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Singh P, Verma A, Somani K, Poduval S, Verma OP. Primary Mucoepidermoid Carcinoma of the Lung Coexisting With Pulmonary Tuberculosis: A Rare Case Report. Cureus 2023; 15:e44978. [PMID: 37822440 PMCID: PMC10563825 DOI: 10.7759/cureus.44978] [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: 09/10/2023] [Indexed: 10/13/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is a well-established neoplasm of the salivary glands. However, the MEC of the lung is an exceedingly rare neoplasm that falls under the category of salivary gland-type tumors of the lung. Pulmonary MEC is recognized for its indolent progression. Pulmonary tuberculosis (TB) is a prevalent infectious disease in India and ranks among the leading causes of death from infectious diseases. Nevertheless, the co-occurrence of pulmonary MEC with pulmonary TB is a rare phenomenon that has not been documented in the literature. In this report, we describe a 54-year-old male patient who presented with symptoms of dysphagia, weight loss, and fever. Histopathological examination diagnosed him with pulmonary MEC, and concurrent cytology and Gene-Xpert tests confirmed tuberculosis. This case represents the first documented instance of this particular co-occurrence. It underscores the limitations of radiology in diagnosing such a rare neoplasm, especially when there is an absence of lung parenchyma infiltration and a mass lesion. Additionally, this case supports the possibility of an interdependent relationship between malignancies and tuberculosis.
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Affiliation(s)
- Pretty Singh
- Department of Pathology and Laboratory Medicine, Apollomedics Super Speciality Hospital, Lucknow, IND
| | - Abhishek Verma
- Department of Pulmonary Medicine, Apollomedics Super Speciality Hospital, Lucknow, IND
| | - Kavita Somani
- Department of Pathology and Laboratory Medicine, Apollomedics Super Speciality Hospital, Lucknow, IND
| | - Sujatha Poduval
- Department of Pathology and Laboratory Medicine, Apollomedics Super Speciality Hospital, Lucknow, IND
| | - Om Prakash Verma
- Department of Pulmonary Medicine, Apollomedics Super Speciality Hospital, Lucknow, IND
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Scrivani PV, Percival A. Anatomic study of the canine bronchial tree using silicone casts, radiography, and CT. Vet Radiol Ultrasound 2023; 64:36-41. [PMID: 35917231 DOI: 10.1111/vru.13141] [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: 02/04/2022] [Revised: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 01/25/2023] Open
Abstract
This prospective anatomic study examined the canine lower airway lumen morphology by visual inspection, radiography, and CT of silicone casts of two dogs. Study results showed the lobar, bronchopulmonary segmental, and pulmonary lobular organization of the lungs grossly reflected in the hierarchically clustered branching structure of the bronchial tree. Study results also provided a basis for differentiating bronchial and bronchiolar patterns. Whereas images of silicone-filled bronchial lumens produced large-diameter, branching, tapering bands that radiated from the lung hilus, the pattern was different for small airways. Images of silicone-filled bronchiole lumens produced small-diameter, branching, tapering, nonradiating lines that created a speckled pattern resembling micronodules and, unexpectedly during radiography, small-diameter rings with air-filled lumens attributed to positive and negative summation shadows. Consequently, imaging patterns in dogs might be affected by pulmonary lobular morphology and might differentiate large and small airway diseases.
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Affiliation(s)
- Peter V Scrivani
- Department of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Aaron Percival
- Department of Clinical Sciences, Cornell University, Ithaca, New York, USA
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Wells G, Glasgow JN, Nargan K, Lumamba K, Madansein R, Maharaj K, Hunter RL, Naidoo T, Coetzer L, le Roux S, du Plessis A, Steyn AJC. Micro-Computed Tomography Analysis of the Human Tuberculous Lung Reveals Remarkable Heterogeneity in Three-dimensional Granuloma Morphology. Am J Respir Crit Care Med 2021; 204:583-595. [PMID: 34015247 PMCID: PMC8491258 DOI: 10.1164/rccm.202101-0032oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 01/06/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
Rationale: Our current understanding of tuberculosis (TB) pathophysiology is limited by a reliance on animal models, the paucity of human TB lung tissue, and traditional histopathological analysis, a destructive two-dimensional approach that provides limited spatial insight. Determining the three-dimensional (3D) structure of the necrotic granuloma, a characteristic feature of TB, will more accurately inform preventive TB strategies.Objectives: To ascertain the 3D shape of the human tuberculous granuloma and its spatial relationship with airways and vasculature within large lung tissues.Methods: We characterized the 3D microanatomical environment of human tuberculous lungs by using micro computed tomography, histopathology, and immunohistochemistry. By using 3D segmentation software, we accurately reconstructed TB granulomas, vasculature, and airways in three dimensions and confirmed our findings by using histopathology and immunohistochemistry.Measurements and Main Results: We observed marked heterogeneity in the morphology, volume, and number of TB granulomas in human lung sections. Unlike depictions of granulomas as simple spherical structures, human necrotic granulomas exhibit complex, cylindrical, branched morphologies that are connected to the airways and shaped by the bronchi. The use of 3D imaging of human TB lung sections provides unanticipated insight into the spatial organization of TB granulomas in relation to the airways and vasculature.Conclusions: Our findings highlight the likelihood that a single, structurally complex lesion could be mistakenly viewed as multiple independent lesions when evaluated in two dimensions. In addition, the lack of vascularization within obstructed bronchi establishes a paradigm for antimycobacterial drug tolerance. Lastly, our results suggest that bronchogenic spread of Mycobacterium tuberculosis reseeds the lung.
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Affiliation(s)
- Gordon Wells
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | | | - Kievershen Nargan
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Kapongo Lumamba
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Rajhmun Madansein
- Department of Cardiothoracic Surgery, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Kameel Maharaj
- Department of Cardiothoracic Surgery, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Robert L. Hunter
- Department of Pathology and Laboratory Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas
| | - Threnesan Naidoo
- Department of Anatomical Pathology, National Health Laboratory Service, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; and
| | - Llelani Coetzer
- Computed Tomography Scanner Facility, Central Analytical Facilities, Stellenbosch University, Stellenbosch, South Africa
| | - Stephan le Roux
- Computed Tomography Scanner Facility, Central Analytical Facilities, Stellenbosch University, Stellenbosch, South Africa
| | - Anton du Plessis
- Computed Tomography Scanner Facility, Central Analytical Facilities, Stellenbosch University, Stellenbosch, South Africa
| | - Adrie J. C. Steyn
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Department of Microbiology and
- Centers for AIDS Research and Free Radical Biology, University of Alabama at Birmingham, Birmingham, Alabama
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Shiroyama T, Nasu S, Tanaka A, Hirashima T. Tree-in-bud Pattern in ALK-positive Lung Adenocarcinoma. Intern Med 2020; 59:1461. [PMID: 32161218 PMCID: PMC7332627 DOI: 10.2169/internalmedicine.4076-19] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Takayuki Shiroyama
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Japan
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
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Kumaran SP, Abdul Aziz Z, Viswamitra S, Narayanam SK, Ghosal N. Tree-in-bud Appearance in the Brain: Fungal Granuloma on Contrast Magnetic Resonance Imaging. Asian J Neurosurg 2017; 12:741-742. [PMID: 29114299 PMCID: PMC5652111 DOI: 10.4103/ajns.ajns_89_14] [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: 11/07/2022] Open
Abstract
We describe a case of dural-based homogenously enhancing fungal granuloma in a 29-year-old male who presented with 3 months history of headache. The peculiarity of the case was that there were streaky areas of enhancement around the lesion in the brain parenchyma which resembled tree-in-bud like appearance. The patient underwent surgery and histopathological analysis revealed numerous Aspergillus hyphae. To the best of our knowledge, this is the first case report of a fungal granuloma with atypical parenchymal enhancement pattern.
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Affiliation(s)
- Sunitha P Kumaran
- Department of Radiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Zarina Abdul Aziz
- Department of Radiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Sanjaya Viswamitra
- Department of Radiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Sai Kiran Narayanam
- Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Nandita Ghosal
- Department of Pathology, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
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