The Aim of the study was to reveal if PET-CT analysis of primary and of secondary lung cancer could be related to the onset of lipid peroxidation in cancer and in surrounding non-malignant lung tissue.MethodsNineteen patients with primary lung cancer and seventeen patients with pulmonary metastasis were involved in the study. Their lungs were analyzed by PET-CT scanning before radical surgical removal of the cancer. Specific immunohistochemistry for the major bioactive marker of lipid peroxidation, 4-hydroxynonenal (HNE), was done for the malignant and surrounding non-malignant lung tissue using genuine monoclonal antibody specific for the HNE-histidine adducts.ResultsBoth the intensity of the PET-CT analysis and the HNE-immunohistochemistry were in correlation with the size of the tumors analyzed, while primary lung carcinomas were larger than the metastatic tumors. The intensity of the HNE-immunohistochemistry in the surrounding lung tissue was more pronounced in the metastatic than in the primary tumors, but it was negatively correlated with the cancer volume determined by PET-CT. The appearance of HNE was more pronounced in non-malignant surrounding tissue than in cancer or stromal cells, both in case of primary and metastatic tumors.ConclusionsBoth PET-CT and HNE-immunohistochemistry reflect the size of the malignant tissue. However, lipid peroxidation of non-malignant lung tissue in the vicinity of cancer is more pronounced in metastatic than in primary malignancies and might represent the mechanism of defense against cancer, as was recently revealed also in case of human liver cancer.

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Patient: Male, 28-year-old Final Diagnosis: Giant cell bone tumor • osteoclastoma Symptoms: Wrist swelling and pain Medication: — Clinical Procedure: Radiology imaging • orthopaedic surgery Specialty: Orthopedics and Traumatology • Radiology Objective: Rare disease Background: Giant cell tumor is a rare tumor of mesenchymal origin. According to World Health Organization classification, it is considered a benign tumor with locally aggressive characteristics and the capacity to metastasize. The tumor typically occurs in the epiphyseal regions, most often of long bones after the completion of bone growth. The disease is characterized by severe pain and swelling of the affected area. Tumor growth is expansive but relatively slow. The tumor rarely metastasizes, but when it does, the lungs are primarily affected. Case Report: A 28-year-old man, otherwise healthy, presented with pain in the right wrist joint, limited range of motion, and spindle-shaped thickening/swelling in the same area, which he had noticed several months earlier. After a comprehensive diagnostic evaluation (wrist X-ray, computed tomography, magnetic resonance imaging, ultrasound-guided biopsy, and histopathological analysis), he was diagnosed with giant cell tumor of the right ulna. The tumor was surgically removed with good recovery, and the patient continued to be seen thereafter in regular followup. Conclusions: The wide range of benign and malignant differential diagnostic entities requires a detailed diagnostic approach and comprehensive assessment, using different radiological modalities, as was done in this case. The final diagnosis was confirmed by histopathological analysis of core biopsy material.

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Synchronous occurrence of multiple lung cancers in the same lobe of the lung is very rare. Most of the tumors diagnosed in this way have the same histologic type. With imaging methods it is difficult to determine if the multiple lung lesions present hematogenous spread of lung cancer (or cancer from other origin) or these lesions present the second primary lung cancer. We report a rare and unusual case of synchronous occurrence of primary adenocarcinoma and squamous cell carcinoma in the same lobe of the lung. Our case demonstrates that in case of synchronous occurrence of multiple lung lesions each lesion should be sampled and histologic type of every lesion should be determined so the further treatment can be planned accordingly.