BACKGROUND: This study was designed to evaluate the FDG uptake ratio of mediastinal node and primary tumors using integrated PET/CT imaging combined with Glut-1 expression of the primary tumor in order to predict the N2 status more accurately in NSCLC patients. MATERIAL AND METHOD: Patients who underwent integrated PET/CT scanning with a detectable mSUV for both primary tumors and mediastinal lymph nodes were eligible for this study. The FDG uptake ratio between the mediastinal node and the primary tumor was calculated. RESULT: The average mSUV of primary tumors and mediastinal nodes were, respectively, 7.4+/-2.2 and 4.2+/-2.2 in N2-positive patients and 7.6+/-3.7 and 2.8+/-6.9 in N2-negative patients. The mean FDG uptake ratio of mediastinal node to primary tumor were 0.58+/-0.23 for malignant N2 lymph nodes and 0.45+/-0.20 for benign lymph nodes (p<0.05). Models which combined Glut-1 expression with an FDG ratio have better diagnostic power than models that use the FDG uptake ratio alone. CONCLUSION: In some patients with a previous history of pulmonary tuberculosis or other inflammatory lung diseases, an FDG uptake ratio combined with Glut-1 expression may be useful in diagnosing mediastinal node metastasis more exactly.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Diseases ; Lung Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Tuberculosis, Pulmonary

The prognosis of lung cancer is very poor. Patients with lung cancer have usually no symptom in early stage or some mild cough, sputum. When patient feel weight loss or dyspnea, majority of patients with lung cancer are advanced stage and inoperable. The growth rate of lung cancer is different according to cell type of tumor and related to prognosis. Generally, tumor. doubling time (TDT) of lung cancer has been known that small cell lung cancer is about 65 days, squamous cell carcinoma is about 90 days, and adenocarcinoma is about 185 days. There has been rarely reported of lung cancer with very fast or very slow growth. The prognosis of a slow growing lung cancer is relatively good but rapidly growing cancer is not. We report a very rare case that surgicallytreated early stage non-small cell lung cancer (adenocarcinoma) with 4-year- TDT without invasion or distant metastasis
Adenocarcinoma* ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cough ; Dyspnea ; Humans ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis ; Prognosis ; Small Cell Lung Carcinoma ; Sputum ; Weight Loss

Lung cancer has become a leading cause of cancer death in Korea. Accurate staging of non-small cell lung cancer (NSCLC) is essential to the ability to offer a patient the most effective available treatment and the best estimate of prognosis. PET with F-18 fluorodeoxyglucose (FDG) is indicated for the nodal staging of NSCLC and detection of distant metastases. Use of PET for mediastinal staging should not be relied on as a sole staging modality, and positive findings should be confirmed by mediastinoscopy. FDG PET avoids futile surgery by a more accurate selection of patients, especially by the detection of unexpected distant metastases.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Korea ; Lung Neoplasms ; Mediastinoscopy ; Neoplasm Metastasis ; Prognosis

Lung cancer is the leading cause of cancer-related deaths worldwide. Targeted therapy is beneficial in most cases, but the development of drug resistance stands as an obstacle to good prognosis. Multiple mechanisms were explored such as genetic alterations, activation of bypass signaling, and phenotypic transition. These intrinsic and/or extrinsic dynamic regulations facilitate tumor cell survival in meeting the demands of signaling under different stimulus. This review introduces lung cancer plasticity and heterogeneity and their correlation with drug resistance. While cancer plasticity and heterogeneity play an essential role in the development of drug resistance, the manipulation of them may bring some inspirations to cancer prognosis and treatment. That is to say, lung cancer plasticity and heterogeneity present us with not only challenges but also opportunities.
Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; Drug Resistance, Neoplasm ; genetics ; Humans ; Lung Neoplasms ; genetics ; metabolism

Carcinoma, Non-Small-Cell Lung/pathology* ; Consensus ; Humans ; Lung Neoplasms/pathology* ; Neoadjuvant Therapy ; Neoplasm Staging

The pulmonary giant cell carcinoma is classified as a variant of a large cell carcinoma and is diagnosed by the minimum component of 10% huge, pleomorphic and multinucleated giant tumor cell and emperipolesis of the neutrophils into the tumor cells. This tumor is characterized by local recurrences and early metastasis with extremely short patient survival. However, there are some reports that state that the survival time was extended by the operative resection and postoperative adjuvant chemotherapy and radiotherapy. A 46-year old male was admitted with complaint of hemoptysis for 2 months. Through chest X-ray and chest CT, a 5cm sized mass was found in the apical segment of the right upper lobe. During the preoperative evaluation, stenotic lesion in the left anterior descending coronary artery was found and treated by percutaneous transarterial coronary angioplasty. Four weeks later, right upper lobectomy was performed and the mass was proven to be a giant cell carcinoma. The patient received adjuvant chemotherapy and radiotherapy.
Angioplasty ; Carcinoma, Bronchogenic ; Carcinoma, Giant Cell* ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung ; Chemotherapy, Adjuvant ; Coronary Vessels ; Emperipolesis ; Giant Cells* ; Hemoptysis ; Humans ; Lung Neoplasms ; Male ; Middle Aged ; Neoplasm Metastasis ; Neutrophils ; Radiotherapy ; Recurrence ; Thorax ; Tomography, X-Ray Computed

Ovarian cancer is generally primary cancer and less frequently originates from metastasis from non-gynecological cancer. Ovarian metastasis from lung cancer represents only 2~4% of all ovarian metastatic cancers. We report a case of ovarian metastasis of non-small cell lung cancer with epidermal growth factor receptor mutation. The patient underwent cytoreductive surgery for the ovarian mass and erlotinib therapy for the metastatic lung cancer. Erlotinib therapy markedly decreased the size of lung mass.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Receptor, Epidermal Growth Factor ; Erlotinib Hydrochloride

BACKGROUND: Traditionally, patients with stage IIIB non small cell lung cancer (NSCLC) have been considered inoperable due to the short-term survival rate of this disease. However, some recent papers have reported good surgical treatment results for T4 lesions in stage IIIB NSCLC. This study reports the results of stage IIIB NSCLC patients who underwent surgical treatment at our institute. MATERIAL AND METHOD: This study includes 109 patients who were diagnosed with pathological stage IIIA lung cancer and 59 patients who were diagnosed with pathological stage IIIB at our institute between 1994 to December 2001. Patients who underwent neo-adjuvant chemotherapy and radiation therapy were excluded from this study. According to the TNM classification, 13 patients from stage IIIA were classified into T3N1, 12 into T1N2, 73 into T2N2 and 11 into T3N2. Stage IIIB patients consisted of 26 patients with T4N0, 18 with T4N1, 14 with T4N2, and 1 with T4N3. RESULT: The 30-day mortality for stage IIIA and IIIB were 4.58% and 5.08% respectively. The overall survival rate at the 1st, 2nd, 3rd, and 5th year were 69.1%, 53.7%, 41.6%, and 30.7% respectively in stage IIIA and 68.8%, 55.6%, 42.9%, and 35.9% respectively in stage IIIB. Patients with satellite nodules in the same lobe& no lymph node involvement had a survival rate of 53.9% in 3 years compared with 15.2% in patients with satellite nodules in the same lobe with lymph node involvement. CONCLUSION: Surgical treatment is recommended for selected stage IIIB NSCLC patients (pathological N0 stage& completely resectable patients), particularly for patients with satellite nodules in the same lobe& no lymph node involvement.
Carcinoma, Non-Small-Cell Lung* ; Classification ; Drug Therapy ; Humans ; Lung ; Lung Neoplasms ; Lymph Nodes ; Mortality ; Neoplasm Staging ; Small Cell Lung Carcinoma ; Survival Rate

"Tumor-to-tumor" metastasis is a rare event; meningioma has been reported as the most common primary intracranial tumor to harbor cancer metastases. Several hypotheses have been previously proposed to explain this occurrence, but the exact mechanism by which these metastases develop into meningiomas is not yet understood. Magnetic resonance imaging and spectroscopy have been valuable diagnostic tools, but preoperative diagnosis of metastasis to meningioma remains highly difficult. We present a case report of a metastasis of non-small cell lung cancer into an intracranial meningioma.
Carcinoma, Non-Small-Cell Lung ; Carcinoma, Small Cell ; Lung Neoplasms ; Magnetic Resonance Imaging ; Meningioma ; Neoplasm Metastasis ; Spectrum Analysis

BACKGROUND: Current studies on multimodal strategy for N2 non-small cell lung cancer are being high interest have drawn much attention. N2 lung cancer, however, is composed of is divided into several subgroups with that have different prognoses. The prognostic factors still ramain controversial. METHODS: Between January 1990 and June 1999, 180 patients with N2 lung cancer who underwent surgical resection were investigated, excluding 10 of these for surgical mortality. All patients underwent mediastinal lymph node dissection. 20 clinicopathologic factors were investigated by univariable and multivariable analyses to identify significant prognostic factors among resected N2 disease. RESULTS: The overall 5-year survival rate was 20.6%. Multivariable analyses among overall patients revealed 3 significant prognostic factors:Age, Histologic type, Vascular invasion. Based on the result, 49 patients with both age more than 60 and pathologic Non-squamous cell showed a 5-year survival of 5.0%, whereas 37 patients with neither of the factors showed a 5-year survival of 56.6%(p<0.001). And 12 patients with both vascular invasion and pathologic Non-squamous cell showed a 5-year survival of 11.9%, whereas 67 patients with neither of the factors showed a 5-year survival of 33.6%(p=0.01). CONCLUSION: The prognosis of surgically resected N2 disease varies according to the 2 significant prognosis factors. Tumor size may be an additional influencing factor in the prognosis of N2 disease.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms ; Lung* ; Lymph Node Excision ; Lymph Nodes* ; Mortality ; Neoplasm Metastasis* ; Prognosis ; Survival Rate