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Presented by: Ulrike Gruber Mosenbacher, Feldkirch, Austria
Clinical History
18 years old slim male patient with a history of chronic cough since 4 weeks. Primarily fever, which could be reduced after antibiotic therapy, followed by recurrence and infury of a right distal rib because of forced coughing.
At admission no symptoms except slight pain at injured rib during coughing. No b-symptoms.
CT scan of a medistinal right sided lesion in chest X-ray reveals an inhomogeneous structure with stippled calcification without fat, measuring 8x8x4 cm, between sternum, jugulm and heart, pushing back aorta and trunk of pulmonary artery.
5x3 cm infiltrate in the right sinus phrenicocostalis.
CCT and CT of abdomen and pelvis normal, testes normal by palpation.
Resection of the tumor incl. frozen section for tumor diagnosis and resection margins.
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| TUVIII | TUV | TUIII | Thymus | TUVIII |
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| Diagnosis & Comments [0] |
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Presented by: Stefan Dojcinov, Cardiff, United Kingdom
Female, 66. The patient, a non-smoker, presented with a right lower lobe lung lesion. The clinical suspicion was of non-small cell lung cancer or tuberculosis. Right VATs lower lobe wedge resection was undertaken.
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Presented by: Fiorella Calabrese, Padova, Italy
A 62-year-old woman with long history of productive cough, recurrent episodes of fever and prolonged usage of antibiotics developed in the last three years respiratory dysfunction and severe hypoxemia requiring non invasive ventilatory support.
Radiologic studies showed dilated airways more diffuse and prominent in the last computed tomography scan. The patient was considered eligible for bilateral lung transplantation. Bronchoalveolar lavage culture before lung transplantation was positive for Staphylococcus aureus and Pseudomonas aeruginosa. The lung section is from the explanted native lungs. |
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| Slide 1 | HE 1 | HE 2 | Chromogranin | MNF116 | 34BE12 |
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Presented by: John Chan, Kowloon, Hong Kong
This 55-year-old man is an ex-smoker with good past health. He presented with dry cough noticed for 3 months. PET-CT scan revealed multiple hypermetabolic nodules in both lungs, bulky tumor in mediastinum, metastatic lymph nodes in right hilum, extensive pleural disease and multiple nodules in the liver. A liver biopsy was performed.
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| Sldie 1 - HE | Sldie 2 - HE | Slide 3 - HE | Slide 4 - HE | Slide 5 - HE | Slide 6 - HE | Slide 7 - HE |
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| Slide 8 - cKIT |
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Presented by: Philipp Ströbel, Göttingen, Germany
A 22-year-old patient presented with increasing dyspnea, anterior thoracic pain, coughing, and fever since two weeks which persisted under antibiotic treatment. His medical history was unremarkable. Thoracic computed tomography (CT) revealed an 11-cm tumor located in the anterior mediastinum, close to the pulmonary artery and aortic arch, extending to but not infiltrating the chest wall. A large thymoma was suspected and transsternal complete resection of the mediastinal mass, wedge resection of the anterior portion of the left upper lobe, and excision of the left phrenic nerve due to tumor involvement was performed. Tumor-free resection margins were confirmed by microscopic examination of intraoperative frozen sections.
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| Cystic teratoma overview | Cystic teratoma detail high power | NEC carcinoid pattern w small hepatic remnant | NEC solid pattern |
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Presented by: Ulrike Gruber Mosenbacher, Feldkirch, Austria
A 69 years old patient was readmitted to the hospital after resection of the left upper lobe of the lung 4 months before because of SqCLC (T1 N0 R0 M0 L1 V1). The patient was an ex-smoker (50 py a year) before the diagnosis of lung cancer. He had been a farmer and a locksmith.
At readmission the patient suffered from dyspnoe, chest pain and weight loss. He had medication against cardial insufficiency and corticosteroids (Dexamethason, 8 mg). There was candidiasis of the oral mucosa. Vital capacity was reduced. Chest x-ray revealed ground glass opacity of the left residual lung with destroyed areas (abscess) in the upper part and pleural effusion was seen basally. In the bronchial washing ESBL-producing E. coli was found and treated according to resistance test. Bronchoscopy revealed irregularities of the bronchial mucosa of the residual left-upper-lobe bronchus, suspicious for recurrent cancer.
Endobronchial biopsies from this area were taken (snap-shots 1-3). PET scan showed strong enhancement in the left lung, so 9 days after bronchoscopy a transthoracic biopsy was taken. (snapshot).
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| Slide 1 | Bronchial biopsy 1 | Bronchial biopsy 2 | Bronchial biopsy 3 | Transthoracal biopsy |
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| Diagnosis & Comments [0] |
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Presented by: Fiorella Calabrese, Padova, Italy
A 25-yr-old man heavy smoker affected by Langerhans cell histiocytosis was referred to our Centre in 2010 for bilateral lung transplantation (LTX). He received our routine immunosuppression regimen comprising ciclosporin, azathioprin and prednisone. In the first two months the patient had two episodes of parenchymal acute rejection (mild and moderate: grade A2 and A3, respectively) which responded to high doses of corticosteroids. Five months after LTX the patient developed respiratory dysfunction and computed tomography (CT) revealed pulmonary infiltrates some of them with cavitations.
Due to progressive lung dysfunction, the patient died six months after LTX and autopsy was performed.
Figure 1: Lung sections from lung grafts (autoptic specimens): Hematoxylin & eosin stain
Figure 2: Lung sections from lung grafts (autoptic specimens): Grocott silver stain |
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Presented by: Lina Carvalho; Cristina Fonseca; Rui Proença, 3000 Coimbra, Portugal
A 53-year-old male complaining of right-side chest pain and mild fever of 2 weeks duration; chronic cough and sputum, mostly in the morning, without recent changes. Smoker of 50 packs/year. CT: a mass in the posterior right lower lobe of 6.6 x 3.3 cm, soft tissue density and also right para-tracheal and sub-carinal enlarged lymph nodes. Right Lower Lobectomy. |
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| Diagnosis & Comments [0] |
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