Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Malignant cartilaginous tumors of the lung are unusual, and although their occurrence has been reported in the literature in some cases, their separation from other benign cartilaginous tumors of the lung can be very difficult. Four cases of primary chondrosarcomas of the lung are presented. The patients are 2 men and 2 women between the ages of 51 and 69 years. Clinically, the most common symptoms were chest pain, dyspnea, and cough. Two tumors were centrally located, whereas 2 tumors were peripheral. Complete surgical resection was accomplished in all the patients. Histologically, 2 tumors were low grade of the hyaline type, whereas 2 tumors were predominantly myxoid chondrosarcomas. In the 2 myxoid chondrosarcomas immunohistochemical studies for keratin, desmin, smooth muscle actin, and CD31 were negative, whereas S-100 protein shows focal positive staining in both cases. Follow-up showed that one patient with low-grade tumor was alive and well at 36 months, whereas one patient with myxoid chondrosarcoma died 45 days after diagnosis because of surgical complications. Two additional patients were lost to follow-up. Our study highlights the ubiquitous distribution of chondrosarcomas and the histopathologic spectrum that these tumors may show when occurring in the lung.
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PMID:Primary pulmonary chondrosarcomas: a clinicopathologic study of 4 cases. 2149 64

NUT midline carcinoma (NMC) is a poorly differentiated tumor typically driven by a t(15;19) rearrangement leading to a NUT fusion event. This rare and uniformly fatal tumor arises in multiple organ sites; however the clinical, radiographic, and pathologic characteristics of primary pulmonary NMC are poorly defined. We identified eight cases of primary pulmonary NMC in our consult practice over 4 years and, using a NUT immunohistochemistry screen, retrospectively identified one additional case from 166 (0.6%) consecutive in-house biopsies of lung carcinomas lacking glandular differentiation. Eight cases had available clinical and radiographic data and shared a remarkable degree of similarity. The median age at presentation was 30 (range 21-68). Six patients had little or no smoking history. All complained of 1 to 3 months of cough at presentation. Computed tomography scans showed a large, centrally located primary mass with confluent involvement of mediastinal lymph nodes, pleural disease, and sparing of the contralateral lung. Lytic bone metastases were common but brain metastases were absent in all cases. Pathologically, all cases showed primitive-appearing round to epitheloid cells growing in nests and sheets. All tumors expressed keratin, p63 or p40, and NUT protein. Eight cases had a fluorescence in situ hybridization-proven BRD4-NUT or BRD3-NUT rearrangement; one case was presumed to have a NUT-variant fusion event. Median overall survival was 2.2 months. Despite the rarity of primary pulmonary NMC, it is important to recognize this entity to counsel patients regarding outcome and to identify candidates for targeted BRD inhibitors currently in clinical trials.
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PMID:Primary Pulmonary NUT Midline Carcinoma: Clinical, Radiographic, and Pathologic Characterizations. 2600 Nov 44

Nuclear protein in testis (NUT) midline carcinoma (NMC) is a clinically lethal malignancy affecting all age group often located in the midline structures such as mediastinum, larynx and nasopharynx. It is characterized by chromosomal translocation between chromosomes 15 and 19 with the formation of chimeric gene BRD-NUT. We present the cytologic findings of NMC including the immunohistochemical stains performed. The patient is a 34-year-old man who presented with 1 month history of dyspnea and interscapular pain followed by nonproductive cough a week before consultation. He was initially diagnosed with pneumonia. Due to progression of symptoms, a chest CT scan was performed revealing a large hilar mass and mediastinal adenopathy. A core biopsy with touch preparations of the hilar mass was performed which revealed cohesive malignant cells with ovoid to elongated nuclei, fine to coarse chromatin pattern, irregular nuclear contour, prominent nucleoli, and scant ill-defined cytoplasm arranged in sheets and focally pseudoglandular pattern. Although focal nuclear overlapping and crush artifact were identified, karyorrhectic debris and mitotic figures were rare. Squamous differentiation was absent. The core biopsy showed discohesive malignant cells with tumor necrosis. No nuclear molding, glandular or squamous differentiation was identified. The tumor was immunoreactive for p63 and NUT with high Ki-67 (>80%). The tumor was negative for keratin, lymphoid, myeloid, neuroendocrine markers and S-100. This case emphasizes that cytologic features of NMC can mimic poorly differentiated, undifferentiated and neuroendocrine carcinomas and the importance of immunohistochemical stains especially NUT monoclonal antibody in arriving at the diagnosis.
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PMID:Cytologic findings of NUT midline carcinoma in the hilum of the lung. 2613 51

Malignant pleural mesothelioma (MPM) is a rare neoplasm. It predominantly affects elderly individuals aged over 70 years presenting with a unilateral pleural tumor usually associated with previous asbestos exposure. The respiratory symptoms are associated with ipsilateral pleural involvement with concomitant pleural effusions. The diagnosis of MPM is established by the morphologic and immunohistochemical features of a cytologic specimen. MPM can present as three histologic subtypes: epithelioid, sarcomatoid, or biphasic. We present a case of an 85-year-old Caucasian female with a history of occupational asbestos exposure. She complained of 1-week history of progressive sharp right flank and scapular pain with mild shortness of breath, dry cough and pleuritic chest pain. CT of the chest showed a large loculated right pleural effusion with adjacent pleural thickening. CT abdomen and pelvis was negative for other neoplastic findings. CT-guided core biopsy of the right pleural-based mass was positive for a spindle to plasmacytoid small blue cell tumor. An extensive immunohistochemical panel was non-specific. A focal OSCAR keratin and WT-1 expression in the absence of carcinoma markers, a malignant mesothelioma, biphasic type was diagnosed. Further workup with PET-CT and cytotoxic chemotherapy combined with immunotherapy or tyrosine kinase inhibitors was recommended by oncology. The patient refused further imaging and treatment, and palliative care was consulted.
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PMID:Malignant Pleural Mesothelioma, Biphasic Type: An Unusual and Insidious Case of Rapidly Progressive Small Blue Cell Tumor. 3010 62

Seven primary thymic epithelial neoplasms, 3 thymomas and 4 thymic carcinomas, with rhabdomyomatous component are herein described. The patients are 2 women and 5 men between the ages of 42 and 62 years (average, 52 years). Clinically, the patients presented with nonspecific symptoms of cough, chest pain, and dyspnea. None of the patients had history of myasthenia gravis or of previous malignancy. Diagnostic imaging revealed the presence of an anterior mediastinal mass in all the patients. Surgical resection was accomplished in all the cases. The 3 thymoma cases were encapsulated tumors: histologically, 2 were lymphocyte rich (World Health Organization type B1), and 1 was an atypical thymoma (World Health Organization type B3). All the thymic carcinomas were ill-defined tumor masses with infiltrative borders and histologically were high-grade carcinomas. In each tumor, in different proportion, there were easily identifiable areas with rhabdomyomatous component characterized by larger cells with eosinophilic cytoplasm and eccentrically placed nuclei. Immunohistochemical stains in all cases showed clearly demarcated presence of the epithelial component (keratin positive/desmin and myoglobin negative) and the rhabdomyomatous component (desmin and myoglobin positive/keratin negative). The 3 patients with thymoma are alive and without recurrence 3 and 5 years after surgical resection, whereas 3 patients with carcinoma died between 2 and 3 years after surgical resection. One patient with thymic carcinoma was lost to follow-up. The current cases highlight the ubiquitous distribution of myoid cells in different types of thymic epithelial neoplasms.
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PMID:Thymic epithelial neoplasms with rhabdomyomatous component: a clinicopathological and immunohistochemical study of 7 cases. 3021 23

A case of a primary lung carcinoma with histologic and immunohistochemical features of a mammary carcinoma is presented. The patient is a 72-year-old man who presented with symptoms of cough and dyspnea. Diagnostic imaging showed a bronchial tumor in the left lower lobe that was surgically resected by a left lower lobectomy. The tumor was characterized by a homogenous cellular proliferation composed of small to medium-sized cells with round nuclei and inconspicuous nucleoli. Multiple immunohistochemical stains were performed, and the tumor was notably positive for estrogen receptor, progesterone receptor, GATA3, and pan-keratin, while molecular analysis showed somatic mutation in ARID1A. Clinical follow-up showed that the patient is alive and well 18 months post-surgical resection without evidence of recurrence or metastatic disease. Based on the overall features of this neoplasm, we consider that the tumor herein presented represents an unusual type of lung carcinoma that we refer to as primary mammary-like carcinoma of the lung.
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PMID:Primary Mammary-Like Carcinoma of the Lung: A Case Report of a Distinct Type of Primary Lung Carcinoma. 3205 Aug 37

Twenty-five cases of micronodular thymomas with prominent cystic changes are presented. The patients are 13 men and 12 women between the ages of 38 and 69 years. Clinically, the majority of patients presented with nonspecific symptoms of cough, chest pain, and dyspnea. Four patients were asymptomatic. Diagnostic imaging showed the presence of an anterior mediastinal mass and surgical resection of the tumor mass was performed in all the patients. Histologically, all the tumors were characterized by the presence of cystic structures of varying sizes lined by different types of epithelium. In addition, the tumors were characterized by nodules of epithelial cells embedded in a lymphocyte-rich stroma with germinal centers. Twenty-one tumors were encapsulated while 4 tumors were minimally invasive. Immunohistochemical stains were positive for keratin in the nodular epithelial component while CD45 and CD20 were positive in the lymphoid component. Clinical follow-up ranging from 12 to 24 months was obtained in 19 patients. All the patients were alive and well without disease. No clinical follow-up was available in 6 patients. The cases presented in this article highlight the existence of cystic micronodular thymomas, which can be easily misdiagnosed as a multilocular thymic cyst.
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PMID:Micronodular Thymomas With Prominent Cystic Changes: A Clinicopathological and Immunohistochemical Study of 25 Cases. 3302 63


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