Therapeutic endobronchial resection of a benign tumor in a patient with cystic fibrosis

Abstract A patient with cystic fibrosis presented recurrent pneumonia in the upper right lobe. A polypoid lesion was found during bronchoscopy. We report the first case of a successful endoscopic resection of an inflammatory polyp without need for open surgery and without recurrence of the tumor nor lung infection. Key clinical Message This report highlights the usefulness of bronchoscopy in case of recurrent pneumonia with the same localization even in CF patients where the presence of bronchiectasis as promoting factor of infections could delay the diagnosis

A rare case of multimetastatic cardiac angiosarcoma

Cardiac malignant tumors are rare entities with nonspecific clinical presentation and poor prognosis. Here, we report a case of about a 30-year-old man who was admitted for right thoracic pain. Imaging indicated a cardiac malignant tumor, and pathology confirmed the diagnosis. Our case highlights the value of multimodal imaging in the differential diagnosis of a cardiac mass.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Phenotypic variation of an ALK-positive large cell neuroendocrine lung carcinoma with carcinoid morphology during treatment with ALK-inhibitors

Rearrangement of the ALK gene and overexpression of ALK seems to occur very rarely in neuroendocrine lung tumors, with only 3 cases of atypical carcinoid and 1 large cell neuroendocrine carcinoma (LCNEC) reported in detail until now.(1,2,3,4) Here, we report a case of an ALK-positive neuroendocrine lung tumor showing a variable phenotype during the course of treatment. A pulmonary lesion with mediastinal adenopathies was detected in a 69-year-old, non-smoking female of Turkish origin during work-up for back pain. A very small amount of tumoral tissue was obtained through fine needle aspiration of a lymph node and stainings performed on paraffin-embedded tissue showed a very limited amount of tumoral tissue with a well-differentiated cytological aspect with regular nuclei. This article is protected by copyright. All rights reserved

Hibernoma-like Changes and TFE3 Expression in Mesothelioma Mimicking TFE3-Translocation Renal Cell Carcinoma: A Diagnostic Pitfall.

The long delay between asbestos exposure and the development of mesothelioma will likely result in an increased incidence of mesothelioma in our industrialized societies. Radiation therapy is another factor known to induce these tumors. We describe a rare case of foamy looking mesothelioma in a 63-year-old patient with a long oncology history of a supposed peritoneal carcinomatosis. The pathologist was faced with a diagnostic pitfall as this peritoneal clear cell tumor expressed transcription factor binding to immunoglobulin heavy constant mu enhancer 3 (TFE3) at the nuclear level. Fortunately, the pathologist performed an extensive panel of immunomarkers, leading to a final diagnosis of epithelioid mesothelioma. Thus, we describe the first case of mesothelioma expressing TFE3. Note that there was no rearrangement of TFE3 in fluorescence in situ hybridization

Chilblains and COVID-19: why SARS-CoV-2 endothelial infection is questioned.

Recently, Colmenero et al (1) demonstrated, by immunohistochemistry, the presence of SARS‐CoV‐2 in endothelial cells of skin biopsy specimens of chilblains in seven patients. These results raise some questions: The presence of the virus at cutaneous and vascular levels in otherwise asymptomatic patients with negative RT‐PCR is unexpected. Vascular damage by direct viral effect is expected to be a sign of severity. It is also surprising that only feet are affected

Infection à Mycobacterium avium simulant un adénocarcinome pulmonaire : un potentiel piège diagnostique

Introduction : L’incidence des infections à mycobactéries atypiques est estimée en Europe à un cas pour 100 000 personnes/année. Malgré la rareté des infections mycobactériennes non tuberculeuses, le Mycobacterium avium peut réaliser une lésion nodulaire donnant le change avec un cancer pulmonaire. Nous rapportons un cas de mycobactériose atypique pulmonaire, ayant conduit à la lobectomie. Observation : Il s’agit d’un nodule pulmonaire droit découvert chez un patient de 63 ans, BPCO, partiellement néphrectomisé pour carcinome rénal, hebdomadairement sous méthotrexate pour polyarthrite rhumatoïde. À la tomographie par émission de positron (TEP scan), la lésion était faiblement hypermétabolique, avec des micronodules non hypermétaboliques de la petite scissure. La bronchoscopie ne retrouvait pas de lésions endoluminales. L’examen cytobactériologique était non contributif. L’examen histopathologique du nodule pulmonaire apical, obtenu par biopsie transthoracique révélait un adénocarcinome bronchique au stade T1(a)N0M0. Le patient bénéficia alors d’une lobectomie supérieure avec curage ganglionnaire. L’analyse anatomopathologique a retrouvé des nodules granulomateux nécrosant entourés de cellules géantes évoquant un tuberculome. La culture mycobactérienne des échantillons de lavage bronchique s’est révélée positive à Mycobacterium avium après 7 semaines. Conclusion : Dans les formes pseudonéoplasiques des mycobactérioses atypiques, la présence d’anomalies cytonucléaires alvéolaires inflammatoires peut mimer un adénocarcinome. Faire la différence entre les anomalies cytonucléaires d’origine réactionnelles ou d’origine néoplasique reste donc une difficulté journalière en histopathologie.[Mycobacterium avium tumoral infection mimicking a lung adenocarcinoma: A potential diagnostic pitfall]. Introduction: The incidence of atypical mycobacterial infection in Europe is estimated at one case per 100,000 persons/year. Despite the low incidence of Mycobacterium avium infection, it can result in a nodular lesion simulating lung cancer. We report a case of atypical mycobacteriosis, mimicking lung cancer, which led to a lobectomy. Case report: It was a right pulmonary upper lobe nodule found in a 63-year-old COPD patient, partially nephrectomized for renal carcinoma, and weekly treated by methotrexate for rheumatoid arthritis. FDG uptake was weakly positive on PET-CT (SUV = 2.2) in the upper fissure. Bronchoscopy yielded no lesions and no bacteriological findings. Percutaneous transthoracic lung biopsy revealed lung adenocarcinoma stage T1 (a) N0M0. An upper lobectomy with lymphadenectomy was performed. Histological examination revealed epithelioid granuloma surrounded by giant cells suggestive of tuberculomas. The bronchial washing fluid culture was positive for Mycobacterium avium after 7 weeks. Conclusion: In pseudo-neoplastic forms of atypical mycobacteriosis, the presence of alveolar, inflammatory cytonuclear abnormalities can mimic an adenocarcinoma. Making the difference between the cytonuclears defects related to inflammation or neoplasia remains a daily challenge in histopathology