Ground-glass nodule (GGN) lung cancer often progresses slowly in clinical and there are few clinical studies on long-term follow-up of patients with operable GGN lung cancer treated with stereotactic body radiation therapy (SBRT). We present a successful case of GGN lung cancer treated with SBRT, but a new GGN was found in the lung adjacent to the SBRT target during follow-up. The nodule progressed rapidly and was confirmed as lung adenocarcinoma by surgical resection. No significant risk factors and related driving genes were found in molecular pathological findings and genetic tests. It deserves further study whether new GGN is related to the SBRT. This case suggests that the follow-up after SBRT should be vigilant against the occurrence of new rapidly progressive lung cancer in the target area and adjacent lung tissue.
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Humans ; Lung Neoplasms/pathology* ; Radiosurgery ; Retrospective Studies ; Adenocarcinoma of Lung/surgery* ; Lung/pathology*

Giant extralobar pulmonary sequestration in newborns is still relatively rare in pulmonary diseases, and there are few relevant studies published. A neonate with the giant extralobar pulmonary sequestration accompanied by severe pleural effusion was reported here. After 12 days of birth, the diseased lung tissue was surgically extracted. The patient had an uneventful postoperative recovery and was discharged from the hospital. The case shows the advantage of early surgical treatment to extralobar pulmonary sequestration with severe pleural effusion in neonatal period.

Objective:Lung cancer is characterized by its high incidence and case fatality rate.Factors related to population composition and cancer prevention programme policy have an effect on the incidence and diagnosis of lung cancer.This study aims to provide scientific support for early diagnosis and treatment of lung cancer by investigating the clinic information,pathological,and imaging characteristics of surgical patients with lung cancer. Methods:The data of 2 058 patients,who underwent surgery for lung cancer in the Department of Thoracic Surgery of Xiangya Hospital of Central South University from 2016 to 2019,were retrospectively collected to analyze changes in clinic information,pathological,and imaging characteristics. Results:From 2016 to 2019,the number of patients per year was 280,376,524,and 878,respectively.Adenocarcinoma(68.1%)was the most common pathological type of surgical patients with lung cancer.From 2016 to 2019,the proportion of adenocarcinoma was increased from 55.5%to 74.1%.The proportion lung cancer patients in stage IA was increased from 38.9%to 62.3%,and the proportion of patients who underwent sublobar resection was increased from 1.8%to 8.6%.The proportion of lymph node sampling was increased in 2019.Compared with the rate in 2016,the detection rate of nodules with diameter≤1 cm detected by CT before surgery in 2019 was significantly improved(2.0%vs 18.2%),and the detection rate of nodules with diameter>3 cm was decreased(34.7%vs 18.3%).From 2016 to 2019,the proportion of lesions with pure ground-glass density and partial solid density detected by CT was increased from 2.0%and 16.6%to 20.0%and 37.3%,respectively.The proportion of solid density was decreased from 81.4%to 42.7%. Conclusion:The number of lung cancer surgery patients is rapidly increasing year by year,the proportion of CT-detected purely ground-glass density and partially solid density lesions are increasing,the proportion of patients with adenocarcinoma is rising,the proportion of early-stage lung cancer is increasing,smaller lung cancers are detected in earlier clinical stage leading to a more minimally invasive approach to the surgical methods.

Objective:To explore the role of active screening in the diagnosis and treatment of early lung cancer, and give health management recommendations.Methods:A retrospective study was conducted to collect lung cancer patients who had complete population sociology, clinical information, pathology and imaging characteristics in the Thoracic Surgery in Xiangya Hospital of Central South University from 2016 to 2019. According to different diagnostic modes, they were divided into an active screening group (1082 cases) and a passive case finding group (974 cases), to analyze their differences in demographic sociological, clinical information, pathology and imaging characteristics, and to discuss the key points of population management in the active screening group.Results:From 2016 to 2019, the proportion of lung cancer patients in the active screening group increased from 36.1% to 54.2%, and the proportion of patients found to have lung cancer by CT examination in the active screening group increased from 82.2% to 96.8%. Compared with the passive case finding group, the active screening group had a higher proportion of women, non-smokers, patients with precursor glandular lesions and adenocarcinoma, patients in stage 0 and stage I, patients with lesion diameter (d)≤1 cm and 1

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that develops from vascular endothelial cells. It has been reported to occur many sites of body, but the most common EHE presentations are soft tissue (limbs), bone, liver and lung. Compared with other pulmonary tumors, pulmonary epithelioid hemangioendothelioma (P-EHE) is relatively rare. According to a literature review, more than 100 cases have been described all over the world. Due to the low incidence of P-EHE, lack of specificity in clinical symptoms and radiological findings, it is often misdiagnosed. Meanwhile, many patients do not receive appropriate treatment, resulting in poor prognosis in some cases. Histology and immunohistochemical methods are essential for diagnosis. However, there is no established standard treatment for P-EHE, because of the rarity of the disease. When the lesions are small and limited in number, surgical is the best treatment, achieving the purpose of diagnosis and treatment at the same time. This article tries to present the etiopathogenesis, clinical manifestations, diagnosis, treatment and prognosis of P-EHE.
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Objective:To summarize the surgical treatment experience of thoracic solitary fibrous tumors(SFTs),especially some spe-cial SFTs.Methods:Patients with SFTs in our department between January 2009 and May 2017 were recruited in this study and the clinical characteristics were summarized.Results:Twenty-one patients(11 men and 10 women)with an average age of 48.3 years were included.Tumor sizes ranged from 3 to 30 cm and 13 patients(61.9%)harbored pleural tumors,while 8 patients harbored tu-mors from other special thoracic sites (including 1 case of trachea SFT and 1 case of pulmonary SFT). Surgical treatment was per-formed in 19 patients,17 of whom underwent complete tumor resection and two patients underwent palliative resection.One patient did not undergo surgery and was lost to follow-up,and another patient who did not undergo surgery died because of a heart attack af-ter discharge.The 19 patients who underwent surgery were followed up for 1-96 months,3 patients of whom underwent reoperation for tumor recurrence at 12,26,and 72 months after surgery,respectively,while the remaining patients had no recurrence.Seven pa-tients(33.3%)were confirmed with malignancy after operation or biopsy.Conclusions:Thoracic SFTs are mainly from the pleura and the surgical results are favorable.Resection after recurrence can achieve favorable results.

Bronchogenic cyst occurring in the diaphragm is rare and thoracoscopic cyst resection is mainly effective treatment. The coronary artery bleeding after video-assisted thoracoscopic surgery (VATS) has never been described; here we report a case of left coronary artery injury after thoracoscopic itradiaphragmatic bronchogenic cyst resection, which may be caused by metallic troca or chest tube.
Bronchogenic Cyst ; surgery ; Coronary Vessels ; diagnostic imaging ; Diaphragm ; Hemorrhage ; diagnostic imaging ; etiology ; Humans ; Male ; Middle Aged ; Thoracic Surgery, Video-Assisted ; adverse effects ; Time Factors ; Tomography, X-Ray Computed

Objective To explore different clinical and pathological features of thymomas with and without myasthenia gravis(MG),and accumulate the experience of perioperative managements.Methods Patients with thymoma admitted by our department between June 2010 and June 2016,were retrospectively reviewed.Results Of the 273 patieuts,150 were males and 143 were fenales(median age:48 years).115 of all patients(42.1％) were combined with paraneoplastic diseases.There was no mortality during perioperative period.Video-assisted Thoracoscopic surgery was successfully performed for 246 cases(90.1％).The female thymoma patients with with MG(TMG) were more than those without MG and thymic hyperplasia (53.0％ VS 39.5％,P =0.036).Compared to the thymoma patients without MG and thymic hyperplasia,the TMG was associated with younger age of onset [(46.6 ± 12.9) years VS.(50.6 ± 14.32) years,P =0.026],longer hospital stay [(18.3 ± 9.4)days VS.(14.6 ±5.7) days,P =0.000],higher postoperative complications morbidity(22.0％ VS.11.6％,P =0.027).Although the TMG has a lower recurrence rate,there was no significant difference between the two groups for recurrence rate(0 VS.2％,P =0.274).Conclusion Extended thymectomy should be recommended for thymoma and thymic hyperplasia whether combined with or without paraneoplastic diseases.

We present a case of two-year old boy with solitary atypical adenomatous hyperplasia (AAH) in extralobar sequestration (ELS), which was misdiagnosed as diaphragmatic hernia before surgery. Review of AAH and pulmonary sequestration (PS) revealed that the present case is the youngest of solitary AAH and also the first report of solitary AAH arising in ELS without a primary lung cancer. In a sense, the present case firstly supports the hypothesis that ELS may be an underlying cancer predisposition syndrome, so aggressive surgical therapy should be recommended for ELS.