Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is rare, with a more favorable prognosis compared with that of other types of non-small cell lung cancers. Herein, we describe an interesting case of primary pulmonary LELC confirmed postoperatively, which had been initially diagnosed as poorly differentiated adenocarcinoma. We suggest that despite the rarity of pulmonary LELC, it should be included as one of the differential diagnoses for lung malignancies. Physicians should consider taking a larger biopsy, especially when histologic examination shows undifferentiated nature.
Adenocarcinoma* ; Biopsy ; Carcinoma, Non-Small-Cell Lung ; Diagnosis, Differential ; Lung ; Lung Neoplasms ; Prognosis

Immune cell infiltration is of great significance for the diagnosis and prognosis of cancer. In this study, we collected gene expression data of non-small cell lung cancer (NSCLC) and normal tissues included in TCGA database, obtained the proportion of 22 immune cells by CIBERSORT tool, and then evaluated the infiltration of immune cells. Subsequently, based on the proportion of 22 immune cells, a classification model of NSCLC tissues and normal tissues was constructed using machine learning methods. The AUC, sensitivity and specificity of classification model built by random forest algorithm reached 0.987, 0.98 and 0.84, respectively. In addition, the AUC, sensitivity and specificity of classification model of lung adenocarcinoma and lung squamous carcinoma tissues constructed by random forest method 0.827, 0.75 and 0.77, respectively. Finally, we constructed a prognosis model of NSCLC by combining the immunocyte score composed of 8 strongly correlated features of 22 immunocyte features screened by LASSO regression with clinical features. After evaluation and verification, C-index reached 0.71 and the calibration curves of three years and five years were well fitted in the prognosis model, which could accurately predict the degree of prognostic risk. This study aims to provide a new strategy for the diagnosis and prognosis of NSCLC based on the classification model and prognosis model established by immune cell infiltration.
Algorithms ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; physiopathology ; Humans ; Lung Neoplasms ; diagnosis ; physiopathology ; Machine Learning ; Prognosis

Pulmonary sarcomatoid carcinoma (PSC) is a rare, poorly differentiated, subtype of non-small cell lung carcinoma (NSCLC) and constitutes approximately 0.1% to 0.5% of all lung malignancies. PSC can be divided into five subtypes based on the 2015 World Health Organization (WHO) classification of lung tumors: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma. Some imaging characteristics can be found for PSC although no special symptoms. The accurate pathological diagnosis of PSC can be a significant challenge, which depends on pathology and immunohistochemistry. PSC should be managed similar to other NSCLC, surgical resection is the standard management for early stage cases, moreover, multimodal treatment should be considered. However, PSC is insensitive to radiotherapy and chemotherapy, and has high rate of local and metastatic recurrence and poor prognosis. With the development of molecular pathology, targeted therapy and immunotherapy may have broad prospects.
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Carcinoma, Non-Small-Cell Lung ; diagnosis ; therapy ; Lung Neoplasms ; diagnosis ; therapy ; Prognosis

Humans ; Carcinoma, Non-Small-Cell Lung/diagnosis* ; Consensus ; Lung Neoplasms/diagnosis* ; Asian People ; China

Humans ; Consensus ; Lung Neoplasms/pathology* ; Carcinoma, Non-Small-Cell Lung/diagnosis* ; Biopsy

Biopsy, Fine-Needle ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; pathology ; Humans ; In Situ Hybridization, Fluorescence ; Lung Neoplasms ; diagnosis ; pathology ; Small Cell Lung Carcinoma ; diagnosis ; pathology

A 34-year-old male presented with fluctuating diplopia, ptosis and motor weakness, who had been suffering from idiopathic thrombocytopenic purpura (ITP) and non-small cell lung cancer (NSCLC). Clinical and laboratory findings confirmed the diagnosis of generalized myasthenia gravis (MG). MG was successfully managed with pharmacologic treatments including an immunosuppressive agent. To the best of our knowledge, this is the first case of MG combined with ITP and NSCLC.
Adult ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Diplopia ; Humans ; Male ; Myasthenia Gravis* ; Purpura, Thrombocytopenic, Idiopathic*

Intracardiac metastasis as the initial presentation of malignant neoplasm is very rare. We report here on a 64-year-old man with non-small cell lung cancer (NSCLC) initially presenting with intracardiac metastasis which was identified with 18-F fluorodeoxyglucose positron emission tomography (FDG PET). The patient was admitted with complaints of exertional dyspnea and vague chest discomfort that had developed a few weeks ago. Two-dimensional echocardiography revealed a heart mass attached to its akinetic wall in the right ventricular chamber. CT and MRI demonstrated a large tumor involving the epicardium and myocardium in the right ventricle, and there was a mass in the right lower lobe of the lung along with multiple lymphadenopathies. Cytologic examination of the percutaneous needle aspiration of a lymph node in the anterior mediastinum revealed malignant epithelial cell nests, and this was strongly suggestive of squamous cell carcinoma. Subsequent FDG PET confirmed that the intracardiac mass had an abnormally increased FDG uptake, and again this was strongly suggestive of malignancy. By systemically considering these imaging studies, we were able to diagnose the mass as intracardiac metastasis of NSCLC.
Carcinoma, Non-Small-Cell Lung/*diagnosis ; Heart Neoplasms/diagnosis/*secondary ; Heart Ventricles/pathology ; Humans ; Lung Neoplasms/*diagnosis ; Male ; Middle Aged

Despite complete resection of tumor and mediastinal lymph node dissection, the post-operative survival rate of early stage I non-small cell carcinoma is not so good due to increased recurrences. So, we tried to use one of the chemotherapeutic agents after complete resection of lung carcinoma even though the pathologic final diagnosis is stage IA or IB in order to improve post-operative survivals. One-hundred and eight male and 23 female patients (mean age: 62 years, range: 28~83 years) participated in this clinical study from January 1992 to April 2002 at the Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea. Twenty-nine patients were in stage IA and 102 were in stage IB. Among them, 3 patients died from surgical problems and 3 patients died from non surgical problems. Fifty-six patients were placed in the UFT treated group and 61 patients were in the control group. The 5-year survival rate of the patients treated with UFT was 88.6% and the 5-year survival rate of the patients in control group was 72.3% (p=0.0596). The results of our trial indicate that even patients with stage IA and IB non-small cell lung carcinoma would be benefited from orall UFT after complete surgical resection of the tumor.
Carcinoma, Non-Small-Cell Lung ; Diagnosis ; Female ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Lymph Node Excision ; Male ; Recurrence ; Seoul ; Survival Rate

Carcinoma, Non-Small-Cell Lung ; diagnosis ; metabolism ; therapy ; Humans ; Lung Neoplasms ; diagnosis ; metabolism ; therapy ; Receptor Protein-Tyrosine Kinases ; metabolism