Subungual metastasis resulting from internal malignancies is an extremely rare event. A few cases of subungual metastasis from lung cancer have been reported. However, subungual metastasis arising from lung cancer without any other form of distant metastases has not been reported. The misdiagnosis of a solitary subungual metastases as a benign inflammatory lesion is an important problem as it may cause the misdiagnosis of a lower stage of lung cancer. We may be reporting the first case of a subungual metastasis from lung cancer without any other distant metastases.
Carcinoma, Squamous Cell/secondary* ; Carcinoma, Squamous Cell/radiography ; Carcinoma, Squamous Cell/pathology ; Case Report ; Human ; Lung Neoplasms/radiography ; Lung Neoplasms/pathology* ; Male ; Middle Age ; Nails*/pathology ; Radiography, Thoracic ; Skin Neoplasms/secondary* ; Skin Neoplasms/pathology ; Tomography, X-Ray Computed

Patellar metastases are very rare. There have been approximately 20 cases reported in the literature. We have also noted two other reports of patellar metastasis from lung carcinoma as the first manifestation of lung cancer in our literature review. We present a case of patellar metastasis as the first manifestation of lung epidermoid carcinoma in a patient who was a smoker for 33 years.
Arthrography ; Bone Neoplasms/secondary* ; Bone Neoplasms/radiography ; Bone Neoplasms/pathology ; Carcinoma, Squamous Cell/secondary* ; Carcinoma, Squamous Cell/radiography ; Carcinoma, Squamous Cell/pathology ; Case Report ; Human ; Lung Neoplasms/radiography* ; Male ; Middle Age ; Patella* ; Radiography, Thoracic ; Tomography, X-Ray Computed

OBJECTIVE: To analyze the plain chest radiographic and CT findings of superficial endobronchial lung cancer and to correlate these with the findings of histopathology. MATERIALS AND METHODS: This study involved 19 consecutive patients with pathologically proven lung cancer confined to the bronchial wall. Chest radiographs and CT scans were reviewed for the presence of parenchymal abnormalities, endobronchial nodules, bronchial obstruction, and bronchial wall thickening and stenosis. The CT and histopathologic findings were compared. RESULTS: Sixteen of the 19 patients had abnormal chest radiographic findings, while in 15 (79%), CT revealed bronchial abnormalities: an endobronchial nodule in seven, bronchial obstruction in five, and bronchial wall thickening and stenosis in three. Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one. CONCLUSION: CT helps detect superficial endobronchial lung cancer in 79% of these patients, though there is some disagreement between the CT findings and the pathologic pattern of bronchial lesions. Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.
Carcinoma in Situ/pathology/radiography ; Carcinoma, Squamous Cell/pathology/*radiography ; Human ; Lung/pathology ; Lung Neoplasms/pathology/*radiography ; Male ; Middle Age ; Neoplasm Invasiveness ; *Tomography, X-Ray Computed

CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. Although many diseases that affect the lacrimal gland and fossa are specifically diagnosed by imaging, it is frequently very difficult to differentiate each specific disease on the basis of image characteristics alone due to intrinsic similarities. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a non-enhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. A careful clinical evaluation and moreover, a pathologic verification, are needed. In this pictorial review, the various imaging spectrums of pathologic masses involving the lacrimal gland and fossa are presented, along with appropriate anatomy and pathology reviews.
Carcinoma, Squamous Cell/radiography ; Conjunctival Neoplasms/radiography ; Cysts/radiography ; Eye Neoplasms/*radiography ; Hemangiopericytoma/radiography ; Humans ; Lacrimal Apparatus/*pathology ; Lacrimal Apparatus Diseases/radiography ; Lipoma/radiography ; Lymphoma/radiography ; Neoplasms, Glandular and Epithelial/radiography ; Neurofibroma/radiography ; Sarcoma, Myeloid/radiography

OBJECTIVE: To describe computed tomography (CT) features of metastatic gallbladder (GB) tumors (MGTs) from various primary tumors and to determine whether there are differential imaging features of MGTs according to different primary tumors. MATERIALS AND METHODS: Twenty-one patients who had pathologically confirmed MGTs and underwent CT were retrospectively enrolled. Clinical findings including presenting symptoms, type of surgery, and interval between primary and metastatic tumors were recorded. Histologic features of primary tumor and MGTs including depth of invasion were also reviewed. Imaging findings were analyzed for the location and morphology of MGTs, pattern and degree of enhancement, depth of invasion, presence of intact overlying mucosa, and concordance between imaging features of primary and metastatic tumors. Significant differences between the histologies of MGTs and imaging features were determined. RESULTS: The most common primary tumor metastasized to the GB was gastric cancer (n = 8), followed by renal cell carcinoma (n = 4) and hepatocellular carcinoma (n = 3). All MGTs (n = 21) manifested as infiltrative wall thickenings (n = 15) or as polypoid lesions (n = 6) on CT, similar to the features of primary GB cancers. There were significant differences in the morphology of MGTs, enhancement pattern, enhancement degree, and depth of invasion according to the histology of primary tumors (p < 0.05). Metastatic adenocarcinomas of the GB manifested as infiltrative and persistently enhancing wall thickenings, while non-adenocarcinomatous metastases usually manifested as polypoid lesions with early wash-in and wash-out. CONCLUSION: Although CT findings of MGTs are similar to those of primary GB cancer, they are significantly different between the various histologies of primary tumors.
Adenocarcinoma/pathology/radiography/secondary ; Adult ; Aged ; Carcinoma, Hepatocellular/pathology/radiography/secondary ; Carcinoma, Renal Cell/pathology/radiography/secondary ; Carcinoma, Squamous Cell/pathology/radiography/secondary ; Diagnosis, Differential ; Female ; Gallbladder Neoplasms/pathology/*radiography/*secondary ; Humans ; Kidney Neoplasms/pathology ; Liver Neoplasms/pathology ; Male ; Melanoma/pathology/radiography/secondary ; Middle Aged ; Neoplasm Invasiveness/radiography ; Retrospective Studies ; Stomach Neoplasms/pathology ; *Tomography, X-Ray Computed

Synchronous primary lung cancers are relatively rare. The accurate diagnosis remains challenging, despite of the routine use of bronchoscopy and computed tomography (CT) of the chest. Herein we report a case of synchronous triple primary cancers of the right lung in a 72-year-old male patient in whom each tumor presented distinct CT imaging findings.
Adenocarcinoma/*diagnosis/pathology/radiography ; Adenocarcinoma, Mucinous/*diagnosis/pathology/radiography ; Aged ; Bronchoscopy ; Carcinoma, Squamous Cell/*diagnosis/pathology/radiography ; Diagnosis, Differential ; Humans ; Lung Neoplasms/*diagnosis/pathology/radiography ; Male ; Neoplasm Staging ; Neoplasms, Multiple Primary ; Positron-Emission Tomography ; Tomography, X-Ray Computed

The aim of our study was to describe the radiologic findings of extensive acute lung injury associated with limited thoracic irradiation. Limited thoracic irradiation occasionally results in acute lung injury. In this condition, chest radiograph shows diffuse ground-glass appearance in both lungs and thin-section CT scans show diffuse bilateral ground-glass attenuation with traction bronchiectasis, interlobular septal thickening and intralobular smooth linear opacities.
Acute Disease ; Adenocarcinoma/radiotherapy ; Adenocarcinoma/pathology ; Adenocarcinoma/drug therapy ; Adenocarcinoma/complications* ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/drug therapy ; Carcinoma, Squamous Cell/complications* ; Journal Article ; Human ; Lung/radiation effects* ; Lung/pathology ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/pathology ; Lung Neoplasms/drug therapy ; Lung Neoplasms/complications* ; Male ; Middle Age ; Radiation Injuries/radiography ; Radiation Injuries/pathology ; Radiation Injuries/etiology* ; Thorax/radiation effects

Vesicoenteric fistula is a rare complication of bladder squamous cell carcinoma. We report the case of a 70-year-old male who complained of painless, total gross hematuria. Abdominopelvic computed tomography (CT) revealed an approximately 2.7-cm lobulated and contoured enhancing mass in the bladder dome. We performed partial cystectomy of the bladder dome after transurethral resection of the bladder. The biopsy result was bladder squamous cell carcinoma, with infiltrating serosa histopathologically, but the resection margin was free. Postoperatively, follow-up CT was done after 3 months. Follow-up CT revealed an approximately 4.7-cmx4.0-cm lobulated, contoured, and heterogeneous mass in the bladder dome. A vesicoenteric fistula was visible by cystography. Here we report this case of a vesicoenteric fistula due to bladder squamous cell carcinoma.
Aged ; Carcinoma, Squamous Cell/*complications/pathology/radiography ; Fatal Outcome ; Humans ; Intestinal Fistula/*etiology/radiography ; Male ; Sigmoid Diseases/*etiology/radiography ; Tomography, X-Ray Computed ; Urinary Bladder Fistula/*etiology/radiography ; Urinary Bladder Neoplasms/*complications/pathology/radiography

OBJECTIVE: We wanted to describe the retrospective CT features of subtle pleural metastasis without large effusion that would suggest inoperable lung cancer. MATERIALS AND METHODS: We enrolled 14 patients who had open thoracotomy attempted for lung cancer, but they were proven to be inoperable due to pleural metastasis. Our study also included 20 control patients who were proven as having no pleural metastasis. We retrospectively evaluated the nodularity and thickening of the pleura and the associated pleural effusion on the preoperative chest CT scans. We reviewed the histologic cancer types, the size, shape and location of the lung cancer and the associated mediastinal lymphadenopathy. RESULTS: Subtle pleural nodularity or focal thickening was noted in seven patients (50%) having pleural metastasis and also in three patients (15%) of control group who were without pleural metastasis. More than one of the pleural changes such as subtle pleural nodularity, focal thickening or effusion was identified in eight (57%) patients having pleural metastasis and also in three patients (15%) of the control group, and these findings were significantly less frequent in the control group patients than for the patients with pleural metastasis (p = 0.02). The histologic types of primary lung cancer in patients with pleural metastasis revealed as adenocarcinoma in 10 patients (71%) and squamous cell carcinoma in four patients (29%). The location, size and shape of the primary lung cancer and the associated mediastinal lymphadenopathy showed no significant correlation with pleural metastasis. CONCLUSION: If any subtle pleural nodularity or thickening is found on preoperative chest CT scans of patients with lung cancer, the possibility of pleural metastasis should be considered.
Adenocarcinoma/radiography/secondary ; Adult ; Aged ; Carcinoma, Squamous Cell/radiography/secondary ; Female ; Humans ; Lung Neoplasms/*pathology ; Male ; Middle Aged ; Pleural Effusion, Malignant/pathology ; Pleural Neoplasms/*radiography/*secondary ; Preoperative Care ; Retrospective Studies ; *Tomography, X-Ray Computed

OBJECTIVEThe aim of this study is to investigate the release of TNF-alpha mRNA in two lung cancer cell lines in vitro and the regulation of TNF-alpha mRNA expression by ionizing radiation.

METHODSTwo lung cancer cell lines (A549 and NCI-H596) were investigated for their TNF-alpha mRNA expression before and after exposure to different irradiation doses (2, 5, 10, 20, 30 and 40 Gy) and at different time intervals (1, 3, 6, 12, 24, 48 and 72 hours after irradiation). The TNF-alpha mRNA expression was quantified by fluorescence-based real-time quantitative RT-PCR. Colony formation assays were performed after irradiation with a dose of 2, 4, 6, and 8 Gy to determine the clonogenic survival.

RESULTSDependent on the dose given, irradiation was found to cause increasing induction of TNF-alpha mRNA expression of NCI-H596 cells, reaching maximal level after 40 Gy irradiation, which was 83 times higher than that of normal controls. On the other hand, dependent on the time after irradiation, TNF-alpha mRNA expression of NCI-H596 and A549 cells was increased, reaching maximal level at 6h for NCI-H596 cells, which was 568 times higher than that of normal control cells. TNF-alpha mRNA expression of A549 cells was increased to maximum at 1 h after irradiation and was 136 times higher than that of control cells. Colony formation efficiency (number of colonies divided by the number of inoculated cells) of unirradiated control A549 and NCI-H596 cells was 0.37-0.45 and 0.12-0.24, respectively. The survival fraction (SF) of A549 cells was 47.3% +/- 9.0% at 2 Gy, 18.0% +/- 3.0% at 4 Gy, 6.0% +/- 2.0% at 6 Gy, 1.4% +/- 0.3% at 8 Gy. The SF of NCI-H596 cells was 55.2% +/- 51.0% at 2 Gy, 15.9% +/- 9.2% at 4 Gy, 3.5% +/- 1.7% at 6 Gy; 0.9% +/- 0.6% at 8 Gy. The curves of TNF-alpha expression of the two tumor cell lines were nearly identical, therefore the radiosensitivity of these cell lines was similar. Statistically there was no significant difference for D(0) and D(q) (P > 0.05).

CONCLUSIONThe two lung cancer cell lines studied express TNF-alpha following irradiation in a time- and irradiation dose-dependent manner. Radiation-induced TNF-alpha production of tumor cells may be of paramount importance not only for tumor behaviour, but also in respect to potential damage to normal tissues and the clinical status of the host.

Adenocarcinoma ; diagnostic imaging ; metabolism ; pathology ; Carcinoma, Squamous Cell ; diagnostic imaging ; metabolism ; pathology ; Cell Line, Tumor ; Humans ; Lung Neoplasms ; diagnostic imaging ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Radiation Dosage ; Radiography ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha ; biosynthesis ; genetics