scholarly journals A diagnostic conundrum in the context of a pandemic of Coronavirus Disease 2019 (COVID-19)

2021 ◽  
Vol 2021 (11) ◽  
Author(s):  
Deborah L Abraham ◽  
Joyce Omatseye ◽  
Jason Gittens
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Polymerase Chain Reaction ◽  
Cognitive Bias ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Clinical Progression ◽  
Chain Reaction ◽  
Peripheral Lung ◽  
Complicating Factors ◽  
Polymerase Chain

ABSTRACT A 52-year-old with lung cancer and brain metastases, on a 3-month weaning regime of dexamethasone, had a coincidental finding of bilateral, patchy ground-glass opacifications of both central and peripheral lung fields on computed tomography (CT). This was reported to be a sign of Coronavirus Disease 2019 (COVID-19). On Day 13, due to poor clinical progression and multiple negative reverse transcriptase-polymerase chain reaction tests for COVID-19, an alternative diagnosis was sought. Subsequently, this led to a diagnosis of Pneumocystis jirovecii pneumonia. This case demonstrates complicating factors in the diagnosis of COVID-19 and the presence of cognitive bias during a pandemic, which may lead clinicians to overlook a diagnosis, which may otherwise be addressed earlier.

Promoter Hypermethylation for Molecular Nodal Staging in Non–Small Cell Lung Cancer

2007 ◽  
Vol 131 (6) ◽  
pp. 936-941
Author(s):  
A. Mazin Safar ◽  
Horace Spencer ◽  
Xiaobo Su ◽  
Craig A. Cooney ◽  
Ali Shwaiki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Polymerase Chain Reaction ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Promoter Hypermethylation ◽  
Small Cell ◽  
Small Cell Lung ◽  
Chain Reaction ◽  
Specific Polymerase Chain Reaction ◽  
Polymerase Chain

Abstract Context.— Even among cases of non–small cell lung cancer (NSCLC) in the most favorable stage (IA), the disease-specific mortality is 25% or greater. One plausible explanation implicates the simplistic standard pathologic procedures used to designate lymph node involvement. A more sensitive assessment of the nodal status may improve staging. Objective.—To determine the prognostic impact of detecting an abnormal molecular event (promoter hypermethylation in a set of relevant genes) in histologically uninvolved lymph nodes in resected NSCLC. Design.—In this retrospective analysis of archived material, we examined DNA extracted from lymph nodes of stage I NSCLC (n = 180). Patients underwent surgery between 1991 and 1995 in a single institution. Methylation-specific polymerase chain reaction was used to detect promoter hypermethylation in a panel of 8 genes. Survival data were extracted from the computerized database at the Tumor Registry. Results.—Evidence of promoter hypermethylation in at least 1 gene was detected in 67% of these N0 nodes. The most commonly hypermethylated gene was E-cadherin (53%). The hypermethylation frequency for the remaining genes were as follows: APC, 5%; p16, 9%; MGMT, 11%; hMLH1, 15%; RASSF1A, 4%; DAP kinase, 9%; and ATM, 19%. The presence of promoter hypermethylation in 2 or more genes did not influence the overall, median, or 5-year survival rates. Conclusions.—Identifying promoter hypermethylation (in our panel) in N0 lymph nodes in stage I NSCLC cannot be recommended for clinical decision making. Molecular abnormalities, including those found in cancer by qualitative methylation-specific polymerase chain reaction, are not synonymous with established, histologically detectable metastasis.

Detection of EGFR Gene Mutation in Lung Cancer by Mutant-Enriched Polymerase Chain Reaction Assay

2006 ◽  
Vol 12 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Hiroaki Asano ◽  
Shinichi Toyooka ◽  
Masaki Tokumo ◽  
Kouichi Ichimura ◽  
Keisuke Aoe ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Polymerase Chain Reaction ◽  
Gene Mutation ◽  
Polymerase Chain Reaction Assay ◽  
Chain Reaction ◽  
Egfr Gene ◽  
Polymerase Chain ◽  
Egfr Gene Mutation
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