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Hatakeyama N, Hino H, Takeuch E, Sakiyama S, Shinohara T. An 18 F-FDG-PET-Positive Mucoid Impaction With Ring Enhancement on CT Mimicking Lung Cancer. Clin Nucl Med 2022; 47:904-905. [PMID: 35485845 DOI: 10.1097/rlu.0000000000004257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We encountered a case of an 18 F-FDG PET-positive solitary nodule with ring enhancement on CT mimicking lung cancer in the left S6 region of an 80-year-old woman. Since transbronchial biopsy by endobronchial ultrasonography with a guide sheath could not obtain sufficient material, despite the guide sheath being placed within the lesion, the patient underwent thoracoscopic partial left S6 resection. The nodule was diagnosed as acquired cystic bronchiectasis and mucoid impaction associated with chronic inflammation. The ring-shaped enhancement and the 18 F-FDG uptake may reflect angiogenesis in the cystic wall and accumulation of viable inflammatory cells in the wall and inner space, respectively.
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Affiliation(s)
| | | | - Eiji Takeuch
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Kochi
| | | | - Tsutomu Shinohara
- Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
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Hamada N, Ishiga M, Ooue Y, Kimura G, Tanimoto Y. A Fast-growing Benign Metastasizing Leiomyoma Mimicking Malignancy. Intern Med 2022; 61:223-227. [PMID: 34275987 PMCID: PMC8851189 DOI: 10.2169/internalmedicine.7804-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a rare case of fast-growing benign metastasizing leiomyoma. A 52-year-old woman was admitted to our hospital with abnormal chest shadows. Chest computed tomography showed well-circumscribed cystic tumors. Because malignancy could not be completely distinguished in fast-growing tumors, video-assisted thoracic surgery was performed. The pathological findings revealed many cysts and the proliferation of smooth muscle cells. According to the Stanford criteria, the tumor was diagnosed as benign metastasizing leiomyoma. One possible reason for the fast growth of the tumor was enlargement of the cysts. Malignant diseases characterized by cystic tumors are rare but occasionally reported. Therefore, differentiation by a pathological examination is essential.
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Affiliation(s)
- Noboru Hamada
- Department of Respiratory Medicine, Okayama City Hospital, Japan
| | - Mitsunori Ishiga
- Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
| | - Yasuhiro Ooue
- Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
| | - Goro Kimura
- Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
| | - Yasushi Tanimoto
- Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
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Savu C, Melinte A, Gibu A, Varban S, Diaconu C, Stiru O, Balescu I, Bacalbasa N. Pulmonary Mucinous Cystadenoma - A Rare Pathology. In Vivo 2021; 35:629-634. [PMID: 33402519 DOI: 10.21873/invivo.12301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Pulmonary cystadenoma is a very rare benign tumor of the lung with slow growth rate and most often, asymptomatic. CASE REPORT We present the case of a 58-year-old patient admitted in the hospital for coughing with hemoptoic sputum. Standard thoracic radiography revealed a 4/5 cm macronodular opacity in the right inferior lobe, paracardiac. Thoracic computed tomography (CT) with contrast discovered a 3.8/4.7 cm homogenous mass in the right inferior lobe. After intraoperative assessment of the lesion a lower right lobectomy with mediastinal and local lymphadenectomy was performed. CONCLUSION Pulmonary mucinous cystadenoma is one of the primary pulmonary mucinous cystic neoplasia (PMCT) alongside PMCT of low malignancy and pulmonary mucinous cystadenocarcinoma (PMCAC). Because of this and because of the clinical and imagistic similarities between these main entities, establishing a preoperative diagnosis becomes very difficult. Therefore, histopathological and immunohistochemistry studies are mandatory in order to establish the correct diagnosis.
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Affiliation(s)
- Cornel Savu
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumology, Bucharest, Romania.,Department of Thoracic Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexandru Melinte
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumology, Bucharest, Romania
| | - Alexandru Gibu
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumology, Bucharest, Romania
| | - Stefania Varban
- Department of Pathology, "Marius Nasta" National Institute of Pneumology, Bucharest, Romania
| | - Camelia Diaconu
- Department of Internal Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, Bucharest, Romania
| | - Ovidiu Stiru
- Department of Cardiovascular Surgery, "Prof. Dr. C. C. Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania.,Department of Cardiovascular Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina Balescu
- Department of Surgery, "Ponderas" Academic Hospital, Bucharest, Romania;
| | - Nicolae Bacalbasa
- Department of Visceral Surgery, Center of Excellence in Translational Medicine "Fundeni" Clinical Institute, Bucharest, Romania.,Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Todhe P, Sharma N, Shetty A, Ochieng P. Pulmonary mucinous cystadenocarcinoma: an unusual presentation and literature review. BMJ Case Rep 2020; 13:13/7/e235567. [PMID: 32675126 DOI: 10.1136/bcr-2020-235567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Abstract
Cystic lung disease is a group of heterogeneous pulmonary diseases resulting from hereditary/congenital disorders, systemic disorders and infectious causes among others. Pulmonary mucinous cystic neoplasia is a spectrum of neoplastic cystic diseases with abundant mucin, of which pulmonary mucinous cystadenocarcinoma (PMC) is a rare malignant subtype. We present a case of a 66-year-old man who presented with dyspnoea, cough, fatigue and weight loss. Imaging of his chest showed numerous cavitary lesions, and the diagnosis of PMC was made based on lung biopsy. He received palliative chemotherapy and died 1 year later. We present a literature review of PMC based on 26 reported cases, including our own.
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Affiliation(s)
- Pandi Todhe
- Department of Internal Medicine, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA
| | - Nishant Sharma
- Department of Internal Medicine, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA
| | - Ajay Shetty
- Department of Pulmonary and Critical Care Medicine, Geisinger Community Medical Center, Scranton, Pennsylvania, USA
| | - Pius Ochieng
- Department of Pulmonary and Critical Care Medicine, Geisinger Community Medical Center, Scranton, Pennsylvania, USA
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Kadota N, Shinohara T, Naruse K, Hino H, Ogushi F. A lobulated mass in the left lower lobe: not what it seems. Thorax 2019; 74:519-520. [PMID: 30712022 DOI: 10.1136/thoraxjnl-2018-212520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/07/2018] [Accepted: 01/14/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Naoki Kadota
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Tsutomu Shinohara
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Keishi Naruse
- Division of Pathology, National Hospital Organization Kochi Hospita, Kochi, Japan
| | - Hiroyuki Hino
- Division of Thoracic Surgery, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Fumitaka Ogushi
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
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Abstract
OBJECTIVE We aimed to assess CT and 18F-FDG PET/CT findings of colloid adenocarcinoma of the lung in seven patients. MATERIALS AND METHODS From 2010 to 2017, seven patients with surgically proven colloid adenocarcinoma of the lung were identified. CT (both enhanced and unenhanced) and PET/CT findings were analyzed, and the imaging features were compared with histopathologic reports. Clinical and demographic features were also analyzed. RESULTS In all cases except one, tumors showed low attenuation on unenhanced CT scans, ranging in attenuation from -16.5 to 20.7 HU (median, 9.2 HU). After contrast medium injection, enhancement was scant, so net enhancement ranged from 0.4 to 29.0 HU (median, 4.1 HU). All tumors had a lobulated contour. Stippled calcifications within the tumor were seen in one patient. The maximum standardized uptake value of tumors on PET/CT ranged from 1.5 to 4.5 (median, 3.5). In six of seven patients, FDG accumulation was seen in the tumor walls (n = 3, curvilinear uptake) or in both the tumor walls and tumor septa (n = 3, crisscross uptake). Six patients were alive without recurrence after a median follow-up period of 2.3 years (range, 2 months to 5 years). In one patient, who was alive at follow-up 4 years after imaging and had received adjuvant concurrent chemoradiation therapy after lobectomy, recurrent disease was detected 6 months after completion of the therapy. CONCLUSION On CT, pulmonary colloid adenocarcinomas present as lobulated homogeneously low-attenuation tumors. At PET, curvilinear or crisscross FDG uptake is seen within the tumor where tumor cells are lining the walls or septal structures.
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Christianson BE, Gupta S, Vyas SG, Spartz H, Keshavamurthy JH. A diagnostic challenge: An incidental lung nodule in a 48-year-old nonsmoker. Lung India 2018; 35:251-255. [PMID: 29697085 PMCID: PMC5946561 DOI: 10.4103/lungindia.lungindia_212_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Abstract
A 43-year-old female with a medical history of renal stones, hypertension, diabetes mellitus Type 2, and depression presented to her urologist with bilateral flank pain. She complained of worsening exertional dyspnea over the last several months with recent weight gain. She also endorsed night sweats and intermittent, scant hemoptysis over the past year. She denied fever, chills, nausea, vomiting, diarrhea, constipation, hematuria, or excessive joint or muscle pain. Physical examination was unremarkable. Computed tomography scan of abdomen and pelvis demonstrated bilateral nonobstructing renal stones and a 1.8 cm × 1.7 cm nodular opacity in the right lower lobe of the lung, not present on previous scan 1 year prior. Surgical wedge resection was performed and subsequent pathologic examination demonstrated a 1.2 cm × 0.6 cm × 0.5 cm soft, gelatinous well-demarcated mass in the right lower lobe wedge specimen without gross evidence of necrosis or hemorrhage confirming colloid adenocarcinoma of the lung.
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Affiliation(s)
| | - Supriya Gupta
- Department of Radiology, Medical College of Georgia, Augusta, GA, USA
| | - Shikhar G Vyas
- Department of Pathology, Medical College of Georgia, Augusta, GA, USA
| | - Helena Spartz
- Department of Pathology, Medical College of Georgia, Augusta, GA, USA
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Kalkanis A, Palaiodimos L, Klinaki I, Karantanis D, Kalkanis D. 18F-FDG PET/CT Imaging of Pulmonary Mucinous Cystadenocarcinoma with Signet Ring Cells. Nucl Med Mol Imaging 2016; 51:277-280. [PMID: 28878858 DOI: 10.1007/s13139-016-0402-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 01/16/2016] [Accepted: 01/26/2016] [Indexed: 11/30/2022] Open
Abstract
A 63-year-old male with a recently diagnosed right lung lesion was referred for staging. F-FDG PET/CT scan revealed a hypodense, cystic-like mass in the right upper lung lobe, which demonstrated low, diffuse 18F-FDG uptake, likely due to the presence of mucus, as well as intensely hypermetabolic right hilar and right paratracheal lymph nodes. Transbronchial biopsy revealed a primary pulmonary mucinous cystadenocarcinoma with the presence of signet ring cell carcinoma, a co-existence of two rare variants of lung adenocarcinoma. This case report demonstrates the metabolic phenotype along with the radiographic characteristics of this rare tumor and its metastases.
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Affiliation(s)
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center / Albert Einstein College of Medicine, 1955 Williamsbridge Road, Bronx, NY 10461 USA
- Society of Junior Doctors, Athens, Greece
| | - Ifigeneia Klinaki
- Department of Nuclear Medicine, Biotypos Diagnostic Center, Athens, Greece
| | | | - Dimitrios Kalkanis
- Department of Nuclear Medicine, 251 Greek Airforce Hospital, Athens, Greece
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Resection of a solitary pulmonary metastasis from prostatic Adenocarcinoma misdiagnosed as a Bronchocele: usefulness of 18F-choline and 18F-FDG PET/CT. J Thorac Oncol 2015; 9:1826-9. [PMID: 25393797 DOI: 10.1097/jto.0000000000000270] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Reply to "18F-Choline PET-CT in the Management of Lung Cancer and Mucinous Tumors?". J Thorac Oncol 2015; 10:e49-50. [PMID: 26001152 DOI: 10.1097/jto.0000000000000527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Moon SM, Seon HJ, Choi YD, Song SY. A rare pleural mucinous cystadenocarcinoma mimicking loculated empyema initially: A case report. Indian J Radiol Imaging 2014; 23:301-3. [PMID: 24604931 PMCID: PMC3932569 DOI: 10.4103/0971-3026.125568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
We report a case of pleural mucinous cystadenocarcinoma which was mistaken to be a loculated empyema on chest CT. To the best of our knowledge, this entity has never been previously reported in literature.
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Affiliation(s)
- Sung Min Moon
- Department of Radiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Hyun Ju Seon
- Department of Radiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Sang-Yun Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Gwangju, South Korea
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