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AbstractIntroductionCongenital pulmonary airway malformation (CPAM), previously described as congenital cystic adenomatoid malformation (CCAM), is a congenital disorder of lung parenchyma. The association with the presence of a malignant transformation like rhabdomyosarcoma, pleuropulmonary blastoma, and most common invasive mucinous adenocarcinoma (IMA) is a rare development described in patients with CPAM.Patients and methodsHere, we report the case of a 68-year-old male patient who underwent a right lower lobectomy for a mass in the right pulmonary lobe. From his clinical history, we noted a recurrent pulmonary infection of a bullous malformation in the right lower lobe treated with antibiotics.ResultsThe histopathological finding showed an invasive mucinous adenocarcinoma arising in a type 1 CPAM in the right lower lobe. A review of presentation, diagnosis, and treatment of this association is described in a case report.ConclusionsSurgical resection should be considered in adults with asymptomatic cysts to prevent malignant transformation. For further analysis, histopathological examination of specimen is essential for a proper diagnosis and eventually further postoperative treatment.

The 2015 WHO classification of tumors categorized malignant mesothelioma into epithelioid, biphasic (BMM), and sarcomatoid (SMM) for prognostic relevance and treatment decisions. The survival of BMM is suspected to correlate with the amount of the sarcomatoid component. The criteria for a sarcomatoid component and the interobserver variability between pathologists for identifying this component are not well described. In ambiguous cases, a “transitional” (TMM) subtype has been proposed but was not accepted as a specific subtype in the 2015 WHO classification. The aims of this study were to evaluate the interobserver agreement in the diagnosis of BMM, to determine the nature and the significance of TMM subtype, and to relate the percentage of sarcomatoid component with survival. The value of staining for BRCA-1-associated protein (BAP1) and CDKN2A(p16) fluorescence in situ hybridization (FISH) were also assessed with respect to each of the tumoral components.

Despite donor organ shortage, a large proportion of possible donor lungs are declined for transplantation. Criteria for accepting/declining lungs remain controversial because of the lack of adequate tools to aid in decision‐making. We collected, air‐inflated, and froze a large series of declined/unused donor lungs and subjected these lung specimens to CTexamination. Affected target regions were scanned by using micro‐CT. Lungs from 28 donors were collected. Two lungs were unused, six were declined for non–allograft‐related reasons (collectively denominated nonallograft declines, n = 8), and 20 were declined because of allograft‐related reasons. CTscanning demonstrated normal lung parenchyma in only four of eight nonallograft declines, while relatively normal parenchyma was found in 12 of 20 allograft‐related declines. CTand micro‐CTexaminations confirmed the reason for decline in most lungs and revealed unexpected (unknown from clinical files or physical inspection) CTabnormalities in other lungs. CT‐based measurements showed a higher mass and density in the lungs with CTalterations compared with lungs without CTabnormalities. CTcould aid in the decision‐making to accept or decline donor lungs which could lead to an increase in the quantity and quality of lung allografts. The authors show that CT scanning could aid in the decision to accept or decline donor lungs.

Despite donor organ shortage, a large proportion of possible donor lungs are declined for transplantation. Criteria for accepting/declining lungs remain controversial because of the lack of adequate tools to aid in decision-making. We collected, air-inflated, and froze a large series of declined/unused donor lungs and subjected these lung specimens to CT examination. Affected target regions were scanned by using micro-CT. Lungs from 28 donors were collected. Two lungs were unused, six were declined for non–allograft-related reasons (collectively denominated nonallograft declines, n = 8), and 20 were declined because of allograft-related reasons. CT scanning demonstrated normal lung parenchyma in only four of eight nonallograft declines, while relatively normal parenchyma was found in 12 of 20 allograft-related declines. CT and micro-CT examinations confirmed the reason for decline in most lungs and revealed unexpected (unknown from clinical files or physical inspection) CT abnormalities in other lungs. CT-based measurements showed a higher mass and density in the lungs with CT alterations compared with lungs without CT abnormalities. CT could aid in the decision-making to accept or decline donor lungs which could lead to an increase in the quantity and quality of lung allografts.

This is the first report of intense fluorodeoxyglucose positron emission tomography (FDGPET) uptake secondary to thymic hyperplasia during follow-up for thyroid carcinoma. A 36-yr-old woman underwent thyroidectomy for a papillary carcinoma measuring 4 cm in diameter. After two doses of radioiodine, thyroglobulin (Tg) remained detectable following recombinant human TSH (rhTSH) stimulation. A whole body scan (WBS) was negative. On computed tomography (CT) scan, a slightly lobulated thymus was visualized. PET scan showed intense thymic uptake. Following resection, anatomo-pathological analysis showed homogenous hyperplastic thymic gland without neoplastic cells. Two months later, under levothyroxin (L-T4) substitution, Tg was no longer detectable and PET scanning did not show any 18-FDG uptake. This observation suggests that thymic FDG uptake does not necessarily herald recurrence of thyroid carcinoma and must be interpreted with caution in such a setting. Other conditions associated with abnormal uptake by hyperplastic thymus must also be envisaged.

To assess the effectiveness of positron emission tomography with radiolabeled [18F]-2-fluoro-deoxy-D-glucose (PET-FDG) imaging in mediastinal lymph node (LN) staging for non-small cell lung carcinoma (NSCLC) and to compare it to conventional clinical and surgical staging.

To determine the presence of occult micrometastasis (OM) in a selected population of surgically resectable patients presenting with non-small cell lung carcinoma (NSCLC) and to evaluate its prognostic value on relapses and survival.

BackgroundDental technicians are potentially exposed to various occupational dusts and chemicals. Not surprisingly, occupational related lung diseases have been documented in this population.

Background Dental technicians are potentially exposed to various occupational dusts and chemicals. Not surprisingly, occupational related lung diseases have been documented in this population. Methods We describe the case of a dental laboratory technician presenting progressive exertional dyspnea and cough. We used lung function tests, computed tomography, histological examination, mineralogical and immunological studies to characterize his condition. Results Lung function studies disclosed a restrictive pattern with a low diffusion capacity. A high-resolution CT scan revealed the presence of micronodules in both lungs corresponding to non-caseating foreign body granulomas at histological examination. Mineralogic studies showed the presence of silica, silicates, and aluminum. The lymphocytic transformation test was positive with the bronchoalveolar lavage for beryllium. Conclusions This dental technician developed pulmonary granulomatosis. Combined histological, mineralogical, and immunological studies led us to consider the diagnosis of pneumoconiosis most likely related to occupational exposure to beryllium and aluminum. Am. J. Ind. Med. 34:628–631, 1998. © 1998 Wiley-Liss, Inc.

La sertraline fait partie des inhibiteurs sélectifs de la recapture de la sérotonine souvent utilisés comme traitement de première ligne dans la dépression. Plusieurs tableaux de pneumopathies interstitielles imputables à la sertraline ont été décrits.

Non-specific interstitial pneumonia is characterized pathologically by uniform interstitial inflammation and fibrosis. This disease is most commonly demonstrated on high resolution CT as subpleural ground-glass opacity mixed with irregular linear opacities. The authors report a case of non-specific interstitial pneumonia with high resolution findings consistent with a “crazy paving pattern”. This appearance, represented by smoothly thickened interlobular septa with a background of geographic areas of ground-glass opacity, is unusual for non-specific interstitial pneumonia and was indistinguishable from other interstitial or alveolar lung diseases.

SummaryWe report about 2 cases of isolated mediastinal tuberculous lymphadenitis presenting without parenchymal infiltrates. Although rare, this mode of presentation reminds the clinician that tuberculosis has to be included in the differential diagnosis of mediastinal masses even in the absence of parenchymal lesion. Both cases illustrate the value of mediastinoscopic examination to assess the diagnosis.