk patients. The lesions were subjected to life (laser-induced fluorescence endoscopy) bronchoscopy and molecular follow-up over a 4 year period. The presence and the persistence of specific genetic alterations were correlated with recurrence or progression of the disease on follow-up. Molecular lesions considered as highly predictive of invasion could be prospectively used as diagnostic markers of high risk for lung cancer in exposed patients.
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8/49. Sclerosing haemangioma arising within extralobar pulmonary sequestration.

    Extralobar pulmonary sequestration is a rare anomaly of abnormal pulmonary tissue without any communication to the bronchial tree. Sclerosing haemangioma is a rare lung tumour, generally seen in middle-aged women. The combination of these two rare pathologies has not been previously reported. We describe the CT and CT angiographic findings of sclerosing haemangioma arising within an extralobar pulmonary sequestration in a 2-year-old girl.
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9/49. Unexplained biliary tract dilatation in lung cancer patients.

    Three patients, two men and one woman, diagnosed as having adenocarcinoma of the lung were found to have changes in cholestatic biochemical values, and CT scan of the abdomen demonstrated dilation of the biliary tree. Upon further evaluation using ERCP marked dilation of the biliary tree was confirmed. There was no anatomic obstruction to bile flow, no neoplastic involvement of the liver or bile ducts and no evidence of any infiltrative process or disease to explain the dilation. A paraneoplastic syndrome is proposed as the etiology of the biliary tract abnormality. Along with other more common causes, this newly described paraneoplastic syndrome should be considered in the differential diagnosis of lung cancer in patients presenting with cholestasis and biliary tract dilation.
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10/49. Polymorphous low-grade adenocarcinoma in the lung: a case report.

    Although uncommon, it is well recognized that salivary gland-type tumors can occur as primary lung tumors, probably arising from minor salivary-type glands lining the bronchial tree. Polymorphous low-grade adenocarcinoma (PLGA) is a rare tumor that usually originates from oral minor salivary glands. There are only 2 reported cases showing metastasis to the lung; however, a primary lung tumor has not been reported so far. In this report we describe the clinical and pathological features of another case of PLGA involving the lung, but in a patient with no evidence of a previous oropharyngeal primary. While our case probably represents another example of metastatic PLGA to the lung, to our knowledge, it is the first description of a PLGA involving the lung in the absence of a history of a previous primary oral salivary gland tumor.
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