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Idiopathic pulmonary fibrosis in patients with early-stage non-small-cell lung cancer after surgical resection Cover

Idiopathic pulmonary fibrosis in patients with early-stage non-small-cell lung cancer after surgical resection

Open Access
|Sep 2019

Figures & Tables

Figure 1

Radiological images and images of pathological specimens for Patient No.1. (A) CT scan before lung resection demonstrating honeycomb cystic changes in the subpleural regions of the lung characteristic for typical UIP pattern and tumor in left lower lobe. (B) CT scan after (radical treatment) lobectomy showing extensive bilateral ground glass opacities which are consistant with acute exacerbation of UIP and progressive reticular fibrotic changes. (C) Surgical specimen showing subpleural honeycombing with fibroblastic focus. (D) Autopsy specimen showing acute lung injury with hyaline membranes.
Radiological images and images of pathological specimens for Patient No.1. (A) CT scan before lung resection demonstrating honeycomb cystic changes in the subpleural regions of the lung characteristic for typical UIP pattern and tumor in left lower lobe. (B) CT scan after (radical treatment) lobectomy showing extensive bilateral ground glass opacities which are consistant with acute exacerbation of UIP and progressive reticular fibrotic changes. (C) Surgical specimen showing subpleural honeycombing with fibroblastic focus. (D) Autopsy specimen showing acute lung injury with hyaline membranes.

Figure 2

Radiological images and images of pathological specimens for Patient No.2. (A) Chest X ray before surgical resection shows some reticular changes in the periphery of the lower lobes. CT shows reticular fibrotic changes with multiple calcifications in the periphery of the lung in combination with paraseptal emphsema and small tumor in the left lower lobe. (B) Chest X ray after left sided lobectomy shows new bilateral alveolar opacities. (C) Surgical resection specimen demonstrating microcystic changes with fibroblastic focus. (D) Autopsy specimen showing acute lung injury with hyaline membranes
Radiological images and images of pathological specimens for Patient No.2. (A) Chest X ray before surgical resection shows some reticular changes in the periphery of the lower lobes. CT shows reticular fibrotic changes with multiple calcifications in the periphery of the lung in combination with paraseptal emphsema and small tumor in the left lower lobe. (B) Chest X ray after left sided lobectomy shows new bilateral alveolar opacities. (C) Surgical resection specimen demonstrating microcystic changes with fibroblastic focus. (D) Autopsy specimen showing acute lung injury with hyaline membranes

Baseline clinical, radiological and pathological characteristics of the two patients who died in two months time after radical treatment of early-stage non-small cell lung cancer due to acute exacerbation of idiopathic pulmonary fibrosis (IPF)

CharacteristicsPatient No. 1Patient No. 2
GenderMaleMale
Age, years7381
Smoking statusFormer-smokerFormer-smoker
FEV1/FVC before operation72%70%
FEV1 before operation2800 ml (93%)3110 ml (121%)
FVC before operation3900 ml (94%)4570 ml (122%)
DLCO before operation57%47%
Histological subtypeSquamous cell carcinomaSquamous cell carcinoma
Pathologic TNM stage (8th edition)IIIAIA
Lobe distributionLeft lower lobeLeft lower lobe
Type of operationLobectomyLobectomy
Adjuvant therapyChemotherapy and radiotherapyNo
Time from the end of radical treatment till death54 days after finishing radiotherapy14 days after surgical resection

Baseline clinical, radiological and pathological characteristics of patients with early-stage non-small cell lung cancer and idiopathic interstitial pneumonia

Characteristics N = 13 (%)
GenderMale11 (84.6)
Female2 (15.4)
Age, years 73.3 ± 4
Current smoker3 (23.1)
Smoking statusFormer-smoker8 (61.5)
Never-smoker2 (15.4)
FEV1/FVC before operation 0.71 ± 0.08
FEV1 before operationml %2769 ± 690 101.6 ± 20
FVC before operationml %3910 ± 818 105 ±19
DLCO before operation%74.2 ±21
Squamous cell carcinoma7 (53.8)
Histological subtypeAdenocarcinoma5 (38.5)
Adenosquamous cell carcinoma1 (7.7)
pT1a3 (23.0)
pT2a6 (46.2)
pT2b4 (30.8)
Pathologic TNM stageIA2 (15.4)
(8th edition)IB2 (15.4)
IIA3 (23.0)
IIB4 (30.8)
IIIA2 (15.4)
Left lower lobe7 (53.8)
Lobe distributionRight lower lobe4 (30.8)
Right middle lobe2 (15.4)
Type of operationLobectomy Bilobectomy11 (84.6) 2 (15.4)
Adjuvant chemotherapy4 (30.8)
Adjuvant therapyAdjuvant radiotherapy1 (7.7)
DOI: https://doi.org/10.2478/raon-2019-0032 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 357 - 361
Submitted on: Jan 22, 2019
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Accepted on: Jun 26, 2019
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Published on: Sep 24, 2019
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2019 Hribernik Nezka, Pozek Igor, Kern Izidor, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.