Pulmonary adenocarcinoma T1N0M0 and its classification

Over the last decade, use of the term bronchioloalveolar carcinoma (BAC) has come under constant scrutiny as some consider it an anachronism or a term that provides incorrect information about this neoplasm. To that extent, it has recently been suggested to replace the term BAC with that of in situ adenocarcinoma (AIS) or minimally invasive adenocarcinoma (MIA) for small solitary adenocarcinomas with either pure bronchioloalveolar growth (AIS) or predominant bronchioloalveolar growth and ≤5-mm invasion (MIA). However, as of today, there is no comprehensive study of these tumors, and most of what has been published in this context is based on a review of the literature that focused on scattered short series of cases describing either small adenocarcinomas or BAC. More recently, a large series of cases of a more comprehensive nature that included all early-stage adenocarcinomas (T1N0M0) has cast some doubt regarding the need for the proposed change in nomenclature. At the same time, it was suggested that if indeed that notion is maintained, a more serious and comprehensive study of actual cases must be undertaken. The details of the issues surrounding this subject are presented in this review.     

Thymomas I: a clinicopathologic correlation of 250 cases with emphasis on the World Health Organization schema

We describe 250 cases of thymoma with emphasis on World Health Organization (WHO) histologic subtyping. The patients were 120 males and 130 females between the ages of 13 and 92 years. Surgical resection was performed, and histologic material was evaluated in every case. Macroscopically, the tumors varied in size from 3 to 20 cm in greatest diameter; about 12% were encapsulated, and about 88% were invasive tumors. A minimum of 5 sections of tumor was evaluated. Histologically, following the schema proposed by the WHO, 21.6% of thymomas were type A, 1.23% type B1, 3.2% type B2, and 9.2% type B3. More than 50% of tumors after subtyping fell into the mixed categories, which, in essence, diminishes the clinical impact of histologic subtyping over staging. The study herein described highlights that all thymomas had the potential to become invasive tumors.     

Malignant biphasic tumors of the lungs

Malignant biphasic tumors of the lungs are rare primary tumors of the bronchopulmonary system. These tumors are composed of malignant epithelial and mesenchymal elements and together comprise <2% of all primary pulmonary neoplasms. The tumors belonging to this group include pulmonary blastoma, pleuropulmonary blastoma, and carcinosarcoma. In this study, the clinicopathologic features, immunohistochemical phenotype, molecular biological characteristics, and the differential diagnosis of these uncommon neoplasms are discussed.     

Effects of the SLCO1B1*1B haplotype on the pharmacokinetics and pharmacodynamics of repaglinide and nateglinide

OBJECTIVE: Organic anion transporting polypeptide 1B1 (OATP1B1), encoded by SLCO1B1, is an influx transporter expressed on the sinusoidal membrane of human hepatocytes. The aim of this study was to investigate whether the SLCO1B1*1B haplotype affects the pharmacokinetics and pharmacodynamics of repaglinide and nateglinide. METHODS: Eight healthy volunteers with the SLCO1B1*1B/*1B genotype and 16 with the SLCO1B1*1A/*1A genotype ingested a single 0.5-mg dose of repaglinide and, after a washout period of 1 week, a single 60-mg dose of nateglinide. Plasma repaglinide and nateglinide and blood glucose concentrations were measured for 7 h. RESULTS: The AUC(0-infinity) and Cmax of repaglinide were 32% (P=0.007) and 24% lower (P=0.056) in the individuals with the SLCO1B1*1B/*1B genotype than in those with the SLCO1B1*1A/*1A genotype. The mean blood glucose concentration from 0 to 7 h after repaglinide intake was 10% higher in the SLCO1B1*1B/*1B participants than in the SLCO1B1*1A/*1A participants (P=0.007). The Cmax of nateglinide occurred earlier in the SLCO1B1*1B/*1B participants than in the SLCO1B1*1A/*1A participants (P=0.004), but no differences were seen in the other pharmacokinetic variables of nateglinide. CONCLUSION: The SLCO1B1*1B/*1B genotype is associated with reduced plasma concentrations of repaglinide, consistent with an enhanced hepatic uptake by OATP1B1, but has limited effects on the pharmacokinetics of nateglinide.