Pulmonary carcinosarcoma initially presenting as invasive aspergillosis: A case report of previously unreported combination

Department of Medicine, Sinai Grace Hospital/Detroit Medical Center, Detroit, Michigan, USA.
Diagnostic Pathology (Impact Factor: 2.6). 01/2010; 5(1):11. DOI: 10.1186/1746-1596-5-11
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Carcinosarcoma of the lung is a malignant tumor composed of a mixture of carcinoma and sarcoma elements. The carcinomatous component is most commonly squamous followed by adenocarcinoma. The sarcomatous component commonly comprises the bulk of the tumor and shows poorly differentiated spindle cell features. Foci of differentiated sarcomatous elements such as chondrosarcoma and osteosarcoma may be seen. Aspergillus pneumonia is the most common form of invasive aspergillosis and occurs mainly in patients with malignancy, immunocompromizing or debilitating diseases. Patients with Aspergillus pneumonia present with fever, cough, chest pain and occasionally hemoptysis. Tissue examination is the most reliable method for diagnosis, and mortality rate is high.
We describe a case of primary carcinosarcoma of the lung concurrently occurring with invasive pulmonary aspergillosis in a 66-year old patient.

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Available from: Doina David, Oct 13, 2015
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    • "The incidence of respiratory failure is significant after inhalational injuries, with subsequent hypoxemia, pneumonia, respiratory failure, prolonged ventilatory support and extended hospitalization [3] [4] [5] [6]. Enclosed-space fires, loss of consciousness, facial burns and large TBSA (>40%) should raise the suspicion of SII [8]. "
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    ABSTRACT: Smoke-inhalation injury (SII) is an unfavorable prognostic sign and a major cause of mortality in burn patients. Subsequently, it is important to diagnose early, determine accurately the injuries severity and to intervene early in these patients.
    03/2015; 16. DOI:10.1016/j.ejcdt.2015.03.015
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    • "Groups of patients graded according to depth of mucosal damage estimated by fiberoptic bronchoscopy on admission, in line with Chou’s classification[3] "
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    ABSTRACT: As acute inhalational injury is an uncommon presentation to most institutions, a standard approach to its assessment and management, especially using flexible bronchoscopy, has not received significant attention. The objective of this study is to evaluate the value of using flexible bronchoscopy as part of the evaluation and management of patients with inhalational lung injury. Twenty-three cases of inhalational lung injury were treated in our three hospitals after a fire in a residential building. The twenty cases that underwent bronchoscopy as part of their management are included in this analysis. After admission, the first bronchoscopy was conducted within 18-72 hours post inhalational injury. G2-level patients were reexamined 24 hours after the first bronchoscopy, while G1-level patients were reexamined 72 hours later. Subsequently, all patients were re-examined every 2-3 days until recovered or until only tunica mucosa bronchi congestion was identified by bronchoscopy. Twenty patients had airway injury diagnosed by bronchoscopy including burns to the larynx and glottis or large airways. Bronchoscopic classification of the inhalation injury was performed, identifying 12 cases of grade G1 changes and 8 cases of grade G2. The airway injury in the 12 cases of grade G1 patients demonstrated recovery in 2-8 days, in the airway injury of the 8 cases of grade G2 patients had a prolonged recovery with airway injury improving in 6-21 days averaged. The difference in recovery time between the two groups was significant (P <0.05). The use of flexible bronchoscopy has great value in the diagnosis of inhalational injury without any complications. Its use should be incorporated into clinical practice.Virtual slides: The virtual slide(s) for this article can be found here:
    Diagnostic Pathology 10/2013; 8(1):174. DOI:10.1186/1746-1596-8-174 · 2.60 Impact Factor
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    • "In this case, absence of predominant chondromatous lesion helps to exclude chondrosarcoma. Pulmonary carcinosarcoma is ruled out for lack of carcinomatous component [11]. "
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    ABSTRACT: Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft-tissue sarcoma, which primarily occurs deep in the extremities, especially in skeletal muscle, or tendon. EMC of the pleura has been described, however, no case of primary EMC arising from lung has been previously reported. We describe herein, a 51-year-old Asian female initially manifested with signs of severe anemia who presented with a lung mass unrelated to pleura that was morphologically typical EMC, with strong immunoreactivity for vimentin and NSE. Two weeks after resection, the anemia was cured. The patient continued with follow-up, without sign of abnormality 32 months after operation. Virtual slides The virtual slides for this article can be found here:
    Diagnostic Pathology 08/2012; 7(1):112. DOI:10.1186/1746-1596-7-112 · 2.60 Impact Factor
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