Pulmonary pleomorphic carcinoma; report of a case

We report a case of a 64-year-old man with pleomorphic carcinoma of the lung and thymic cyst. He was admitted to our hospital because of an abnormal shadow observed on chest X-ray. Computed tomography (CT) showed a mass lesion located in the right upper lobe and a non-invasive anterior mediastinal tumor adjacent to the left brachiocepharic vein. On enhanced CT, the lung mass showed central low-attenuation areas with a substantial enhancement in the periphery. Preoperative transbronchial blushing cytology of the mass revealed adenocarcinoma. With a diagnosis of primary lung cancer (cT3N0M0) and mediastinal tumor, an operation was performed through a median sternotomy. The mediastinal tumor was excised and a right upper lobectomy and were also accomplished, because the lung tumor did not show adhesion or pleural invasion. Histopathologic examination of the resected specimen revealed that the lung tumor composed of a mixture of spindle and giant cell features and contained a component of adenocarcinoma and squamous cell carcinoma. This finding yielded a pathological diagnosis of pleomorphic carcinoma (pT2N0M0). The mediastinal tumor was diagnosed as thymic cyst. The postoperative course was uneventful, and he is currently well 6 months after surgery.     

Pulmonary pleomorphic carcinoma

Pleomorphic carcinoma is a rare primary pulmonary malignancy. We report 2 surgical cases of pulmonary pleomorphic carcinoma. The first case was a 71-year-old male. Chest computed tomography (CT) showed a rapidly growing tumor with irregular density. Transbronchial lung biopsy revealed the tumor to be malignant. Left lower lobectomy was performed. Pathological diagnosis was pleomorphic carcinoma (pT2N2M0, stage IIIA). He died 8 months after surgery due to brain metastasis and mediastinal lymph node metastasis. The second case was a 74-year-old male who complained of bloody sputum. Chest CT showed a tumor with cavity in the right middle lobe. Brushing cytology under bronchofiberscopy revealed atypical cell. Right middle lobectomy and partial resection of the right lower lobe were performed. Pathological diagnosis was also pleomorphic carcinoma (pT2N0M0, stage IB). He has no findings of recurrence nor metastasis 15 months after the operation.     

Pulmonary pleomorphic carcinoma with rapid and peculiar metastases; report of a case

A 54-year-old man was pointed out a mass shadow during treatment of suspected acute pyothorax. He was diagnosed as large cell carcinoma by transbronchial biopsy. Preoperative chemotherapy and right lower lobectomy were done. In pathological examination, he was diagnosed as pulmonary pleomorpic carcinoma. Postoperatively, he had rapid metastases of the pancreas, skin, muscle, brain and oral cavity. We reported a case of pulmonary pleomorphic carcinoma with rapid and peculiar metastases.     

Pulmonary undifferentiated carcinoma associated with severe inflammatory response; report of 2 cases

We present 2 cases with pulmonary undifferentiated carcinoma accompanying severe inflammatory responses. Both patients initially complained high-grade fever. Laboratory data on admission showed leukocytosis and elevation of serum CRP level. In both cases, the tumors were characterized by a low-density mass with the enhanced wall on chest computed tomography (CT). The presence of tumor cells could not be identified by bronchoscopical examination. One patient was suffered from left adrenal metastasis at the diagnosis. Both patients underwent pulmonary resection for the primary tumor. The tumors consisted of marked necrotic tissue and were histologically diagnosed as pulmonary undifferentiated carcinoma cells with sarcomatous elements, which was compatible with pleomorphic carcinoma by new World Health Organization (WHO) classification (1999). After operation, systemic inflammatory response such as high-grade fever, leukocytosis, high level of serum CRP continued and progressed. Furthermore, extrathoracic metastatic lesions newly appeared. Both patients died within 100 days after operation.     

Gingival metastasis of pulmonary pleomorphic carcinoma; report of a case

A 71-year-old male was admitted to the hospital complaining of cough. The chest X-ray and computed tomography (CT) revealed a large tumor in the right lower lung, which was diagnosed as poorly differentiated adenocarcinoma. As the tumor grew rapidly and caused obstructive pneumonia, right middle and lower lobectomy was performed even if right gingival tumor was suspected as metastasis from lung tumor. The patient complicated with aspiration pneumonia after operation and died on the 20th postoperative day. The prognosis of lung cancer with gingival metastasis is very poor. Early detection and appropriate therapy is necessary.     

Cavitating pleomorphic carcinoma of the lung; report of a case

We report a case of a previously healthy 76-year-old male with cavitating pleomorphic carcinoma of the lung. He was admitted because of an abnormal lung shadow on chest X-ray. Computed tomography (CT) showed a well-demarcated nodular shadow within thin-walled cavity in the right upper lobe. Because the lesion was revealed as adenocarcinoma by transbronchial lung biopsy, right upper lobectomy was performed. By histopathologic examination of the resected specimen, the nodule contained a component of spindle cell features and the cavity wall was composed of adenocarcinoma. The final diagnosis was pleomorphic carcinoma. Postoperative course has been uneventful for 12 months after surgery.     

壶腹周围同时癌2例

同时存在的两种不同组织来源的壶腹周围癌少见,作者收治2例,经手术切除后病理证实,现报告如下。     

Pulmonary pleomorphic liposarcoma

Pulmonary liposarcoma is extremely rare with 6 cases previously reported in the English literature. The following is a report of a 36-year-old man with pulmonary liposarcoma. The patient had chest pain and a mass shadow in the right lower lung field was revealed on a chest X-ray film. A computed tomography and magnetic resonance imaging showed a heterogeneous tumor, compressing the right lower lobe of the lung. Because of the fatty tissue component in the tumor on the chest computed tomography, and the appearance as an extrapulmonary mass, preoperative diagnosis was posterior mediastinal liposarcoma. But thoracotomy revealed that the tumor originated from the lung. Right lower lobectomy and lymph node dissection was carried out with no additional therapy. The pathological diagnosis was pleomorphic liposarcoma originated from the lung. Two months after the operation, the patient died of respiratory failure due to local recurrence.     

Malignant transformation in pleomorphic xanthoastrocytoma--a report of two cases

Pleomorphic xanthoastrocytomas (PXA) with malignant transformation are reported in two adult men with a long history of seizures, recent onset of neurological symptoms and superficially located, temporal lobe lesions. Although PXA is generally described as having relatively benign behaviour, this report adds two further cases of malignant transformation to the literature.     

Pulmonary thromboembolism after lung resection in patients with schizophrenia; report of 2 cases

We report 2 cases of pulmonary thromboembolism after lung resection in patients with schizophrenia. The first case is a 67-year-old woman. She underwent right lower lobectomy for primary lung cancer and suddenly felt dyspnea 2 days after the operation. She was diagnosed pulmonary thromboembolism by computed tomography (CT) and lung perfusion scintigram, and recoverd soon. The second case is a 42-year-old man. He underwent partial resection of the right lung for metastatic germ cell tumor. Six days after the operation, he fell into acute respiratory failure and died in spite of resuscitation. The autopsy showed that the cause of death was pulmonary thromboembolism. Because patients with schizophrenia have high-risk of pulmonary thromboembolism, extreme care must be exercised to avoid it.     

Verrucous carcinoma of the kidney: report of 2 cases

The verrucous carcinoma is an unusual shape of well differentiated squamous cell carcinoma, first described at the ORL region; the kidney location is rare; the risk factors are represented essentially by lithiasis and/or urinary infection; the clinical symptom is not specific. Diagnosis is facilitated by radiological investigations and particularly excretory urogram/ultrasound; certainly diagnosis is pathological. The nephro-ureterectomy with collar resection of the bladder is the choice treatment. We report two observations and we clarify clinicopathological aspects of this type of carcinoma and we discuss the prognosis.     

肝内胆管神经内分泌癌二例报告

肝内胆管神经内分泌癌是一种较罕见的肝脏癌肿,现将厦门大学附属中山医院近期2例病人的诊治报道如下. 临床资料 病例1,女,57岁,因"反复右上腹痛1个月"入院就诊.体检:巩膜无黄染,全身浅表淋巴结未扪及肿大.腹平坦,右上腹压痛,无反跳痛,肝脾肋下未触及,肝区叩痛阳性,移动性浊音阴性,肠鸣音正常.     

肺隔离症（附14例报告）

目的 探讨肺隔离症（PS）的临床特点及X线特征，指导术前诊断及治疗方法。方法 回顾分析10年来14例肺隔离症患者资料。结果 14例患者术前误诊率高达71％（10／14），均经手术后病理证实，CT及X线的特征性表现可提高诊断率，手术治疗后均痊愈出院。结论 肺隔离症虽有相应的临床表现及X线特征，但术前鉴别诊断困难，手术治疗即可明确诊断，亦可获得满意疗效，手术切除应注意异常动脉的处理。     

Synchronous ipsilateral renal cell carcinoma and transitional cell carcinoma: report of 2 cases

Two cases of synchronous ipsilateral renal cell carcinoma and renal pelvic transitional cell carcinoma are presented, one in a 70-year-old man and another in a 54-year-old man. These two cases were diagnosed preoperatively as synchronous ipsilateral renal tumor and pelvic tumor from urine cytology, retrograde pyelography, computed tomography and magnetic resonance imaging, and in both two cases, nephroureterectomy was performed. Pathological diagnosis was renal cell carcinoma and renal pelvic transitional cell carcinoma, which existed incidentally in the same kidney. To our knowledge, these cases are the 34th and 35th reported cases of synchronous ipsilateral renal cell carcinoma and renal pelvic transitional cell carcinoma in Japan.