Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
Interact Cardiovasc Thorac Surg. 2022 Jul 9;35(2). doi: 10.1093/icvts/ivac203.
The management of patients with an explanted malignancy after lung transplantation is not well understood. We reviewed our institutional experience and outcomes at a single academic medical centre between December 1997 and April 2021 for patients with malignancies of all histologic types identified on explant pathology. Primary lung cancers were reclassified using the 8th Edition TNM staging and the 2021 World Health Organization histologic classification of lung cancers. Of the 733 patients undergoing lung transplantation, 15 (2.05%) were found to have malignancy on the explanted lungs, including 6 (0.82%) primary lung cancers. Four patients were found to have early-stage lung cancers, while 2 patients had advanced-stage IV disease. Survival ranged from 0 to 109 months for the entire cohort with median 23.2 [49.9] months in those with primary lung cancers. There were 2 recurrences following explanted stage I (15 months) and stage IV (53 months) diseases. Other explant pathologies included carcinoid tumourlets in 6 patients, lymphoma in 2 and metastatic leiomyosarcoma in 1. In conclusion, explanted lung malignancies are an infrequent but significant finding on explant pathology. Further data are needed to better characterize and stratify this patient cohort.
移植肺中恶性肿瘤的管理尚不清楚。我们回顾了 1997 年 12 月至 2021 年 4 月期间在一家学术医疗中心的机构经验和结果，涉及所有组织学类型的恶性肿瘤患者，这些肿瘤是通过移植肺的病理检查发现的。原发性肺癌使用第 8 版 TNM 分期和 2021 年世界卫生组织肺癌组织学分类重新分类。在 733 例接受肺移植的患者中，有 15 例（2.05%）在移植肺中发现恶性肿瘤，包括 6 例（0.82%）原发性肺癌。4 例患者发现为早期肺癌，2 例为晚期 IV 期疾病。整个队列的生存时间从 0 到 109 个月不等，原发性肺癌患者的中位生存时间为 23.2[49.9]个月。有 2 例分别在移植后 I 期（15 个月）和 IV 期（53 个月）疾病中复发。其他移植病理包括 6 例类癌瘤，2 例淋巴瘤和 1 例转移性平滑肌肉瘤。总之，移植肺中的恶性肿瘤是移植肺病理检查中罕见但重要的发现。需要进一步的数据来更好地描述和分层这一患者群体。
