The lung is a common site for metastasis of malignant tumors from other organs. The metastatic cascade is a complex process that involves a series of events. Tumors can spread to the lung through hematogenous or lymphangitic routes. In the absence of extrathoracic metastasis, complete resection is associated with increased survival, regardless of histology. With appropriate patient selection, life expectancy is often improved with pulmonary metastasectomy. Stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) are 2 approaches that have been increasingly reported for pulmonary tumors. Although these new therapies have yet to match the long-term success rates of surgical therapy, the techniques demonstrate good results in treating high-risk surgical candidates with metastatic lesions to the lungs that would otherwise be considered with resection. This review will focus on the role of local therapy in oligometastasis that arise in the lung.
Life Expectancy ; Lung ; Metastasectomy ; Neoplasm Metastasis ; Patient Selection

Protein-losing enteropathy (PLE) is a syndrome characterized by excessive gastrointestinal protein loss, resulting in hypoproteinemia and edema. A variety of benign and malignant conditions can be associated with PLE and acute leukemia is a very rare cause of PLE. We report a case of PLE associated with acute lymphoblastic leukemia. A 27-year-old man was admitted due to watery diarrhea, epigastric pain and bilateral leg edema. Laboratory findings showed hypoproteinemia and polycythemia. The diagnosis of PLE and acute lymphoblastic leukemia were confirmed on the measurement of fecal alpha1-antitrypsin clearance and bone marrow examination. After systemic chemotherapy and autologous stem cell transplantation, his clinical symptoms and abnormal laboratory findings were gradually improved.
Adult ; Bone Marrow Cells/pathology ; Endoscopy, Gastrointestinal ; Humans ; Magnetic Resonance Imaging ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*diagnosis/genetics ; Protein-Losing Enteropathies/complications/*diagnosis ; Thoracic Vertebrae/radiography ; Tomography, X-Ray Computed ; Translocation, Genetic ; alpha 1-Antitrypsin/analysis

Renal cell carcinoma is well known for its tendency to metastasize early to the lung, bone, and liver, but skeletal muscle is an extremely unusual site of metastasis. We report here on an unusual case with numerous skeletal muscle metastases in the posterior abdominal wall and buttock 2 years after radical nephrectomy for renal cell carcinoma.
Abdominal Wall ; Buttocks ; Carcinoma, Renal Cell* ; Liver ; Lung ; Muscle, Skeletal* ; Neoplasm Metastasis* ; Nephrectomy*

A central nervous system (CNS) relapse is a rare but mostly fatal complication in patients with diffuse large B cell lymphoma (DLBCL). CNS involvement can occur as an isolated event or can be combined with progression of systemic disease. There are limited data on treatment outcomes of patients with DLBCL and secondary CNS involvement. We report the clinical data, treatments, and outcomes of two DLBCL patients with isolated CNS relapses involving the brain parenchyma. Isolated CNS disease involving the brain parenchyma may be potentially treatable as the initial relapse site after complete remission from systemic treatment.
Brain* ; Central Nervous System ; Central Nervous System Diseases ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Recurrence*

The idiopathic hypereosinophilic syndrome consists of peripheral blood eosinophilia of 1500/mm3 or more without a known cause, plus signs and symptoms of organ eosinophilia. The prognosis of HES without treatment is poor. However, about one third of the patients with this syndrome may respond to corticosteroid thrapy. Morever, the majority of the remainder may have a favorable response to hydroxyurea. We present here a case of hypereosinophilic syndrome without any identifiable causes, involving bone marrow, liver, lungs and cervical lymph node. We tried corticosteroid as a treatment but it showed no response. However the hydroxyurea showed good response.
Bone Marrow ; Eosinophilia ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome ; Liver ; Lung ; Lymph Nodes ; Prognosis

PURPOSE: We have examined the expression of c-erbB-2 oncogene in sera and tissues of non-small cell lung cancer patients. MATERIALS AND METHODS: Serum levels of c-erbB-2 protein were measured by an enzyme im munoassay in 55 patients with non-small cell lung cancer. Sera from patients with surgical therapy were evaluated again after surgery. Immunohistochemical staining was performed in 47 of these tumors. RESULTS: Elevated levels (> or =45 U/mL, control mean 2SD) were observed in 15% of 55 non-small cell lung cancer patients, as compared with none of control subjects (p<0.05). The incidence of elevated level was higher in the adenocarcinoma than squamous cell carcinoma (22% vs 4%, p<0.01). The serum levels of c-erbB-2 protein decreased significantly after surgical tumor ablation (p<0.01). Tissue overexpression was obtained in 23/47 cases (49%). The incidence of c-erbB-2 overexpression was higher in the adenocarcinoma (73% vs 29%, p<0.005). No relationship was found between c-erbB-2 protein expression in serum and tumor tissue and clinicopathologic feature. Elevated serum c-erbB-2 levels predicted tissue overexpression with sensitivity 30% and specificity 96%. There was relationship between serum level and expression in tumor tissue of c-erbB-2 protein. CONCLUSION: Serum and tissue levels of c-erbB-2 correlate in patients with non-small cell carcinoma. Serum c-erbB-2 protein may be a useful indicator of tumor burden in patients with non-small cell lung cancer.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Incidence ; Oncogenes ; Receptor, erbB-2* ; Sensitivity and Specificity ; Tumor Burden

BACKGROUND: The possibility of cord blood transplantation in adults was limited by the amount of cord blood that could be collected. Cord blood transplantation after ex vivo expansion with cytokines have already been tried in adults. Amifostine is a phosphorylated aminothiol that affords broad cytoprotection from the myelosuppressive effects of antineoplastic agents. The purposes of this study were to investigate expansion of progenitor and myeloid cells after ex vivo culture of mononuclear cells (MNCs) in umbilical cord blood with growth factor and characterize hematopoietic activities of amifostine. METHODS: MNCs were cultured and ex vivo expanded into myeloid progenitors by using hematopoietic growth factors (IL-1beta, IL-3, IL-6, G-CSF, GM-CSF, SCF, EPO) which are known to stimulate differentiation and proliferation of myeloid progenitors. MNCs exposed to the appropriate amount of amifostine for 15 min were cultured in semisolid media and harvested at 24h intervals, and then apoptosis was assessed by propidium iodide staining. RESULTS: Myeloid colonies were successfully produced from MNCs. Maximal expansion was obtained with the combination of IL-3+SCF+G-CSF+GM-CSF. SCF was thought to be the most important growth factor for expansion of myeloid progenitor. Pretreatment with amifostine for 15 min stimulated formation of hematopoietic colonies at clinically relevant concentrations ranging from 1 to 100 micrometer. Increase in colony number compare to control were comparable after pretreatment with amifostine (10micrometer), and CFU-GEMM and BFU-E were highly responsive. Further enhancement of colony was not observed after prolonging the duration of pre- incubation exposure to 1, 8 and 24 hours. Amifostine enhanced IL-1 and IL-3 induced formation of CFU-GEMM and BFU-E. Incubation of MNCs with amifostine in suspension culture increased recovery of secondary colonies. Treatment with amifostine retarded cell loss and apoptosis, and promoted cell survival at 24, 48 and 72 hours in cytokine-deficient medium. CONCLUSION: Cord blood MNCs can be successfully expanded into myeloid progenitors by using hematopoietic growth factors. This investigation extend the previously recognized hematologic effects of amifostine, and indicate that in addition to its cytoprotective properties, amifostine is a stimulant of hematopoietic progenitor growth.
Adult ; Amifostine* ; Antineoplastic Agents ; Apoptosis ; Cell Survival ; Cytokines ; Cytoprotection ; Erythroid Precursor Cells ; Fetal Blood ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-1 ; Interleukin-3 ; Interleukin-6 ; Myeloid Cells ; Myeloid Progenitor Cells ; Propidium

Essential thrombocythemia (ET), a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets, and increased incidence of thrombosis and hemorrhage. We consider a diagnosis of ET when an unexplained and persistent thrombocytosis is observed. It is difficult to consider ET first when we meet a patient with esophageal varix bleeding or unusual multiple thromboses like mesenteric vein, splenic vein, and portal vein. This article reports a patient who presented initially with esophageal varix bleeding and unusual multiple thromboses, thereafter, she was diagnosed with ET after testing positive for the Janus Tyrosine Kinase 2 (JAK2) V617F mutation. In conclusion, in patients with varix bleeding and unusual multiple thromboses, myeloproliferative disorders like essential thrombocythemia should be considered as a potential cause and testing for the JAK2 mutation is warranted.
Blood Platelets ; Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Incidence ; Mesenteric Veins ; Myeloproliferative Disorders ; Portal Vein ; Splenic Vein ; Thrombocythemia, Essential ; Thrombocytosis ; Thrombosis ; TYK2 Kinase ; Varicose Veins

BACKGROUND: Lung cancer incidence is gradually leveling off in developed countries but is continuing to rise in Korea. Because of the rapid increasing in smoking prevalence among women and youngers, the lung cancer incidence is expected to increase within next three and four decades. The aims of the present study are to analyses the smoking habits in patients with lung cancer and to evaluate of the relative risk of smoking habits in patients with lung cancer. METHOD: The present investigation was hospital-based, case control study. It included data from 93 case subjects with lung cancer and 1132 controls with disease unrelated to smoking using smoking history questionnaire by direct personal interview. RESULT: Compared with non-smoker, those who smoked more than 50 years had an odds ratio for lung cancer of 8.8(1.8-20.7). The odds ratios was 8.5(3.5-20.7) for those whose total number of cigarettes per days exceeded 41 and 5.5(2.3-13.3) for men with started habitual smoking less than 20 years old. The risk was increased in men with more than 41 pack years of cigarette smoking(OR:5.5, 95% CI:2.6-11.9). Odds ratios associated with cigarette smoking were 2.5(1.1-5.8), 5.1(2.6-10.4) for exsmoker and current smoker, respectively and 2.2(1.0-4.6) for non-filter smoker with more than 16 years. CONCLUSION: There was a clear dose-response relationship between the risk of lung cancer and smoking. We conclude that smoking dose is important risk factor for lung cancer and smoking habits may be, also.
Case-Control Studies ; Developed Countries ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms* ; Lung* ; Male ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Smoke* ; Smoking* ; Tobacco Products ; Young Adult

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare T-cell lymphoma characterized by involvement of the subcutaneous tissue of neoplastic T lymphocytes. SPTCL with hemophagocytic syndrome (HPS) is associated with an aggressive clinical course and treatment of SPTCL with HPS is not well established. Cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) therapy is not successful in most patients suffering from SPTCL with HPS. The role of high dose chemotherapy followed by hematopoietic stem cell transplantation (HSCT) remains controversial. We report a case of relapsed SPTCL after CHOP chemotherapy and salvage chemotherapy followed by autologous HSCT, which had rapid improvement within weeks after cyclosporine and prednisolone. Immunosuppressive therapy may be an important and successful treatment option in SPTCL patients, even though they may have clinically aggressive disease.
Cyclophosphamide ; Cyclosporine ; Doxorubicin ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma ; Lymphoma, T-Cell ; Panniculitis ; Prednisolone ; Stress, Psychological ; Subcutaneous Tissue ; T-Lymphocytes ; Vincristine