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Objective: This study aims to analyze the adverse drug events (ADEs) associated with tolvaptan in the Food and Drug Administration Adverse Event Reporting System database from the fourth quarter of 2009 to the second quarter of 2024. Methods: After standardizing the data, various signal detection techniques, including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network, and Multi-Item Gamma Poisson Shrinker, were employed for analysis. Results: Among the 7,486 ADE reports where tolvaptan was the primary suspected drug, a total of 196 preferred terms were identified, spanning 24 different system organ classes. Specifically, hepatobiliary disorders, renal and urinary disorders, and metabolic and nutritional disorders were found to be characteristic adverse reactions associated with tolvaptan. Additionally, uncommon but notable ADE signals were observed, such as renal cyst rupture, renal cyst infection, polycystic liver disease, and renal cyst hemorrhage. These several ADEs have not been referred to in the previous literature. Notably, strong ADE signals were detected for decreased urine osmolality [n = 5, ROR 149.74, PRR 149.7, IC (Information Component) 7.13, EBGM (Empirical Bayes Geometric Mean) 139.79], osmotic demyelination syndrome (n = 38, ROR 128.47, PRR 128.25, IC 6.92, EBGM 120.91), and pulmonary-related tumors such as bronchial metastatic carcinoma, bronchial carcinoma, metastatic small cell lung carcinoma, and small cell lung carcinoma. In the concomitant medication analysis of 7,486 suspected adverse drug reaction reports related to tolvaptan, the top three drugs most commonly used in combination with tolvaptan were furosemide, spironolactone, and amlodipine. Conclusion: While tolvaptan provides therapeutic benefits, it poses a risk of significant adverse reactions. Clinicians should closely monitor the occurrence of events related to hepatobiliary disorders, renal and urinary disorders, metabolic and nutritional disorders, as well as benign, malignant, and indeterminate tumors during its clinical use. [ABSTRACT FROM AUTHOR]

Background: FDG-PET/CT is considered a noninvasive method for mediastinal staging and functional assessment of lung cancer. Standardized uptake value maximum (SUVmax) estimates the activity of the tumor and its aggressiveness. Aim: To measure the relation of clinical, demographic, radiological factors, histopathology, and SUVmax in patients of bronchogenic carcinoma. Patients and methods: The study was a prospective cross-sectional study on 47 confirmed lung cancer patients admitted to the Chest Department of Ain Shams University Hospital from April 2022 to May 2023. Demographic data, clinical examination, complete blood count, tumor site and size in CT chest or PET-CT, histopathology, and SUVmax values in PET-CT scans with staging according to the 8th TNM system were done. SUVmax relation with all parameters was done. Results: In this study, the relation between age, smoking habits (P =0.60), comorbidities (P =0.18), and tumor SUVmax was not significant. No relation between tumor characteristics: site (P =0.27), histopathology (P =0.46), extrapulmonary metastases including mediastinal lymph node (P =0.09), and tumor SUVmax. Positive significant correlation between tumor size, T staging, and tumor SUVmax. No correlation between age, pack year, N staging, M staging, TNM staging, and tumor SUVmax. No significant correlation was found between laboratory tests: TLC count, HB count, platelet count, and tumor SUVmax. No relation between tumor histopathology and tumor site (P =0.32), with no significant relation between tumor histopathology and patients age (P =0.77), pack year (P =0.89), or tumor size (P =0.07). Conclusion: Tumor size and T staging positively correlated with SUVmax. SUVmax was higher in squamous cell carcinoma patients with no statistically significant relation. [ABSTRACT FROM AUTHOR]

A 74-year-old woman with a long-standing intrapulmonary bronchogenic cyst (IPBC) was diagnosed with adenosquamous carcinoma after presenting with persistent hyponatremia. This case represents the first reported instance of such a transformation in an IPBC. The patient underwent surgery and received adjuvant chemotherapy and immunotherapy, achieving remission 2.4 years post-treatment. The study highlights the importance of monitoring bronchogenic cysts for potential malignant transformation, even decades after initial diagnosis. [Extracted from the article]

Objective: This meta-analysis aims to examine the effectiveness of veliparib, a poly ADP-ribose polymerase inhibitor, in combination with chemotherapy in treating bronchogenic carcinoma. Methods: PubMed, Cochrane, Scopus, and Web of Science were searched for eligible randomized controlled trials comparing veliparib plus chemotherapy to standard chemotherapy in adult lung cancer patients, until July 2023. The main outcomes were overall survival (OS) and progression-free survival (PFS). Results: This meta-analysis included six studies encompassing 2,136 patients. Veliparib has a slight OS improvement over placebo, HR = 0.91, 95% CI [0.83 to 1.0], p = 0.05. Veliparib offers more OS benefit in the subpopulation of non-small cell lung cancer (NSCLC) than small-cell lung cancer (SCLC), HR = 0.89, 95% CI [0.81,0.99], p = 0.03 and HR = 1.00, 95% CI [0.79, 1.28], p = 0.97, respectively. There was no significant PFS benefit between the two groups, HR = 0.92, 95% CI [0.81–1.01], p = 0.08). Conclusion: Veliparib has a marginal inclination for overall survival improvement, more so in NSCLC, with an acceptable safety profile. Our results merit the pursuit of better-powered trials to support further the extent of veliparib's effectiveness in lung cancer patients. Registration: PROSPERO (CRD42023453705) [ABSTRACT FROM AUTHOR]

Background: Lung cancer is one of the most frequent cancers and a major cause of cancer death worldwide. Lung cancer accounts for 11.6% of all new cancer cases identified each year and is quickly becoming the most prevalent fatal neoplastic disorder in the world, accounting for 18.4% of all cancer-related fatalities worldwide1. Objectives: 1. To study the clinical profile of newly diagnosed bronchogenic carcinoma patients. 2. To study the clinicopathological correlation among various histological types of bronchogenic carcinoma in the above patients. 3. To study the extrapulmonary manifestations and the prevalence of identifiable paraneoplastic syndromes (if present) in patients with bronchogenic carcinoma. MATERIAL & METHODS: Study Design: Prospective hospital-based observational study. Study area: The study was conducted in the Department of Pulmonary Medicine, Government Medical College, Kadapa. Study Period: June 2023 - December 2023. Sample size: The study consisted of 52 subjects. Sampling method: Simple random Sampling Technique. Inclusion criteria: Patients attending hospital, diagnosed with bronchogenic carcinoma in the specified period. Study tools and Data collection procedure: Patients included in the study were selected according to the inclusion and exclusion criteria. After obtaining informed consent, data was gathered from history, objective examination of the patients and lab investigations using a semi-structured questionnaire. The localisation of the tumors was done by chest x-ray, fibre optic bronchoscopy and/or CT scan as required. Tissue diagnosis was obtained by FNAC/biopsy or other cytology and histopathological examination of the specimen was carried out. The type pattern of paraneoplastic syndromes was noted. Results: COPD (65.38%) and Diabetes (23%) were the common co-morbidities affecting the study population followed by HTN (19.2%). H/O old PTB was noted in 11.5% of the patients and 1 patient (1.9%) had h/o ILD. 2(3.8%) patients had past h/o malignancy. One patient had h/o squamous cell carcinoma of the right ear another patient had cervical cancer and 1 (3.8%) patient had a family history of malignancy (first-degree relative). Conclusion: Lung cancer is a rapidly progressive disease with a very high mortality rate but treatment in the early stage may give a good prognosis. High-risk patients with having smoking history should be evaluated clinic radiologically with high suspicion so that early diagnosis can be made and the quality of life of patients can be improved. Primary lung cancer should always be suspected in a person presenting with unexplained cough for several weeks with other symptoms such as weight loss, and fever with non-resolving collapse-consolidation on chest radiograph. [ABSTRACT FROM AUTHOR]

Introduction Asbestos exposure is linked with incident of pulmonary diseases comprising of bronchogenic carcinoma, mesothelioma, pleural plaque and asbestosis. International Agency for Research on Cancer (IARC) has classified all types of asbestos as carcinogens. The exact pathogenic mechanisms by which asbestos fibres trigger pulmonary toxicity and neoplasia have not been fully understood. Many research studies have been undertaken for understanding the mechanisms of asbestos’s pathogenicity. India is an extensive user of asbestos, a very limited data is available on its effect on Indian population. Methods Factories workers using asbestos as raw material were included in the study. A detail history related to asbestos use was recorded in the form of questionnaire. The sputum and blood samples were collected from 100 workers. Their smear was made for pathological examination. The serum was used for evaluation of IgG, IgA, and IgM by using immune-diffusion method. Effect of asbestos fiber on p53 gene was also assessed. Results Medical examination of asbestos exposed workers indicated a recent upper respiratory tract infection. Peripheral smear showed toxic transformed lymphocytes. In 14 cases, Plasmacytoid lymphocytes were seen. DNA extracted was studied by single stand conformation polymorphism, one mutation in exon 5 was detected. Discussion Our findings presents initial pathological changes due to asbestos exposure. Thus simple techniques of blood and sputum examination can help in early detection of asbestos exposure. [ABSTRACT FROM AUTHOR]

The chemotherapeutic agent vincristine is commonly used for a variety of hematologic cancers, as well as solid tumors of the head and neck, bronchial carcinoma, as part of the procarbazine, lomustine and vincristine (PCV) regimen, for glioma. Damage to nerve tissue (neuropathy) is often dose-limiting and restricts treatment. Nimodipine is a calcium antagonist that has also shown neuroprotective properties in preliminary studies. In this approach here, we investigated the effects of the combination of vincristine and nimodipine on three cancer cell lines (A549, SAS and LN229) and neuronal cells (RN33B, SW10). Fluorescence microscopy, lactate dehydrogenase (LDH) assays and Western blot analyses were used. Nimodipine was able to enhance the cell death effects of vincristine in all tumor cells, while neuronal cells were protected and showed less cell death. There was an opposite change in the protein levels of Ak strain transforming/protein kinase B (AKT) in tumor cells (down) and neuronal cells (up), with simultaneous increased protein levels of cyclic adenosine monophosphate response element-binding protein (CREB) in all cell lines. In the future, this approach may improve tumor response to chemotherapy and reduce unwanted side effects such as neuropathy. [ABSTRACT FROM AUTHOR]

Background: Malignant airway obstruction is commonly found in patients with lung cancer and is associated with significant morbidity and mortality. Relieving malignant obstruction may improve symptoms, quality of life, and life expectancy. The aim of the present work is to determine the efficacy of endobronchial intratumoral injection of 5-Fluorouracil as a chemotherapeutic agent in palliative care for patients with inoperable nonsmall-cell lung cancer (NSCLC). Patients and methods: A total of 30 patients diagnosed as inoperable advanced-stage NSCLC were included into this randomized prospective controlled comparative study and divided into two groups (group A: 15 patients received the conventional sessions of systemic chemotherapy only and group B: 15 patients received the conventional sessions of systemic chemotherapy in addition to two to three sessions of local endobronchial intratumoral chemotherapy using 5-fluorouracil). Patient characteristics, histology, airways infiltrated with the tumor, performance status, treatment cycles, complications, and therapeutic outcomes were evaluated. Tumor response was analyzed based on bronchoscopic evaluation performed on completion of the final treatment session. Results: There was no significant difference in the total objective response between patients who used systemic chemotherapy alone for treatment of advanced NSCLC and those who used systemic chemotherapy in addition to sessions of local chemotherapy using 5-fluorouracil that was injected intratumorally through bronchoscopy in multiple sessions. Conclusion: We concluded that endobronchial intratumoral chemotherapy using 5-fluorouracil is not an effective promising treatment approach for palliative treatment of patients with advanced malignant endobronchial NSCLC. [ABSTRACT FROM AUTHOR]

Background: Among the most frequent causes of cancer-related mortality is bronchogenic carcinoma. Radiological imaging is essential for prognosis, prediction, and therapy planning. PET/CT greatly improves management and offers more accurate staging and follow-up. This study aimed to assess PET/CT impact on lung cancer restaging and follow-up. Methods: This prospective cross-sectional study included 48 cases of pathologically confirmed bronchogenic carcinoma incorporated for staging and follow-up after therapy. Every patient had PET/CT, and the data was analyzed using TNM staging, RECIST and PERCIST criteria used for treatment response assessment. Results: PET/CT resulted in modification in TNM staging for 16 patients and 12 patients showed various surgical staging. In the follow-up group, ten cases had difference between RECIST and PERCIST results with most of them (6 cases) displayed alteration from partial response to stable response. When pre-treatment and post-treatment SUVs in responder and non-responder groups were compared, it was found that responder group's post-treatment SUV was significantly lower than baseline SUV (P<0.001). With an AUC of 0.948, P value <0.001, and at a cutoff value of ≤9, we discovered that post-treatment SUV can successfully distinguish responders from non-responders with 100% sensitivity, 63.64% specificity, 76.55% PPV, and 100% NPV and ∆ SUV can distinguish with 100% sensitivity and 54.55% specificity. Conclusions: PET/CT was found to be reliable and efficient in assessment of tumor, nodal and metastatic staging leading to significant impact on TNM staging of bronchogenic carcinoma and provide a more comprehensive and functional therapy assessment. [ABSTRACT FROM AUTHOR]

Hybrid positron emission tomography/magnetic resonance imaging (PET/MR) opens new possibilities in multimodal multiparametric (m2p) image analyses. But even the simultaneous acquisition of positron emission tomography (PET) and magnetic resonance imaging (MRI) does not guarantee perfect voxel-by-voxel co-registration due to organs and distortions, especially in diffusion-weighted imaging (DWI), which would be, however, crucial to derive biologically meaningful information. Thus, our aim was to optimize fusion and voxel-wise analyses of DWI and standardized uptake values (SUVs) using a novel software for m2p analyses. Using research software, we evaluated the precision of image co-registration and voxel-wise analyses including the rigid and elastic 3D registration of DWI and [18F]-Fluorodeoxyglucose (FDG)-PET from an integrated PET/MR system. We analyzed DWI distortions with a volume-preserving constraint in three different 3D-printed phantom models. A total of 12 PET/MR-DWI clinical datasets (bronchial carcinoma patients) were referenced to the T1 weighted-DIXON sequence. Back mapping of scatterplots and voxel-wise registration was performed and compared to the non-optimized datasets. Fusion was rated using a 5-point Likert scale. Using the 3D-elastic co-registration algorithm, geometric shapes were restored in phantom measurements; the measured ADC values did not change significantly (F = 1.12, p = 0.34). Reader assessment showed a significant improvement in fusion precision for DWI and morphological landmarks in the 3D-registered datasets (4.3 ± 0.2 vs. 4.6 ± 0.2, p = 0.009). Most pronounced differences were noted for the chest wall (p = 0.006), tumor (p = 0.007), and skin contour (p = 0.014). Co-registration increased the number of plausible ADC and SUV combinations by 25%. The volume-preserving elastic 3D registration of DWI significantly improved the precision of fusion with anatomical sequences in phantom and clinical datasets. The research software allowed for a voxel-wise analysis and visualization of [18F]FDG-PET/MR data as a "combined diffusivity–metabolic index" (cDMI). The clinical value of the optimized PET/MR biomarker can thus be tested in future PET/MR studies. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is difficult to differentiate between chronic obstructive pulmonary disease (COPD)-peripheral bronchogenic carcinoma (COPD-PBC) and inflammatory masses. OBJECTIVE: This study aims to predict COPD-PBC based on clinical data and preoperative Habitat-based enhanced CT radiomics (HECT radiomics) modeling. METHODS: A retrospective analysis was conducted on clinical imaging data of 232 cases of postoperative pathological confirmed PBC or inflammatory masses. The PBC group consisted of 82 cases, while the non-PBC group consisted of 150 cases. A training set and a testing set were established using a 7:3 ratio and a time cutoff point. In the training set, multiple models were established using clinical data and radiomics texture changes within different enhanced areas of the CT mass (HECT radiomics). The AUC values of each model were compared using Delong's test, and the clinical net benefit of the models was tested using decision curve analysis (DCA). The models were then externally validated in the testing set, and a nomogram of predicting COPD-PBC was created. RESULTS: Univariate analysis confirmed that female gender, tumor morphology, CEA, Cyfra21-1, CT enhancement pattern, and Habitat-Radscore B/C were predictive factors for COPD-PBC (P < 0.05). The combination model based on these factors had significantly higher predictive performance [AUC: 0.894, 95% CI (0.836–0.936)] than the clinical data model [AUC: 0.758, 95% CI (0.685–0.822)] and radiomics model [AUC: 0.828, 95% CI (0.761–0.882)]. DCA also confirmed the higher clinical net benefit of the combination model, which was validated in the testing set. The nomogram developed based on the combination model helped predict COPD-PBC. CONCLUSION: The combination model based on clinical data and Habitat-based enhanced CT radiomics can help differentiate COPD-PBC, providing a new non-invasive and efficient method for its diagnosis, treatment, and clinical decision-making. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is considered the most common malignant neoplasm in males worldwide and the 2nd important reason for cancer-related male deaths after bronchogenic carcinoma. Objective: The purpose of this research is to assess how diffusion weighted image (DWI) and apparent diffusion coefficient (ADC) value characterise prostatic cysts, senile prostatic hyperplasia, prostate cancer, and the normal prostatic gland. Patients and methods: We enrolled 60 cases with suspicious prostatic lesions,20 cases with benign prostatic hypertrophy, 20 cases prostate cancer and 20 with prostatic cyst along with 20 controls. All underwent magnetic resonance imaging (MRI) for prostatic assessment and Trans-rectal ultrasonography (TRUS) guided biopsy. Results: Prostate cancer had a considerably lower mean ADC value (p-value < 0.001) than normal central gland (CG), peripheral zone (PZ), and benign prostatic hyperplasia (BPH) nodules. The ADC value of the PZ tissue had been substantially higher than that of the normal central zone (CZ) (p<0.001). While the prostatic cyst's ADC value was much greater than CZ's (p < 0.001), the BPH lesion's ADC value had been significantly lower than CZ's (p < 0.001). Conclusions: DWI has been a useful tool for gathering information on the tissue properties of the prostate's various anatomical zones. In contrast to normal tissue, BPH, and prostate cysts, prostate carcinoma cause restricted diffusion of water, which may be used in the differential diagnosis of benign and malignant lesions. [ABSTRACT FROM AUTHOR]

Objective: Our study was to investigate the impact of taurolactone, a novel anti-tumor and anti-angiogenic drug, on AGGF1, an angiogenic factor, and angiogenesis mimicry in patients diagnosed with hepatocellular carcinoma (HCC). Methods: A total of 120 HCC patients were enrolled from the Department of Oncology and Hepatobiliary Surgery at our hospital between May 2021 and December 2022. HCC diagnoses were confirmed through imaging or tissue biopsy for all patients. The age of patients ranged from 37 to 72 years, with an average age of 64.29 ± 4.58 years. These participants were divided equally into two groups: the control group and the observation group, each consisting of 60 individuals. While the control group received standard drug treatment, the observation group was administered taurolactone treatment. Before being included in the study, all participants or their legal representatives provided signed informed consent. Patient demographic information was collected through a questionnaire survey. ELISA was used to measure the levels of VEGF and AGGF1 in patients following treatment. Western blot was applied to assess the protein expression of PDGF, Angiopoietin, and AGGF1. MRI imaging technology was utilized to assess the perfusion characteristics of tumor blood vessels in patients. Tumor vessel density was compared between patients using ultrasonography. We also conducted a comparison between the two groups in terms of progression-free survival and overall survival. Results: General patient information between the two groups showed no significant differences (P > 0.05). Of note, the observation group exhibited greatly lower levels of VEGF and AGGF1 compared to the control group (P < 0.05). Moreover, the levels of PDGF, Angiopoietin, and AGGF1 protein expression were significantly reduced in the observation group compared to the control group (P < 0.05). In terms of tumor perfusion, the observation group displayed lower average and maximum perfusion volumes in tumor blood vessels compared to the control group (P < 0.05). Additionally, the observation group demonstrated delayed peak times and arrival times of tumor blood vessels in comparison to the control group (P < 0.05). Furthermore, the density of tumor blood vessels was notably lower in the observation group compared to the control group (P < 0.05). Patients in the observation group had longer progression-free survival and overall survival than the control group (P < 0.05). Conclusion: In HCC patients, our study highlighted the potential efficacy of taurolactone treatment as it effectively inhibited angiogenic factors and angiogenesis mimicry, ultimately leading to an improved prognosis for these patients. [ABSTRACT FROM AUTHOR]

Introduction/Aim. Adrenal incidentalomas (AIs) are defined as tumours revealed during imaging procedures of abdomen or abdominal laparotomy, performed in patients without previous suspicion for adrenal disease. This study was conducted to evaluate morphological and functional features of AIs seven years after the initial diagnosis. Patients and Thirty-eight AI patients were monitored for seven years, with CT scans used for morphological follow-up. Hormonal activity assessments included basal cortisol levels, adrenocorticotropic hormone, overnight dexamethasone suppression test, plasma or urinary metanephrines, vanillymandelic acid, electrolytes, hematocrit, acid-base status, oral glucose tolerance test, and chromogranin A. Results. Functional activity was confirmed in six patients, with mild autonomous cortisol secretion (MACS) detected in two patients. Nine patients underwent adrenalectomy. Histopathological examination revealed hormonal activity in six cases, adrenocortical carcinoma was found in one patient, while secondary deposits from bronchial carcinoma were detected in one patient. Among the remaining 29 patients observed for the first year, tumor size remained stable. After seven years, two patients experienced tumor enlargement = 1 cm, along with the development of MACS on endocrine evaluation. Adrenalectomy was recommended for one patient due to tumor size exceeding 4 cm. Conclusion. The initial adrenal incidentaloma (AI) evaluation must include comprehensive diagnostic procedures for surgical consideration. Subsequent follow-up should include CT imaging after 12 months to monitor the tumor growth. Although mild autonomous cortisol secretion does not tend to progress to overt Cushing's syndrome, it can develop in patients initially considered to have hormonally inactive tumor. Our findings suggest that even small adrenal masses (< 4 cm) can enlarge over seven years, potentially evolving into MACS. Therefore, regular long-term monitoring every 5 - 7 years is recommended. [ABSTRACT FROM AUTHOR]

Background: Bronchogenic carcinoma, a predominant form of lung cancer, continues to challenge diagnostic modalities with its late detection and poor prognosis. Interleukin-6 (IL-6), a cytokine involved in inflammatory and immune responses, has recently been scrutinized for its potential role as a biomarker in various cancers. This clinical study evaluates the clinical value of IL-6 levels in patients with bronchogenic carcinoma, aiming to establish its utility in early diagnosis and prognosis estimation. Materials and Methods: A total of 200 participants were enrolled in this study, divided evenly into two groups: patients diagnosed with bronchogenic carcinoma and a control group of healthy individuals. Serum IL-6 levels were measured using enzyme-linked immunosorbent assay (ELISA). The study also assessed the correlation of IL-6 levels with disease stage, tumor size, and patient survival rates. Statistical analysis was performed using SPSS software, employing t-tests and chi-square tests where applicable. Results: The study found significantly higher levels of IL-6 in patients with bronchogenic carcinoma compared to the control group (mean IL-6 levels of 45 pg/mL vs. 12 pg/mL, respectively; p<0.001). Further, IL-6 levels correlated positively with advanced disease stage and larger tumor size. Patients with IL-6 levels above 60 pg/mL had a significantly lower 5-year survival rate (30%) compared to those with levels below 60 pg/mL (65%). Conclusion: Elevated IL-6 levels are associated with bronchogenic carcinoma and correlate with disease severity and lower survival rates. These findings suggest that IL-6 can serve as a valuable biomarker for the early detection and prognosis of bronchogenic carcinoma. Further studies are recommended to validate these findings and explore the therapeutic potential of targeting IL-6 in lung cancer treatment. [ABSTRACT FROM AUTHOR]

Bronchogenic cysts are uncommon congenital malformations of the respiratory system. These cysts can be categorized as intrapulmonary, mediastinal, or ectopic. Ectopic bronchogenic cysts, which lack distinctive clinical and imaging features, are particularly challenging to diagnose. This study presents a 48-year-old woman having a small intestinal bronchogenic cyst. She was repeatedly misdiagnosed as having an ovarian chocolate cyst or a cystic mass of bladder origin three years ago. However, no cyst was found during the operation. Half a year prior to presenting at our hospital, the patient developed frequent urination, prompting her to seek further treatment. We eventually discovered a cyst in the small intestine. The histological evaluation of the specimen showed a bronchogenic cyst. Small intestine bronchogenic cysts are extremely rare and easily misdiagnosed. It should be considered as one of the differential diagnoses of pelvic cysts. Particularly, when intraoperative exploration of the pelvic cavity fails to detect any cysts, consideration should be given to the possibility of small intestine bronchogenic cysts. [ABSTRACT FROM AUTHOR]

Vascular endothelial growth factor receptor tyrosine kinase inhibitors are known to cause perforation as one of their severe side effects, and postoperative and postradiation therapy are known risk factors. However, there are few studies on perforation following tumor shrinkage. A 78-year-old woman with postoperative recurring left collecting duct carcinoma of the right hilar lymph nodes and mediastinum underwent eight courses of nivolumab plus cabozantinib, resulting in tumor shrinkage. Three days after the last administration, she developed fever and cough and was hospitalized for right lobar pneumonia. The patient received long-term antibiotics for bronchial fistula with the destruction of the bronchial wall and secondary lung abscess. When using nivolumab plus cabozantinib combination therapy for a tumor with bronchial invasion, physicians should be aware of bronchial perforation as the tumor shrinks. [ABSTRACT FROM AUTHOR]

A 36-year-old male patient presented with symptoms of cough, sputum, and dyspnea, leading to the discovery of a rare bronchial mucoepidermoid carcinoma. The patient participated in a clinical trial using [68Ga]Ga-Trivehexin PET/CT imaging, which showed intense tracer uptake in the lesion, suggesting a primary bronchial malignancy. The study highlights the potential of [68Ga]Ga-Trivehexin PET as a promising tool for detecting mucoepidermoid carcinoma, a rare type of primary lung tumor. The research was conducted by Huiqin Wu, Ling Li, Zhiwei Xiao, Chongjiao Li, and Yong He, with support from the National Natural Science Foundation of China and Zhongnan Hospital of Wuhan University. [Extracted from the article]

Objective: Unusual clinical course Background: The article discusses an unusual case of papillary thyroid carcinoma in which chronic cough and hemoptysis were the predominant symptoms. While the more common causes of hemoptysis are pulmonary in origin, extrapulmonary etiologies have been reported, including thyroid carcinoma. The clinical presentation of thyroid malignancy in this case mimics many other common disorders, such as pulmonary tuberculosis, bronchogenic carcinoma, bronchiectasis, and chronic obstructive pulmonary disease. Hence, making it challenging to suspect early when patients present to primary care. Case Report: A 54-year-old woman presented with a chronic cough and hemoptysis in our Primary Care Medicine Clinic. While initial assessments in the primary care medicine clinic yielded no remarkable findings, a subsequent high-resolution computed tomography scan of the thorax uncovered a thyroid lesion. Subsequent evaluation in the hospital setting included an ultrasound examination, revealing multiple thyroid nodules, and fine needle aspiration that confirmed papillary thyroid carcinoma. She underwent total thyroidectomy with central and left lateral neck dissection, complicated by left vocal cord palsy. She received 2 cycles of periodic radioactive iodine therapy and injection laryngoplasty postoperatively. There was no evidence of iodin avid disease and recurrence of hemoptysis after surgery. Conclusions: This case report emphasizes the significance of considering papillary thyroid carcinoma when assessing hemoptysis in the primary care setting, as early detection and treatment of it would result in a better outcome. [ABSTRACT FROM AUTHOR]

Background: Lung salivary-type tumors originating from bronchial submucosal glands are rare, only four types of salivary gland-type tumors are listed in 2015 WHO classification of lung tumors. Here, we report a rare case of oncocytic carcinoma (OC) in the right main bronchus. Case presentation: A 34-year-old man presented to our hospital with a two-month history of recurrent hemoptysis and with one month of inspiratory dyspnea. Pulmonary function tests showed mild restrictive ventilatory dysfunction and severe diffusion dysfunction. Furthermore, the flow volume loop showed a variable extra-thoracic obstruction. Computed tomography (CT) of the chest revealed that a polypiform nodule of 13 mm in diameter was at the proximal right main bronchus. Testing for purified protein derivative was positive (category 2). The nodule was resected under bronchoscopy. The bronchial aspirate was negative for mycobacterium tuberculosis and tumor cells. The biopsy sample showed a solid and acinar predominant pattern with abundant eosinophilic cytoplasm. The bronchial mucosa was destroyed and replaced by tumor cells. The loose edematous stromal reaction could be seen in a local area. Immunohistochemically, tumor cells were positive for CK, EMA, Vimentin, CD117, CK7, S100, Mammaglobin and SOX10. Only scattered tumor cells were stained by basal cell markers, including CK5/6, P40 and P63. Electron microscopy revealed numerous swelling mitochondria with lacking mitochondrial cristae in tumor cells. Fluorescence in situ hybridization (FISH) testing for MAML2 and ETV6 rearrangement were negative. Next-generation sequencing analysis of 520 genes in the tissue biopsy specimen showed no somatic mutation. The diagnosis of OC was made. Subsequently, the patient underwent a right upper lobectomy with sleeve resection of the main bronchus and lymph dissection. No recurrent evidence was seen during two years of chest CT follow-up. Conclusions: To our knowledge, this is the first case of primary OC in the bronchus. This patient has no recurrence during two years of follow-up, indicating that primary OC in the bronchus has the same favorable prognosis as in salivary glands. Moreover, complete excision and thorough sampling to know the invasive growth pattern is important to reach the correct diagnosis. [ABSTRACT FROM AUTHOR]

Bronchial squamous carcinoma in situ (CIS) is a preinvasive lesion that is thought to precede invasive carcinoma. We conducted prospective autofluorescence and white light bronchoscopy trials between 1992 and 2016 to assess the prevalence, molecular markers, and outcome of individuals with CIS and other preneoplastic bronchial lesions. Biopsies were evaluated at multiple levels and selected biopsies were tested for aneuploidy and DNA sequenced for TP53 mutation. Thirty‐one individuals with CIS were identified. Twenty‐two cases of CIS occurred in association with concurrent invasive carcinomas. Seven of the invasive tumors were radiographically occult. In two cases, CIS spread from the focus of invasive carcinoma into contralateral lung lobes, forming secondary invasive tumors. In nine cases, CIS occurred as isolated lesions and one progressed to invasive squamous carcinoma at the same site 40 months after discovery. In a second case, CIS was a precursor of carcinoma at a separate site in a different lobe. In seven cases CIS regressed to a lower grade or disappeared. High level chromosomal aneusomy was often associated with TP53 mutation and with invasive carcinoma. CIS most often occurs in association with invasive squamous carcinoma and may extend along the airways into distant lobes. In rare cases, CIS may be observed to directly transform into invasive carcinoma. CIS may be indicative of invasive tumor at a separate distant site. Isolated CIS may regress. Molecular changes parallel histological changes in CIS and may be used to map clonal expansion in the airways. [ABSTRACT FROM AUTHOR]

Objective: The data on clinical, biochemical, radiological characteristics, and outcomes in paediatric ectopic adrenocorticotropic hormone syndrome (EAS) are limited owing to rarity of the condition. We report three new cases and perform a systematic review of paediatric EAS. Design and Method: Case records of paediatric and adolescent EAS patient’s ≤20 years presenting at our centre between 1997 and 2021 were retrospectively reviewed, and a systematic review of the literature published between January 1970 and December 2022 was performed. Results: A total of 161 patients including 3 new patients from our centre were identified. Bronchial neuroendocrine tumours (NET) (28.5%), thymic NET (22.9%), primitive cell-derived tumours (18.6%), and gastro-entero-pancreatic-NET (13.7%) were the common causes. Primitive cell-derived tumours were the most common in the first decade (24/45, 53.4%) and were the largest (82 [60-100] mm), whereas bronchial NETs predominated during the second decade (42/116, 36.2%) and were the smallest (15 [10-25] mm). Computed tomography localized 92.9% (118/127) of paediatric EAS patients. Immediate postoperative remission was attained in 77.9% (88/113) patients, whereas 30.4% (24/ 79) relapsed over a median (IQR) period of 13 (8-36) months. Over a median (IQR) follow-up of 2 (0.6-4.6) years, 31.4% of patients died. The median survival was higher in bronchial NET than in other tumour groups. Distant metastasis and tumour size were independent negative predictors of survival. Conclusions: Aetiological profile of paediatric and adolescent EAS is distinct from that of adults. Bronchial NETs have the best long-term survival, whereas distant metastasis and tumour size predict poor survival. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Bronchogenic carcinoma was considered to be rare in the beginning of the century but has now reached epidemic proportions. This dramatic increase correlates with the widespread prevalence of cigarette smoking. Lung cancer is the leading cause of cancer mortality for both men and women, responsible for more deaths than prostate, breast, and colorectal cancers combined. Bronchogenic carcinoma is typically detected first on chest radiography but computed tomography (CT) scan is the most important imaging technique, providing both TNM staging information and assessment of recurrence because of its better spatial resolution. CT provides precise characterization of the size, contour, extent and tissue composition of the suspicious lesion. Materials & Methods: This is a prospective study was conducted in the Department of Department of Radio diagnosis, Kalinga Institute of Medical Sciences from July 2016 to June 2017. Patients with clinical or radiological suspicion of bronchogenic carcinoma referred for CT scan of thorax was taken. Data was collected from cases of suspected bronchogenic carcinoma referred for CT scan of thorax by purposive sampling using a proforma. All scans are done using GE bright speed 16 slice MDCT with 120 KVp and 300 mAs with 5mm section thickness, retro reconstruction of 0.625mm section thickness and reformation. RESULTS: In our study, out of 50 patients we studied, 38 were male and 12 were female, with male:female ratio of 3:1. Age range of patients included 40-80 (mean age of 55 years). Highest incidence of lung carcinoma was found in the age group of 60-70 years (almost 50%). Out of 50 patients, CT guided transthoracic biopsy was done in 40 patients and USG guided biopsy in 7 patients and transbronchial biopsy in 3 patients. Among these 50 patients, 21 cases were diagnosed as adenocarcinoma (42%). 11 patients (22%) with small cell type. 10 patients (20%) with BAC. 8 patients (16%) being diagnosed squmaous cell type. In regard to the radiological pattern of lung carcinoma, most of the adenocarcinoma presented with pulmonary lesion less than 4 cm and 6 patients presented with pneumonitis and 2 with apical mass. Out of these, three patients had mediastinal involvement and 2 patients had malignant pleural effusion. CONCLUSION: CT scan is the modality of choice for the detection of bronchogenic carcinoma, staging of bronchogenic carcinoma and in the evaluation of metastases. It is very helpful in performing transthoracic biopsies and to the arrival of histopathological diagnosis. Early diagnosis can help better survival. [ABSTRACT FROM AUTHOR]

Currently, clinically relevant multigene-based prognostic assessment models for nasopharyngeal carcinoma (NPC) are limited. This paper reports a novel NPC prognosis assessment model based on multiple established NPC-associated biomarkers. We used a modified meta-analysis approach to retrieve eligible studies and analyse the data. Different prognostic biomarkers and hazard ratios (HRs) with 95 % confidence intervals (CIs) of overall survival (OS) data were extracted and tabulated from eligible studies. We then used the formula based on Parmar et al. to determine OS (expressed as HR with 95 % CI). Prognosis assessment risk scores assigned to the logarithm of HR were the basis for interpreting the multigene prognosis assessment model. Finally, we explained the biological significance of this model using a multigenic NPC oncogenesis network system. We constructed a multigenic NPC prognosis assessment model consisting of 10 prognostic biomarkers to determine the OS rate in NPC patients. Based on the biomarkers' expression patterns, the model could determine 1,023 possible OS rates of NPC patients. The risk score derived determines the prognosis status of the NPC patients. The higher the total risk assessment score, the poorer the prognosis. An NPC-associated network involving all ten biomarkers was also derived. We provided a novel multigenic NPC prognosis assessment model comprising ten prognostic biomarkers on OS rate in NPC patients. A conceptual molecular-based pathophysiological network of NPC oncogenesis supported the biological relevance of this model. [ABSTRACT FROM AUTHOR]

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Background: Breast carcinoma is a common malignancy in women. It is the second leading cause of cancer death following bronchogenic carcinoma. The incidence of breast cancer is lower in the developing countries. The age at presentation, disease stage and pathological behaviour varies in between different countries. The mean age at presentation of breast cancer in developing countries one decade earlier than developed countries. This analytical study was conducted to explains the age distribution pattern of breast cancer in Basrah, Iraq. Patients and methods: A prospective analytical study of eight hundred twentyeight patients with breast cancer conducted in Iben Gaswan Teaching Hospital, Basrah, Iraq during the period between January 2007 and December 2018. The data were analysed concerning with the age at presentation, the mean and median age at diagnosis and annual percentage of breast cancer. Results: Breast carcinoma was more common in patients age group between 41 years to 45 years. More than 62% of the patients present below the age of 50 years. The mean age at the time of diagnosis of the breast cancer patients were 48.43 year. The mean age at presentation become more with the advancing age. Conclusion: Age at diagnosis one decade earlier than the developed countries and it became more in the older age in the subsequent years. Breast screening program should be started before the age of fourteen. [ABSTRACT FROM AUTHOR]

Introduction: Bronchogenic carcinoma is a leading cause of cancer-related death in men and women. Early diagnosis and treatment in these cases are essential for a better prognosis. Serum biomarkers such as serum amyloid A (SAA) and CYFRA 21-1 have generated encouraging results regarding their use in the diagnosis of these cases but data on their role in the Indian scenario are still lacking. Aim: The study aims to measure the levels of SAA and CYFRA 21-1 in various types of lung cancer and compare them with patients without lung cancer. It also aims to compare the values of these biomarkers before and after chemotherapy and correlate them with response to treatment. Materials and Methods: It was a prospective, case--control study conducted in the Department of Pulmonary Medicine, Government Medical College, Chandigarh. All histologically and/or cytologically proven lung cancer cases were included in the study group while patients with diseases other than lung cancer formed the control group. All patients were evaluated through a complete history and thorough clinical examination. Measurement of SAA and CYFRA 21-1 in blood was done by sandwich ELISA method. The patients in the study group were followed up regularly and the biomarkers were measured again after four cycles of chemotherapy. The response of tumors to chemotherapy was evaluated as per modified Response Evaluation Criteria in Solid Tumors criteria. The statistical analysis was carried out using SPSS version 19.0. Results: The study group and control group included 20 patients each. Hoarseness of voice and hemoptysis were significantly associated with lung cancer patients (P = 0.001 and P = 0.025, respectively). Serum levels above 8745 ng/ml for SAA and 2.55 ng/ml for serum CYFRA 21-1 were used as diagnostic biomarker in lung cancer. The serum levels of CYFRA 21-1 were found to be significantly raised in nonsmall cell carcinoma (NSCLC) in comparison to SCLC of lung. There was a statistically significant decrease in the serum levels of CYFRA 21-1 in lung cancer patients on C4 cycle of chemotherapy in comparison to C1 cycle (P = 0.014). Conclusion: SAA and CYFRA 21-1 could be valuable diagnostic biomarkers in lung cancer. CYFRA 21-1, in addition, could also be used as prognostic biomarker in lung cancer patients undergoing chemotherapy as it showed significant decrease after C4-cycle of chemotherapy. It can also be a potential biomarker to differentiate small cell and NSCLC. [ABSTRACT FROM AUTHOR]

Introduction: COPD Is Chronic Progressive Irreversible Airway Disease That Results In Restriction Of Physical Activities. Patients With COPD Complain Of Cough With Expectoration, Shortness Of Breath On Excretions, Wheezing. Cigarette smoking, exposure to dust, Smoke Pollutants, and occupational exposure is the usual cause of illness. Patient with COPD may develop long-term complications like Right sided heart failure and bronchogenic Carcinoma. Aims To assess the electrocardiography, echocardiography, hematological and radiological changes to reduce morbidity & mortality effects in COPD. Materials and Methods: The present study was a Randomized control trial. This Study was conducted from December 2020 to May 2022 at Medicine Department of Katihar Medical College. Result: In our study we classified patient with moderate, severe and very severe disease as per the severity of disease and P Pulmonale was found as a common abnormality. The studies responding lower incidence of P Pulmonale might have been done a large no. of Patient without taking into consideration the severity of the disease and R/S ratio > 1 in lead V1 correlated well with severely of COPD. This finding was present in 2(5.88%) in Moderate COPD, 2(6.45%) in severe COPD and 6(17.44%) in very severe COPD. Conclusion: COPD is one of the most prevalent diseases of world. Most of the people in fifth sixth decade usually have the disease. Disease starts earlier and with advancing age increases in severity and older patients usually have severe or very severe disease. Severity also depends on duration of smoking and age at which smoking begins. [ABSTRACT FROM AUTHOR]

Purpose: Improved outcomes in lung cancer treatment are seen in high-volume academic centers, making it important to understand barriers to accessing care at such institutions. Few qualitative studies examine the barriers and facilitators to early-stage lung cancer care at US academic institutions. Methods: Adult patients with suspected or diagnosed early-stage non-small cell lung cancer presenting to a multidisciplinary lung cancer clinic at a US academic institution over a 6-month period beginning in 2019 were purposively sampled for semi-structured interviews. Semi-structured interviews were conducted and a qualitative content analysis was performed using the framework method. Themes relating to barriers and facilitators to lung cancer care were identified through iterative team-based coding. Results: The 26 participants had a mean age of 62 years (SD: 8.4 years) and were majority female (62%), white (77%), and urban (85%). We identified 6 major themes: trust with providers and health systems are valued by patients; financial toxicity negatively influenced the diagnostic and treatment experience; social constraints magnified other barriers; patient self-advocacy as a facilitator of care access; provider advocacy could overcome other barriers; care coordination and good communication were important to patients. Conclusions: We have identified several barriers and facilitators to lung cancer care at an academic center in the US. These factors need to be addressed to improve quality of care among lung cancer patients. Further work will examine our findings in a community setting to understand if our findings are generalizable to patients who do not access a tertiary cancer care center. [ABSTRACT FROM AUTHOR]

Background: The tumor involvement of lymph nodes (LN) in N2 station is a very important factor for the further therapy decision and the prognosis of lung cancer patients. Today, integrated positron emission tomography-computed tomography (PET-CT) is considered to be the new standard in the staging of bronchial carcinoma. The aim of this study is to investigate the correctness of the clinical staging of the mediastinal LNs in operated patients and to investigate the sensitivity and specificity of the PET-CT examination for mediastinal LNs. Subjects and Methods: In the years 2010–2014, 359 patients underwent surgery for bronchial carcinoma. The histological examination of all mediastinal and hilar LNs was used as a reference to the data from the PET-CT examinations. The correctness of the PET staging, overestimation, and underestimation for the N stage was analyzed. In addition, the "sensitivity," "specificity," and "overall accuracy" of the PET-CT examination with regard to the N2 LNs were calculated. Results: It was found that in 8.9% the staging of the mediastinal N2/N3 LN stations was rated too high by the PET and in 11.2% too low. The study showed a sensitivity of 47.37%, a specificity of 90.07%, and an accuracy of 81.01% for the mediastinal LNs. Conclusion: Our study confirms the limited ability of integrated PET-CT in staging the mediastinal LNs. We, therefore, recommend a histological examination of the LNs in patients with PET-positive N2 LNs to avoid false-positive results and to initiate correct therapy. [ABSTRACT FROM AUTHOR]

Background: Primary care is known to be one of the most complex health care settings because of the high number of theoretically possible diagnoses. Therefore, the process of clinical decision-making in primary care includes complex analytical and nonanalytical factors such as gut feelings and dealing with uncertainties. Artificial intelligence is also mandated to offer support in finding valid diagnoses. Nevertheless, to translate some aspects of what occurs during a consultation into a machine-based diagnostic algorithm, the probabilities for the underlying diagnoses (odds ratios) need to be determined. Objective: Cough is one of the most common reasons for a consultation in general practice, the core discipline in primary care. The aim of this scoping review was to identify the available data on cough as a predictor of various diagnoses encountered in general practice. In the context of an ongoing project, we reflect on this database as a possible basis for a machine-based diagnostic algorithm. Furthermore, we discuss the applicability of such an algorithm against the background of the specifics of general practice. Methods: The PubMed, Scopus, Web of Science, and Cochrane Library databases were searched with defined search terms, supplemented by the search for gray literature via the German Journal of Family Medicine until April 20, 2023. The inclusion criterion was the explicit analysis of cough as a predictor of any conceivable disease. Exclusion criteria were articles that did not provide original study results, articles in languages other than English or German, and articles that did not mention cough as a diagnostic predictor. Results: In total, 1458 records were identified for screening, of which 35 articles met our inclusion criteria. Most of the results (11/35, 31%) were found for chronic obstructive pulmonary disease. The others were distributed among the diagnoses of asthma or unspecified obstructive airway disease, various infectious diseases, bronchogenic carcinoma, dyspepsia or gastroesophageal reflux disease, and adverse effects of angiotensin-converting enzyme inhibitors. Positive odds ratios were found for cough as a predictor of chronic obstructive pulmonary disease, influenza, COVID-19 infections, and bronchial carcinoma, whereas the results for cough as a predictor of asthma and other nonspecified obstructive airway diseases were inconsistent. Conclusions: Reliable data on cough as a predictor of various diagnoses encountered in general practice are scarce. The example of cough does not provide a sufficient database to contribute odds to a machine learning–based diagnostic algorithm in a meaningful way. [ABSTRACT FROM AUTHOR]

Objective: We characterize computed tomography (CT) and magnetic resonance imaging (MRI) features of bronchogenic cysts (BCs) and analyze misdiagnosis. Methods: The retrospective study consisted of 83 patients with BCs. CT and MRI images were assessed for mass location, maximum diameter, density, calcification, signal intensity, and enhancement pattern. Eighty-three patients underwent plain CT in which 53 underwent enhanced CT. Thirteen patients received both plain and enhanced MR, and only one received just a plain MR. Results: Eighty-three masses were all solitary, with 71 having a roundish morphology, and twelve having a lobulated or irregular morphology. Sixty-six masses are mediastinal type, four are intrapulmonary type, and 13 are ectopic type. Calcification occurred in 14 lesions. On plain CT, 13 lesions displayed water-like attenuation (-20- 20 Hu), and 70 showed soft-tissue attenuation (=21 Hu). On T1WI, eight masses were hyperintense, three were isointense, and three were hypointense. Fourteen masses were hyperintense on T2WI and (Apparent Diffusion Coefficient) ADC sequence. On (Diffusion Weighted Imaging) DWI, six masses were hypointense and eight were hyperintense. Enhanced T1WI showed seven cases were unenhanced, while six were marginally enhanced. Twenty cases were misdiagnosed as thymomas, eleven as neurogenic tumors, six as lymphangiomas, and two as lung cancer. Five cases were misdiagnosed as other diseases. Patients with BCs underwent MR (42.9%) had a lower rate of misdiagnosis than those who underwent CT alone (53.0%). Conclusion: The imaging findings of BCs in the chest are generally consistent. Misdiagnosis occurs frequently when CT attenuation values exceed 20 Hu. Diagnostic accuracy of BCs tends to improve with preoperative MR examination. [ABSTRACT FROM AUTHOR]

Background: In the ATLANTIS study, second-line lurbinectedin/doxorubicin did not improve overall survival (OS), however patients with a chemotherapy-free interval (CTFI) of ≥180 days had an improved progression free survival (PFS). The objective of this retrospective study was to identify the proportion of real-world small cell lung cancer (SCLC) patients who are suitable for lurbinectedin-based therapy based on these criteria. Methods: A retrospective study of all SCLC referred to BC Cancer between 2012 and 2017 was conducted. Patient demographics, staging, treatment, and survival data were collected retrospectively. Baseline characteristics were compared using descriptive statistics. OS was calculated using Kaplan–Meier curves. Statistically significant p-value was <0.05. Results: A total of 1048 patients were identified. Baseline characteristics: median age 68 years, 47% male, 61% current smoking status, 68% extensive disease. Best supportive care was received by 22%. First-line systemic therapy was platinum doublet for 71% of the population. Second-line systemic therapy was delivered to 22%. Of the 219 patients who received second-line systemic therapy after platinum doublet, 183 patients had a CTFI of ≥90 days and 107 patients had a CTFI of ≥180 days. Patients originally treated as limited stage disease, received platinum doublet as second line, received thoracic radiation (RT) or prophylactic cranial irradiation (PCI) were more likely to have a CTFI of ≥90 and ≥180 days. Conclusion: In our real-world SCLC population, only 21% of the SCLC population received second-line therapy after platinum doublet with 17% achieving CTFI of ≥90 days and 10% CTFI of ≥180 days. Based on this retrospective review, only a small fraction of platinum-treated patients would be preferentially offered lurbinectedin in the second-line setting. [ABSTRACT FROM AUTHOR]

Introduction: Lung malignancy is the main and utmost type of cancer cases and mortality with raising trends in recent decades particularly in emergent countries like India. Lung malignancy can be suspected when patient presents with clinical symptoms like cough, hemoptysis or incidental abnormality on chest x-ray/ Computed Tomography or by screening with low-dose CT. Material and Methods: A retrospective observational study done at Government hospital for chest and communicable diseases under Andhra Medical College, India from Jan 2017 to Dec 2019. Patients diagnosed with bronchogenic carcinoma either inpatient or outpatient were taken into consideration for analysis. Results: A total of 173 subjects were considered in study for analysis. Mean age found to be 57.67±11.36 years. 121 patients were male and 52 were female. 69.36% patients belonged to rural areas. 82.08% which accounted for 142 patients were smokers. Mean smoking index was 258±246.63. Most common presentation was cough and sob i.e., 83.24%. Most common radiological presentation was mass i.e., 54.3% (94) followed by pleural effusion in 24 cases (13.8%). Adenocarcinoma was observed in 83 patients (48%) followed by squamous cell in 61 patients (35%). Conclusion: Lung cancer was more common in elderly subjects with age >50 years with mean age of presentation in females being lower than males. Adenocarcinoma was the predominant histological type in both males and females. Smoking still continues to be the main and important risk factor for lung cancer. [ABSTRACT FROM AUTHOR]

Aim: To present a maxillary tumour showing features of sclerosing odontogenic carcinoma (SOC), i.e. bland cytology, partly sclerotic stroma and neural involvement, and contemplate whether its diagnostic feature, neural involvement, could represent epithelial neurotropism in a central odontogenic fibroma (COdF). Materials and methods: A 58‐year‐old male presented with a depression on the palatal side of the alveolar ridge, extending from the right canine to the right first molar tooth. A CBCT of the maxilla revealed a multilocular radiolucency, with ill‐defined borders, causing destruction of the buccal and palatal cortical bone. Results: Complete removal of the tumour was performed under general anaesthesia. Healing was uneventful and there was no evidence of recurrence in the 36 months clinical and radiographical follow up. The final diagnosis was an odontogenic tumour with bland cytology, sclerosis and neural involvement, consistent with SOC. Conclusions: The tumour presented herein showed clinical, radiographical and microscopical features consistent with SOC and COdF, with neural involvement favouring a diagnosis of SOC. Epithelial neurotropism in a COdF could account for the similarities between those lesions and the rather quiescent, for an infiltrative intraosseous carcinoma, clinical behaviour of SOC. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the diagnostic accuracy of contrast enhanced CT scan in diagnosing bronchogenic carcinoma, taking histopathology as gold standard. STUDY DESIGN: Cross-sectional validation study. SETTING: Department of Radiology, Armed Forces Institute of Radiology, Rawalpindi from 8th December 2020 to 7th June 2021. METHODOLOGY: A total of 148 patients with suspected bronchogenic carcinoma between 20-70 years of age were included. Patients with already taking treatment, CRF and h/o allergy to contrast agent were excluded. Then CT was performed on Toshiba Asteion Multi Slice Scanner with I/V contrast.CT scan findings were interpreted by one consultant radiologist (at least 5 years of experience) and was looked for bronchogenic carcinoma as per-operational definition. All patients were then undergone CT guided trans-thoracic biopsy of pulmonary lesions by the relevant interventional radiologist and specimen was sent to institutional pathology laboratory for histopathology. RESULTS: Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of contrast enhanced CT scan in diagnosing bronchogenic carcinoma, taking histopathology as gold standard was 94.32%, 91.67%, 94.32%, 91.67% and 93.24% respectively. CONCLUSION: This study concluded that the diagnostic accuracy of contrast enhanced CT scan in diagnosing bronchogenic carcinoma is very high. [ABSTRACT FROM AUTHOR]

Background: Situs inversus totalis (SIT) is a relatively rare congenital abnormality in which the major thoracic and abdominal visceral organs are reversed from their usual positions. In patients with SIT and bronchial carcinoma, surgical difficulty increases sharply. It has been reported that the video-assisted thoracic surgery (VATS) still poses the operator to a challenge situation. The similarity of surgical positions and the flexibility of the mechanical arm in robotic surgery, may be beneficial to SIT patients due to reducing technical difficulties. Here, we present a first case of SIT patient with lung cancer, in which Da Vinci robot-assisted thoracic surgery (RATS) was performed successfully.Case Presentation: A 66-year old patient, previously diagnosed with SIT since childhood, came to our hospital with two pulmonary nodules in his left lung field. The bigger one had increased somewhat for the last 2 years of follow-up. Software Mimics was preoperatively carried out to analyze anatomical variations. RATS was conducted to complete left upper lobectomy and left middle wedge resection. The patient had no intraoperative complications and was discharged day 5 after the operation.Conclusions: This is the first report of a successful robot-assisted lung cancer resection in a patient with SIT. In such challenging cases as lung cancer and rare anomaly as SIT, RATS is more advantageous and suitable than VATS with the help of software Mimics utilized for 3D reconstruction, which can identify the anatomical abnormalities and facilitate the surgical procedures. [ABSTRACT FROM AUTHOR]

Introduction: Bronchogenic carcinoma accounts for more cancer-related deaths than any other malignancy and is the most frequently diagnosed cancer in the world. Bronchogenic carcinoma is by far the leading cause of cancer death among both men and women, making up almost 25% of all cancer deaths. The objective of this study was to identify the changing trends, if any, in radiological patterns of bronchogenic carcinoma to document the various computed tomography (CT) appearances of bronchogenic carcinoma with histopathologic correlation.Methods: This was a single-center cross-sectional study on 162 patients with clinical or radiological suspicion of bronchogenic carcinoma with histopathological confirmation of diagnosis.Results: There was a male preponderance with bronchogenic carcinoma and smoking being the most common risk factor. Squamous cell carcinoma followed by adenocarcinoma and small cell carcinoma is the most common histologic subtype. Squamous cell carcinoma was noted to be present predominantly in the peripheral location (55.5%), and adenocarcinoma was noted to be present predominantly in the central location (68.4%).Conclusion: CT is the imaging modality of choice for evaluating bronchogenic carcinoma and provides for precise characterization of the size, extent, and staging of the carcinoma. Among 162 bronchogenic carcinoma cases evaluated in the current study, a definite changing trend in the radiological pattern of squamous cell carcinoma and adenocarcinoma was observed. Squamous cell carcinoma was predominantly noted to be a peripheral tumor, and adenocarcinoma is predominantly noted to be a central tumor. Surveillance or restaging scans are recommended, considering the high mortality rate in patients with bronchogenic carcinoma. [ABSTRACT FROM AUTHOR]

Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumor. It is characterized by showing, on histopathological examination, clusters of vacuolated and clear tumor cells with epithelial differentiation surrounded by fibrocollagenous stroma and fibroblasts. The present study presents a rare clinical case of mandibular CCOC associated with an impacted tooth in a 26-year-old woman surgically treated with mandibulectomy and reconstruction with iliac crest bone graft. The patient has been followed up for 22 months without signs of recurrence. A search for case report/case series was carried out in the PUBMED database, as well as in the references of relevant previously published literature reviews. Ninety-six publications were identified, totaling 136 distinct cases reported. Female sex was the most affected (63.1%) with 63.3% of cases occurring in patients in the fifth, sixth, or seventh decades of life. The mandible was more affected than the maxilla (74.2%). Association of CCOC with impacted teeth was found in 2.4% of cases, thus rendering it a rare occurrence. The present case report corroborates the results of the survey regarding sex and anatomical location of the tumor; however, it contradicts the findings regarding age predilection. The case described is the fourth known occurrence of tooth impaction associated with the tumor and the first in a female. In conclusion, CCOC should be considered, as well as other malignancies, as a possible diagnosis of maxillary or mandibular intraosseous lesions even in unusual circumstances such as in association with impacted teeth and in young patients. [ABSTRACT FROM AUTHOR]

Background: Hypoxia and angiogenesis, as prominent characteristics of malignant tumors, are implicated in the progression of hepatocellular carcinoma (HCC). However, the role of hypoxia in the angiogenesis of liver cancer is unclear. Therefore, we explored the regulatory mechanisms of hypoxia-related angiogenic genes (HRAGs) and the relationship between these genes and the prognosis of HCC. Methods: The transcriptomic and clinical data of HCC samples were downloaded from public datasets, followed by identification of hypoxia- and angiogenesis-related genes in the database. A gene signature model was constructed based on univariate and multivariate Cox regression analyses, and validated in independent cohorts. Kaplan-Meier survival and timedependent receiver operating characteristic (ROC) curves were generated to evaluate the model’s predictive capability. Gene set enrichment analysis (GSEA) was performed to explore signaling pathways regulated by the gene signature. Furthermore, the relationships among gene signature, immune status, and response to anti-angiogenesis agents and immune checkpoint blockade (ICB) were analyzed. Results: The prognostic model was based on three HRAGs (ANGPT2, SERPINE1 and SPP1). The model accurately predicted that low-risk patients would have longer overall survival than high-risk patients, consistent with findings in other cohorts. GSEA indicated that high-risk group membership was significantly associated with hypoxia, angiogenesis, the epithelial-mesenchymal transition, and activity in immune-related pathways. The high-risk group also had more immunosuppressive cells and higher expression of immune checkpoints such as PD-1 and PD-L1. Conversely, the low-risk group had a better response to anti-angiogenesis and ICB therapy. Conclusions: The gene signature based on HRAGs was predictive of prognosis and provided an immunological perspective that will facilitate the development of personalized therapies. [ABSTRACT FROM AUTHOR]

Mucoepidermoid Carcinoma (MEC) it can origin from a mandibular odontogenic cyst. We report the case of a 63‐year‐old man with MEC of the right retromolar trigonum of the mandibula. We performed a wide mandibular excision and immediate reconstruction with a fibula bone free flap. Treatment of mandibular mucoepidermoid carcinoma central type can be carried out safely and aesthetical valid through a wide segmental mandibular excision with an immediate reconstruction with fibula bone‐free flap and a postoperative RT. [ABSTRACT FROM AUTHOR]

Introduction: Primary intraosseous carcinoma, NOS (PIOC), is a rare malignancy which has been described in the maxilla and mandible often arising from odontogenic cysts. The authors describe a case of PIOC arising from a dentigerous cyst associated with a lower right third molar in 78‐year‐old male. Aims: To demonstrate that seemingly innocuous pathology may represent a malignant process. In the presence of 'red‐flag' symptoms, one must consider alternative diagnoses and action them accordingly. Findings and Discussion: The initial clinical and radiographic features suggested a common innocuous presentation, although other features which presented later were suggestive of malignancy. PIOC is treated conventionally by radical surgery to achieve a disease‐free margin with adjuvant neck dissection. In the case described, the patient underwent hemi‐mandibulectomy with neck dissection and fibula free flap reconstruction. Conclusion: Pathology associated with third molars is extremely common, very occasionally malignancy can mimic these more common conditions. As such, careful clinical examination of the affected site and neighbouring structures (including the lymph nodes of the head and neck) should be routinely performed in all patients. Even in the presence of typical features clinical and radiographic features, tissue samples should be sent for histopathological analysis of what may appear to be harmless follicular or early cystic tissue. [ABSTRACT FROM AUTHOR]

Background: Bronchogenic cancer is the most common cause of cancer-related mortality in both sexes all over the world, especially across urban population. However, early diagnosis and timely intervention may minimize the mortality rate to a certain extent and increase the 5-year survival rate to 70–80%. Among the diagnostic modalities available, bronchoscopic biopsy, though gold standard, is less feasible in peripheral centers where we depend more on cytological techniques such as bronchoalveolar lavage (BAL) fluid and sputum cytology for quick diagnosis. Aims and Objectives: This study was conducted at a tertiary care center for studying usefulness of post-bronchoscopic sputum cytology and also to correlate sputum cytology with brushing and washing cytology taking biopsy as the gold standard in the diagnosis of lung cancer. Materials and Methods: A cross-sectional observational study was done in Nil Ratan Sircar Medical College, Kolkata, over a period of 18 months in clinically and radiologically suspected patients of bronchogenic carcinoma. Bronchoscopic samples using a fiber-optic bronchoscope were collected from 50 such patients. In every case, following sequence of events was performed: Pre-biopsy washing (BAL fluid), brushing, biopsy, post-biopsy washing (BAL), and post-bronchoscopy sputum. Cytological examination done and compared with bronchoscopic biopsy specimens of the same. Results: All the available information were meticulously documented in tables and charts along with other variables such as age, sex, morphological types, and cytological and histological diagnosis. SPSS software was used to calculate the efficacy and statistical significance, if any, of these different diagnostic tools and its correlation with the final histological diagnosis. Conclusion: We found that BAL cytology had higher sensitivity and positive predictive value in early and accurate diagnosis of lung malignancy. However, post-bronchoscopy sputum cytology had no additional benefit with respect to BAL and brush cytology (in addition to bronchial biopsy) in diagnosing the same. [ABSTRACT FROM AUTHOR]

A 60‐year‐old woman with an abnormality discovered during a chest X‐ray was referred to the authors' hospital for diagnosis and treatment. Upon enhanced computed tomography (CT), endoscopic ultrasonography, and magnetic resonance imaging, a tumor on the left side of the lower thoracic esophagus was detected. We diagnosed mediastinum cyst. One year after the first visit, a CT examination confirmed an increase in lesion size. Therefore, surgery was performed using a left thoracoscopic approach in the prone position. Before surgery, 3D models were used for simulation. Excision was performed without leakage of the contents. The histopathological diagnosis was a bronchogenic cyst. The left thoracoscopic surgery in the prone position is an uncommon approach but is useful for resecting tumors in the left side of the lower mediastinum. The authors were well‐prepared and able to perform safe and reliable surgery. [ABSTRACT FROM AUTHOR]

Introduction: Long intergenic non-protein-coding RNA 1296 (LINC01296), a newly identified lncRNA, can function as an oncogenic driver to promote the development of multiple carcinomas. However, the effect of LINC01296 on oral squamous cell carcinoma (OSCC) is still unclear.Material and methods: We determined the expression and role of LINC01296 in OSCC tissues and cell lines. The cell viability, migration and invasion were determined by MTT, wound healing assay and transwell assay, respectively. Flow cytometry was used for detecting cell cycle and apoptosis. The interaction and association between LINC01296, microRNA-485-5p (miR-485-5p) and p21 (RAC1) activated kinase 4 (PAK4) were analyzed by RNA immunoprecipitation (RIP) and luciferase reporter assays. The xenograft mouse model was established to detect the effect of LINC01296 on OSCC tumor growth.Results: Our study showed that LINC01296 was over-expressed in OSCC tissues and cell lines. The level of LINC01296 was positively correlated with the patient's tumor node metastasis (TNM) stage and nodal invasion. Knockdown of LINC01296 effectively inhibits cell viability, migration and invasion but promotes cell apoptosis in vitro. The in vivo experiment showed that LINC01296 knockdown inhibited OSCC tumor growth. The following analysis indicated that LINC01296 acted as a ceRNA for miR-485-5p, and PAK4 was identified as a direct target of miR-485-5p. Furthermore, we found that the effects of LINC01296 on OSCC progression were through regulating the expression of PAK4/p-MEK/p-ERK via sponging miR-485-5p.Conclusions: LINC01296 promote the cell cycle, proliferation, migration and invasion, and inhibit apoptosis of OSCC cells through activating the MAPK/ERK signaling pathway via sponging miR-485-5p to regulate PAK4 expression. These results suggested that the LINC01296/miR-485-5p/PAK4 axis was closely associated with OSCC progression. Our study provides a new insight into the molecular pathogenesis of OSCC, and may supply novel biomarkers for diagnosis and therapy of OSCC. [ABSTRACT FROM AUTHOR]

Background: C-reactive protein (CRP) is a commonly used marker of systemic inflammation. The elevated levels of CRP are associated with an increased risk of all-cancer, lung cancer, breast, prostate and colorectal cancer. Present study was aimed to study of association between the serum CRP level and different subtypes in Non-Small Cell Lung Cancer.Material and Methods:Present study was single-center, cross-sectional study, conducted newly diagnosed patients with non-small cell lung cancer. On admission CRP levels were measured & correlated with different subtypes in Non-Small Cell Lung Cancer.Results:Out of 38 subjects, 18 (47.3%) subjects were aged 46-60 & male (57.6%). Breathlessness was the most common presenting symptom (21.2%), followed by cough with breathlessness (18.4%). Squamous Cell Carcinoma was the most common histopathology (55.3%) among the Non-Small Cell Lung Cancer patients. As per TNM classification 16 (42.1%) had stage III followed by 15 (39.5%) had stage IV, 6 (15.8%) had stage II and 1 (2.6%) had stage I. CRP levels were higher in Bronchogenic carcinoma (43.75) followed by Squamous cell carcinoma (41.84) and Adenocarcinoma (15.11).Conclusion:There is no association between serum CRP with different subtypes, tumour size and TNM staging in Non-Small Cell Lung Cancer. Hence, serum CRP is not a useful prognostic indicator in the Non-Small Cell Lung Cancer. [ABSTRACT FROM AUTHOR]

Background: Adipogenic transdifferentiation was an important carcinogenic factor in various tumors, while studies on its role in clear cell renal cell carcinoma (ccRCC) were still relatively few. This study aimed to investigate its prognostic value and mechanism of action in ccRCC. Methods: Gene expression profiles and clinical data of ccRCC patients were obtained from The Cancer Genome Atlas database. Nonnegative matrix factorization was used for clustering. Gene set variation analysis (GSVA) and gene set enrichment analysis (GSEA) were used to analyze the pathways and biological process activities. single-sample GSEA (ssGSEA) was utilized to quantify the relative abundance of each immune cell. Tumor Immune Estimation Resource (TIMER) was used to evaluate the proportion of various immune infiltrating cells across diverse cancer types. Real-Time PCR was performed to examine the gene expression. R software was utilized to analyze the expression and prognostic role of genes in ccRCC. Results: A total of 49 adipose-related genes (ARGs) were screened for differential expression between normal and ccRCC tissues. Based on differentially expressed ARGs, patients with ccRCC were divided into two adipose subtypes with different clinical, molecular, and pathway characteristics. Patients in cluster A exhibited more advanced pathological stages, higher expressions of RARRES2 and immune checkpoint genes, higher immune infiltration scores, and less nutrient metabolism pathways. Adipose differentiation index (ADI) was constructed according to the above ARGs and survival data, and its robustness and accuracy was validated in different cohorts. In addition, it was found that the expression of ARGs was associated with immune cell infiltration and immune checkpoint in ccRCC, among which GBP2 was thought to be the most relevant gene to the tumor immune microenvironment and play a potential role in carcinogenesis and invasion of tumor cells. Conclusion: Our analysis revealed the consistency of higher adipogenic transdifferentiation of tumor cells with worse clinical outcomes in ccRCC. The 16-mRNA signature could predict the prognosis of ccRCC patients with high accuracy. ARGs such as GBP2 might shed light on the development of novel biomarkers and immunotherapies of ccRCC. [ABSTRACT FROM AUTHOR]