Bronchioloalveolar carcinoma arising in a bronchogenic cyst

Endo, Chiaki; Imai, Tadashi; Nakagawa, Hideyuki; Ebina, Atsuko; Kaimori, Mitsuomi

doi:10.1016/s0003-4975(99)01402-2

Cited by 82 publications

(47 citation statements)

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“…However, in the past decades, some studies have shown that asymptomatic patients can develop symptoms during the observation period, and some complications will occur, such as superior vena cava obstruction, infection, pneumothorax, pleural effusion, and arrhythmia even before the onset of symptoms (6,17,20). The potential for malignant changes has been reported in patients with BC (2,(21)(22)(23). In recent years, more and more patients with BC are being diagnosed antenatally with the advent of antenatal diagnosis, which has provided the possibility of studying the natural history of BC (17,(24)(25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Video-assisted thoracic surgery compared with posterolateral thoracotomy for mediastinal bronchogenic cysts in adult patients

Guo

Mei

Liu³

et al. 2016

J. Thorac. Dis.

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The patient demographic characteristics, intraoperative findings, postoperative outcomes and follow-up information were reviewed and analyzed. Results: A total of 99 patients underwent cystectomy were enrolled for the present study. Of those patients, 65 underwent VATS cystectomy (VATS group) and 34 underwent PLT cystectomy (PLT group) during the same period. The VATS group had shorter operative time than the PLT group (108.77±47.81 vs. 144.62±55.16, P=0.001), less intraoperative blood loss (median 20 vs. 100 mL, P<0.001), and less pleural drainage of the first three days after surgery (median 240 vs. 400 mL, P=0.002). In addition, the length of postoperative hospital stay and duration of chest drainage for the VATS group was also shorter than those of the PLT group (4.94±2.01 vs. 8.64±5.52 days, P=0.001; 2.52±1.29 vs. 3.71±1.55 days, P<0.001, respectively). No statistical significance was revealed among the two groups with regard to the maximum diameter of the cysts, pleural atresia, incomplete resection, surgery-related complications, duration of intensive care unit stay, and postoperative complications. Conclusions: Both VATS and PLT are reliable approaches for the surgical resection of MBCs. The VATS approach is superior to PLT with shorter operative time, shorter duration of chest drainage, shorter postoperative hospital stay, less intraoperative blood loss, and less pleural drainage of the first three days after surgery. We conclude that VATS should be the preferred approach for the treatment of MBCs. represent 18% of all primary mediastinal malformations, the exact incidence of Mediastinal bronchogenic cysts (MBCs) is unknown because most patients are asymptomatic (1,4,5). However, more and more patients were detected because of the advanced diagnostic equipment and the increasing application of routine medical examinations in recent years.For adult patients with MBC, surgical resection is generally performed through posterolateral thoracotomy (PLT). With the recent advances in endoscopic instruments and operative techniques, video-assisted thoracic surgery (VATS) resection of MBC has been used with increasing frequency since it was first performed by Mouroux and associates in 1991 (6); it may become a potentially new surgical choice for the treatment of MBCs. However, limited studies have been published to compare the results of VATS versus PLT in adult patients with MBC, thus, uncertainty remains as to whether VATS can be an alternative to PLT for the treatment of MBCs. Thus, we retrospectively reviewed the data of patients with MBCs to reveal whether VATS was superior to PLT or not when concerning the effectiveness and safety in treating MBCs. Methods Data collectionPatients with MBCs who underwent surgical resection between August 2005 and December 2015 were identified from the electronic database of the Department of Thoracic Surgery, West China Hospital, Sichuan University. The clinical history of these patients was reviewed including the following items: patient demographic characteristics [age,...

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Section: Discussionmentioning

confidence: 99%

Video-assisted thoracic surgery compared with posterolateral thoracotomy for mediastinal bronchogenic cysts in adult patients

Guo

Mei

Liu³

et al. 2016

J. Thorac. Dis.

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“…The overwhelming majority of BACs are not associated with congenital lung cysts; the average age at diagnosis of all BACs is 68 years. 72 Twenty-one cases of BAC have been reported in patients with CPAM type 1; 24,50,[73][74][75][76][77][78][79][80][81][82][83][84] in this group the median diagnosis age is 18 years (range 6 months to 75 years) ( Table 2). In most of these cases, the BAC was an incidental finding in a cyst resected for other reasons.…”

Section: Bronchioloalveolar Carcinoma (Bac)mentioning

confidence: 99%

Pulmonary cysts in early childhood and the risk of malignancy

Priest

Williams

Hill

et al. 2008

Pediatric Pulmonology

262

215

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Summary. Surgery for congenital and early childhood lung cysts is often dictated by symptoms such as respiratory distress, infection or pneumothorax. Asymptomatic cysts present a therapeutic dilemma: surgical intervention and ''conservative'' observation have advocates. The risk of malignancy in such cysts is considered by some an indication for surgical intervention and is reviewed in this paper. Pleuropulmonary blastoma (PPB) is the most frequent malignancy associated with childhood lung cysts. Although rare, PPB occurs predictably in certain clinical and familial situations. This unique biology of PPB can inform the cyst management decision. The earliest manifestation of PPB is a malignant lung cyst in young children, clinically and radiographically indistinguishable from benign congenital lung cysts. Histopathologic examination differentiates cystic PPB from the benign cystic variants. Surgical excision of cystic PPB (with or without chemotherapy) cures approximately 85-90% of children. If not excised, cystic PPB evolves to cystic/solid or solid high-grade sarcoma (cure rate 45-60%) by age 2-6 years. Numerous reports of ''malignancy in a congenital lung cyst'' are now understood as the characteristic progression of cystic PPB. PPB is genetically determined in many cases. Detailed family history may reveal the hallmarks of PPB in the patient or young relatives: a unique constellation of diseases including lung cysts, cystic nephroma, childhood cancers, stromal sex-chord ovarian tumors, seminomas or dysgerminomas, intestinal polyps, thyroid hyperplasias, and hamartomas. Pneumothorax and multifocal/bilateral lung cysts also characterize PPB. These diagnoses predict that a lung cyst is more likely PPB than a benign congenital cyst. Patients fitting this pattern deserve histologic diagnosis. The genetic basis for this heritable syndrome is unknown but is being actively investigated.

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“…In about 35% of CCAM1 cases, tufts of mucogenic cells are noted along the surface of large cysts or within the smaller bronchiolar-like structures adjacent to the larger cysts. These cell clusters resemble the mucogenic cells of gastrointestinal epithelium and have been implicated in the occurrence of bronchioloalveolar carcinoma described both in older patients with CCAM1 and in others who have had a CCAM1 removed in infancy [18][19][20][21] . Rhabdomyosarcoma and pleuropulmonary blastoma are yet other major malignancies known to be associated with CCAM [22][23][24] .…”

Section: Discussionmentioning

confidence: 94%

Overexpression of HOXB5, Cyclin D1 and PCNA in Congenital Cystic Adenomatoid Malformation

Wang

Wolgemuth²,

Baxi³

2011

Fetal Diagn Ther

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Objective: We investigated the patterns of expression of HOXB5, cyclin D1 and proliferating cell nuclear antigen (PCNA) proteins in human congenital cystic adenomatoid malformation (CCAM) to establish the molecular basis of its etiology. Methods: Immunohistochemistry was performed on frozen archival specimens of CCAM and normal lung tissue as controls using antibodies against HOXB5, cyclin D1 and PCNA proteins. Results: Immunohistochemistry revealed a higher level of expression of HOXB5, cyclin D1 and PCNA predominantly in mesenchymal cells of the CCAM tissues as compared to normal adjacent control lung tissues. Conclusion: Elevated levels of immunohistochemical detection of HOXB5, cyclin D1 and PCNA were characteristic properties of lung tissue cells in CCAM. This elevated HOXB5 expression may correlate with the aberrant cellular differentiation observed in the CCAM disorder. Elevated expression of cyclin D1 and PCNA further suggests that increased cellular proliferation contributes to the overgrowth of lung tissue in CCAM.

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Bronchioloalveolar carcinoma arising in a bronchogenic cyst

Cited by 82 publications

References 4 publications

Video-assisted thoracic surgery compared with posterolateral thoracotomy for mediastinal bronchogenic cysts in adult patients

Video-assisted thoracic surgery compared with posterolateral thoracotomy for mediastinal bronchogenic cysts in adult patients

Pulmonary cysts in early childhood and the risk of malignancy

Overexpression of HOXB5, Cyclin D1 and PCNA in Congenital Cystic Adenomatoid Malformation

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