1
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Narin Tongal S, Yilmaz Ö, Özgüven AA, Yüksel H. DICER1 Syndrome: Coocurrence of Pleuropulmonary Blastoma and Cystic Nephroma. J Bronchology Interv Pulmonol 2024; 31:94-97. [PMID: 38014858 DOI: 10.1097/lbr.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
| | - Özge Yilmaz
- Department of Pediatrics and Pediatric Allergy and Immunology
| | - Ali Aykan Özgüven
- Department of Pediatrics and Department of Pediatric Oncology, Celal Bayar University, Manisa, Turkey
| | - Hasan Yüksel
- Department of Pediatrics and Pediatric Chest Diseases
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2
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Li C, Guan WB, Wang KZ, Yang SY, Wang RF. [Clinicopathological analysis of type Ⅰ regressed pleuropulmonary blastoma in children]. Zhonghua Bing Li Xue Za Zhi 2023; 52:1154-1156. [PMID: 37899323 DOI: 10.3760/cma.j.cn112151-20230413-00256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Affiliation(s)
- C Li
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - W B Guan
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - K Z Wang
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - S Y Yang
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - R F Wang
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
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3
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Carr K, Wang H, Bedoya M. Type I pleuropulmonary blastoma incidentally diagnosed in an infant with RSV bronchiolitis. Pediatr Pulmonol 2023; 58:1616-1618. [PMID: 36799061 PMCID: PMC10121902 DOI: 10.1002/ppul.26363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 02/18/2023]
Affiliation(s)
- Katherine Carr
- Department of Pediatric Allergy, Immunology and Pulmonary Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Huiying Wang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mariana Bedoya
- Department of Pediatric Allergy, Immunology and Pulmonary Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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4
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Murphy AJ. Can Computed Tomography Scans Reliably Distinguish Pleuropulmonary Blastoma From Congenital Lung Malformations? JAMA Netw Open 2022; 5:e2219826. [PMID: 35771580 DOI: 10.1001/jamanetworkopen.2022.19826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Andrew Jackson Murphy
- Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis
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5
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Hosoda H, Nakashima Y, Koiso H, Nakagawa A, Noguchi C. [Biphasic Pulmonary Blastoma without Recurrence for Six Years After Surgery:Report of a Case]. Kyobu Geka 2022; 75:72-75. [PMID: 35249079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 62-year-old man was referred to our hospital for a lung tumor. Computed tomography (CT) of the chest showed a 62×55×68 mm well-circumscribed tumor in the upper lobe of the right lung. A transbronchial lung biopsy was performed, but a diagnosis was not achieved. Positron emission tomography-CT demonstrated intense F-fluorodeoxyglucose uptake in the mediastinal side of the tumor. Surgery was performed under the suspicion of primary lung cancer. The intraoperative pathological examination indicated a non-small-cell carcinoma. Thus, right upper lobectomy and wedge resection of the right lower lobe were performed. Microscopically, the tumor was composed of epithelial components, mimicking fetal lung tissue and embryogenic stroma. Therefore, the tumor was diagnosed as a biphasic pulmonary blastoma (p-StageⅡA). After the post-operative adjuvant chemotherapy, he has remained healthy without recurrence six years after the surgery.
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Affiliation(s)
- Hiroshi Hosoda
- Department of Thoracic Surgery, Tokyo Kyosai Hospital, Tokyo, Japan
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6
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Pooniya S, McKinnie A, Taylor T, Will M, Wallace W. Classic biphasic pulmonary blastoma (CBPB): a rare primary pulmonary malignancy. BMJ Case Rep 2021; 14:e244151. [PMID: 34376421 PMCID: PMC8356168 DOI: 10.1136/bcr-2021-244151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/04/2022] Open
Abstract
Classic biphasic pulmonary blastoma (CBPB) is a very rare primary pulmonary malignancy with distinctive clinical and pathological features. Usually CBPB presents with either non specific symptoms or is diagnosed incidentally. Histologically CBPB is composed of a mixture of malignant epithelial and stromal cells resembling fetal lung tissue. Surgical resection is the mainstay of treatment with further chemotherapy or radiotherapy on a case-by-case basis. However, due to its rarity, no definite treatment guidelines are available. CBPB overall has a very poor prognosis with a 5-year survival rate of only 15%. Our patient presented with cough and haemoptysis. Her chest radiograph demonstrated a large right-sided lung mass. Further investigations included CT, CT-guided biopsy and PET CT which were discussed at multidisciplinary team meetings. The patient then underwent complete surgical excision. We report this rare malignancy with radiological and pathological features, comparing them with previously reported cases.
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Affiliation(s)
- Shashank Pooniya
- Clinical Radiology, Ninewells Hospital and Medical School, Dundee, UK
| | - Angela McKinnie
- Clinical Radiology, Ninewells Hospital and Medical School, Dundee, UK
| | - Thomas Taylor
- Clinical Radiology, Ninewells Hospital and Medical School, Dundee, UK
| | - Malcolm Will
- Consultant Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - William Wallace
- Professor Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
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7
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Abstract
Pulmonary blastoma (PB) is a very rare malignant lung tumor consisting of classic biphasic PB, well-differentiated fetal adenocarcinoma, and pleuropulmonary blastoma. We herein present an unusual case involving a patient with classic biphasic PB who underwent right upper lobe resection and subsequent treatment. No standard treatment guidelines are available for PB because of its rarity. Our patient received nedaplatin plus paclitaxel as adjuvant chemotherapy. After disease recurrence, the patient received two cycles of etoposide-cisplatin and six cycles of pemetrexed, bevacizumab, and carboplatin. Because of severe adverse effects of the chemotherapy, the patient was finally administered anlotinib, a new oral multikinase inhibitor. Both the tumor size and the serum tumor marker concentration decreased. In conclusion, surgical excision is the treatment of choice for PB. Chemotherapy in the present case resulted in PB activity that was consistent with the literature. Targeted therapies including antiangiogenic agents should be considered as a new treatment option for this rare disease.
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Affiliation(s)
- Zhuanbo Luo
- Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Respiratory Disease, Ningbo Hospital, Zhejiang University School of Medicine, Zhejiang University, Ningbo, Zhejiang, China
| | - Chao Cao
- Department of Respiratory Disease, Ningbo Hospital, Zhejiang University School of Medicine, Zhejiang University, Ningbo, Zhejiang, China
| | - Ning Xu
- Department of Respiratory Disease, Ningbo Hospital, Zhejiang University School of Medicine, Zhejiang University, Ningbo, Zhejiang, China
| | - Kejing Ying
- Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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8
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Arghirescu TS, Cârstea AM, Oprişoni LA, Heredea ER, Burlacu ON, Horhat ID, Popoiu CM. Type II pleuropulmonary blastoma in a 2-year-old girl: a case report. Rom J Morphol Embryol 2019; 60:1305-1310. [PMID: 32239109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pleuropulmonary blastoma (PPB) is a very rare, malignant aggressive primary lung tumor, which occurs mainly in children less than 5 years old. Due to its poor prognosis, it is aggressively treated with multimodal therapy including surgery and chemotherapy. We present a case of PPB in a 2-year-old girl who was brought to the pediatric clinic for fever, cough and respiratory distress. Imaging studies showed a heterogeneous solid-cystic mass (12∕9∕11 cm) in the upper right pulmonary lobe. Through right thoracotomy, a specimen was obtained, the histopathological and immunohistochemical features of the specimen being suggestive for type II PPB. Aggressive chemotherapy and right pneumonectomy resulted in control of disease, the patient being currently in complete remission four years after the diagnosis.
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Affiliation(s)
- Teodora Smaranda Arghirescu
- Department of Pediatrics, "Victor Babeş" University of Medicine and Pharmacy, Timişoara; IIIrd Clinic of Pediatrics, "Louis Ţurcanu" Emergency Hospital for Children, Timişoara, Romania; ; Department of ENT, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania;
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9
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Shomura S, Suzuki H, Kanemitsu S, Kondo C. [Surgical Case of Pulmonary Blastoma;Report of a Case]. Kyobu Geka 2017; 70:1125-1127. [PMID: 29249794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 81-year-old man consulted our hospital because of an abnormal shadow on a chest radiography in the right lower field. Computed tomography of the chest showed a mass shadow measuring 41 mm in diameter in the lower lobe of the right lung. There was no lymph node swelling in the hilum or mediastinum. A diagnosis of the lung cancer was suspected and the patient underwent right lower lobectomy with standard nodal dissection. Microscopically, the tumor revealed the epithelial component mimicking fetal lung tissue and proliferative mesenchymal component consisting of immature and heteromorphic nuclear cells as well. The final diagnosis was pulmonary blastoma classified as pathological stage IIB. He was not scheduled for adjuvant chemotherapy due to his older age.
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Affiliation(s)
- Shin Shomura
- Department of Thoracic Surgery, Mie General Medical Center, Yokkaichi, Japan
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10
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Abstract
Pulmonary blastomas are rare malignancies, representing 0.25% to 0.5% of all primary lung neoplasms with often aggressive progression and poor prognosis. Clinical management of pulmonary blastomas depends on histologic subtype, staging, and presentation, and may consist of surgery, chemotherapy, and radiation. Biphasic pulmonary blastoma is a subtype of pulmonary blastoma that exhibits biphasic histology, with both epithelial and mesenchymal malignant elements. We report a case of biphasic pulmonary blastoma in a 33-year-old female with 1 pack per day history of smoking for approximately 16 years, who presented with left-sided pleuritic chest pain on deep inspiration without otherwise significant pat medical history. Imaging evaluation using chest radiography, computed tomography, and magnetic resonance imaging identified a heterogenous, well-circumscribed, left lower lobe mass with extensive necrosis and hemorrhage. No lymphadenopathy or distant metastasis was detected through imaging evaluation. Surgical resection of the tumor followed by histopathological analysis confirmed a biphasic pulmonary blastoma.
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Affiliation(s)
- Fadi Nemeh
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Anderson H Kuo
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Jenny Ross
- Department of Pathology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Carlos S Restrepo
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
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11
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Bosch-Barrera J, Holguin F, Baldó X, Rubio M, Porta R, Fuentes R, Teixidó C, Ramirez JL, Ferran N, Sebastián F, Rosell R. Neoadjuvant Chemoradiotherapy Treatment for a Classic Biphasic Pulmonary Blastoma with High PD-L1 Expression. Anticancer Res 2015; 35:4871-4875. [PMID: 26254381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Pulmonary blastomas are rare malignant tumors, comprising only 0.25-0.5% of all malignant lung neoplasms. The prognosis of pulmonary blastoma is very poor, with an overall five-year survival of 16%. No standard treatment has been defined for unresectable disease. We present the case of a 25-year-old woman with unresectable locally advanced classic biphasic pulmonary blastoma (CBPB) successfully treated with neodjuvant chemoradiotherapy based on two chemotherapy induction cycles of cisplatin plus etoposide, followed by concurrent weekly cisplatin to 50.4 Gy radiotherapy treatment. The patient had a significant reduction in tumor size, allowing for complete resection by pneumonectomy. Molecular study for epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK), proto-oncogene receptor tyrosine kinase (ROS1) and rearranged during transfection (RET) rearrangements, and programmed death ligand 1 (PD-L1) expression was performed in the pre-treatment tumor sample. Our patient presented a high expression (>90% of tumor cells) of PD-L1. To our knowledge, this is the first report of PD-L1 expression in CBPB. This could lead to new treatment options based on new immunotherapy agents blocking the PD-1/PD-L1 pathway for this rare disease with poor prognosis.
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Affiliation(s)
- Joaquim Bosch-Barrera
- Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain Girona Biomedical Research Institute (IDIBGi), Girona, Spain Department of Medical Sciences, Medical School, University of Girona, Girona, Spain
| | - Francia Holguin
- Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain
| | - Xavier Baldó
- Department of Thoracic Surgery, Doctor Josep Trueta University Hospital, Girona, Spain
| | - Matilde Rubio
- Department of Thoracic Surgery, Doctor Josep Trueta University Hospital, Girona, Spain
| | - Rut Porta
- Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain Girona Biomedical Research Institute (IDIBGi), Girona, Spain Department of Medical Sciences, Medical School, University of Girona, Girona, Spain
| | - Rafael Fuentes
- Department of Radiotherapy. Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Girona, Spain
| | - Cristina Teixidó
- Pangaea Biotech, Quirón Dexeus University Institute, Barcelona, Spain
| | - José Luis Ramirez
- Catalan Institute of Oncology, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Nuria Ferran
- Nuclear Medicine Unit, Department of Radiology, Diagnostic Imaging Institute, Girona, Spain
| | - Fernando Sebastián
- Department of Thoracic Surgery, Doctor Josep Trueta University Hospital, Girona, Spain
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Germans Trias i Pujol University Hospital, Badalona, Spain Dr Rosell Oncology Institute, Quirón Dexeus University Hospital, Barcelona, Spain Molecular Oncology Research Foundation (MORe), Barcelona, Spain
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12
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Anand R, Narula MK, Chadha R, Chander J, Jain M. Pleuropulmonary blastoma. J Indian Med Assoc 2013; 111:128-129. [PMID: 24003574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Pleuropulmonary blastoma is a rare and aggressive malignant tumour that affects young children. A case of pleuropulmonary blastoma has been presented in a 9-year-old male child who was initially diagnosed and treated as pulmonary tuberculosis. Computed tomography of chest revealed a large heterogeneously enhancing mass with calcification in left hemithorax and left pleural effusion. The mass was seen to invade mediastinum and left hemidiaphragm. Thoracotomy revealed unresectable tumour involving both lobes of left lung with invasion of mediastinum and left hemidiaphragm. Biopsy confirmed type II pleuropulmonary blastoma and the child was treated with chemotherapy and radiotherapy.
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Affiliation(s)
- Rama Anand
- Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi 110001
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13
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Jethava A, Dasanu CA. Adult biphasic pulmonary blastoma. Conn Med 2013; 77:19-22. [PMID: 23427368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Pulmonary blastoma is a rare malignant tumor, histologically resembling the fetal lung. Since its first description in 1945, only about 200 cases have been reported worldwide. This tumor predominantly affects children, but has also been reported in adults with a peak incidence in the fourth decade of life. Pulmonary blastoma has a variable clinical course that cannot be determined by its histological appearance. We report a 51-year-old patient with a large biphasic pulmonary blastoma who was treated with surgical excision. The patient remains disease-free eleven months postoperatively. As relapse rates are high in patients with large biphasic (type 2) tumors, the patient is being monitored closely. Although a rare occurrence after the age of 20, pulmonary blastoma should remain in the differential diagnosis of a lung mass in an adult.
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Affiliation(s)
- Ashif Jethava
- Department of Hospital Medicine, Saint Francis Hospital and Medical Center, Hartford, USA
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14
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Agrawal D, Lahiri TK, Lakhotia S, Gupta G. Pulmonary blastoma in a young adult. Indian J Chest Dis Allied Sci 2012; 54:189-192. [PMID: 23008928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Pulmonary blastoma is a rare but aggressive malignancy of the lung comprising epithelial and mesenchymal elements that resemble fetal lung tissue. This report described a case of an 18-year-old male who presented with cough and weight loss for a month. Computed tomography (CT) of the thorax revealed a large mass with mixed solid and cystic lesions on the right side of chest along with pleural effusion and mediastinal lymphadenopathy. Massive debulking was performed followed by chemotherapy. A biphasic pulmonary blastoma was diagnosed on histopathology.
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Affiliation(s)
- Damyanti Agrawal
- Department of Cardiothoracic Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi (Uttar Pradesh), India.
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15
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Oliver A, Ganne PA, Bastien C, Vignaud JM, Regent D, Laurent V. [A rare rumor: pulmonary blastoma with pleural involvement]. J Radiol 2010; 91:1297-1301. [PMID: 21242914 DOI: 10.1016/s0221-0363(10)70196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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16
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Zuker NB, Dietl CA, Kenna S, Fischer EG, Gardner D. Unusual survival of an adult with pleuropulmonary blastoma and neurofibromatosis. J Thorac Cardiovasc Surg 2007; 134:541-2. [PMID: 17662818 DOI: 10.1016/j.jtcvs.2007.04.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2007] [Accepted: 04/26/2007] [Indexed: 10/23/2022]
Affiliation(s)
- Noah B Zuker
- Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131-0001, USA
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17
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Aljehani YM, Elbaz AM, Moghazy KM, Alardi AA, Montaser AA, El-Ghoneimy YF. Pleuropulmonary blastoma. A rare childhood malignancy. Saudi Med J 2007; 28:1443-5. [PMID: 17768479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Pleuropulmonary blastoma PPB is an extremely rare, intrathoracic neoplasm of early childhood with unfavorable outcome. We present a case of a 4-year-old boy with progressive dyspnea due to tension pneumothorax. After chest tube insertion, the CT scan showed large multilocular cystic lesions containing air and solid areas involving the right lower lobe, and its related pleura. Thoracotomy was carried out, and the cyst was removed with the pleural solid areas. Histopathological examination confirmed the diagnosis of PPB type II. Postoperatively, the patient was scheduled to start chemotherapy in a specialized pediatric oncology center to complete the treatment.
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Affiliation(s)
- Yasser M Aljehani
- Department of Surgery, Thoracic Unit, King Faisal University, Al-Khobar, Kingdom of Saudi Arabia.
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18
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Zamboni M, Lannes DC, Monteiro A, Cavalcanti A, De Carli CRS, Da Cás Vita MI, Toscano E, de Blasi SZ, Loureiro GL, de Blasi P. [Pulmonary blastoma]. Rev Port Pneumol 2007; 13:391-5. [PMID: 17632678 DOI: 10.1016/s0873-2159(15)30358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Pulmonary blastoma is a rare primary lung tumor with poor prognosis that commonly presents at a younger age than the non-small cell lung cancer. Classically they are large, symptomatic tumors with lymph nodal metastasis and carry poor prognosis. Pathological examination revealed features suggesting a biphasic tumor with mesenchymal and epithelial components. Over 200 cases have been reported so far worldwide since the first description of the tumor in 1945. Authors present a case of pulmonary blastoma with literature revision.
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Affiliation(s)
- Mauro Zamboni
- MD, FCCP (TE SBPT)-Pneumologista do Grupo de Oncologia Torácica do HC I - INCA/MS - Rio de Janeiro.
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19
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Pilla ES, Sanchez P, Mädke GR, Camargo S, Camargo JDJP. Blastoma pulmonar: tratamento cirúrgico por lobectomia superior direita e broncoplastia. J Bras Pneumol 2006; 32:75-7. [PMID: 17273572 DOI: 10.1590/s1806-37132006000100014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Accepted: 04/24/2005] [Indexed: 11/22/2022] Open
Abstract
O blastoma pulmonar é um tumor maligno raro, de crescimento rápido, composto por uma mistura de células epiteliais e mesenquimais malignas. Relatamos o caso de uma paciente com hemoptise e uma massa no lobo superior direito. Apresentava uma reserva pulmonar limitada e achado fibrobroncoscópico de comprometimento do brônquio intermediário. O tratamento realizado através de lobectomia superior direita com broncoplastia foi inédito. A paciente encontra-se assintomática após 36 meses de seguimento. A literatura é revisada em relação a aspectos clínicos, anatomopatológico e tratamento.
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20
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Affiliation(s)
- Paul D Robinson
- Department of Respiratory Medicine, Children's Hospital at Westmead, University of Sydney, Sydney, New South Wales, Australia.
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21
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Liman ST, Altinok T, Topcu S, Tastepe AI, Uzar A, Demircan S, Demirag F. Survival of biphasic pulmonary blastoma. Respir Med 2005; 100:1174-9. [PMID: 16332433 DOI: 10.1016/j.rmed.2005.10.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Revised: 10/23/2005] [Accepted: 10/25/2005] [Indexed: 01/26/2023]
Abstract
Pulmonary blastoma is a rare malignant lung tumor with a poor prognosis. It is composed of immature mesenchymal and epithelial components that resemble fetal lung tissue. We aimed to share our treatment results in biphasic pulmonary blastoma. In Ataturk Chest Disease and Thoracic Surgery Center, five patients with biphasic pulmonary blastoma (four men, one woman, aged between 27 and 61-mean 39.4) were treated between 1987 and 2000 (0.3% of operated NSCC). Hemoptysis, cough, chest pain and dyspnea were the symptoms. Anemia and high erythrocyte sedimentation rate were determined in two patients. Radiological examinations revealed a mass in four patients and massive pleural effusion in one. None of the patients were diagnosed preoperatively and hence all patients underwent exploratory thoracotomy. Three lobectomy, one pneumonectomy and one wedge resection were performed. Histopathological examinations revealed biphasic pulmonary blastoma in all the patients. Pathological stagings were as follows: 1 patient in T1N0M0 and 1 patient in T2N0M0 (198 and 112 months survival, respectively), three patients in T2N1M0 (9,10,17 months survival). In follow up period, prostate carcinoma and rectum carcinoma were detected as second primary tumors in the patient in stage T2N0M0. In patients who have small size tumors without nodal involvement, long-term survival can be obtained with radical surgery; even in biphasic pulmonary blastomas. According to our limited experiences, N1 nodal involvement shows very poor prognosis.
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Affiliation(s)
- Serife Tuba Liman
- Thoracic Surgery Department, The Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
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22
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Abstract
We describe a resected pulmonary blastoma in an 84-year-old male, the oldest of previously reported patients. A chest X-ray showed a 2 cm-sized abnormal shadow in the left lung field. Five months later computed tomography demonstrated a well-demarcated heterogenous mass, measuring 12 cm in diameter, in the left lower lobe of the lung. This mass was diagnosed as a carcinoma using echo-guided percutaneous biopsy. The patient underwent a left lower lobectomy. The resected specimen revealed the tumor to be a pulmonary blastoma arising from lung tissue. Preoperative diagnosis of pulmonary blastoma is extremely difficult because of the histological heterogeneity of tumor. Since it has been noted that pulmonary blastoma rapidly progresses in a short period of time, surgical treatment should be undertaken as quickly as possible when such a tumor is suspected.
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Affiliation(s)
- Ryoji Kawano
- Surgical Department of Respiratory Center, Mitsui Memorial Hospital, Tokyo, Japan
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23
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Abstract
Pulmonary blastoma is a relatively rare aggressive adult malignancy. The clinical and radiographic features of two cases are described and the literature reviewed. Pulmonary blastoma usually presents radiologically as a well-defined mass lesion on chest radiography, which may be large enough to completely opacify the hemithorax and cause mediastinal shift. On CT, pulmonary blastoma is seen as a mixed solid and cystic lesion with variable contrast enhancement and a necrotic centre. Pleural effusion may be present but is not the predominant abnormality. Our cases are unusual as recurrent pleural effusions in the absence of a significant lung mass were the presenting findings.
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Affiliation(s)
- R I Walker
- Department of Radiology, Northern General Hospiatal, Herries Road, Sheffield S5 7AU, UK
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24
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Abstract
BACKGROUND Pleuropulmonary blastoma (PPB) is a rare tumor of the chest seen in young children and recently recognized as distinct from the pulmonary blastoma typically encountered in adults. OBJECTIVE The purpose of this study is to review and describe the findings of PPB on radiography and CT in four patients. METHODS Radiographs and CT findings were reviewed in four patients with pathologically proven PPB. RESULTS All four cases demonstrated large masses in the right hemithorax with heterogeneous low attenuation, pleural effusion, contralateral mediastinal shift, and lack of chest wall invasion. CONCLUSION When a large pleural-based mass is identified in a young child, PPB should be considered. Suggestive findings include absence of chest wall invasion, presence of pleural fluid, right-sided location, and heterogeneous low attenuation.
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Affiliation(s)
- Lena N Naffaa
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA
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25
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Nakashima M, Inagaki T, Kunimura T, Kushima M, Adachi M, Morohoshi T. Cyopathologic and histologic features of biphasic pulmonary blastoma: a case report. Acta Cytol 2005; 49:87-91. [PMID: 15717762 DOI: 10.1159/000326102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Biphasic pulmonary blastoma is a rare malignant neoplasm of debatable histogenesis. Although well described histologically, it is scarcely mentioned in the cytologic literature. CASE A 78-year-old man reporting intermittent hemoptysis was admitted to the hospital. Chest radiography revealed a right-sided pulmonary mass. Cytologic examination of tumor specimens revealed 2 types of malignant cells. The smears were highly cellular, with a necrotic background. The stromal cells had predominantly round to ovoid or spindle-shaped nuclei and scant cytoplasm, and the nucleoli had slightly irregular borders with coarsely aggregated chromatin. The epithelial cells were arranged in sheets and glandular configurations. The cytoplasm of these cells was finely vacuolated or foamy, with indistinct cellular boundaries; eccentrically located nuclei were hyperchromatic and had irregularly shaped nucleoli. The cell block preparation showed a distinctly biphasic malignant tumor with the classic morphologic features of pulmonary blastoma. CONCLUSION A preoperative diagnosis ofpulmonary blastoma is difficult to obtain by cytopathologic methods. A diagnosis of biphasic pulmonary blastoma should be considered whenever epithelial cells and a separate population of stromal cells are seen in a pulmonary exfoliative cytology specimen.
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Affiliation(s)
- Masanao Nakashima
- First Department of Pathology, Showa University School of Medicine, Tokyo, Japan.
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26
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Abstract
Pleuropulmonary blastoma is a rare and aggressive primary intrathoracic neoplasm of children. T'he prognosis is extremely poor with frequent metastasis to the brain and bone. A 4-year-old boy successfully treated with multimodal therapy despite unfavorable prognostic factors is presented. The authors support the use of aggressive treatment of pleuropulmonary blastoma with surgery, chemotherapy, and radiotherapy.
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Affiliation(s)
- F Güçlü Pinarli
- Gazi University Medical Faculty, Department of Pediatric Oncology, Ankara, Turkey.
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27
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Hasiotou M, Polyviou P, Strantzia CM, Pourtsidis A, Stinios I. Pleuropulmonary blastoma in the area of a previously diagnosed congenital lung cyst: report of two cases. Acta Radiol 2004; 45:289-92. [PMID: 15239424 DOI: 10.1080/02841850410005200] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a rare primary malignant pulmonary tumor in pediatric patients. We report the development of PPB in the area of a previous pulmonary cyst in two children, one boy and one girl 5 and 12 years old, respectively. We present the clinical and radiological findings. A short review of the literature is included.
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Affiliation(s)
- M Hasiotou
- Department of CT and MR Scan of Children's Hospital Agia Sofia, Athens, Greece
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28
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Abstract
PURPOSE To determine the radiologic findings of pulmonary blastoma on chest radiograph and CT. MATERIALS AND METHODS Chest radiographs and CT scans of five patients with pathologically proven pulmonary blastoma were retrospectively evaluated and radiologic findings were correlated with histopathologic findings. RESULTS On chest radiograph, the pulmonary blastoma manifested as a solitary parenchymal mass (n = 2), a solitary parenchymal nodule (n = 1), hilar bulging with fingerlike parenchymal opacities (n = 1), or opacification of hemithorax (n = 1). On CT, the pulmonary blastoma manifested as a solitary parenchymal mass (n = 2), a solitary parenchymal nodule (n = 1), an endobronchial mass with postobstructive pneumonitis (n = 1), or a parenchymal mass with multiple subpleural masses and pleural effusion (n = 1). CONCLUSION Pulmonary blastomas most commonly manifested as a solitary parenchymal mass on chest radiograph and CT. These radiologic features are nonspecific and many primary or metastatic tumors of the lung could be included in differential diagnosis.
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Affiliation(s)
- Hyun Ju Lee
- Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, SNUMRC, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea
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29
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Tan Kendrick A. Cerebral metastasis proven 1 year after an embolic cerebral infarct from pleuropulmonary blastoma. Pediatr Radiol 2004; 34:283. [PMID: 14647995 DOI: 10.1007/s00247-003-1105-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2003] [Accepted: 10/29/2003] [Indexed: 11/26/2022]
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30
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Casey MC, Rafferty D, O'Neill M. An unusual cause of respiratory symptoms in a toddler. Br J Radiol 2003; 76:921-2. [PMID: 14711783 DOI: 10.1259/bjr/98434386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M C Casey
- Department of Radiology, Cork University Hospital, Cork, Ireland
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31
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Abstract
Pleuropulmonary blastoma (PPB) is a rare malignant dysontogenetic neoplasm primarily affecting children and is characterized histologically by a variably mixed blastematous and sarcomatous patterns. We herein report a very exceptional adult case of PPB. A 21-yr-old male patient presented with a left chest pain of two weeks' duration. A computed tomography scan revealed a large, multicystic tumor occupying the left lower hemithorax, leading to the impression of a ruptured mediastinal cystic teratoma. A thoracotomy for resection of the tumor was performed. On histologic examination, the tumor consisted of cystic walls and associated solid lesions which showed undifferentiated blastemal tissues with focal fibrosarcomatous and rhabdoid features. Immunohistochemically the tumor cells only showed diffuse strong positivity for vimentin. The histologic findings corresponded to a type II PPB. The authors suggest that PPB, especially of type I or II, should be included in the radiologic differential diagnosis of mediastinal cystic neoplasms in a young adult.
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Affiliation(s)
- Chang Hun Lee
- Department of Pathology, Pusan National University College of Medicine, Busan, Korea.
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32
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Dertsiz L, Salper A, Kilinçarslan B, Ozbilim G, Demircan A. [Pleuropulmonary blastoma: a case report]. Tuberk Toraks 2003; 51:436-9. [PMID: 15143394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Pulmonary blastoma is a rare seen malignant tumor. It is generally reported in adults. The tumor including immature mesenchimal and/or epithelial structures is morphologically similar to fetal lung tissue. In this study, a male patient having been operated is presented because of the mass found in his chest X-ray. The lesion is histopathologically reported as a pleuropulmonary blastoma. The literature is reviewed because this case has a bad prognosis and is rarely seen.
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Affiliation(s)
- Levent Dertsiz
- Akdeniz University Faculty of Medicine, Thoracic Surgery, Antalya, Turkey.
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33
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de Castro CG, de Almeida SG, Gregianin LJ, Loss JF, Rivero LF, Schwartsmann G, Brunetto AL. High-dose chemotherapy and autologous peripheral blood stem cell rescue in a patient with pleuropulmonary blastoma. J Pediatr Hematol Oncol 2003; 25:78-81. [PMID: 12544779 DOI: 10.1097/00043426-200301000-00016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a rare and aggressive malignant tumor of the lung. Approximately 80 cases of PPB have been published, and in only three cases high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) was applied. A 5-year-old girl presenting with cough, fever, and shortness of breath was referred to the authors in March 1999. A computed tomography scan of the chest showed a tumor mass in the left hemithorax. The lesion was biopsied and the histopathologic report suggested the diagnosis of PPB. The patient received chemotherapy comprising vincristine, actinomycin D, and cyclophosphamide with only a minor response, and treatment was switched to ifosfamide, carboplatin, and etoposide, which produced a partial response. Tumor resection was performed, but margins were positive for PPB. Due to the high risk of recurrence, the authors elected to administrate high-dose chemotherapy using melphalan, etoposide, and carboplatin, followed by autologous HSCT. The patient achieved complete hematologic recovery, and reimaging after HSCT showed no evidence of disease. She relapsed 4 months later and died about 9 months after the completion of high-dose therapy. The role of high-dose chemotherapy and autologous HSCT is likely to be limited in PPB.
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Affiliation(s)
- Cláudio Galvão de Castro
- Pediatric Oncology Unit, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos 2350, 3rd Floor, Porto Alegre, RS, Brazil 90035-003.
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34
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Robert J, Pache JC, Seium Y, de Perrot M, Spiliopoulos A. Pulmonary blastoma: report of five cases and identification of clinical features suggestive of the disease. Eur J Cardiothorac Surg 2002; 22:708-11. [PMID: 12414034 DOI: 10.1016/s1010-7940(02)00529-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Identification of clinical features suggestive of pulmonary blastoma (PB) through a retrospective comparison with cases of non-small cell lung cancer (NSCLC) operated during the same period. METHODS Between 1977 and 1999, five patients were operated for PB at Geneva University Hospital (four women and one man, aged 32-46 years--mean 36.8) versus 1913 consecutive patients (1558 men and 355 women, mean age 61.2) for primary NSCLC. In the PB subgroup (0.3%), the pulmonary tumor was single, located in an upper lobe in all but one instance, and measured between 5 and 13 cm (mean 9.6), whereas in the total NSCLC group, 27% of patients had tumors <3 cm (T1), evenly distributed in both lungs. All but one PB patients were symptomatic, compared to 45% in the NSCLC group. RESULTS The five patients with PB underwent curative pulmonary excisions (lobectomy in three and pneumonectomy in two) with mediastinal lymph node sampling. Pathological examination revealed extensive tumor necrosis in four, and N2 lymph node metastases in four (in the total NSCLC group, N2 disease was diagnosed in 21%). Postoperatively, three PB patients received radio- and/or chemotherapy. Four patients died between six and 30 months after the operation (mean 15), whereas 5-year survival in the NSCLC group was 32%, with a median survival of 3.7 years; the fifth patient is alive 28 months later, without any sign of recurrence. CONCLUSIONS Compared to operated NSCLC, PB are rare, large, and symptomatic tumors; they affect younger patients and carry a worse prognosis.
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Affiliation(s)
- John Robert
- Clinic of Thoracic Surgery, University Hospital, Geneva, Switzerland.
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35
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Abstract
Although most lesions that occur in the chest have a nonspecific soft-tissue appearance, fat-containing lesions are occasionally encountered at cross-sectional computed tomography (CT) or magnetic resonance imaging. The various fat-containing lesions of the chest include parenchymal and endobronchial lesions such as hamartoma, lipoid pneumonia, and lipoma. Endobronchial hamartoma usually appears at CT as a lesion with a smooth edge, focal collections of fat, or fat collections that alternate with foci of calcification. Mediastinal fat-containing lesions include germ cell neoplasms, thymolipomas, lipomas, and liposarcomas. The most frequent CT manifestation of the germ cell neoplasm teratoma is a heterogeneous mass with soft-tissue, fluid, fat, and calcium attenuation. Cardiac lesions with fat content include lipomatous hypertrophy of the interatrial septum and arrhythmogenic right ventricular dysplasia. Diagnosis of the former is made with CT when a smooth, nonenhancing, well-marginated fat-containing lesion is identified in the interatrial septum. Finally, fat may herniate into the chest at several characteristic locations. When such a lesion is identified, the time required for differential diagnosis is significantly reduced, often allowing a definitive radiologic diagnosis. Sagittal and coronal reformatted images can add valuable information by showing diaphragmatic defects and hernia contents.
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Affiliation(s)
- Scott C Gaerte
- Department of Radiology, Indiana University School of Medicine, Indiana University Hospital, Indianapolis, IN 46202-5253, USA.
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36
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Ortiz De Saracho J, Pantoja L, Ludeña MD. [Pulmonary blastoma: an unexpected finding in a woman with polyarthritis]. Arch Bronconeumol 2002; 38:197-8. [PMID: 11953276 DOI: 10.1016/s0300-2896(02)75191-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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37
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Parsons SK, Fishman SJ, Hoorntje LE, Jaramillo D, Marcus KC, Perez-Atayde AR, Kozakewich HP, Grier HE, Shamberger RC. Aggressive multimodal treatment of pleuropulmonary blastoma. Ann Thorac Surg 2001; 72:939-42. [PMID: 11565696 DOI: 10.1016/s0003-4975(00)02411-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Pleuropulmonary blastoma is a rare intrathoracic neoplasm almost solely confined to childhood. Survival is poor. The authors report 2 children with extensive intrathoracic disease who are long term survivors after multimodal therapy. Both children received multiagent neoadjuvant chemotherapy, followed by surgical resection to remove all gross tumor. Postoperative chemotherapy was given to both children; radiotherapy was also given in the second case because of a question of positive tumor margins. Experience supports the use of multimodal therapy, including an aggressive surgical approach in the potentially curative treatment of this tumor.
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Affiliation(s)
- S K Parsons
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA.
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38
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Abstract
A three-and-half-year-old boy presented with recurrent chest infections, fever and weight loss of three month duration not responding to antibiotics. The chest X-ray and CT scan revealed a large well-circumscribed mass in right upper thorax with collapse of right upper lobe. A preoperative diagnosis could not be made even after fine needle aspiration cytology. Thoracotomy and right upper lobectomy was done and the biopsy report was an inflammatory pseudotumor. The child remained well for three months after which his symptoms and the mass recurred. The histopathology slides were reviewed and revealed a biphasic malignant tumor suggestive of Pulmonary Blastoma (PB). Patient received four cycles of chemotherapy followed by re-exploration. The recurrent tumour could only be excised partly and the child succumbed to persistent shock postoperatively. The final histopathological diagnosis was confirmed as PB. Primary pulmonary neoplasms in children are rare and of these PB which is even rarer, constitutes less than 15%. The report highlights that the lack of familiarity with this entity still causes error in the diagnosis of PB.
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Affiliation(s)
- A Prasad
- Department of Pediatric Surgery and Pediatrics, Maulana Azad Medical College, New Delhi-110002, India
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39
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Abstract
A case of a 4-year-old girl with pleuropulmonary blastoma is reported. Surgical resection of the tumor was performed and histologic examination revealed pleuropulmonary blastoma with rhabdomyosarcomatous differentiation. Postoperative chemotherapy was administered and 3 weeks after initiation of treatment protocol a second site of lesion in the retroperitoneum was revealed with extension to the mediastinum, which shared similar mesenchymal neoplastic characteristics to the previously diagnosed primary lesion. The girl died 4 1/2 months after initial evidence of disease because of brain metastasis, indicating a very aggressive neoplasm unresponsive to treatment.
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Affiliation(s)
- C Perdikogianni
- Department of Pediatric Hematology/Oncology, University Hospital of Heraklion, 71500 Crete, Greece
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40
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Mott BD, Canver CC, Nazeer T, Buchan A, Ilves R. Staged resection of bilateral pleuropulmonary blastoma in a two-month old girl. J Cardiovasc Surg (Torino) 2001; 42:135-7. [PMID: 11292922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Pleuropulmonary blastoma is a rare unilateral intrathoracic tumor of childhood. We report an unusual case of bilateral pleuropulmonary blastoma in a two-month old girl who underwent staged thoracotomies for complete wedge resection of both neoplasm. She remains well and tumor free two years after the operation.
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Affiliation(s)
- B D Mott
- Division of Cardiothoracic Surgery, Albany Medical College, Albany, New York, USA
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41
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Abstract
Pulmonary blastoma is a rare non-small-cell lung cancer. In a statistically significant proportion of cases it is combined with cystic lung disease in children. The biphasic pulmonary blastoma and the well-differentiated fetal adenocarcinoma are the most frequent manifestations of pulmonary blastoma. If metastatic disease is ruled out, surgical therapy should be guided by the principles for radical therapy of NSCLC. There are no sufficient recommendations yet for therapy of stage IIIb and IV (UICC 1997) disease.
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Affiliation(s)
- S Welter
- Klinik für Allgemein- und Thoraxchirurgie, Florence-Nightingale-Krankenhaus Kaiserswerth, Düsseldorf.
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42
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Ishida Y, Kato K, Kigasawa H, Ohama Y, Ijiri R, Tanaka Y. Synchronous occurrence of pleuropulmonary blastoma and cystic nephroma: possible genetic link in cystic lesions of the lung and the kidney. Med Pediatr Oncol 2000; 35:85-7. [PMID: 10881016 DOI: 10.1002/1096-911x(200007)35:1<85::aid-mpo17>3.0.co;2-o] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Y Ishida
- Division of Hematology, Kanagawa Children's Medical Center, Yokohama, Japan
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Uçar B, Akgün N, Bör O, Işiksoy S, Kuşku M, Dernek S, Paşaoğlu O. Biphasic pulmonary blastoma in a child. Turk J Pediatr 2000; 42:258-63. [PMID: 11105632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Pulmonary blastoma (PB) is a rare malignant pulmonary tumor composed of immature mesenchyme and/or epithelium that resembles an embryonic lung at 10-16 weeks gestation. PBs constitute only 0.25 to 0.5 percent of all primary malignant lung tumors. Approximately 20 percent of the reported cases have occurred in pediatric patients. A seven-year-old girl presented with fever, cough, respiratory distress and chest pain on the left side. An x-ray, ultrasonography and a computed tomographic scan of the chest showed a large mass consisting of solid and cystic components almost completely occupying the left hemithorax associated with pleural effusion. The diagnosis of biphasic PB was established by histological examination of thoracotomy material. The patient was considered inoperable due to tumor involvement of the mediastinum, and she died two days after the initiation of chemotherapy. We report this case of PB to raise attention to the clinical, radiological and pathological features of PB in childhood because of its rarity.
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Affiliation(s)
- B Uçar
- Department of Pediatrics, Osmangazi University Faculty of Medicine, Eskişehir, Turkey
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44
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Abstract
A five-month-old infant presented with a sudden choking cough and mild dyspnea. Bilateral cystic pulmonary images were found on a chest X-ray, leading to exploratory surgery. A pleuropulmonary blastoma, a rare malignant embryonic tumor of childhood, was diagnosed on histologic examination. This case illustrates the necessity of performing surgical resection and histologic evaluation of any pulmonary cystic malformations, particularly when bilateral.
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Affiliation(s)
- P Reix
- Unité pneumologie, allergologie, mucoviscidose, Centre hospitalier Lyon-Sud, Pierre-Bénite, France
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45
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Affiliation(s)
- M T Di Tullio
- Pediatric Oncology Service, Pediatric Department II, University of Naples, Naples, Italy.
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46
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Abstract
BACKGROUND AND PROCEDURE Pleuropulmonary blastoma (PPB) identifies different types of pulmonary tumors in the pediatric age. It is extremely uncommon and is known to have a very poor prognosis, with only few cases surviving after 10 years follow-up. Our experience with such a patient and long-term follow-up (12 years) is therefore of interest. She was a 2-year-old girl admitted with a history of respiratory distress and underwent a left thoracotomy. The tumor was removed and after 1 month a polychemotherapy course was started using dactinomycin and vincristine for 6 months. The patient remains disease-free 12 years after the operation. CONCLUSIONS The biologic behavior of the tumor is considered unpredictable, and for this reason much effort has been expended in trying to identify prognostic factors. The preoperative size of the mass (size <5 cm) in our patient, its complete excision, and the histologic aspects might be helpful in identifying favorable prognostic factors.
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Affiliation(s)
- C Romeo
- Department of Clinical and Experimental Medicine, University of Catanzaro, Catanzaro, Italy
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47
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Hill DA, Sadeghi S, Schultz MZ, Burr JS, Dehner LP. Pleuropulmonary blastoma in an adult: an initial case report. Cancer 1999; 85:2368-74. [PMID: 10357407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Pleuropulmonary blastoma (PPB) is a unique dysontogenetic neoplasm of childhood. Its primitive, sarcomatous features are analogous to those of other dysembryonic or dysontogenetic tumors, such as Wilms tumor, hepatoblastoma, neuroblastoma, and embryonal rhabdomyosarcoma. PPB typically presents in young children, most younger than 5 years, as a pulmonary and/or pleural-based tumor with cystic, solid, or combined cystic and solid features. These neoplasms are characterized histologically by primitive mesenchymal or a mixture of primitive and sarcomatous components and generally have an unfavorable clinical outcome: death occurs within 1-2 years after diagnosis. METHODS Clinicopathologic and radiographic findings of a man age 36 years with a cystic and solid mass in the left hemithorax were reviewed and compared with previously studied cases of PPB. RESULTS Pathologic examination of the mass revealed a cystic and solid neoplasm composed of malignant mesenchymal cells that were immunoreactive for vimentin and muscle specific actin and focally for desmin. The architectural and cytologic appearances as well as the immunohistochemical profile were those of type II PPB. CONCLUSIONS To the authors' knowledge, all previously reported cases of PPB occurred in children age 12 years or younger. They believe that this case represents the first occurrence of PPB in an adult and documents the finding that, although it is uncommon, adults can develop primitive neoplasms that are usually associated with the pediatric population. In addition, the clinicopathologic features observed in the authors' adult patient were consistent with their experience with this tumor type in children. The patient died less than 1 year after diagnosis.
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Affiliation(s)
- D A Hill
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish Hospital, Washington University Medical Center, St. Louis, Missouri 63110, USA
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48
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Mehnert F, Claussen CD. [Pleuro-pulmonary blastoma in the child]. ROFO-FORTSCHR RONTG 1999; 170:M17. [PMID: 10206672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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49
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Majid OA, Rajendran U, Baker LT. Pulmonary blastoma. Ann Thorac Cardiovasc Surg 1998; 4:47-52. [PMID: 9495909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pulmonary blastoma is a rare tumor containing both mesenchymal and/or epithelial elements that mimics the embryonal tissues of the developing lungs. We are presenting two cases of pulmonary blastoma for its rarity and reviewed the literature for clinical features, investigative findings, classification, management and prognosis.
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Affiliation(s)
- O A Majid
- Thoracic Surgical Department, Chest Disease Hospital, 13041 Safat, Kuwait
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50
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Adirim TA, King R, Klein BL. Radiological case of the month. Congenital cystic adenomatoid malformation of the lung and pulmonary blastoma. Arch Pediatr Adolesc Med 1997; 151:1053-4. [PMID: 9343020 DOI: 10.1001/archpedi.1997.02170470087017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- T A Adirim
- Emergency Medical Trauma Center, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA
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