Environmental/Occupational Exposure to Radon and Non-Pulmonary Neoplasm Risk: A Review of Epidemiologic Evidence

Although Radon (Rn) is a known agent for lung cancer, the link between Rn exposure and other non-pulmonary neoplasms remains unclear. The aim of this review is to investigate the role of Rn in the development of tumors other than lung cancer in both occupational and environmental exposure. Particularly, our attention has been focused on leukemia and tumors related to brain and central nervous system (CNS), skin, stomach, kidney, and breast. The epidemiologic literature has been systematically reviewed focusing on workers, general population, and pediatric population. A weak increase in leukemia risk due to Rn exposure was found, but bias and confounding factors cannot be ruled out. The results of studies conducted on stomach cancer are mixed, although with some prevalence for a positive association with Rn exposure. In the case of brain and CNS cancer and skin cancer, results are inconclusive, while no association was found for breast and kidney cancers. Overall, the available evidence does not support a conclusion that a causal association has been established between Rn exposure and the risk of other non-pulmonary neoplasms mainly due to the limited number and heterogeneity of existing studies. To confirm this result, a statistical analysis should be necessary, even if it is now not applicable for the few studies available.

Incidental Benign Giant Pulmonary Chondroid Hamartoma

Hamartomas constitute a small portion of all pulmonary neoplasms. Here we present a case which was found incidentally on CT scan of the abdomen, a rare case of a giant pulmonary hamartoma (PH) was identified in the lower lobe of the left lung. The patient underwent a left exploratory thoracotomy and left lower lobectomy and the lesion was removed and identified as a chondroid hamartoma. The patient recovered successfully and obtained a repeated CT scan in 3 months, which showed no residual disease or recurrence

An unusual 7 cm large typical carcinoid managed by surgery: a rare case report

Carcinoid tumors of the lung are uncommon group of pulmonary neoplasms. Most common site is gastrointestinal tract followed by lungs. Typical pulmonary carcinoids are usually small as described in various case series size of a typical carcinoid may ranges from 0.5-2 cm and are managed surgically. Here we present a case of unusually large typical carcinoid measuring up to 7 cm which was managed surgically.

Primary Solid Pulmonary Adenocarcinoma in a dog

Background: In veterinary medicine, although primary lung tumors are rare compared to metastatic malignant neoplasms, an increase in the number of primary lung tumors in dogs has been reported in the past decades. Consequently, identifying epidemiological, clinical, and pathological features of these neoplasms is essential for early and precise diagnosis. This paper aimed to report a case of a non-metastatic primary solid pulmonary adenocarcinoma in a dog and review the clinical, pathological, and immunohistochemical aspects of this neoplasm.Case: An 8-year-old female Cocker Spaniel was admitted to the Small Animals Veterinary Hospital of the Rural Federal University of Rio de Janeiro (Brazil) with a history of progressive weight loss and clinical dyspnea. Physical examination revealed the following: body temperature, 38.7ºC; capillary refill time, one second; heart rate, 104 beats/min; respiratory rate, 40 breaths/min; pallor mucosa; blood glucose, 133 mg/dL; and body score, 2 (1-9). A thoracic radiograph revealed a diffuse radiopaque pattern of the pulmonary parenchyma, pleural effusion, and a large mass that extended through both hemithoraces. An ultrasound-guided cytological examination was performed and displayed moderate cellularity in a bloody background. Cells presented distinct cell borders, large bluish cytoplasm, round hyperchromatic or vesicular nuclei, and evident nucleoli. Three months after the first clinical consultation, the dog’s state kept deteriorating and the owner opted for the euthanasia. Autopsy of the lungs showed multiple, poorly defined, coalescent nodules with an average size of 20.0×15.0×10.0 cm. The nodules occupied roughly 70% of the pulmonary parenchyma, including right and left cranial lobes, medium lobe, and a large portion of the caudal lobe. The cross-sections of the tumors were multinodular, soft, and white. Cystic areas filled with bloody exudates were also found within the tumor. Representative tissue samples were fixed in 10% formalin, processed routinely, and stained with Hematoxylin and Eosin. Fragments from the lung tumor were submitted for immunohistochemistry evaluation with primary antibodies anti-CK pan, anti-CK7, anti-CK20, anti-vimentin, TTF-1, CD56, synaptophysin, and chromogranin. Microscopic examination of the tumor revealed a dense and solid monomorphic epithelial neoplastic proliferation supported by a thin and scant fibrovascular stroma. Cells presented distinct cell borders, a slightly granular eosinophilic cytoplasm, hyperchromatic, round, and vesicular nuclei, evident nucleoli, and numerous mitoses. Necrotic areas were also observed scattered in the tumor. Immunohistochemically the cells expressed CK pan and CK7 but failed to express immunoreactivity to vimentin, CK20, TTF-1, CD56, synaptophysin, and chromogranin. The morphological and immunohistochemical features were consistent with a primary lung tumor, and hence, classified as a solid adenocarcinoma.Discussion: The solid pattern of primary lung adenocarcinomas is uncommon in domestic animals. Assessment of morphological features and immunohistochemical evaluation are essential for the definitive diagnosis of primary pulmonary neoplasms. Due to the increased number of primary pulmonary tumors reported in dogs in the last few decades, primary pulmonary neoplasms should be considered in the differential diagnosis of pulmonary masses, especially when there is no evidence of tumors elsewhere in the body.