Left Lung, Superior Lobe, Anterior Segment

Abstract Background: Adenocarcinoma is the most common primary lung malignant tumor. However, pulmonary carcinoid tumorlets are rare neuroendocrine tumors, and the coexistence of adenocarcinoma and pulmonary carcinoid tumorlets is extremely rare. Herein, we describe a case of lung adenocarcinoma complicated with carcinoid tumorlets.Case presentation: A 71-year-old female patient was admitted to the hospital after physical examination, multiple micronodules were in the inferior lobe of the left lung and right lung for 2 years, and a tumor was in the superior lobe of the left lung for 1 month. The patient underwent resection of the superior lobe of the left lung and wedge resection of the inferior lobe of the left lung by Video-assisted Thoracoscopic Surgery(VATS). The pathology of the superior lobe of the left lung was adenocarcinoma (pathological stage pT1cN0M0, IA3 stage), and the pathology of the inferior lobe of the left lung was carcinoid tumorlets. The patient was discharged from the hospital one week after the operation and recovered well after follow-up without recurrence.Conclusions: The lack of understanding of carcinoid tumorlets in the clinic causes their misdiagnosis or missed diagnosis. At the same time, the lack of understand also suggests that we should pay attention not only to mass-type lung tumors but also to pulmonary micronodules.

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Hemoptisis pada Pasien Aspergilloma Paru Kiri

Jurnal Respirasi ◽

10.20473/jr.v4-i.2.2018.38-44 ◽

2018 ◽

Vol 4 (2) ◽

pp. 38

Author(s):

Gilang Muhammad Setyo Nugroho ◽

Laksmi Wulandari

Keyword(s):

Surgical Therapy ◽

Lung Tissue ◽

Physical Condition ◽

Left Lung ◽

Fungus Ball ◽

Good Physical Condition ◽

Superior Lobe ◽

Examination Result ◽

Life Threatening ◽

History Of

Background: Aspergilloma is a fungus ball (misetoma) that occurs because there is a cavity in the parenchyma due to previous lung disease. This fungus ball can move inside the cavity but does not invate the cavity wall. The presence of fungus ball causes recurrent hemoptysis. Case: We present a 45-year-old female patient with left lung Aspergilloma. Diagnosis of Aspergilloma was based on histopathology from FNAB CT guiding of left pulmonary which showed Aspergillus. Patient was treated with left superior lobe lobectomy at the hospital. The examination result of anatomical patology obtained from lung tissue was aspergillosis, from GeneXpert examination lung tissue showed positive MTB with rifampisin sensitive. Post-operative condition of the patient was stable, surgical wound improved, took off drain patient. There were clinical improvements after the surgery. Discussion: Diagnosis of Aspergilloma was based on clinical, radiology, and microbiology. Aspergilloma with severe symptoms (hemoptysis massive with life-threatening or other complications that require more than 1 time hospitalisation) and good physical condition should undergo surgical therapy in the form of lobectomy in accordance with the extent of lung abnormalities. Patient got first category anti tuberculosis drugs for 6 months and fluconazole for 2 months. Conclusion: It is necessary to consider the suspicion of Aspergillus infection, in patient with history of previous tuberculosis accompanied by a history of recurrent hemoptysis. Patient with reccurent hemoptysis and good physical condition should undergo surgical therapy.

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Neutrophil accumulations due to pulmonary thromboxane synthesis mediate acid aspiration injury

Journal of Applied Physiology ◽

10.1152/jappl.1991.70.4.1511 ◽

1991 ◽

Vol 70 (4) ◽

pp. 1511-1517 ◽

Cited By ~ 23

Author(s):

G. Goldman ◽

R. Welbourn ◽

J. M. Klausner ◽

L. Kobzik ◽

C. R. Valeri ◽

...

Keyword(s):

Anterior Segment ◽

Left Lung ◽

Weight Ratio ◽

Dry Weight ◽

Control Group ◽

Acid Aspiration ◽

High Protein Concentration ◽

Lung Segment ◽

Synthase Inhibitor

Acid aspiration leads to lung injury associated with high levels of plasma thromboxane (Tx). This study tests the role of Tx synthesis by the aspirated lung segment in mediating local and remote neutrophil (PMN) sequestration, alveolar diapedesis, and permeability edema. Anesthetized rats underwent tracheostomy and insertion of a fine-bore cannula into the anterior segment of the left lung. This was followed by the installation of either 0.1 ml saline (n = 18) or the Tx synthase inhibitor OKY 046 (0.1 mg/kg in 0.1 ml, n = 18). Twenty minutes later either 0.1 ml 0.1 N HCL or 0.1 ml saline was similarly introduced (n = 18). Three hours later, in the saline-HCl group, the rise in Tx concentration in both plasma (1,340 pg/ml) and bronchoalveolar lavage (BAL) fluid (2,100 pg/ml) was higher than that in the saline-saline aspirated control group (350 and 115 pg/ml, respectively; both P less than 0.05). In the acid-aspirated lung PMN sequestration [87 PMN/10 high-power fields (HPF)] and diapedesis (96 x 10(4) PMN/ml in BAL) were higher than control values of 7 PMN/10 HPF and 3 x 10(4) PMN/ml (both P less than 0.05). Acid aspiration induced local permeability edema with a high protein concentration in BAL of 3,350 micrograms/ml and an increase in lung wet-to-dry weight ratio (W/D) of 6.6, both higher than control values of 482 micrograms/ml and 3.4, respectively (P less than 0.05). Leukosequestration in the aspirated side started at 30 min and was progressive over a 3-h monitoring period.(ABSTRACT TRUNCATED AT 250 WORDS)

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Left Vocal Cord Paralysis Detected by PET/CT in a Case of Lung Cancer

Case Reports in Oncological Medicine ◽

10.1155/2015/617294 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Ali Ozan Oner ◽

Adil Boz ◽

Evrim Surer Budak ◽

Gulnihal Hale Kaplan Kurt

Keyword(s):

Lung Cancer ◽

Vocal Cord ◽

Vocal Cord Paralysis ◽

Anterior Segment ◽

Left Lung ◽

Apical Region ◽

Left Vocal Cord ◽

Primary Mass ◽

Pet Ct ◽

Left Recurrent Laryngeal Nerve

We report a patient with lung cancer. The first PET/CT imaging revealed hypermetabolic mass in the left aortopulmonary region and hypermetabolic nodule in the anterior segment of the upper lobe of the left lung. After completing chemotherapy and radiotherapy against the primary mass in the left lung, the patient underwent a second PET/CT examination for evaluation of treatment response. This test demonstrated, compared with the first PET/CT, an increase in the size and metabolic activity of the primary mass in the left lung in addition to multiple, pathologic-sized, hypermetabolic metastatic lymph nodes as well as multiple metastatic sclerotic areas in bones. These findings were interpreted as progressive disease. In addition, an asymmetrical FDG uptake was noticed at the level of right vocal cord. During follow-up, a laryngoscopy was performed, which demonstrated left vocal cord paralysis with no apparent mass. Thus, we attributed the paralytic appearance of the left vocal cord to infiltration of the left recurrent laryngeal nerve by the primary mass located in the apical region of the left lung. In conclusion, the knowledge of this pitfall is important to avoid false-positive PET results.

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Multimodality imaging of a rare pulmonary artery sessile mass: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa551 ◽

2021 ◽

Author(s):

Laura Piscitelli ◽

Ilaria Dentamaro ◽

Gaetano Pezzicoli ◽

Carlo D’Agostino

Keyword(s):

Pulmonary Artery ◽

Cardiac Mri ◽

Multimodality Imaging ◽

Anticoagulation Therapy ◽

Three Dimensional ◽

Left Lung ◽

Laboratory Findings ◽

Positron Emission ◽

Superior Lobe ◽

Magnetic Resonance Imaging Mri

Abstract Background Primary pulmonary artery masses are unusual entities that mimic pulmonary embolism (PE) in clinical presentation and on imaging studies. It is necessary to perform advanced diagnostic exams, such as transesophageal echocardiography (TEE) and cardiac magnetic resonance imaging (MRI), to determine the proper diagnosis. In unclear cases, laboratory findings, morphological follow-up, and response to anticoagulant therapy can help to clarify the diagnosis. Case summary A 47-year-old previously healthy man with worsening effort dyspnoea underwent chest computed tomography (CT) for suspicion of PE, which showed a pedunculated eccentric mass at the origin of the pulmonary artery causing severe stenosis. The patient was started on anticoagulation therapy, but, after TEE and cardiac MRI, a neoplastic fibroelastic mass was suspected. Unexpectedly, 18fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT revealed a unique area of glucose uptake in the superior lobe of the left lung and not in the pulmonary artery. The biopsy was consistent with pleomorphic high-grade lung sarcoma. After 3 months of chemotherapy, a CT scan showed progression of the lung disease with no change in the arterial mass, which was therefore confirmed as pulmonary fibroelastoma. Discussion Due to the rarity of pulmonary artery tumours, they can be initially misdiagnosed as PE or a metastasis of a lung sarcoma. Three-dimensional TEE and cardiac MRI are particularly useful in differentiating tumours from PE.

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