Rapid killer: Lung squamous cell cancer

Background: Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy. NSCLC is a heterogeneous group of diseases that differs in cytology and includes adenocarcinoma, squamous cell carcinoma, bronchioloalveolar carcinoma, and poorly differentiated carcinoma. Usually, NSCLC, in contrast to SCLC, spreads locally, and the doubling time of squamous cell carcinoma is 133 days which classifies it as a relatively slow-growing tumor.Case presentation: We present the case of a 72-year-old male, recently diagnosed with squamous cell carcinoma in the right upper lobe along with secondary deposits. Few days after diagnosis, the patient had severe respiratory distress. This endobronchial tumor has increased significantly in size upon bronchoscopic visualization causing a complete obstruction of his right main bronchus and hypoxemic respiratory failure requiring intubation.Conclusion: To our knowledge, there are few reported cases where lung adenocarcinoma progressed rapidly over days. Squamous cell carcinoma usually takes 3 to 6 months to double in size, but in our case, the progression was very fast. In the last decade, it was confirmed that the doubling time of a tumor is an independent factor in the prognosis of lung cancer patients. On the other hand, further studies are needed to identify genes associated with rapid progression and a worse prognosis for lung squamous cell carcinoma. Hence, this aggressive tumor is a “rapid killer.”

Pathological Examination and Differential Diagnosis of Pulmonary Ground-Glass Opacities by CT-Guided Percutaneous Needle Biopsy

In order to explore the pathological examination and differential diagnosis of pulmonary ground-glass opacities (GGO) with CT-guided percutaneous needle biopsy (CTPNB), this study retrospectively analyzed the medical records of 120 cases of patients who were diagnosed with pulmonary GGO and underwent CTPNB in a hospital designated by this study from December 2014 to December 2018. The results showed that all the 120 cases of patients were successfully punctured at one time and obtained sufficient tissue specimens with the puncture success rate and diagnostic accuracy both of 100%, being able to make a clear qualitative diagnosis. Among them, 30 cases were malignant lesions including 14 cases of bronchioloalveolar carcinoma and 16 cases of metastatic carcinoma; 90 cases were benign lesions including 52 cases of hematogenous pulmonary tuberculosis, 14 cases of sarcoidosis, 12 cases of silicosis and coal workers’ pneumoconiosis, 6 cases of interstitial pneumonia, 4 cases of alveolar proteinosis, and 2 case of allergic pneumonia. The complications of the 120 patients during the treatment included 8 cases of pneumothorax with an incidence of 6.67% (8/120), in which 2 case had the pulmonary tissue compression rate of about 25% and the other cases had no obvious perceived symptoms and required no special treatment, and 10 cases of hemoptysis with an incidence of 8.33% (10/120), whose symptoms disappeared after the treatment with batroxobin, and had no serious symptoms such as air embolism complication. The sensitivity, specificity, and accuracy of CTPNB in the diagnosis of malignant pulmonary GGO were 83.67% (82/98), 100% (22/22), and 86.67% (104/120), respectively, without statistically significant differences in diagnostic efficacy (P > 0.05). In summary, the CTPNB for the diagnosis of malignant pulmonary GGO has high sensitivity, specificity, and accuracy, and the CTPNB is also the simplest and most important approach to obtain effective pathological examinations and differential diagnoses of pulmonary GGO, which has simple operation, high accuracy and few complications, and has high application value for the qualitative diagnosis of pulmonary GGO.

MUC5AC Expression in Various Tumor Types and Nonneoplastic Tissue: A Tissue Microarray Study on 10 399 Tissue Samples

Background: Mucin 5AC (MUC5AC) belongs to the glycoprotein family of secreted gel-forming mucins and is physiologically expressed in some epithelial cells. Studies have shown that MUC5AC is also expressed in several cancer types suggesting a potential utility for the distinction of tumor types and subtypes. Methods: To systematically determine MUC5AC expression in normal and cancerous tissues, a tissue microarray containing 10 399 samples from 111 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. Results: MUC5AC was expressed in normal mucus-producing cells of various organs. At least weak MUC5AC positivity was seen in 44 of 111 (40%) tumor entities. Of these 44 tumor entities, 28 included also tumors with strong positivity. MUC5AC immunostaining was most commonly seen in esophageal adenocarcinoma (72%), colon adenoma (62%), ductal adenocarcinoma of the pancreas (64%), mucinous carcinoma of the ovary (46%), diffuse gastric adenocarcinoma (44%), pancreatic ampullary adenocarcinoma (41%), intestinal gastric adenocarcinoma (39%), and bronchioloalveolar carcinoma (33%). Clinically relevant tumors with complete or almost complete absence of MUC5AC staining included small cell carcinoma of the lung (0% of 17), clear cell renal cell carcinoma (0% of 507), papillary thyroid carcinoma (0% of 359), breast cancer (2% of 1097), prostate cancer (2% of 228), soft tissue tumors (0.1% of 968), and hematological neoplasias (0% of 111). Conclusion: The highly standardized analysis of a broad range of cancers identified a ranking order of tumors according to their relative prevalence of MUC5AC expression.

Statistical Reflections Regarding the Significance of the Microscopic Examination in the Diagnosis of Mammary and Abdominal Neoplasias in Cats

76 cats were clinical examined for mammary and abdominal neoplasias. In 41 cats were performed microscopic examination. Regarding the location of the primary tumors 70 cats had mammary tumors. Isolated, six cases of primary non-mammary tumors were diagnosed following necropsy and histopathology. Following cytopathological and histopathological examinations, 14 tumor types were identified, of which 3 benign and 11 malignant. Benign tumoral types consisted of lipoma, vesical leiomyoma and mammary adenoma. Diagnosed malignant cases consisted of simple mammary adenocarcinoma, solid adenocarcinoma, compact adenocarcinoma, hepatic cholangiocarcinoma, compact carcinoma, mixed pulmonar bronchioloalveolar carcinoma, hemangiosarcoma, mammary comedocarcinoma, solid carcinoma and mixed adenocarcinoma.