The Role of Pulmonary Veins in Cancer Progression from a Computed Tomography Viewpoint

Abstract

Background. We studied the role of pulmonary veins in cancer progression using computed tomography (CT) scans. Methods. We obtained data from 260 patients with pulmonary vein obstruction syndrome (PVOS). We used CT scans to investigate pulmonary lesions in relation to pulmonary veins. We divided the lesions into central and peripheral lesions by their anatomical location: in the lung parenchymal tissue or pulmonary vein; in the superior or inferior pulmonary vein; and by unilateral or bilateral presence in the lungs. Results. Of the 260 PVOS patients, 226 (87%) had central lesions, 231 (89%) had peripheral lesions, and 190 (75%) had mixed central and peripheral lesions. Among the 226 central lesions, 93% had lesions within the superior pulmonary vein, either bilaterally or unilaterally. Among the 231 peripheral lesions, 65% involved bilateral lungs, 70% involved lesions within the inferior pulmonary veins, and 23% had obvious metastatic extensions into the left atrium. All patients exhibited nodules within their pulmonary veins. The predeath status included respiratory failure (40%) and loss of consciousness (60%). Conclusion. CT scans play an important role in following tumor progression within pulmonary veins. Besides respiratory distress, PVOS cancer cells entering centrally can result in cardiac and cerebral events and loss of consciousness or can metastasize peripherally from the pulmonary veins to the lungs.

Bladder Urothelial Carcinoma with Peritoneal Involvement: Benefit of Continuous Maintenance Chemotherapy

“…Evidence suggests that critical elements of the tumor microenvironment are immune and inflammatory cells, blood and lymphatic vascular networks, fibroblasts, and the extracellular matrix (33). Cytokine production and alteration of hemostasis in cancer can promote tumor progression (16). Cancer cachexia, thromboembolic complications, and neoplastic fever are all linked to cytokine production by inflammatory cells (34)(35)(36), although thromboembolic complications are also associated with vascular disorders.…”

“…Identification of inflammatory cytokines in patients with bladder cancer is necessary (15) due to paraneoplastic syndromes related to cytokine production, including thromboembolism complications, cachexia, and neoplastic fever, during the disease course (16,17). Enoxaparin (Sanofi-Aventis) was administered to treat thromboembolism complications, medroxyprogesterone acetate for cancer cachexia, and naproxen for neoplastic fever.…”

Survival Benefit for Patients With Metastatic Urothelial Carcinoma Receiving Continuous Maintenance Chemotherapy

“…These included thromboembolism complications such as PVOS, cerebral thrombosis and cachexia, and neoplastic fever. Enoxaparin (Sanofi-Aventis) and dexamethasone were administered to treat thromboembolism complications, while progesterone agents and naproxen were administered for cancer cachexia and neoplastic fever, respectively (3,4,8,9). Analysis of survival time for more than two years.…”

“…Inflammatory cytokines are important mediators of MUC (3,4). Transforming growth factor-beta (TGF-β) signaling activity promotes cancer progression at multiple stages of the metastatic process, including the epithelial-to-mesenchymal transition (EMT) (5).…”

“…Production of inflammatory cytokines can be due to cancer itself and/or from host reactions, such as invasive procedures, therapy, or infection. Increased production of inflammatory cytokines can result in thromboembolic complications, cancer cachexia, and tumor progression, which can carry poor prognosis (3,4,6). The main thromboembolic complications are cerebral thrombosis and pulmonary vein obstructive syndrome (PVOS) (3,4).…”