Primary pulmonary amebic abscess in a patient with pulmonary adenocarcinoma:a case report

Background:Primary pulmonary amoeba is very rare and here we report a case of a 68-year-old man presenting with primary pulmonary amoeba after undergoing chemotherapy for lung adenocarcinoma.Case presentation:In October 2016,the man aged 68 was admitted to our hospital because of repeated cough for 8 months and hemoptysis for 1 month.He was diagnosed lung adenocarcinoma and underwent surgery in 2012 without receiving chemotherapy.In March 2016,the patients suffered recurrence of cancer and was treated with chemotherapy.After 2 months of chemotherapy,the patient had consistent cough with white sputum,and chest CT showed a local lung nodule.The physicians suspected that the patient had pulmonary infectious diseases,and he was treated with empirical antibacterial treatment.However,his symptom wasn’t relieved and later the percutaneous lung biopsy found trophozites of Entamoeba histolytica.After administration of metronidazole,the symptoms of the patient were markedly relieved and the lesions were absorbed.Conclusions:In such cases where patients with pulmonary nodules were in immunodeficiency state and had adequate but ineffective anti-bacterial treatment,Entamoeba histolytica infection could be one of the rare causes.Percutaneous lung biopsy should be recommended and specific dying for parasites should be done when necessary.

Diagnosis and treatment of primary pulmonary enteric adenocarcinoma:Report of Six cases

BACKGROUND Primary pulmonary enteric adenocarcinoma(PEAC)is a very rare subtype of invasive adenocarcinoma,and there have been no large studies on PEAC to date.Therefore,it is necessary to obtain much more information about the clinical and pathological features,diagnosis,differential diagnosis,and treatment of PEAC.CASE SUMMARY All clinical data of six patients with confirmed PEAC from 2013 to 2018 were collected,and data on diagnosis,differential diagnosis,and treatment of PEAC are discussed combined with all the associated literature.The mean age of six patients was 64.0±5.6(59-73)years old.Their clinical manifestations were heterogeneous,and during their disease course,there were no gastrointestinal symptoms.There was no evidence from colonoscopy or imaging studies to suggest digestive tract tumors or new metastases.The most commonly mutated gene was KRAS(50.0%),and the pathological features of the six cases were similar to those of colorectal cancer.CDX2(83.3%)and CK7(66.7%)had the highest positive rates upon immunohistochemical examination.In the associated literature,252 cases were identified,and the most commonly mutated gene was KRAS(42.9%).Additionally,CDX2(68.3%)and CK7(85.8%)had the highest positive rates.Patients mainly received surgery,chemotherapy,and radiotherapy,immunotherapy was not included.CONCLUSION Positive results for CDX2 and CK7 play an important role in the diagnosis and differential diagnosis of PEAC,and immunotherapy or targeted therapy focused on KRAS needs to be further studied for the treatment of PEAC.

Case report of a mixed pulmonary large cell neuroendocrine carcinoma

A 57 year-old male patient was found to have a lesion in the middle lobe of his right lung using chest computed tomography(CT).Tumor cells were detected,and surgical excision was performed.The patient was diagnosed with mixed large cell neuroendocrine carcinoma,and underwent six cycles of a chemotherapy regimen comprising etoposide combined with cisplatin.Genetic testing revealed an EGFR mutation,which prompted oxitinib-targeted therapy.To date,no signs of recurrence or metastasis have been reported.

Secondary Hypertrophic Osteoarthropathy or Pierre-Marie Syndrome Bamberger: Clinical Case and Literature Review

Secondary hypertrophic osteoarthropathy, or Pierre-Marie Bamberger syndrome, is characterized by the association of digital clubbing, polyarthritis and periostitis affecting the long bones. Most commonly it is a paraneoplastic syndrome associated with lung cancer in 80% of cases. We report the case of a 49-year-old female patient who is actively smoking, one pack per day for 20 years. Seen in consultation for pain and swelling of the hands, elbows, knees, ankles, and feet evolving for about 5 months, associated with a poorly differentiated pulmonary adenocarcinoma. On history, she told us about a weight loss of about 8 kg, no fever, no cough, no family history of inflammatory rheumatism or cancer. Bilateral digital clubbing was noted. The diagnosis was based on imaging and histology. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and chemo-radiotherapy was started.