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Recurrence of bronchioloalveolar carcinoma in donor lung after lung transplantation: Microsatellite analysis demonstrates a recipient origin
Author(s) -
GómezRomán J. Javier,
Del Valle Clara Esparza,
Zarrabeitia M. Teresa,
Martínez José Cifrián,
Goñi Felipe Zurbano,
Lera Roberto Mons,
Cuevas Jorge,
ValBernal J. Fernando
Publication year - 2005
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2005.01872.x
Subject(s) - medicine , adenocarcinoma , transplantation , lung transplantation , pathology , carcinoma , lung , mediastinal lymph node , pneumonectomy , metastasis , lung cancer , wedge resection , cancer , surgery , resection
Bronchioloalveolar carcinoma is a distinctive subtype of pulmonary adenocarcinoma, without effective therapy, although there have recently been some attempts to use lung transplantation. However, a high post‐transplantation local recurrence rate is described with some controversy regarding the possible involved mechanisms, the main possibilities being the lymphatic spread and aerosolization. Presented herein is a case of a bilateral lung transplantation for a bilateral and pneumonic form of non‐mucinous bronchioloalveolar carcinoma in a 43‐year‐old woman. The histological analysis of mediastinal lymph nodes during surgery did not show neoplastic cells. Thirty‐five months after transplantation several nodular opacities in donor lungs were detected. Three pulmonary wedge resections were performed showing a non‐mucinous bronchioloalveolar carcinoma with the same histological characteristics as the primary. Again, the mediastinal lymph nodes were tumor free. A complete microsatellites molecular analysis was performed to compare the primary and recurrent carcinoma using capillary electrophoresis, showing that the recurrent tumor was generated in a recipient cellular clone. The absence of lymph node metastasis and the molecular evidence of the recipient origin of the neoplasm supports the contamination of the new lungs at the time of implantation as being the reason for the high incidence of recurrence after lung transplantation in this kind of disease.