Canine Diffuse Lepidic Predominant Adenocarcinoma

Background: Due to their abundant vascular supply, the lungs are a usual metastatic site, with primary lung cancer presenting a low prevalence in dogs and cats. Among the primary pulmonary tumors afflicting dogs, lepidic carcinoma is the most common and can be classified by site of onset. Lepidic predominant adenocarcinoma is characterized by the proliferation of neoplastic cells along the pulmonary alveoli and pre-existing alveolar structures. Few reports of this specific tumor were found in the literature, so the objective of this study is to describe the clinical, pathological, and immunohistochemical findings of a dog with predominantly diffuse lepidic adenocarcinoma.Case: A 14-year-old, female, spayed, mixed-breed canine with a history of progressive weight loss, cough, respiratory distress, and pain while eating was brought in for a consultation. A presumptive diagnosis of pneumonia was suggested. However, in spite of treatment, the dog died, and a necropsy was performed. Upon gross examination, the lungs were diffusely enlarged, whitish, and stiffened with large and highly vascular nodules. Histopathological findings showed proliferation of neoplastic cells along the vascular walls and within the bronchioalveolar structures, with moderate fibrovascular stroma. The growth patterns resembled the pre-existing alveolar structures, with papillary protrusions into the alveolar lumen. After immunohistochemical evaluation, the definitive diagnosis was diffuse lepidic predominant adenocarcinoma. This tumor is uncommon and difficult to diagnose in the clinical veterinary routine, so it should be considered in the differential diagnosis of respiratory conditions in canines, especially in elderly animals with chronic clinical signs not responsive to antibiotic therapy. Complementary diagnostic examinations such as imaging, laboratory tests, and biopsy are indispensable to the early diagnosis of this lung neoplasm.Discussion: Due to its insidious character, primary lung cancer is underdiagnosed in veterinary medicine and is regularly an incidental x-ray finding. Affected dogs have no clinical signs, and this poses a diagnostic challenge. Primary lung cancer tends to be more prevalent in older and purebred animals. The most frequent clinical sign in dogs is a chronic non-responsive cough, which can be misdiagnosed as another respiratory disease. Hematological findings, such as anemia, neutrophilia, and lymphopenia, can be related to tumor progression. Most reported cases of lepidic adenocarcinoma in dogs have a single pulmonary nodule, and the diffuse form is less common. In this case report, besides the presence of a single pulmonary nodule, there was also widespread involvement of the parenchyma. Histopathology was compatible with lepidic predominant adenocarcinoma, and immunohistochemistry was positive for pan-cytokeratin, confirming the epithelial origin of the tumor, and negative for TFF-1. Despite being a highly specific marker for lung cancer in dogs, TFF-1 has variable sensitivity among the different types of lung cancer. Fixation time and the location of the tumor sections may have contributed to the seronegative result obtained. In conclusion, lepidic adenocarcinoma is a primary lung neoplasia that is uncommon and presents a diagnostic challenge to veterinary clinicians. Therefore, it should be included as a differential diagnosis in older, purebred animals presenting chronic respiratory clinical signs that are refractory to treatment.

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Abstract P6-03-05: An Approach for the Differential Diagnosis of Primary Lung Cancer and Breast Cancer Relapse Presenting as a Solitary Pulmonary Nodule in Patients after Breast Surgery

10.1158/0008-5472.sabcs10-p6-03-05 ◽

2010 ◽

Author(s):

T Fujita ◽

H Hayashi ◽

M Hattori ◽

A Horio ◽

M Yamada ◽

...

Keyword(s):

Breast Cancer ◽

Lung Cancer ◽

Differential Diagnosis ◽

Pulmonary Nodule ◽

Solitary Pulmonary Nodule ◽

Breast Surgery ◽

Primary Lung Cancer ◽

Cancer Relapse ◽

Breast Cancer Relapse

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Stepwise examination for differential diagnosis of primary lung cancer and breast cancer relapse presenting as a solitary pulmonary nodule in patients after mastectomy

Journal of Surgical Oncology ◽

10.1002/jso.21149 ◽

2008 ◽

Vol 98 (7) ◽

pp. 510-514 ◽

Cited By ~ 10

Author(s):

Toshiki Okasaka ◽

Noriyasu Usami ◽

Tetsuya Mitsudomi ◽

Yasushi Yatabe ◽

Keitaro Matsuo ◽

...

Keyword(s):

Breast Cancer ◽

Lung Cancer ◽

Differential Diagnosis ◽

Pulmonary Nodule ◽

Solitary Pulmonary Nodule ◽

Primary Lung Cancer ◽

Cancer Relapse ◽

Breast Cancer Relapse

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Plasma Metabolomics Study in Lung Cancer Screening and Differential Diagnosis

10.21203/rs.3.rs-190217/v1 ◽

2021 ◽

Author(s):

Zixu Liu ◽

Lei Guo ◽

Shuai Liu ◽

Minjun Du ◽

Yicheng Liang ◽

...

Keyword(s):

Lung Cancer ◽

Differential Diagnosis ◽

Pulmonary Nodule ◽

Primary Lung Cancer ◽

Pulmonary Nodules ◽

Lung Cancer Screening ◽

Population Group ◽

Healthy People ◽

Healthy Population ◽

Validation Set

Abstract [Objectives] By studying the plasma metabolomics of patients with different pulmonary nodules and healthy people, we can find the difference in plasma low-molecular metabolites among them. [Methods] Patients with pulmonary nodules admitted to our department were divided into three groups: pulmonary metastatic carcinoma (PMC), benign pulmonary nodules (BPN), and primary lung cancer (PLC). Meanwhile healthy people were enrolled as healthy population group (HPG). PLC and HPG were equally divided into the Discovery Set and Validation set. [Results] Five significant low-molecular metabolites were found by comparison of four groups as a whole. Four to six metabolites were selected by comparison of the three pulmonary nodule groups with healthy people respectively. The AUC of ROC of these metabolites were all＞0.93. Each pairwise comparison within the three pulmonary nodule groups all found three metabolites, whose AUC of ROC were all＞0.83. From the comparison of PLC and HPG in the discovery set, six metabolites were selected. Their AUC of ROC were all greater than 0.95 in the validation set, indicating that they had a strong ability to differentiate between primary lung cancer and healthy people. [Conclusions] We can find the significant changes of some low-molecular metabolites among three pulmonary nodules and healthy people. These metabolites had the potential to be biomarkers for screening and differential diagnosis of lung cancer.

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Endotracheal Metastasis Causing Airway Obstruction

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2019.10.44964 ◽

2020 ◽

Vol 4 (1) ◽

pp. 96-98

Author(s):

Yudai Yano ◽

Takashi Fujiwara ◽

Masanobu Mizuta

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Emergency Department ◽

Differential Diagnosis ◽

Respiratory Symptoms ◽

Primary Lung Cancer ◽

Chest Computed Tomography ◽

Important Differential Diagnosis ◽

Emergency Tracheostomy ◽

Rare Lesion

Endotracheal metastasis, a critical complication of primary lung cancer, is an extremely rare lesion. A 73-year-old woman who had previously received treatment for lung cancer presented to our emergency department with dyspnea. A chest computed tomography and nasopharyngolaryngoscopy showed an endotracheal mass below the epiglottis, obstructing the trachea almost completely. The patient had an emergency tracheostomy, and then the mass was removed via median laryngotomy. This lesion was proven to be a recurrent metastasis of lung cancer. Clinicians should recognize endotracheal metastasis as an important differential diagnosis in cancer patients presenting with respiratory symptoms.

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Solitary pulmonary nodule of benign metastasizing leiomyoma associated with primary lung cancer: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-5-500 ◽

2011 ◽

Vol 5 (1) ◽

Cited By ~ 2

Author(s):

Masahiro Naito ◽

Tetsu Kobayashi ◽

Masamichi Yoshida ◽

Kentaro Fujiwara ◽

Masahiro Onishi ◽

...

Keyword(s):

Lung Cancer ◽

Case Report ◽

Pulmonary Nodule ◽

Solitary Pulmonary Nodule ◽

Primary Lung Cancer ◽

Benign Metastasizing Leiomyoma ◽

Metastasizing Leiomyoma

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Solitary Pulmonary Nodule

DeckerMed Surgery ◽

10.2310/surg.2048 ◽

2018 ◽

Author(s):

Taine T.V. Pechet ◽

Olugbenga T Okusanya

Keyword(s):

Lung Cancer ◽

Positron Emission Tomography ◽

Differential Diagnosis ◽

Cell Lung Cancer ◽

Pulmonary Nodule ◽

Solitary Pulmonary Nodule ◽

Emission Tomography ◽

Common Finding ◽

Benign Lesions ◽

Positron Emission

The solitary pulmonary nodule is a common finding that is observed in more than 150,000 persons each year in the United States. Factors influencing probability of malignancy are discussed, including age and environmental factors. Investigative studies are described. Imaging includes chest radiography, computed tomography, and positron emission tomography. Biopsy can be excisional or performed via transthoracic needle or bronchoscopy. The differential diagnosis is broad and can include malignant or benign lesions. Malignant lesions include nonsmall cell lung cancer, small cell lung cancer, pulmonary neuroendocrine tumors, and metastatic malignancies. Benign lesions can include pulmonary hamartoma or inflammatory or infectious nodules. Few, if any, randomized controlled trials exist to direct management. Most clinicians rely on a combination of single-institution studies, a few prospective trials, and clinical acumen to assess a given patient's risk profile to inform decisions on invasive and noninvasive testing. In this review, the tables describe the differential diagnosis of a solitary pulmonary nodule, factors affecting malignant probability of a solitary pulmonary nodule, and the initial assessment of probability of cancer in a solitary pulmonary nodule. This review contains 5 figures, 4 tables, and 73 references. Key Words: bronchoscopy, compute tomography, lung cancer, nodule, positron emission tomography, solitary

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Pneumoconiosis

Chest Imaging ◽

10.1093/med/9780199858064.003.0065 ◽

2019 ◽

pp. 379-381

Author(s):

Sanjeev Bhalla

Keyword(s):

Lung Cancer ◽

Pulmonary Nodule ◽

Primary Lung Cancer ◽

Imaging Findings ◽

Dust Inhalation ◽

Inhaled Particles ◽

Potential Case ◽

Key Features ◽

Imaging Signs ◽

Indeterminate Pulmonary Nodule

The term pneumoconiosis refers to lung disease related to dust inhalation. The inhaled particles produce a pulmonary reaction that may result in fibrosis as with asbestosis or silicosis or may result in a macrophage reaction with little fibrosis. Three key features must be addressed in a potential case of pneumoconiosis: identification of imaging signs of exposure, location of imaging findings and distribution of imaging abnormalities. Patients with pneumoconiosis may present with very subtle abnormalities usually well characterized on thin section CT or HRCT. When areas of cavitation are seen, tuberculosis must be considered in association with silicosis and coal worker pneumoconiosis. In addition, any noncalcified or indeterminate pulmonary nodule must be carefully assessed as some pneumoconioses, most notably silicosis and asbestosis, result in a higher incidence of primary lung cancer.

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A divergent pseudoglandular configuration of cutaneous plasmacytoma in dogs

Journal of Veterinary Diagnostic Investigation ◽

10.1177/1040638717735868 ◽

2017 ◽

Vol 30 (2) ◽

pp. 260-262 ◽

Cited By ~ 1

Author(s):

Brittany McHale ◽

Uriel Blas-Machado ◽

Fabiano N. Oliveira ◽

Daniel R. Rissi

Keyword(s):

Multiple Myeloma ◽

Differential Diagnosis ◽

Oral Cavity ◽

Diagnostic Challenge ◽

Neoplastic Cells ◽

The Mean ◽

Other Neoplasms ◽

Tumor Histogenesis

Cutaneous and mucocutaneous plasmacytoma (PCT) is a common neoplasm of dogs. Tumors can be single or multiple and occur predominantly in the oral cavity, lip, ears, digits, and trunk. Although these tumors typically offer no diagnostic challenge for the pathologist, subsets of PCTs with atypical morphologic configurations may make differentiation from other neoplasms difficult. We describe 6 cases of canine cutaneous and mucocutaneous PCT with pseudoglandular arrangement of neoplastic cells. The mean age of affected dogs was 11.3 y, and multiple breeds and sites were affected. Histologically, neoplastic cells were arranged in sheets, packets, and pseudoglandular structures containing central accumulations of blood or eosinophilic material admixed with neoplastic cells and hemosiderin-laden macrophages. Given the presence of pseudoglandular structures resembling neoplastic acini, epithelial neoplasia was occasionally included in the differential diagnosis. Neoplastic cells were strongly immunopositive for multiple myeloma oncogene 1 ( MUM-1) and immunonegative for pancytokeratin AE1/AE3. Canine cutaneous and mucocutaneous PCTs with pseudoglandular morphology may resemble epithelial neoplasia and raise questions about tumor histogenesis.

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Next-generation sequencing facilitates differentiating between multiple primary lung cancer and intrapulmonary metastasis: a case series

Diagnostic Pathology ◽

10.1186/s13000-021-01083-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Changjiang Liu ◽

Chengang Liu ◽

Xiao Zou ◽

Lin Shao ◽

Ying Sun ◽

...

Keyword(s):

Lung Cancer ◽

Differential Diagnosis ◽

Primary Lung Cancer ◽

Invasive Adenocarcinoma ◽

Free Survival ◽

Multiple Primary ◽

Minimally Invasive Adenocarcinoma ◽

The Right ◽

Generation Sequencing

Abstract Background In lung cancer management, differential diagnosis between multiple primary lung cancer (MPLC) and intrapulmonary metastasis (IMP) is a critical point that is of direct therapeutic and clinical importance. However, this process often suffers from absence of a gold standard, resulting in equivocal cases. Herein, we present a series of three cases, in which genomic alteration patterns revealed by next-generation sequencing (NGS) facilitated the differential diagnosis between MPLC and IMP. Case presentation Case 1 was a 57-year-old female with two separate lesions in the upper lobe and the lower lobe of left lung, which were both histopathologically determined as T2aN0M0 adenocarcinomas. NGS identified an EGFR L858R in one lesion and an EGFR 20 exon insertion in the other one, suggestive of double primary malignancies. The patient underwent wedge resections and received an adjuvant treatment of icotinib and chemotherapy. She had a disease-free survival (DFS) of 19 months and counting. Case 2 was a 55-year-old female with multiple small lesions in both lungs. Histopathological examinations of resected lesions from right upper lobe revealed three subtypes: atypical adenomatous hyperplasia of alveolar epithelium, adenocarcinomas in situ and minimally invasive adenocarcinoma. NGS identified two different BRAF driver mutations G466E and V600_K601delinsE in two lesions of adenocarcinoma in situ, and a BRAF K601E in a lesion of minimally invasive adenocarcinoma. Case 3, a 68-year-old male, had the right upper lobe lesion histophathologically classified as a stage T3NxM0 mixed adenoneuroendocrine carcinoma and the left upper lobe lesion as a stage T1aN0M0 adenocarcinoma. NGS performed with different loci of surgical tissues revealed a rare sensitizing EGFR mutation G719A shared by the right upper lobe lesion and lymph node, and two EGFR mutations L861Q and G719S in left upper lobe lesion. The patient received icotinib treatment postoperatively and achieved a stable disease with a progression-free survival of 5 months. Conclusion Our cases provide evidence for utility of NGS in facilitating diagnosis and treatment decisions.

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