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Guler S, Hull NC, Arteta M, Allen-Rhoades W, Shahi M, Ishitani MB, Demirel N. An unusual case of metastatic trophoblastic neoplasm presenting with diffuse cystic lung disease and pulmonary artery pseudoaneurysms in a teenager. Pediatr Pulmonol 2024; 59:1482-1486. [PMID: 38390771 DOI: 10.1002/ppul.26936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/07/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
Diffuse cystic lung diseases (DCLDs) are a diverse group of lung disorders characterized by the presence of multiple air filled cysts within the lung tissue. These cysts are thin walled and surrounded by normal lung tissue. In adults, DCLD can be associated with various conditions such as lymphangioleiomyomatosis (LAM), Langerhans cell histiocytosis, cancers, and more. In children, DCLD is often linked to lung developmental abnormalities, with bronchopulmonary dysplasia being a common cause. Patients with pulmonary cysts are typically asymptomatic, but some may experience mild symptoms or pneumothorax. While DCLD in children is rarely due to malignancy, metastatic lung disease can be a cause. It is important for clinicians to be aware of the possibility of metastatic lung disease when encountering DCLD.
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Affiliation(s)
- Sevim Guler
- Istanbul University-Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Nathan C Hull
- Division of Pediatric Radiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Manuel Arteta
- Division of Pediatric Pulmonology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Wendy Allen-Rhoades
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Maryam Shahi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael B Ishitani
- Division of Pediatric Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Nadir Demirel
- Division of Pediatric Pulmonology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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2
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Kocer SY, Hull NC, Dean Potter D, Madigan T, Boland JM, Demirel N. Late development of pneumatoceles in necrotizing pneumonia. Pediatr Pulmonol 2024; 59:502-505. [PMID: 38014600 DOI: 10.1002/ppul.26777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/09/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Sila Y Kocer
- Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Nathan C Hull
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Donald Dean Potter
- Department of Surgery, Division of Pediatric Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Theresa Madigan
- Department of Pediatric and Adolescent Medicine, Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer M Boland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nadir Demirel
- Department of Pediatric and Adolescent Medicine, Division of Pediatric Pulmonology, Mayo Clinic, Rochester, Minnesota, USA
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3
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Kawachi R, Nakatani Y, Furuya M, Nakamura N, Kondo Y, Nagashima Y, Nakayama T, Okada M, Sakurai H, Masuda S. Pulmonary interstitial glycogenosis in Birt-Hogg-Dubé syndrome-associated lung cysts: A new insight into the pathogenesis? Pathol Int 2023; 73:601-608. [PMID: 37818800 DOI: 10.1111/pin.13383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023]
Abstract
Multiple lung cysts are one of the major features of Birt-Hogg-Dubé syndrome (BHD), but little is known about their nature and pathogenesis. We report a case of a woman diagnosed with BHD lung cysts who exhibited pulmonary interstitial glycogenosis (PIG), a mesenchymal abnormality hitherto undescribed in this disease, in specimens resected at 14 and 29 years of age. Histopathologically, oval to spindle clear cells were seen in the subepithelial interstitial tissue of septal structures and the walls of the cysts. They had abundant periodic acid-Schiff-positive cytoplasmic glycogen. Immunohistochemically, these cells were positive for a few markers of mesenchymal stem cell-like lineage, including vimentin, CD44, and CD10, and negative for markers of epithelial or specific mesenchymal differentiation; these results were consistent with the reported immunophenotype of PIG cells. These PIG cells were more abundant in her specimen at age 14 years than in the second specimen from adulthood. The present case suggests that BHD lung cysts belong to a group of pulmonary developmental disorders characterized by combined PIG and alveolar simplification/cystic change. Disorders with PIG may persist until adulthood and may be of clinical and pathological significance.
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Affiliation(s)
- Riken Kawachi
- Division of Respiratory Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Yukio Nakatani
- Department of Pathology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | | | - Naoya Nakamura
- Department of Pathology, Tokai University Hospital, Isehara, Japan
| | - Yusuke Kondo
- Department of Pathology, Tokai University Hospital, Isehara, Japan
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomohiro Nakayama
- Laboratory Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Masahiro Okada
- Radiology, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroyuki Sakurai
- Division of Respiratory Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Shinobu Masuda
- Pathology, Nihon University School of Medicine, Tokyo, Japan
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Bandara H, Madegedara D. Exploring bilateral pneumothorax leading to a rare diagnosis in a young lady. Respirol Case Rep 2023; 11:e01180. [PMID: 37303312 PMCID: PMC10251254 DOI: 10.1002/rcr2.1180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
Bilateral pneumothorax is a rare occurrence and vigilant clinical examination is mandatory to suspect that during the presentation. This case illustrates a young lady presented with bilateral pneumothorax, new identification of lung cysts and chylous pleural effusion leading to diagnosis of lymphangioleiomyomatosis.
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Affiliation(s)
- Harshana Bandara
- Respiratory Medicine UnitNational Hospital of KandyKandySri Lanka
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van Riel L, van Hulst RA, van Hest L, van Moorselaar RJA, Boerrigter BG, Franken SM, Wolthuis RMF, Dubbink HJ, Marciniak SJ, Gupta N, van de Beek I, Houweling AC. Recommendations on scuba diving in Birt-Hogg-Dubé syndrome. Expert Rev Respir Med 2023; 17:1003-1008. [PMID: 37991821 PMCID: PMC10763569 DOI: 10.1080/17476348.2023.2284375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Although very uncommon, severe injury and death can occur during scuba diving. One of the main causes of scuba diving fatalities is pulmonary barotrauma due to significant changes in ambient pressure. Pathology of the lung parenchyma, such as cystic lesions, might increase the risk of pulmonary barotrauma. AREAS COVERED Birt-Hogg-Dubé syndrome (BHD), caused by pathogenic variants in the FLCN gene, is characterized by skin fibrofolliculomas, an increased risk of renal cell carcinoma, multiple lung cysts and spontaneous pneumothorax. Given the pulmonary involvement, in some countries patients with BHD are generally recommended to avoid scuba diving, although evidence-based guidelines are lacking. We aim to provide recommendations on scuba diving for patients with BHD, based on a survey of literature on pulmonary cysts and pulmonary barotrauma in scuba diving. EXPERT OPINION In our opinion, although the absolute risks are likely to be low, caution is warranted. Given the relative paucity of literature and the potential fatal outcome, patients with BHD with a strong desire for scuba diving should be informed of the potential risks in a personal assessment. If available a diving physician should be consulted, and a low radiation dose chest computed tomography (CT)-scan to assess pulmonary lesions could be considered.
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Affiliation(s)
- L. van Riel
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - RA. van Hulst
- Department of Hyperbaric Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - L. van Hest
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RJA. van Moorselaar
- Department of Urology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - BG. Boerrigter
- Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - SM. Franken
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RMF. Wolthuis
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - HJ. Dubbink
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - SJ. Marciniak
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
- Royal Papworth Hospital, Trumpington, Cambridge, UK
| | - N. Gupta
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - I. van de Beek
- Family Cancer Clinic, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - AC. Houweling
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Patel P, Anamika F, Ali R. Pulmonary Langerhans Cell Histiocytosis Masquerading as Lymphangioleiomyomatosis. Cureus 2023; 15:e38486. [PMID: 37273350 PMCID: PMC10237305 DOI: 10.7759/cureus.38486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Pulmonary Langerhans cell histiocytosis (PLCH) is an uncommon lung disease that affects young adults aged 20 to 40 years with current or prior history of smoking. The pathologic cell type in PLCH is a dendritic cell of the monocyte-macrophage line that resembles cutaneous Langerhans cells. This report presents the case of a 42-year-old woman with PLCH. We discuss her clinical symptoms, diagnostic tests, and treatment plan, with a specific focus on the radiologic features. The patient exhibited a radiologic appearance similar to that of lymphangiomyomatosis with histologic evidence of PLCH.
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Affiliation(s)
- Priya Patel
- Sleep Medicine, Hackensack Meridian Health Ocean University Medical Center, Brick Township, USA
| | - Fnu Anamika
- Internal Medicine, Hackensack Meridian Health Ocean University Medical Center, Brick Township, USA
| | - Rana Ali
- Pulmonary and Sleep Medicine, Hackensack Meridian Health Ocean University Medical Center, Brick Township, USA
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7
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Kinoshita Y, Miyamura T, Kushima H, Ishii H. Basal Lung Cysts in Birt-Hogg-Dubé Syndrome. Intern Med 2022; 61:3755. [PMID: 35569993 PMCID: PMC9841111 DOI: 10.2169/internalmedicine.9656-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Yoshiaki Kinoshita
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan
| | - Takuto Miyamura
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan
| | - Hisako Kushima
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan
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8
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Muacevic A, Adler JR. Cystic Lung Changes in Down Syndrome: A Case Report. Cureus 2022; 14:e31867. [PMID: 36579267 PMCID: PMC9792304 DOI: 10.7759/cureus.31867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 11/25/2022] Open
Abstract
A wide spectrum of multi-organ complications have been associated with Down syndrome. Pulmonary complications are a leading cause of morbidity and mortality in Down syndrome. A four-year-old boy with Down syndrome presented to our emergency department with a cough and shortness of breath. He had signs of respiratory distress and decreased air entry in the right lung. A chest radiograph revealed airspace opacity and an air bronchogram in the right lung, both consistent with pneumonia. Oxygen saturation was not maintained on a non-rebreather mask, and the patient required admission to the intensive care unit, where he underwent intubation and mechanical ventilation. With the aggressive antibiotic therapy, the patient had improvements in terms of laboratory and radiographic findings. However, clinical symptoms persisted. Hence, a computed tomography (CT) scan was performed, which demonstrated findings of pulmonary edema and unexpected findings of subpleural cystic lung changes bilaterally with significant replacement of the right middle lobe with these cysts. Initially, these cysts caused significant confusion for the treating physicians and were misinterpreted as honeycombing changes related to end-stage lung disease. However, radiologists confirmed the incidental nature of these cysts in patients with Down syndrome. Appropriate recognition of this entity is crucial to avoid its misinterpretation, which may cause unnecessary laboratory and radiological investigations.
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9
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Degheili JA, Tanios B, Nasser M. Renal and Lung Cysts in Birt-Hogg-Dubé Syndrome: A Continuum of the Same Disorder. Cureus 2021; 13:e18878. [PMID: 34804727 PMCID: PMC8599113 DOI: 10.7759/cureus.18878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 11/06/2022] Open
Abstract
Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal-dominant disorder, affecting multiple organs, mostly the skin, lungs, and kidneys. The prevalence of BHD syndrome is difficult to define given the rarity of the disease. Patients present most often with primary spontaneous pneumothorax. Renal tumors are a characteristic finding in BHD, and are often bilateral and multifocal and of the chromophobe and oncocytoma variant. Very scarce reports have highlighted the presence of simple renal cysts, as the only phenotypical renal manifestation, in BHD patients. Herein, we highlight two novel cases of bilateral multiple renal and pelvic cysts, in two females with genetically proven BHD syndrome, doubting a potential association with BHD syndrome.
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Affiliation(s)
- Jad A Degheili
- Division of Pediatric Urology, Department of Surgery, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, CAN.,Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, LBN
| | - Bassem Tanios
- Division of Nephrology and Hypertension, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LBN
| | - Mouhamad Nasser
- Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, University Hospital of Lyon, Lyon, FRA
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10
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Munden RF, Black WC, Hartman TE, MacMahon H, Ko JP, Dyer DS, Naidich D, Rossi SE, McAdams HP, Goodman EM, Brown K, Kent M, Carter BW, Chiles C, Leung AN, Boiselle PM, Kazerooni EA, Berland LL, Pandharipande PV. Managing Incidental Findings on Thoracic CT: Lung Findings. A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol 2021; 18:1267-1279. [PMID: 34246574 DOI: 10.1016/j.jacr.2021.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 12/17/2022]
Abstract
The ACR Incidental Findings Committee presents recommendations for managing incidentally detected lung findings on thoracic CT. The Chest Subcommittee is composed of thoracic radiologists who endorsed and developed the provided guidance. These recommendations represent a combination of current published evidence and expert opinion and were finalized by informal iterative consensus. The recommendations address commonly encountered incidental findings in the lungs and are not intended to be a comprehensive review of all pulmonary incidental findings. The goal is to improve the quality of care by providing guidance on management of incidentally detected thoracic findings.
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Affiliation(s)
- Reginald F Munden
- Professor, Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, South Carolina; Chair, Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - William C Black
- Professor of Radiology, Emeritus, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - Heber MacMahon
- Professor of Radiology, Section of Thoracic Imaging, Department of Radiology, The University of Chicago, Chicago, Illinois
| | - Jane P Ko
- Professor of Radiology, Department of Radiology, NYU Langone Health, New York, New York; Fellowship Director, Cardiothoracic Imaging, Department of Radiology, NYU Langone Health, New York, New York
| | - Debra S Dyer
- Professor, Department of Radiology, National Jewish Health, Denver, Colorado; Chair, Department of Radiology, National Jewish Health, Denver, Colorado
| | - David Naidich
- Professor, Emeritus, NYU-Langone Health, New York, New York; Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Santiago E Rossi
- Chairman, Centro Rossi, Buenos Aires, Argentina; Chest Section Head, Hospital Cetrángolo, Buenos Aires, Argentina
| | - H Page McAdams
- Professor of Radiology, Duke University Health System, Durham, North Carolina
| | - Eric M Goodman
- Assistant Professor, Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York; Associate Program Director, Diagnostic Radiology, Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Kathleen Brown
- Professor, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California; Section Chief, Thoracic Imaging, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California; Assistant Dean, Equity and Diversity Inclusion, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Michael Kent
- Associate Professor of Surgery, Harvard Medical School, Boston, Massachusetts; Director, Minimally Invasive Thoracic Surgery, Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Brett W Carter
- Associate Professor, Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas; Director of Clinical Operations, University of Texas MD Anderson Cancer Center, Houston, Texas; Chief Patient Safety and Quality Officer, Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Caroline Chiles
- Professor, Department of Radiology, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Ann N Leung
- Professor, Clinical Affairs, Stanford University Medical Center, Stanford, California; Associate Chair, Clinical Affairs, Stanford University Medical Center, Stanford, California; Department of Radiology, Stanford University Medical Center, Stanford, California
| | - Phillip M Boiselle
- Professor, Quinnipiac's Frank H. Netter MD School of Medicine, North Haven, Connecticut; Dean, Quinnipiac's Frank H. Netter MD School of Medicine, William and Barbara Weldon Dean's Chair of Medicine, North Haven, Connecticut
| | - Ella A Kazerooni
- Professor of Radiology, Division of Cardiothoracic Radiology and Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Lincoln L Berland
- Professor Emeritus, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pari V Pandharipande
- Director, MGH Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts; Associate Chair, Integrated Imaging & Imaging Sciences, MGH Radiology, Massachusetts General Hospital, Boston, Massachusetts; Executive Director, Clinical Enterprise Integration, Mass General Brigham (MGB) Radiology, Massachusetts General Hospital, Boston, Massachusetts; Associate Professor of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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11
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Baldi BG, dos Santos Fernandes CJC, Heiden GI, Freitas CSG, Sobral JB, Kairalla RA, Carvalho CRR, Souza R. Association between pulmonary artery to aorta diameter ratio with pulmonary hypertension and outcomes in diffuse cystic lung diseases. Medicine (Baltimore) 2021; 100:e26483. [PMID: 34160461 PMCID: PMC8238321 DOI: 10.1097/md.0000000000026483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/28/2021] [Indexed: 01/04/2023] Open
Abstract
To investigate the importance of pulmonary vascular measurements on computed tomography (CT) in predicting pulmonary hypertension (PH) and worse outcomes in diffuse cystic lung diseases (DCLDs).We conducted a cross-sectional study of patients with DCLDs. Patients underwent pulmonary function tests, a six-minute walk test (6MWT), chest CT, transthoracic echocardiography, and right heart catheterization. Pulmonary artery (PA) diameter and PA-ascending aorta ratio (PA-Ao ratio) were obtained from CT. Mean pulmonary artery pressure (mPAP) from right heart catheterization was correlated with tomographic, functional, and echocardiographic variables. The association between the PA-Ao ratio with outcomes was determined by Kaplan-Meier curves.Thirty-four patients were included (18 with pulmonary Langerhans cell histiocytosis and 16 with lymphangioleiomyomatosis, mean age 46 ± 9 years). Forced expiratory volume in the first second and lung diffusing capacity for carbon monoxide were 47 ± 20% and 38 ± 21% predicted, respectively. PA diameter and PA-Ao ratio were 29 ± 6 mm and 0.95 ± 0.24, respectively. PA-Ao ratio > 1 occurred in 38.2% of patients. PA-Ao ratio was a good predictor of PH. mPAP correlated best with PA-Ao ratio, PA diameter, oxygen desaturation during six-minute walk test, and echocardiographic variables. Patients with PA-Ao ratio > 1 had greater mPAP, and a higher risk of death or lung transplantation (log-rank, P < .001) than those with PA-Ao ratio ≤ 1.The PA-Ao ratio measured on CT scan has a potential role as a non-invasive tool to predict the presence of PH and as a prognostic parameter in patients with DCLDs.
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Affiliation(s)
| | | | | | | | - Juliana Barbosa Sobral
- Laboratório de Ecocardiografia, Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Rogério Souza
- Divisão de Pneumologia, Instituto do Coração (InCor)
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12
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Thakare PH, Utpat K, Desai U, Joshi J, Nayak C. Birt-Hogg-Dubé syndrome - an unique case series. Adv Respir Med 2021; 89:55-59. [PMID: 33471358 DOI: 10.5603/arm.a2020.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 07/31/2020] [Accepted: 08/09/2020] [Indexed: 11/25/2022]
Abstract
Birt-Hogg-Dubé syndrome (BHDS) is an uncommon autosomal dominant syndrome. It is also known as Hornstein-Knickenberg syndrome. It is an inherited disorder culminating in mutations in folliculin coding gene (FLCN). The clinical exhibitions of the syn-drome are multi-systemic, comprising of a constellation of pulmonary, dermatologic and renal system manifestations. The most common presentations include fibrofolliculomas, renal cell carcinomas, lung cysts and spontaneous pneumothorax. The treatment is conservative with regular monitoring of the renal and lung parameters. Fibrofolliculomas may require surgical excision and recurrent events of pneumothorax may warrant pleurodesis. We reported a case series of 2 patients presenting with symptoms of progressive breathlessness along with dermatological manifestations and subsequently showing radiological manifestations of Birt-Hogg-Dubé syndrome in the form of lung cysts.
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Affiliation(s)
| | - Ketaki Utpat
- Department of Pulmonary Medicine, TN Medical College and BYL Nair Hospital, Mumbai, India
| | - Unnati Desai
- Department of Pulmonary Medicine, TN Medical College and BYL Nair Hospital, Mumbai, India
| | - Jyotsna Joshi
- Department of Pulmonary Medicine, TN Medical College and BYL Nair Hospital, Mumbai, India
| | - Chitra Nayak
- Department of Pulmonary Medicine, TN Medical College and BYL Nair Hospital, Mumbai, India
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13
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Gündoğdu E, Emekli E, Acer E, Özer İ. Birt-hogg-Dubé Syndrome Incidentally Identified in a Potential Liver Donor. Curr Med Imaging 2020; 17:807-810. [PMID: 33334292 DOI: 10.2174/1573405616666201217111929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 10/18/2020] [Accepted: 11/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Birt-Hogg-Dubé Syndrome (BHDS), an autosomal dominant hereditary condition, occurs due to mutations in the gene encoding folliculin (FLCN) in the short arm of the 17th chromosome characterized by lung cysts with specific skin findings and renal cell carcinoma. Patients have usually complaints related to dyspnea and chest pain due to pneumothorax but they may be asymptomatic due to wide phenotypic heterogeneity. Herein, we report the imaging findings of a case 32-year-old male with BHDS without any symptom who was diagnosed incidentally by computed tomography (CT) due to organ donation. CASE REPORT In a 32-year-old male patient evaluated as a potential liver donor, CT was performed for preoperative preparation. The patient's medical history was unremarkable. In the CT examination, multiple air cysts of different sizes in both lungs were observed and also, a 7-cm solid renal mass of the right kidney was observed in the dynamic examination. Due to a large number of lung cysts and the presence of solid renal tumors at a young age, BHDS was considered. The patient underwent partial nephrectomy, and the pathology result was hybrid oncocytic-chromophobe renal cell carcinoma. In the genetic examination, a heterozygous germline mutation was detected in the 11th exon of the FLCN gene. CONCLUSION While potential organ donors are generally healthy and asymptomatic individuals, incidental lesions can be detected in the donor organ or other organs in the examination area during radiological imaging. Although most incidental lesions are benign, important clinical conditions can rarely be observed, as in our case. Familial and syndromic conditions should also be considered for the presence of solid renal masses incidentally detected at a young age. To the best of our knowledge, this is the first reported case of BHDS in English literature who was diagnosed incidentally on computed tomography for being a living liver donor.
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Affiliation(s)
- Elif Gündoğdu
- Department of Radiology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
| | - Emre Emekli
- Department of Radiology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
| | - Ersoy Acer
- Department of Dermatology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
| | - İlter Özer
- Department of General Surgery, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
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Fuller S, Del Rivero J, Venzon D, Ilanchezhian M, Allen D, Folio L, Ling A, Widemann B, Fontana JR, Glod J. Pulmonary Function in Patients With Multiple Endocrine Neoplasia 2B. J Clin Endocrinol Metab 2020; 105:5843672. [PMID: 32448901 PMCID: PMC7365699 DOI: 10.1210/clinem/dgaa296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/19/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Multiple endocrine neoplasia type 2B (MEN2B) is a rare cancer predisposition syndrome resulting from an autosomal-dominant germline mutation of the RET proto-oncogene. No prior studies have investigated pulmonary function in patients with MEN2B. OBJECTIVE This study characterized the pulmonary function of patients with MEN2B. DESIGN This is a retrospective analysis of pulmonary function tests (PFTs) and chest imaging of patients enrolled in the Natural History Study of Children and Adults with MEN2A or MEN2B at the National Institutes of Health. RESULTS Thirty-six patients with MEN2B (18 males, 18 females) were selected based on the availability of PFTs; 27 patients underwent at least 2 PFTs and imaging studies. Diffusion abnormalities were observed in 94% (33/35) of the patients, with 63% (22/35) having moderate to severe defects. A declining trend in diffusion capacity was seen over time, with an estimated slope of -2.9% per year (P = 0.0001). Restrictive and obstructive abnormalities were observed in 57% (20/35) and 39% (14/36), respectively. Computed tomography imaging revealed pulmonary thin-walled cavities (lung cysts) in 28% (9/32) of patients and metastatic lung disease in 34% (11/32) of patients; patients with metastatic lung lesions also tended to have thin-walled cavities (P = 0.035). CONCLUSIONS This study characterized pulmonary function within a MEN2B cohort. Diffusion, restrictive, and obstructive abnormalities were evident, and lung cysts were present in 28% of patients. Further research is required to determine the mechanism of the atypical pulmonary features observed in this cohort.
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Affiliation(s)
- Sarah Fuller
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jaydira Del Rivero
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
- Correspondence and Reprint Requests: Jaydira Del Rivero, MD, Developmental Therapeutics Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, MSC 1906 Building 10, CRC 13C-434, Bethesda, MD 20892. E-mail:
| | - David Venzon
- Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Maran Ilanchezhian
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Deborah Allen
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Les Folio
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Alexander Ling
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Brigitte Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Joseph R Fontana
- Pulmonary Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - John Glod
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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15
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Taveira-DaSilva AM, Markello TC, Kleiner DE, Jones AM, Groden C, Macnamara E, Yokoyama T, Gahl WA, Gochuico BR, Moss J. Expanding the phenotype of COPA syndrome: a kindred with typical and atypical features. J Med Genet 2018; 56:778-782. [PMID: 30385646 PMCID: PMC6860403 DOI: 10.1136/jmedgenet-2018-105560] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/14/2018] [Accepted: 09/30/2018] [Indexed: 11/19/2022]
Abstract
Background Copa syndrome is a rare autosomal dominant disorder with abnormal intracellular vesicle trafficking. The objective of this work is to expand the knowledge about this disorder by delineating phenotypic features of an unreported COPA family. Methods and results A heterozygous missense variant (c.698 G>A, p.Arg233His) in COPA was identified in four members of a three-generation kindred with lung, autoimmune and malignant disease of unknown aetiology. Ages of onset were 56, 26, 16 and 1 year, with earlier age of onset in successive generations. Presenting symptoms were cough and dyspnoea. Findings included small lung cysts, follicular bronchiolitis, interstitial lung disease, neuroendocrine cell hyperplasia, rheumatoid arthritis, avascular necrosis and select abnormal autoimmune serologies. Neither alveolar haemorrhage nor glomerular disease were present. Features not previously associated with Copa syndrome included neuromyelitis optica, pulmonary carcinoid tumour, clear cell renal carcinoma, renal cysts, hepatic cysts, nephrolithiasis, pyelonephritis and meningitis. Longitudinal evaluations demonstrated slow progression of lung disease and extrapulmonary cysts. Conclusions Worsening severity with successive generations may be observed in Copa syndrome. Extrapulmonary cysts, malignancies, autoimmune neurological disorders and infections are clinical features that may be associated with Copa syndrome. Further studies are indicated to fully define the phenotypic spectrum of this disorder.
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Affiliation(s)
- Angelo M Taveira-DaSilva
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - David E Kleiner
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Amanda M Jones
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - Tadafumi Yokoyama
- Medical Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - William A Gahl
- NIH Undiagnosed Diseases Program, Bethesda, Maryland, USA.,Medical Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Bernadette R Gochuico
- Medical Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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16
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Raoof S, Bondalapati P, Vydyula R, Ryu JH, Gupta N, Raoof S, Galvin J, Rosen MJ, Lynch D, Travis W, Mehta S, Lazzaro R, Naidich D. Cystic Lung Diseases: Algorithmic Approach. Chest 2016; 150:945-965. [PMID: 27180915 DOI: 10.1016/j.chest.2016.04.026] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 02/16/2016] [Accepted: 04/06/2016] [Indexed: 12/14/2022] Open
Abstract
Cysts are commonly seen on CT scans of the lungs, and diagnosis can be challenging. Clinical and radiographic features combined with a multidisciplinary approach may help differentiate among various disease entities, allowing correct diagnosis. It is important to distinguish cysts from cavities because they each have distinct etiologies and associated clinical disorders. Conditions such as emphysema, and cystic bronchiectasis may also mimic cystic disease. A simplified classification of cysts is proposed. Cysts can occur in greater profusion in the subpleural areas, when they typically represent paraseptal emphysema, bullae, or honeycombing. Cysts that are present in the lung parenchyma but away from subpleural areas may be present without any other abnormalities on high-resolution CT scans. These are further categorized into solitary or multifocal/diffuse cysts. Solitary cysts may be incidentally discovered and may be an age related phenomenon or may be a remnant of prior trauma or infection. Multifocal/diffuse cysts can occur with lymphoid interstitial pneumonia, Birt-Hogg-Dubé syndrome, tracheobronchial papillomatosis, or primary and metastatic cancers. Multifocal/diffuse cysts may be associated with nodules (lymphoid interstitial pneumonia, light-chain deposition disease, amyloidosis, and Langerhans cell histiocytosis) or with ground-glass opacities (Pneumocystis jirovecii pneumonia and desquamative interstitial pneumonia). Using the results of the high-resolution CT scans as a starting point, and incorporating the patient's clinical history, physical examination, and laboratory findings, is likely to narrow the differential diagnosis of cystic lesions considerably.
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Affiliation(s)
| | | | | | | | - Nishant Gupta
- Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati
| | | | - Jeff Galvin
- Department of Radiology, University of Maryland
| | - Mark J Rosen
- Pulmonary, Critical Care and Sleep Medicine, North Shore University Hospital
| | - David Lynch
- Department of Radiology, National Jewish Health
| | - William Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center
| | | | - Richard Lazzaro
- Department of Thoracic Surgery, Lenox Hill Hospital, Northwell Health
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17
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Zhang M, Tie HT, Wang CL, Wu QC. Pulmonary interstitial cholesterol crystals associated with diffuse lung cysts in adult: a case report and literature review. J Cardiothorac Surg 2016; 11:11. [PMID: 26781770 PMCID: PMC4717644 DOI: 10.1186/s13019-016-0397-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 01/10/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cholesterol pneumonitis or endogenous lipoid pneumonia (ELP) result from the accumulation of endogenous cholesterol esters in the lungs, leading to a fibroblastic interstitial inflammatory process, and may be complicated by a secondary bacterial or fungal infection. Striking features were cholesterol clefts in the alveolar and interstitial spaces and alveolar wall-thickening with lymphocytic infiltrations, which was called pulmonary interstitial and intra-alveolar cholesterol granulomas (PICG). CASE PRESENTATION We report a case of pneumothorax with diffuse lung cysts and pulmonary interstitial cholesterol in a 26-year-old woman. Our case is unique because development of PICG or ELP has been observed in children, but rarely in adult. Most cases could be linked to exogenous sources like inhalation of lipid material or gastroesophageal reflex (GER). In our case, no signs of GER could be discovered. Diffuse lung cysts coexisting with pulmonary interstitial cholesterol crystals are never reported. Additionally, no multinucleated giant cells or granuloma are found pathologically, which make the diagnosis of PICG or lipoid pneumonia difficult. CONCLUSIONS Pulmonary interstitial cholesterol crystals may develop gradually and evenly distributed throughout the entire lung and resulted in severe distortion of the native structure of the lung.
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Affiliation(s)
- Min Zhang
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Hong-Tao Tie
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Cheng-Long Wang
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Qing-Chen Wu
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Abstract
The diffuse cystic lung diseases (DCLDs) are a group of pathophysiologically heterogenous processes that are characterized by the presence of multiple spherical or irregularly shaped, thin-walled, air-filled spaces within the pulmonary parenchyma. Although the mechanisms of cyst formation remain incompletely defined for all DCLDs, in most cases lung remodeling associated with inflammatory or infiltrative processes results in displacement, destruction, or replacement of alveolar septa, distal airways, and small vessels within the secondary lobules of the lung. The DCLDs can be broadly classified according to underlying etiology as those caused by low-grade or high-grade metastasizing neoplasms, polyclonal or monoclonal lymphoproliferative disorders, infections, interstitial lung diseases, smoking, and congenital or developmental defects. In the first of a two-part series, we present an overview of the cystic lung diseases caused by neoplasms, infections, smoking-related diseases, and interstitial lung diseases, with a focus on lymphangioleiomyomatosis and pulmonary Langerhans cell histiocytosis.
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Affiliation(s)
- Nishant Gupta
- 1 Division of Pulmonary, Critical Care, and Sleep Medicine and.,2 Veterans Affairs Medical Center, Department of Veterans Affairs, Cincinnati, Ohio
| | - Robert Vassallo
- 3 Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota; and
| | - Kathryn A Wikenheiser-Brokamp
- 4 Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, Ohio.,5 Division of Pathology and Laboratory Medicine and.,6 Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Francis X McCormack
- 1 Division of Pulmonary, Critical Care, and Sleep Medicine and.,2 Veterans Affairs Medical Center, Department of Veterans Affairs, Cincinnati, Ohio
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19
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Chen W, Lin Y, Yu Y, Wei P, Dai H. Recurrent bilateral spontaneous pneumothorax secondary to lung adenocarcinoma with epidermal growth factor receptor mutation. Thorac Cancer 2015; 7:257-60. [PMID: 27042232 PMCID: PMC4773303 DOI: 10.1111/1759-7714.12292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/08/2015] [Indexed: 12/17/2022] Open
Abstract
A 42‐year‐old female patient was admitted for recurrent bilateral spontaneous pneumothorax. High resolution computed tomography showed bilateral pneumothorax and numerous round and oval, thin‐walled lung cysts. Microscopically, each small cyst was composed of distended subpleural alveolar spaces. Tumor cells, characteristic of acinar adenocarcinoma, obstructed and narrowed the terminal bronchioles. There was no tumor necrosis or mucin production. This suggested check‐valve as a possible mechanism of the thin‐walled cysts and pneumothorax. Genetic analysis suggested that the tumors were positive for epidermal growth factor receptor mutation L858R in exon 21. Bilateral spontaneous pneumothorax and thin‐walled cysts in association with lung cancer is rarely reported and may be confused with cystic benign lung lesions.
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Affiliation(s)
- Wenhui Chen
- Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China
| | - Yingxiang Lin
- Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China
| | - Yanxia Yu
- Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China
| | - Ping Wei
- Department of Pathology Beijing Chao-Yang Hospital Capital Medical University Beijing China
| | - Huaping Dai
- Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China
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20
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Schultz KAP, Harris A, Williams GM, Baldinger S, Doros L, Valusek P, Frazier AL, Dehner LP, Messinger Y, Hill DA. Judicious DICER1 testing and surveillance imaging facilitates early diagnosis and cure of pleuropulmonary blastoma. Pediatr Blood Cancer 2014; 61:1695-7. [PMID: 24821309 PMCID: PMC4139105 DOI: 10.1002/pbc.25092] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 04/16/2014] [Indexed: 12/15/2022]
Abstract
Pleuropulmonary blastoma (PPB) and Sertoli-Leydig cell tumor (SLCT) are both associated with germline mutations in DICER1. In this brief report, a maternal history of SLCT led to identification of a deleterious DICER1 mutation in the patient and her asymptomatic infant. Radiographic screening revealed a large Type I PPB, which was completely resected. Identification of DICER1 mutation carriers and imaging of children at risk for PPB may allow detection of PPB in its earliest and most curable form, leading to increased likelihood of surgical cure and decreased risks of treatment-related late effects.
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Affiliation(s)
- Kris Ann P Schultz
- International Ovarian and Testicular Stromal Tumor Registry, Children's Hospital and Clinics of Minnesota, Minneapolis, Minnesota; International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota; Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
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21
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Abbey P, Narula MK, Anand R, Chandra J. Persistent pulmonary interstitial emphysema in a case of Langerhans cell histiocytosis. Indian J Radiol Imaging 2014; 24:121-4. [PMID: 25024518 PMCID: PMC4094960 DOI: 10.4103/0971-3026.134386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 10-month-old boy with multisystem Langerhans cell histiocytosis showing thin-walled lung cysts along with computed tomography (CT) evidence of persistent pulmonary interstitial emphysema (PPIE), in the absence of pneumothorax or pneumomediastinum. Follow-up CT performed after 6 months demonstrated complete resolution of interstitial emphysema.
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Affiliation(s)
- Pooja Abbey
- Department of Radio-Diagnosis, Medical College and Associated Hospitals, New Delhi, India
| | - Mahender K Narula
- Department of Radio-Diagnosis, Medical College and Associated Hospitals, New Delhi, India
| | - Rama Anand
- Department of Radio-Diagnosis, Medical College and Associated Hospitals, New Delhi, India
| | - Jagdish Chandra
- Department of Pediatrics, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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