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Sporn, Thomas Arthur

Overview:

Mesothelioma, lung cancer, occupational and asbestos-related diseases

Positions:

Associate Professor of Pathology

Pathology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.A. 1982

B.A. — University of Vermont

M.D. 1986

M.D. — Georgetown University

Resident, Pulmonary Diseases And Critical Care Medicine

Georgetown University

Resident, Pathology

Duke University

Forensic Pathologist/Assistant Chief Medical Examiner, Pathology

University of North Carolina at Chapel Hill

Resident, Pathology

Duke University

Pulmonary Fellow, Pathology

Duke University

Grants:

Phase I/II Trial of ZD1839 and Celecoxib in Ex-Smokers

Administered By
Medicine, Medical Oncology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 26, 2002
End Date
August 31, 2007

Publications:

Malignant peritoneal mesothelioma and Crohn disease.

Mesothelial reaction simulating peritoneal diffuse malignant mesothelioma (MM) has been reported in the setting of Crohn ileitis. To our knowledge, peritoneal MM arising in patients with inflammatory bowel disease (IBD) has not been reported. The purpose of this study is to report the clinicopathological characteristics of patients with peritoneal MM and IBD.A database of approximately 3800 MM was reviewed for cases of MM in patients with IBD.Three patients (0.08%) with peritoneal MM and Crohn disease (CD) were identified, including two women and one man ranging in age from 56 to 65 years. All had a long-standing history of diarrhoea and an established diagnosis of CD of 3 years or greater duration. Two had epithelial MM and one had biphasic MM. Only one had documented asbestos exposure.Peritoneal MM occurs rarely in patients with IBD, but interestingly, has only been observed in the setting of CD and not in patients with ulcerative colitis. Chronic inflammation has been associated with the development of MM in rare instances and these three cases suggest that CD with transmural inflammation may also be a precursor. The precise role of CD-related transmural inflammation in the carcinogenesis of peritoneal MM remains to be determined.

Authors
Butnor, KJ; Pavlisko, EN; Sporn, TA; Roggli, VL
MLA Citation
Butnor, KJ, Pavlisko, EN, Sporn, TA, and Roggli, VL. "Malignant peritoneal mesothelioma and Crohn disease." Journal of clinical pathology 70.3 (March 2017): 228-232.
PMID
27484913
Source
epmc
Published In
Journal of Clinical Pathology
Volume
70
Issue
3
Publish Date
2017
Start Page
228
End Page
232
DOI
10.1136/jclinpath-2016-203945

A hard (metal) case: Value of analytical scanning electron microscopy.

Exposure to hard metal (tungsten carbide) dust is a rare cause of interstitial lung disease. Although most cases have a distinctive morphology known as giant cell interstitial pneumonitis, other patterns have been described as well. In such cases, the true nature of the interstitial process may be difficult to recognize. We present a case with unusual morphological features in which analytical scanning electron microscopy (SEM) was used to detect the presence of tungsten as well as other metallic particles. A combination of careful exposure history and examination by analytical SEM is useful for arriving at the correct diagnosis in such difficult cases.

Authors
Sporn, TA; Roggli, VL
MLA Citation
Sporn, TA, and Roggli, VL. "A hard (metal) case: Value of analytical scanning electron microscopy." Ultrastructural pathology 40.3 (May 2016): 147-150.
PMID
26953808
Source
epmc
Published In
Ultrastructural Pathology (Informa)
Volume
40
Issue
3
Publish Date
2016
Start Page
147
End Page
150
DOI
10.3109/01913123.2016.1151092

Diffuse malignant mesothelioma and synchronous lung cancer: A clinicopathological study of 18 cases.

To examine the clinicopathologic characteristics of individuals with diffuse malignant mesothelioma (DMM) occurring concurrently with lung cancer (LC).A database of approximately 3800 patients with DMM was reviewed, from which 18 patients (0.5%) who had synchronous LC were identified. The clinicopathologic features, as well as the occupational exposure history and fiber burden analysis data were examined.The patient median age was 68 years (range 58-84 years). Of the 18 patients (14 male, 4 female), 11 (61%) had epithelial, 5 (28%) had biphasic, and 2 (11%) had sarcomatoid DMM, with the majority (16 cases; 89%) originating in the pleura and only 2 were peritoneal. Among the histologic types of LC, adenocarcinoma was most frequent (12 cases; 67%), while 5 cases of squamous cell carcinoma, and 1 case of small cell carcinoma were observed. Three patients also had a history of prior malignancy (1 with testicular seminoma and bladder carcinoma and 2 with prostate carcinoma). Fifteen patients had a positive smoking history. All but 3 had documented asbestos exposure. Three had histologic features of asbestosis. Mineral analysis performed in 8 showed an elevated asbestos fiber burden in 4 (22%). Amosite was detected in 4 patients, crocidolite in 3, and non-commercial amphiboles in 5.The finding of simultaneous carcinoma of the lung and DMM is distinctly unusual. The majority of patients are male smokers with pleural epithelial DMM and lung adenocarcinoma. This study represents the largest cohort of patients reported to date with synchronous malignant mesothelioma and lung cancer, and we propose guidelines for making a diagnosis of synchronous malignant mesothelioma and primary lung cancer.

Authors
Butnor, KJ; Brownlee, NA; Mahar, A; Pavlisko, EN; Sporn, TA; Roggli, VL
MLA Citation
Butnor, KJ, Brownlee, NA, Mahar, A, Pavlisko, EN, Sporn, TA, and Roggli, VL. "Diffuse malignant mesothelioma and synchronous lung cancer: A clinicopathological study of 18 cases." Lung cancer (Amsterdam, Netherlands) 95 (May 2016): 1-7.
PMID
27040844
Source
epmc
Published In
Lung Cancer
Volume
95
Publish Date
2016
Start Page
1
End Page
7
DOI
10.1016/j.lungcan.2016.02.007

Carcinoma of the lung in the absence of asbestosis: The value of lung fiber burden analysis.

Asbestos is universally recognized as a carcinogen for the lower respiratory tract. However, asbestos is a contributory factor in a small fraction of lung cancers, the vast majority of which are related to cigarette smoking. The challenge for the pathologist is to determine when a lung cancer may be attributed to past asbestos exposure. The finding of asbestosis either clinically or pathologically is a useful marker for such a determination. However, in the absence of asbestosis, it has been suggested that a fiber burden as determined by analytical electron microscopy within the range of asbestosis is sufficient for determination of a causal contribution. We report here an example of a case of lung cancer in which fiber burden studies showed an asbestos concentration within the range of asbestosis as determined by scanning electron microscopy (SEM).

Authors
Roggli, VL; Sporn, TA
MLA Citation
Roggli, VL, and Sporn, TA. "Carcinoma of the lung in the absence of asbestosis: The value of lung fiber burden analysis." Ultrastructural pathology 40.3 (May 2016): 151-154.
PMID
27043967
Source
epmc
Published In
Ultrastructural Pathology (Informa)
Volume
40
Issue
3
Publish Date
2016
Start Page
151
End Page
154
DOI
10.3109/01913123.2016.1154915

Malignant mesothelioma not related to asbestos exposure: Analytical scanning electron microscopic analysis of 83 cases and comparison with 442 asbestos-related cases.

Epidemiological studies indicate that 80-90% of mesotheliomas are asbestos related. This suggests that 10-20% are not. Lung fiber burden analysis provides objective information about past exposures to asbestos. We have performed lung fiber burden analysis on a large cohort of mesothelioma cases and compared the findings with a reference population. Herein we report our findings along with demographic and exposure data.

Authors
Kraynie, A; de Ridder, GG; Sporn, TA; Pavlisko, EN; Roggli, VL
MLA Citation
Kraynie, A, de Ridder, GG, Sporn, TA, Pavlisko, EN, and Roggli, VL. "Malignant mesothelioma not related to asbestos exposure: Analytical scanning electron microscopic analysis of 83 cases and comparison with 442 asbestos-related cases." Ultrastructural pathology 40.3 (May 2016): 142-146.
PMID
27070945
Source
epmc
Published In
Ultrastructural Pathology (Informa)
Volume
40
Issue
3
Publish Date
2016
Start Page
142
End Page
146
DOI
10.3109/01913123.2016.1154633

Endogenous pneumoconiosis: Analytical scanning electron microscopic analysis of a case.

Pneumoconiosis is often considered a disease of the lung initiated by exposure to dust or other airborne particles, resulting in injury to the lungs. The term "endogenous pneumoconiosis" has been used in the literature to describe the deposition of compounds on the elastic fibers of the lung, usually in the setting of cardiac failure. In the case we present here, the patient aspirated a foreign body resulting in damage to the lung tissue and subsequent deposition of endogenous compounds on the elastic fibers of the pulmonary parenchyma and vasculature. We determined the composition of this mineral and mapped the distribution of elements using a combination of backscattered electron microscopy and energy dispersive spectrometry.

Authors
Galeotti, J; Sporn, TA; Ingram, P; Wahidi, MM; Roggli, VL
MLA Citation
Galeotti, J, Sporn, TA, Ingram, P, Wahidi, MM, and Roggli, VL. "Endogenous pneumoconiosis: Analytical scanning electron microscopic analysis of a case." Ultrastructural pathology 40.3 (May 2016): 159-162.
PMID
27281119
Source
epmc
Published In
Ultrastructural Pathology (Informa)
Volume
40
Issue
3
Publish Date
2016
Start Page
159
End Page
162
DOI
10.3109/01913123.2016.1170084

Abnormalities in hyperpolarized (129)Xe magnetic resonance imaging and spectroscopy in two patients with pulmonary vascular disease.

The diagnosis of pulmonary vascular disease (PVD) is usually based on hemodynamic and/or clinical criteria. Noninvasive imaging of the heart and proximal vasculature can also provide useful information. An alternate approach to such criteria in the diagnosis of PVD is to image the vascular abnormalities in the lungs themselves. Hyperpolarized (HP) (129)Xe magnetic resonance imaging (MRI) is a novel technique for assessing abnormalities in ventilation and gas exchange in the lungs. We applied this technique to two patients for whom there was clinical suspicion of PVD. Two patients who had significant hypoxemia and dyspnea with no significant abnormalities on computed tomography imaging or ventilation-perfusion scan and only mild or borderline pulmonary arterial hypertension at catheterization were evaluated. They underwent HP (129)Xe imaging and subsequently had tissue diagnosis obtained from lung pathology. In both patients, HP (129)Xe imaging demonstrated normal ventilation but markedly decreased gas transfer to red blood cells with focal defects on imaging, a pattern distinct from those previously described for idiopathic pulmonary fibrosis or obstructive lung disease. Pathology on both patients later demonstrated severe PVD. These findings suggest that HP (129)Xe MRI may be useful in the diagnosis of PVD and monitoring response to therapy. Further studies are required to determine its sensitivity and specificity in these settings.

Authors
Dahhan, T; Kaushik, SS; He, M; Mammarappallil, JG; Tapson, VF; McAdams, HP; Sporn, TA; Driehuys, B; Rajagopal, S
MLA Citation
Dahhan, T, Kaushik, SS, He, M, Mammarappallil, JG, Tapson, VF, McAdams, HP, Sporn, TA, Driehuys, B, and Rajagopal, S. "Abnormalities in hyperpolarized (129)Xe magnetic resonance imaging and spectroscopy in two patients with pulmonary vascular disease." Pulmonary circulation 6.1 (March 2016): 126-131.
PMID
27162620
Source
epmc
Published In
Pulmonary Circulation
Volume
6
Issue
1
Publish Date
2016
Start Page
126
End Page
131
DOI
10.1086/685110

Malignant (Diffuse) Mesothelioma in Patients With Hematologic Malignancies: A Clinicopathologic Study of 45 Cases.

Ionizing radiation has a role in the development of malignant mesothelioma, in several epidemiologic studies, including patients with hematologic malignancies.To study the clinicopathologic characteristics of patients with malignant mesothelioma and hematologic malignancies with and without a history of radiotherapy.From a database of approximately 3600 patients with malignant mesothelioma, we identified 45 patients (1%) who also had hematologic malignancies. We examined clinicopathologic features and noted whether the patient had received radiotherapy for malignancy, comparing those with and those without such exposure.Among the 45 cases, 18 (40%) had Hodgkin lymphoma, 15 (33%) had non-Hodgkin lymphoma, 10 (4%) had chronic lymphocytic leukemia, and 2 (22%) had chronic myelogenous leukemia; 20 patients (44%) had a history of radiotherapy, and 23 (51%) did not. Most patients with Hodgkin lymphoma (16 of 18; 90.0%) received radiation, whereas none of the patients with leukemia (0 of 12) and only 20% (3 of 15) of the patients with non-Hodgkin lymphoma did so. Patients without radiation were older than patients who received radiotherapy (median, 73 versus 54 years, respectively; P < .001), had a shorter interval from diagnosis of hematologic malignancy to that of mesothelioma (median, 2 versus 24 years, respectively; P < .001), and had a shorter survival period (median, 6.0 versus 14.0 months, respectively; P = .02). Epithelial mesotheliomas were proportionately more common in patients with a history of radiotherapy.Patients with mesothelioma and hematologic malignancies with a history of radiation tended to be younger, had a longer interval from diagnosis of hematologic malignancy to that of mesothelioma, had a longer survival period, and were more likely to have the epithelial variant compared with patients without radiotherapy.

Authors
Li, X; Brownlee, NA; Sporn, TA; Mahar, A; Roggli, VL
MLA Citation
Li, X, Brownlee, NA, Sporn, TA, Mahar, A, and Roggli, VL. "Malignant (Diffuse) Mesothelioma in Patients With Hematologic Malignancies: A Clinicopathologic Study of 45 Cases." Archives of pathology & laboratory medicine 139.9 (September 2015): 1129-1136.
PMID
25844559
Source
epmc
Published In
Archives of Pathology and Laboratory Medicine
Volume
139
Issue
9
Publish Date
2015
Start Page
1129
End Page
1136
DOI
10.5858/arpa.2014-0569-oa

The cell of origin and subtype of K-Ras-induced lung tumors are modified by Notch and Sox2.

Cell type-specific conditional activation of oncogenic K-Ras is a powerful tool for investigating the cell of origin of adenocarcinomas in the mouse lung. Our previous studies showed that K-Ras activation with a CC10(Scgb1a1)-CreER driver leads to adenocarcinoma in a subset of alveolar type II cells and hyperplasia in the bronchioalveolar duct region. However, no tumors develop in the bronchioles, although recombination occurs throughout this region. To explore underlying mechanisms, we simultaneously modulated either Notch signaling or Sox2 levels in the CC10+ cells along with activation of K-Ras. Inhibition of Notch strongly inhibits adenocarcinoma formation but promotes squamous hyperplasia in the alveoli. In contrast, activation of Notch leads to widespread Sox2+, Sox9+, and CC10+ papillary adenocarcinomas throughout the bronchioles. Chromatin immunoprecipitation demonstrates Sox2 binding to NOTCH1 and NOTCH2 regulatory regions. In transgenic mouse models, overexpression of Sox2 leads to a significant reduction of Notch1 and Notch2 transcripts, while a 50% reduction in Sox2 leads to widespread papillary adenocarcinoma in the bronchioles. Taken together, our data demonstrate that the cell of origin of K-Ras-induced tumors in the lung depends on levels of Sox2 expression affecting Notch signaling. In addition, the subtype of tumors arising from type II cells is determined in part by Notch activation or suppression.

Authors
Xu, X; Huang, L; Futtner, C; Schwab, B; Rampersad, RR; Lu, Y; Sporn, TA; Hogan, BLM; Onaitis, MW
MLA Citation
Xu, X, Huang, L, Futtner, C, Schwab, B, Rampersad, RR, Lu, Y, Sporn, TA, Hogan, BLM, and Onaitis, MW. "The cell of origin and subtype of K-Ras-induced lung tumors are modified by Notch and Sox2." Genes & development 28.17 (September 2014): 1929-1939.
PMID
25184679
Source
epmc
Published In
Genes & development
Volume
28
Issue
17
Publish Date
2014
Start Page
1929
End Page
1939
DOI
10.1101/gad.243717.114

Mesothelioma

© Springer-Verlag Berlin Heidelberg 2014. Mesothelioma, literally “tumor of the mesothelium,” is a term often used synonymously with malignant (diffuse) mesothelioma, the malignant neoplasm arising from the serosal linings of the pleural, pericardial, or peritoneal cavities. These major body cavities are lined by a single layer of flattened to cuboidal cells of mesodermal origin that constitute the mesothelium proper [1]. This serosal membranous lining includes not only the mesothelium but also the underlying basement membrane, a matrix of elastic fibroconnective tissue containing lymphatic and vascular channels, and scattered mesenchymal cells as well. Mesothelial cells possess a complex cytoskeletal network of intermediate filaments, produce hyaluronic acid, and have distinctive ultrastructural features including numerous pinocytotic vesicles and long surface microvilli that project into the serous cavities (Fig. 5.1) [2, 3] . It remains uncertain whether mesothelioma results from the malignant transformation of the differentiated mesothelial cell or from more primitive progenitor cells, such as the submesothelial mesenchymal cell, or from both [4].

Authors
Pavlisko, EN; Sporn, TA
MLA Citation
Pavlisko, EN, and Sporn, TA. "Mesothelioma." Pathology of Asbestos-Associated Diseases, Third Edition. January 1, 2014. 81-140.
Source
scopus
Publish Date
2014
Start Page
81
End Page
140
DOI
10.1007/978-3-642-41193-9_5

Asbestosis

© Springer-Verlag Berlin Heidelberg 2014. The term pneumoconiosis dates to Zenker’s 1866 description of pulmonary disease processes related to the inhalation of dusts [1]. As some dust, including asbestos fibers, may be found in the lungs of virtually all adults from the general population, pneumoconiosis now refers to the accumulation of excessive amounts of dust in the parenchyma of the lung and the pathologic response to its presence [2] . Asbestosis, the form of pneumoconiosis related to excessive amounts of asbestos fibers in the substance of the lung, is the prototype of diseases caused by inhalation of mineral fibers. Asbestos is a commercial, legal, and regulatory term, rather than a strictly mineralogical one, that encompasses a group of naturally occurring fibrous silicates whose differing physicochemical attributes confer a spectrum of pathologic properties upon their inhalation and deposition into the lung. Much has been learned from experimental models about the pathogenesis of asbestos-induced lung injury, which is reviewed in detail in Chap. 10. The reader is directed to Chap. 3 for a discussion of asbestos bodies, the histologic emblem of asbestos exposure, and a requisite component of the pathologic diagnosis of asbestosis. Chapter 11 discusses the methodology and results of quantitative tissue analysis for asbestosis, other asbestos-related diseases, as well as normal and disease control populations. The present chapter describes the morphologic features of asbestosis and relates them to the clinical and radiographic features of the disease.

Authors
Sporn, TA; Roggli, VL
MLA Citation
Sporn, TA, and Roggli, VL. "Asbestosis." Pathology of Asbestos-Associated Diseases, Third Edition. January 1, 2014. 53-80.
Source
scopus
Publish Date
2014
Start Page
53
End Page
80
DOI
10.1007/978-3-642-41193-9_4

Pathology of asbestos-associated diseases, third edition

© Springer-Verlag Berlin Heidelberg 2014. The third edition of Pathology of Asbestos-Associated Diseases builds on the success of the previous editions by fully updating knowledge on diagnostic and epidemiologic aspects and presenting important new insights derived from new epidemiologic studies and animal studies. Background information is first provided on the mineralogy of asbestos, occupational and environmental exposure, and asbestos bodies. The various diseases associated with asbestos exposure are then considered in turn, with detailed description and illustration of pathologic features as well as extensive discussion of etiology, epidemiology, differential diagnosis, treatment, and prognosis. Further chapters are devoted to cytopathology, experimental models of disease, and analysis of tissue mineral fiber content. In addition, the medicolegal issues relating to asbestos-associated diseases are analyzed from the point of view of both the plaintiff and the defendant. This book will be an essential reference for pathologists and an invaluable source of information for pulmonologists, radiologists, and occupational medical practitioners.

Authors
Oury, TD; Sporn, TA; Roggli, VL
MLA Citation
Oury, TD, Sporn, TA, and Roggli, VL. Pathology of asbestos-associated diseases, third edition. January 1, 2014.
Source
scopus
Publish Date
2014
Start Page
1
End Page
357
DOI
10.1007/978-3-642-41193-9

Cytopathology of asbestos-associated diseases

© Springer-Verlag Berlin Heidelberg 2014. Asbestos is the generic term typically used for six naturally occurring fibrous silicates that are or have been exploited commercially: the serpentine chrysotile and the amphiboles amosite, crocidolite, anthophyllite, tremolite, and actinolite [1].

Authors
Schneider, F; Sporn, TA
MLA Citation
Schneider, F, and Sporn, TA. "Cytopathology of asbestos-associated diseases." Pathology of Asbestos-Associated Diseases, Third Edition. January 1, 2014. 193-213.
Source
scopus
Publish Date
2014
Start Page
193
End Page
213
DOI
10.1007/978-3-642-41193-9_9

The mineralogy of asbestos

© Springer-Verlag Berlin Heidelberg 2014. Minerals are naturally occurring inorganic compounds of specific chemical composition and crystal structure. Their nomenclature typically stems as an honorific, to indicate a pertinent geographic area or to highlight a distinctive characteristic of the compound. The term asbestos collectively references a group of naturally occurring fibrous minerals which have been exploited in numerous commercial and industrial settings and applications dating to antiquity. Its myriad uses as a “miracle mineral” owe to its remarkable properties of extreme resistance to thermal and chemical breakdown, tensile strength, and fibrous habit which allows it to be spun and woven into textiles. Abundant in nature, it has been mined considerably, and in all continents save Antarctica. The nomenclature concerning asbestos and its related species is complex, owing to the interest held therein by scientific disciplines such as geology, mineralogy and medicine, as well as legal and regulatory authorities. The silicate minerals may have fibrous and nonfibrous habits. The group of asbestos and “asbestiform” minerals shares the common features of occurrence as flexible polyfilamentous bundles, long fiber length, and small fiber diameter. As fibrous silicates, asbestos minerals are broadly classified into the serpentine (chrysotile) and amphibole (crocidolite, amosite, tremolite, anthophyllite, actinolite) series, both of which may also contain allied but nonfibrous forms of similar or even identical chemical composition, nonpathogenic to humans. As such, amphibole minerals in the non-polyfilamentous habit are not classified as asbestos, nor are some other asbestiform amphiboles which are not commercially exploitable. Although generally grouped, classified, and regulated generically as asbestos, the serpentine and amphibole groups have different geologic occurrences and, more importantly, significant differences in crystalline structures and chemical compositions. These in turn impart differences in fiber structure and dimension, as well as biopersistence, leading to marked differences in relative potency for causing disease in humans for the group of minerals known as asbestos. Derived from the Greek term for “unquenchable” or “indestructible,” asbestos is the collective term for a family of naturally occurring fibrous silicates that exist in metamorphic, altered basic, or ultra basic igneous rock. Asbestos and asbestiform minerals are narrowly defined and classified, as will be discussed below. The asbestos minerals have found much utility owing to their common properties of thermochemical and electrical resistance, high tensile strength, and flexibility. Insoluble in water and organic solvents, its fine fibers may be spun and woven into textiles and incorporated into many other types of materials; asbestos has seen literally thousands of industrial applications. The usage of asbestos dates through fact and fable to thousands of years ago. Once believed to have almost magical capabilities, first descriptions document its usage in the manufacture of pottery in Finland ca. 2500 B.C. Additional historical attributions for early asbestos usage include cremation garments for royalty and for embalming the pharaohs of ancient Egypt. Emperor Charlemagne reportedly astonished his guests at a feast by throwing table cloths made from asbestos into a fire from which the garments would be removed clean and unharmed. Medieval alchemists termed the mineral “salamander stone” referring to a mythical fireproof animal, and during these times asbestos was used in suits of armor [1] . Deposits of asbestos in the Ural Mountains led to the development of factories producing asbestos textiles in 1720. In the seventeenth century, fibrous minerals discovered in Germany termed Bergflachs or Bergleder likely contained amphibole asbestos, and by the mid-nineteenth century, some 20 asbestos mines were operating in Europe [2]. In colonial America, asbestos deposits were discovered in Pennsylvania and New England, where it was woven into textiles, and chrysotile was discovered in Quebec, Canada, in 1860 [2] . Significant commercial usage of asbestos did not occur until the latter part of the nineteenth century, with the development of demand for insulation for the burgeoning steam technology. At the turn of the twentieth century, additional applications for the useful minerals had been developed, deposits of amphibole asbestos species had been discovered in South Africa, and asbestos was once more being mined in the Urals, this time in large quantities. Commercial exploitation of asbestos was now global and full blown, and by 1980 over 100 million tons of asbestos had been mined worldwide [2], accompanied by the development of serious health concerns related to its usage. The purpose of this chapter is to describe what the groups of minerals classified as asbestos are from a mineralogic perspective, where they occur, and what are the important distinctions that allow relative differences within members of the asbestos group to have differing potencies on the basis of such differences in terms of inducing injury and producing disease following inhalation. It is well known from animal models that the oncogenic potential of fibrous dust increases following reductions in fiber diameter and decreases with reduction in fiber length, and these considerations are generally more important than the chemical composition of the fibers themselves [3-6] . The longer fibers have more potency to induce cell injury, proliferation, oxidant release, and inflammation. It is also the durability of the fibrous dust that confers biopersistence and the potential to induce malignant disease following deposition of fibers in the peripheral airways and migration of fibers to the serosal membrane. Contemporary usage of asbestos has been curtailed following its wide recognition as a most dangerous substance; it is noteworthy that the health hazards of asbestos date to antiquity as well. Pliny the Elder cautioned against the purchase of quarry slaves from asbestos mines, noting that they tended to die young [1]. Contemporary usage of asbestos is highly variable, although global demand still measures in the millions of metric tons. The European Union, Australia, and Japan are examples of states which enforce national bans on asbestos products; other countries allow its usage and enforce variably stringent regulations on fiber type and permitted levels of exposure. In 2006, six countries (the Russian Federation, the People’s Republic of China, Kazakhstan, Brazil, Canada, and Zimbabwe) contributed to 96% of the world’s production of asbestos [7, 8] In the USA, asbestos consumption fell to 1,730 metric tons in 2007, chiefly in the form of chrysotile-containing roofing products [8].

Authors
Sporn, TA
MLA Citation
Sporn, TA. "The mineralogy of asbestos." Pathology of Asbestos-Associated Diseases, Third Edition. January 1, 2014. 1-10.
Source
scopus
Publish Date
2014
Start Page
1
End Page
10
DOI
10.1007/978-3-642-41193-9_1

SV40 and the lung

© 2014 Springer-Verlag Berlin Heidelberg. All rights are reserved. Subsequent to its identification as an inadvertent contaminant of early poliovirus vaccines and in view of its potential to induce a number of tumors in animal models, simian virus 40 (SV40) has become among the most studied animal viruses. Studies of SV40's molecular biology have led to important discoveries in viral-induced carcinogenesis, but the actual role for SV40 in the causation of human disease remains a complex and highly debated topic. The inadvertent exposure to SV40 through contaminated vaccine lots, affecting millions of people in the United States alone, has sparked one of the most elaborate, contentious, and controversial debates in contemporary oncologic research. It is the purpose of this chapter to review the capacity of the virus to infect humans and to cause disease, particularly in the lung and its serosal membrane, the pleura.

Authors
Sporn, TA
MLA Citation
Sporn, TA. "SV40 and the lung." Viruses and the Lung: Infections and Non-Infectious Viral-Linked Lung Disorders. July 1, 2013. 197-202.
Source
scopus
Publish Date
2013
Start Page
197
End Page
202
DOI
10.1007/978-3-642-40605-8_22

Relationship between pulmonary emphysema and renal function in smokers.

Authors
Pavlisko, EN; Roggli, VL; Sporn, TA; Oury, TD
MLA Citation
Pavlisko, EN, Roggli, VL, Sporn, TA, and Oury, TD. "Relationship between pulmonary emphysema and renal function in smokers." Chest 143.5 (May 2013): 1516-1517. (Letter)
PMID
23648928
Source
pubmed
Published In
Chest
Volume
143
Issue
5
Publish Date
2013
Start Page
1516
End Page
1517
DOI
10.1378/chest.13-0125

Familial idiopathic interstitial pneumonia: histopathology and survival in 30 patients.

CONTEXT: Familial idiopathic interstitial pneumonia (F-IIP) describes the unexplained occurrence of diffuse parenchymal lung disease in related individuals. Prevailing wisdom suggests that the histopathology of F-IIP is indistinguishable from that of idiopathic pulmonary fibrosis, namely, usual interstitial pneumonia (UIP). OBJECTIVE: To define the histopathology of F-IIP in lung tissue samples. DESIGN: Tissue sections from 30 patients with F-IIP, enrolled in a national research program, were evaluated by 3 pulmonary pathologists using 15 predefined histopathologic features. Each feature was recorded independently before a final diagnosis was chosen from a limited list dichotomized between UIP or "not UIP." These 2 groups were then compared to survival. RESULTS: The consensus diagnosis for the F-IIP cohort was an unclassifiable parenchymal fibrosis (60%), with a high incidence of histopathologic honeycombing, fibroblast foci, and smooth muscle in fibrosis. Usual interstitial pneumonia, strictly defined, was identified in less than half of the F-IIP cases (range, 23%-50%). Interobserver agreement was fair (κ  =  0.37) for 2 observers for the overall diagnosis of UIP. Findings unexpected in UIP were prevalent. The survival for the entire F-IIP cohort was poor, with an estimated mortality of 93% and a median age at death of 60.9 years. Subjects with UIP had a shorter survival and younger age at death. CONCLUSIONS: Pulmonary fibrosis was the dominant histopathology identified in our patients, but diagnostic features of UIP were seen in less than 50% of the samples. Overall survival was poor, with mortality accelerated apparently by the presence of a UIP pattern of disease.

Authors
Leslie, KO; Cool, CD; Sporn, TA; Curran-Everett, D; Steele, MP; Brown, KK; Wahidi, MM; Schwartz, DA
MLA Citation
Leslie, KO, Cool, CD, Sporn, TA, Curran-Everett, D, Steele, MP, Brown, KK, Wahidi, MM, and Schwartz, DA. "Familial idiopathic interstitial pneumonia: histopathology and survival in 30 patients." Arch Pathol Lab Med 136.11 (November 2012): 1366-1376.
PMID
23106582
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
136
Issue
11
Publish Date
2012
Start Page
1366
End Page
1376
DOI
10.5858/arpa.2011-0627-OAI

Lymphovascular invasion in non-small-cell lung cancer: implications for staging and adjuvant therapy.

BACKGROUND: Lymphovascular space invasion (LVI) is an established negative prognostic factor and an indication for postoperative radiation therapy in many malignancies. The purpose of this study was to evaluate LVI in patients with early-stage non-small-cell lung cancer, undergoing surgical resection. METHODS: All patients who underwent initial surgery for pT1-3N0-2 non-small-cell lung cancer at Duke University Medical Center from 1995 to 2008 were identified. A multivariate ordinal regression was used to assess the relationship between LVI and pathologic hilar and/or mediastinal lymph node (LN) involvement. A multivariate Cox regression analysis was used to evaluate the relationship of LVI and other clinical and pathologic factors on local failure (LF), freedom from distant metastasis (FFDM), and overall survival (OS). Kaplan-Meier methods were used to generate estimates of LF, FFDM, and OS in patients with and without LVI. RESULTS: One thousand five hundred and fifty-nine patients were identified. LVI was independently associated with the presence of regional LN involvement (p < 0.001) along with lobar (versus sublobar) resections (p < 0.001), and an open thoracotomy (versus video-assisted thoracoscopic surgery). LVI was not independently associated with LF on multivariate analysis (hazard ratio [HR] = 1.23, p = 0.25), but was associated with a lower FFDM (HR 1.52, p = 0.005) and OS (HR 1.26, p = 0.015). In addition, multivariate analysis showed that LVI was strongly associated with increased risk of developing distant metastases (HR = 1.75, p = 0.006) and death (HR = 1.53, p = 0.003) in adenocarcinomas but not in squamous carcinomas. CONCLUSIONS: LVI is associated with an increased risk of harboring regional LN involvement. LVI is also an adverse prognostic factor for the development of distant metastases and long-term survival.

Authors
Higgins, KA; Chino, JP; Ready, N; D'Amico, TA; Berry, MF; Sporn, T; Boyd, J; Kelsey, CR
MLA Citation
Higgins, KA, Chino, JP, Ready, N, D'Amico, TA, Berry, MF, Sporn, T, Boyd, J, and Kelsey, CR. "Lymphovascular invasion in non-small-cell lung cancer: implications for staging and adjuvant therapy." J Thorac Oncol 7.7 (July 2012): 1141-1147.
PMID
22617241
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
7
Issue
7
Publish Date
2012
Start Page
1141
End Page
1147
DOI
10.1097/JTO.0b013e3182519a42

Multicentric reticulohistiocytosis: a unique case with pulmonary fibrosis.

BACKGROUND: Multicentric reticulohistiocytosis (MRH) is a rare disease of uncertain etiology that most commonly presents as a papulonodular cutaneous eruption accompanied by erosive polyarthritis. Although MRH is considered a systemic disorder in that it targets skin and joints, involvement of thoracic and visceral organs is uncommon. OBSERVATIONS: A woman presented with diffuse cutaneous nodules, and skin biopsy findings revealed classic features of MRH. However, she also manifested severe pulmonary symptoms. A lung biopsy specimen showed prominent histiocytic infiltrates exhibiting the same characteristic morphologic features as those seen in her skin. Furthermore, the lung biopsy findings were significant for a pattern of usual interstitial pneumonia accompanied by notable lymphoid aggregates, a pattern of interstitial lung disease typical of systemic autoimmune and inflammatory conditions. CONCLUSIONS: These findings are notable because a histiocytic pulmonary infiltrate suggestive of direct pulmonary involvement by MRH is a rare event. In addition, presentation of MRH in the setting of usual interstitial pneumonia is unique. These observations document a new clinical and histopathologic presentation of MRH that is significant for expanding the idea of MRH as a systemic disease while supporting the notion that MRH is promoted by an inflammatory milieu.

Authors
West, KL; Sporn, T; Puri, PK
MLA Citation
West, KL, Sporn, T, and Puri, PK. "Multicentric reticulohistiocytosis: a unique case with pulmonary fibrosis." Arch Dermatol 148.2 (February 2012): 228-232.
PMID
22351825
Source
pubmed
Published In
Archives of Dermatology
Volume
148
Issue
2
Publish Date
2012
Start Page
228
End Page
232
DOI
10.1001/archdermatol.2011.1331

Occupational lung disease

© Cambridge University Press 2013 and The Estate of the late Herbert Spencer 2013 and The McGraw-Hill Companies Inc. 1962, 1968, 1977, 1985, 1996. Introduction Occupational lung disease is the most significant form of work-related illness in the United States in terms of its severity, frequency and cost to society. The US Department of Labor reported the occurrence of some 4.1 million workplace injuries and illnesses in 2006, including 17 700 respiratory ailments in private industry alone and an incidence of non-fatal occupational respiratory illness of 1.9 cases per 10 000 full-time workers. Occupational lung diseases result in one of the most significant causes of lost work productivity, with the highest rate of days away from work due to respiratory illness sustained by the mining industry. Occupational lung diseases are the third most prevalent (246 per 100 000 population) in the European Union, also with the highest proportion found in the mining industry. Technological advances in construction have led to new groups of at-risk workers in addition to the traditional occupations in mining and quarry work. Global estimates of disability and disease resultant from occupational exposure to airborne particulates also include 386 000 deaths from pneumoconiosis, asthma and other chronic obstructive lung diseases. The toll that occupational lung diseases exact upon society is reflected in estimated direct and indirect costs that number in the billions of dollars. Occupational lung diseases cause significant morbidity, which usually lacks curative medical intervention at the time of presentation, apart from jobsite or occupation modification. Stringent oversight of workplace conditions and permissible exposures on the part of governments and regulatory agencies, along with the retention of occupational health physicians on the part of larger firms, will hopefully mitigate the development of severe disease in the future.

Authors
Sporn, T; Roggli, VL
MLA Citation
Sporn, T, and Roggli, VL. "Occupational lung disease." Spencer's Pathology of the Lung, Sixth Edition. January 1, 2012. 512-562.
Source
scopus
Volume
1
Publish Date
2012
Start Page
512
End Page
562
DOI
10.1017/CBO9781139018760.017

Erratum: Exposure to brake dust and malignant mesothelioma: A study of 10 cases with mineral fiber analyses (Annals of Occupational Hygiene (2003) 47:4 (325-330))

Authors
Butnor, KJ; Sporn, TA; Roggli, VL
MLA Citation
Butnor, KJ, Sporn, TA, and Roggli, VL. "Erratum: Exposure to brake dust and malignant mesothelioma: A study of 10 cases with mineral fiber analyses (Annals of Occupational Hygiene (2003) 47:4 (325-330))." Annals of Occupational Hygiene 56.8 (2012): 975--.
Source
scival
Published In
The Annals of Occupational Hygiene (Elsevier)
Volume
56
Issue
8
Publish Date
2012
Start Page
975-
DOI
10.1093/annhyg/mes071

Bayesian probit regression model for the diagnosis of pulmonary fibrosis: proof-of-principle.

BACKGROUND: The accurate diagnosis of idiopathic pulmonary fibrosis (IPF) is a major clinical challenge. We developed a model to diagnose IPF by applying Bayesian probit regression (BPR) modelling to gene expression profiles of whole lung tissue. METHODS: Whole lung tissue was obtained from patients with idiopathic pulmonary fibrosis (IPF) undergoing surgical lung biopsy or lung transplantation. Controls were obtained from normal organ donors. We performed cluster analyses to explore differences in our dataset. No significant difference was found between samples obtained from different lobes of the same patient. A significant difference was found between samples obtained at biopsy versus explant. Following preliminary analysis of the complete dataset, we selected three subsets for the development of diagnostic gene signatures: the first signature was developed from all IPF samples (as compared to controls); the second signature was developed from the subset of IPF samples obtained at biopsy; the third signature was developed from IPF explants. To assess the validity of each signature, we used an independent cohort of IPF and normal samples. Each signature was used to predict phenotype (IPF versus normal) in samples from the validation cohort. We compared the models' predictions to the true phenotype of each validation sample, and then calculated sensitivity, specificity and accuracy. RESULTS: Surprisingly, we found that all three signatures were reasonably valid predictors of diagnosis, with small differences in test sensitivity, specificity and overall accuracy. CONCLUSIONS: This study represents the first use of BPR on whole lung tissue; previously, BPR was primarily used to develop predictive models for cancer. This also represents the first report of an independently validated IPF gene expression signature. In summary, BPR is a promising tool for the development of gene expression signatures from non-neoplastic lung tissue. In the future, BPR might be used to develop definitive diagnostic gene signatures for IPF, prognostic gene signatures for IPF or gene signatures for other non-neoplastic lung disorders such as bronchiolitis obliterans.

Authors
Meltzer, EB; Barry, WT; D'Amico, TA; Davis, RD; Lin, SS; Onaitis, MW; Morrison, LD; Sporn, TA; Steele, MP; Noble, PW
MLA Citation
Meltzer, EB, Barry, WT, D'Amico, TA, Davis, RD, Lin, SS, Onaitis, MW, Morrison, LD, Sporn, TA, Steele, MP, and Noble, PW. "Bayesian probit regression model for the diagnosis of pulmonary fibrosis: proof-of-principle. (Published online)" BMC Med Genomics 4 (October 5, 2011): 70-.
PMID
21974901
Source
pubmed
Published In
BMC Medical Genomics
Volume
4
Publish Date
2011
Start Page
70
DOI
10.1186/1755-8794-4-70

Mineralogy of asbestos.

The term asbestos collectively refers to a group of naturally occurring fibrous minerals which have been exploited in numerous commercial and industrial settings and applications dating to antiquity. Its myriad uses as a "miracle mineral" owe to its remarkable properties of extreme resistance to thermal and chemical breakdown, tensile strength, and fibrous habit which allows it to be spun and woven into textiles. Abundant in nature, it has been mined considerably, and in all continents save Antarctica. The nomenclature concerning asbestos and its related species is complex, owing to the interest held therein by scientific disciplines such as geology, mineralogy and medicine, as well as legal and regulatory authorities. As fibrous silicates, asbestos minerals are broadly classified into the serpentine (chrysotile) and amphibole (crocidolite, amosite, tremolite, anthophyllite, actinolite) groups, both of which may also contain allied but nonfibrous forms of similar or even identical chemical composition, nonpathogenic to humans. Recently, fibrous amphiboles, not historically classified or regulated as asbestos (winchite, richterite), have been implicated in the causation of serious disease due to their profusion as natural contaminants of vermiculite, a commercially useful and nonfibrous silicate mineral. Although generally grouped, classified, and regulated collectively as asbestos, the serpentine and amphibole groups have different geologic occurrences and, more importantly, significant differences in crystalline structures and chemical compositions. These in turn impart differences in fiber structure and dimension, as well as biopersistence, leading to marked differences in relative potency for causing disease in humans for the group of minerals known as asbestos.

Authors
Sporn, TA
MLA Citation
Sporn, TA. "Mineralogy of asbestos." Recent Results Cancer Res 189 (2011): 1-11. (Review)
PMID
21479892
Source
pubmed
Published In
Recent Results in Cancer Research
Volume
189
Publish Date
2011
Start Page
1
End Page
11
DOI
10.1007/978-3-642-10862-4_1

Paraquat ingestion: a challenging diagnosis.

Paraquat is an herbicide that is highly toxic to humans. Pediatric ingestion has become uncommon in the United States because of preventative efforts. We report here an unintentional, fatal paraquat ingestion by an 8-year-old child. Storage in an inappropriate container, confusion between herbicide trade names, nonspecific symptoms, and a delay in follow-up produced challenges in the diagnosis. In the absence of a clear history of ingestion, paraquat poisoning should be suspected in children who develop skin and mucous membrane burns, gastrointestinal symptoms, acute kidney injury, and respiratory failure.

Authors
Chen, JG; Eldridge, DL; Lodeserto, FJ; Ming, DY; Turner, KM; Vanderford, JL; Sporn, TA; Schulman, SR
MLA Citation
Chen, JG, Eldridge, DL, Lodeserto, FJ, Ming, DY, Turner, KM, Vanderford, JL, Sporn, TA, and Schulman, SR. "Paraquat ingestion: a challenging diagnosis." Pediatrics 125.6 (June 2010): e1505-e1509.
PMID
20478935
Source
pubmed
Published In
Pediatrics
Volume
125
Issue
6
Publish Date
2010
Start Page
e1505
End Page
e1509
DOI
10.1542/peds.2009-2601

Sarcomatoid mesothelioma: a clinical-pathologic correlation of 326 cases.

Sarcomatoid mesothelioma is the least common, but most aggressive of the three major histological types of mesotheliomas. This study comprises 326 cases of sarcomatoid mesotheliomas among 2000 consecutive malignant mesothelioma cases received in consultation (16%). Patients included 312 men (96%) and 14 women (4%), with a median age of 70 years (range 41-94 years). Most tumors were pleural (319; 98%), and 7 were peritoneal (2%). Some desmoplastic features were identified in 110 cases (34%), and 70 (21%) were classified as desmoplastic. Rare subtypes included two cases with a lymphohistiocytoid pattern (<1%) and eight heterologous mesotheliomas (2%). Labeling for cytokeratins (CKs) was observed in 261/280 cases (93%), and for calretinin and vimentin in 31 and 91%, respectively. Pleural plaques were present in 79% of cases for which information was available, and asbestosis was diagnosed in 34/127 cases (27%). Median survival was 3.5 months. Fiber analysis was performed in 61 cases. The median asbestos body count was 1640/g wet lung tissue (by light microscopy). Amosite fibers were the most commonly identified fibers using energy-dispersive X-ray analysis and were significantly higher in the sarcomatoid cases, as were uncoated fibers using scanning electron microscopy. This study represents the largest series of sarcomatoid and desmoplastic malignant mesotheliomas to date and confirms the diagnostic usefulness of CK immunohistochemistry. The relationship with asbestos exposure--particularly amosite--and an association with pleural plaques and less often asbestosis is confirmed.

Authors
Klebe, S; Brownlee, NA; Mahar, A; Burchette, JL; Sporn, TA; Vollmer, RT; Roggli, VL
MLA Citation
Klebe, S, Brownlee, NA, Mahar, A, Burchette, JL, Sporn, TA, Vollmer, RT, and Roggli, VL. "Sarcomatoid mesothelioma: a clinical-pathologic correlation of 326 cases." Mod Pathol 23.3 (March 2010): 470-479.
PMID
20081811
Source
pubmed
Published In
Modern Pathology
Volume
23
Issue
3
Publish Date
2010
Start Page
470
End Page
479
DOI
10.1038/modpathol.2009.180

Asbestos fiber content of lungs with diffuse interstitial fibrosis: An analytical scanning electron microscopic analysis of 249 cases.

CONTEXT: Asbestosis is one of many forms of diffuse interstitial pulmonary fibrosis. Its histologic diagnosis rests on the pattern of fibrosis and the presence of asbestos bodies by light microscopy in lung biopsies. OBJECTIVE: To determine the asbestos fiber burden in patients with diffuse pulmonary fibrosis (DPF) who had a history of asbestos exposure, but whose biopsies did not meet established criteria for asbestosis, and compare it with the fiber burden in confirmed asbestosis cases. DESIGN: Fiber burden analysis was performed using scanning electron microscopy and energy-dispersive x-ray analysis of lung parenchyma from 86 patients with DPF and 163 patients with asbestosis. The correlation of the number of asbestos fibers found for a quantitative degree of fibrosis was analyzed. RESULTS: The fibrosis scores of the asbestosis cases correlated best with the number of uncoated commercial amphibole fibers. Seven DPF cases fell within the 95% interval of asbestos body count by light microscopy and 3 cases within that of the total commercial amphibole fiber count. CONCLUSIONS: Strict histologic criteria are useful for positive identification of asbestosis among cases of advanced pulmonary fibrosis. Few DPF patients with history of asbestos exposure whose biopsies did not meet the criteria for asbestosis may have asbestos fiber counts in the range seen in asbestosis, and fiber type identification by scanning electron microscopy with energy-dispersive x-ray analysis should be considered in these rare instances to avoid false-positive and false-negative diagnoses of asbestosis.

Authors
Schneider, F; Sporn, TA; Roggli, VL
MLA Citation
Schneider, F, Sporn, TA, and Roggli, VL. "Asbestos fiber content of lungs with diffuse interstitial fibrosis: An analytical scanning electron microscopic analysis of 249 cases." Arch Pathol Lab Med 134.3 (March 2010): 457-461.
PMID
20196673
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
134
Issue
3
Publish Date
2010
Start Page
457
End Page
461
DOI
10.1043/1543-2165-134.3.457

Preoperative radiation therapy and chemotherapy for pulmonary blastoma: a case report.

Authors
Zagar, TM; Blackwell, S; Crawford, J; D'Amico, T; Christensen, JD; Sporn, TA; Kelsey, CR
MLA Citation
Zagar, TM, Blackwell, S, Crawford, J, D'Amico, T, Christensen, JD, Sporn, TA, and Kelsey, CR. "Preoperative radiation therapy and chemotherapy for pulmonary blastoma: a case report." J Thorac Oncol 5.2 (February 2010): 282-283.
PMID
20101153
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
5
Issue
2
Publish Date
2010
Start Page
282
End Page
283
DOI
10.1097/JTO.0b013e3181c420e1

Comparison of transbronchial lung biopsy yield between standard forceps and electrocautery hot forceps in swine.

BACKGROUND: Transbronchial lung biopsy (TBLB) is a commonly performed bronchoscopic procedure. Previous studies have suggested that larger biopsy forceps may improve diagnostic yield; however, the risk of bleeding associated with larger samples may be increased. The hot forceps are large forceps that are connected to an electrocautery system to minimize bleeding at the time of biopsy. OBJECTIVES: We evaluated the hot forceps for improvement in biopsy size and the number of sampled alveoli. METHODS: TBLBs were performed in 2 swine using one type of the forceps, followed by the other forceps 24 h later. Electrocautery was applied from closure of the forceps to retrieval of the sample. A blinded pathologist measured the size of each sample in its longest dimension and calculated the total alveolar content within the largest cross-section from each biopsy. RESULTS: A total of 74 biopsies were collected using each forceps type. Alveolar tissue was present in 25/74 and 26/74 of the biopsies using the hot and conventional forceps, respectively. There was no difference in the size of biopsies collected (2.10 +/- 1.10 vs. 1.83 +/- 0.94 mm; p = 0.164) or in the amount of alveoli per sample (343.2 +/- 402.4 vs. 439.5 +/- 463.5 alveoli; p = 0.433) for hot and conventional forceps, respectively. There was no artifact related to the use of electrocautery, and bleeding was minimal using either forceps system. CONCLUSIONS: The use of the electrocautery hot forceps for TBLB did not result in improvement of the size of biopsies or the amount of collected alveolar tissue in healthy pigs.

Authors
Wahidi, MM; Shofer, SL; Sporn, TA; Ernst, A
MLA Citation
Wahidi, MM, Shofer, SL, Sporn, TA, and Ernst, A. "Comparison of transbronchial lung biopsy yield between standard forceps and electrocautery hot forceps in swine." Respiration 79.2 (2010): 137-140.
PMID
19707013
Source
pubmed
Published In
Respiration; international review of thoracic diseases
Volume
79
Issue
2
Publish Date
2010
Start Page
137
End Page
140
DOI
10.1159/000235818

Giant thoracic liposarcoma treated with induction chemotherapy followed by surgical resection.

Authors
Berry, MF; Sporn, TA; Moore, JO; D'Amico, TA
MLA Citation
Berry, MF, Sporn, TA, Moore, JO, and D'Amico, TA. "Giant thoracic liposarcoma treated with induction chemotherapy followed by surgical resection." J Thorac Oncol 4.6 (June 2009): 768-769.
PMID
19461403
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
4
Issue
6
Publish Date
2009
Start Page
768
End Page
769
DOI
10.1097/JTO.0b013e31819e77ff

Comments on Asbestos fibre concentrations in the lungs of brake workers: another look.

Authors
Roggli, VL; Sporn, TA; Case, BW; Butnor, KJ
MLA Citation
Roggli, VL, Sporn, TA, Case, BW, and Butnor, KJ. "Comments on Asbestos fibre concentrations in the lungs of brake workers: another look." Ann Occup Hyg 53.2 (March 2009): 191-. (Letter)
PMID
19174484
Source
pubmed
Published In
The Annals of Occupational Hygiene (Elsevier)
Volume
53
Issue
2
Publish Date
2009
Start Page
191
DOI
10.1093/annhyg/men079

Pneumoconioses, mineral and vegetable

The term pneumoconiosis, originally coined by Zenker,1 literally means dust in the lung. Because various types of dust can be found in the lungs of virtually all adults, this term has come to mean the accumulation of abnormal amounts of dust in the lungs and the local pathologic response to this dust. A great variety of dust particles have been identified, which, when inhaled in sufficient amounts, are capable of producing disease in humans. The sources of these particles are diverse, ranging from occupational to environmental exposures. Factors important in determining the pathologic response to a given dust exposure include the number, size, and physicochemical properties of the inhaled particles; the route and efficiency of the clearance of particles from the respiratory tract; the nature and intensity of the host's inflammatory response to the particles deposited in the lung; the duration of the exposure and interval since initial exposure; and the interaction between the inhaled particles from multiple sources and other environmental pollutants such as cigarette smoke. © 2008 Springer New York.

Authors
Sporn, TA; Roggli, VL
MLA Citation
Sporn, TA, and Roggli, VL. "Pneumoconioses, mineral and vegetable." 1 (December 1, 2008): 911-949. (Chapter)
Source
scopus
Volume
1
Publish Date
2008
Start Page
911
End Page
949
DOI
10.1007/978-0-387-68792-6_26

Pulmonary histopathology in an experimental model of chronic aspiration is independent of acidity.

Gastroesophageal reflux has become a major health concern in industrialized countries, with drugs aimed at blocking acid production being more frequently prescribed than any other drug. Damage to lung tissue as a result of chronic aspiration of gastric fluid is a primary health risk associated with gastro-esophageal reflux, with such aspiration being suspected in the induction or exacerbation of asthma and other lung diseases. In this study, a rodent model of chronic aspiration was used to characterize the pulmonary histopathology produced by repetitive aspiration events and to investigate the pathologic roles of individual gastric fluid components such as acid and particulate food matter. Rats exposed to chronic aspiration of whole gastric fluid developed a pathology distinct from that of acute lung injury, characterized by granulomatous interstitial pneumonitis with prominent formation of multinucleated giant cells. This pattern of injury could be reproduced with chronic aspiration of particulate food matter and with chronic aspiration of pH-neutralized gastric fluid, but not with chronic aspiration of hydrochloric acid. Thus, since acid-neutralizing therapy is currently the mainstay of treatment for patients with reflux-associated respiratory symptoms, these results strongly suggest that alternative therapeutic approaches aimed at preventing chronic-aspiration induced lung injury may be warranted.

Authors
Downing, TE; Sporn, TA; Bollinger, RR; Davis, RD; Parker, W; Lin, SS
MLA Citation
Downing, TE, Sporn, TA, Bollinger, RR, Davis, RD, Parker, W, and Lin, SS. "Pulmonary histopathology in an experimental model of chronic aspiration is independent of acidity." Exp Biol Med (Maywood) 233.10 (October 2008): 1202-1212.
PMID
18641054
Source
pubmed
Published In
Experimental biology and medicine (Maywood, N.J.)
Volume
233
Issue
10
Publish Date
2008
Start Page
1202
End Page
1212
DOI
10.3181/0801-RM-17

Crocidolite and mesothelioma.

This study reports changes in the frequency of detection of various asbestos fiber types between 1982 and 2005. Crocidolite is increasingly detected in U.S. mesothelioma patients. The percentage of crocidolite fibers detected in lung tissue has risen from 4 to 10%, and the percentage of cases in which crocidolite was detected increased from 19 to 37%. Meanwhile, the frequency of detection of amosite and chrysotile has decreased. The authors performed a detailed analysis of cases in which crocidolite was identified in the absence of amosite. Most of such cases were identified in recent years, a finding of concern since crocidolite is considered the most potent fiber type with respect to the pathogenesis of mesothelioma.

Authors
Schneider, F; Sporn, TA; Roggli, VL
MLA Citation
Schneider, F, Sporn, TA, and Roggli, VL. "Crocidolite and mesothelioma." Ultrastruct Pathol 32.5 (September 2008): 171-177.
PMID
18958788
Source
pubmed
Published In
Ultrastructural Pathology (Informa)
Volume
32
Issue
5
Publish Date
2008
Start Page
171
End Page
177
DOI
10.1080/01913120802343848

Comments on Dodson et al., A technical comparison of evaluating asbestos concentration by phase contrast microscopy (PCM), scanning electron microscopy (SEM), and analytical transmission electron microscopy (ATEM) as illustrated from data generated from a case report.

Authors
Roggli, VL; Sporn, TA; Butnor, KJ
MLA Citation
Roggli, VL, Sporn, TA, and Butnor, KJ. "Comments on Dodson et al., A technical comparison of evaluating asbestos concentration by phase contrast microscopy (PCM), scanning electron microscopy (SEM), and analytical transmission electron microscopy (ATEM) as illustrated from data generated from a case report." Inhal Toxicol 20.12 (September 2008): 1113-1114. (Letter)
PMID
18803062
Source
pubmed
Published In
Inhalation Toxicology (Informa)
Volume
20
Issue
12
Publish Date
2008
Start Page
1113
End Page
1114
DOI
10.1080/08958370802433724

The rexinoid LG100268 and the synthetic triterpenoid CDDO-methyl amide are more potent than erlotinib for prevention of mouse lung carcinogenesis.

Female A/J mice injected with the carcinogen vinyl carbamate develop atypical adenomatous hyperplasias in lungs 4 weeks after injection with the carcinogen. The number and severity of tumors then increase over time, making these mice a useful model for evaluating potential chemopreventive agents. The rexinoid LG100268 (LG268), a selective ligand for the retinoid X receptor, and the methyl amide of the synthetic triterpenoid 2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oic acid (CDDO) both significantly reduced the number, size, and severity of the histopathology of lung tumors in female A/J mice when fed in diet for 14 to 20 weeks. The total tumor burden was 85% to 87% lower in mice fed LG268 and CDDO-MA than in controls, and the percentage of high-grade tumors decreased from 59% in the controls to 25% or 30% with CDDO-MA and LG268. Erlotinib, which is used to treat lung cancer patients and is an inhibitor of the epidermal growth factor receptor, was less effective in this model. Immunohistochemical staining of geminin, a marker of cell cycle progression, was higher in lung sections from control mice than in mice treated with LG268. Because rexinoids and triterpenoids signal through different biological pathways, they should be tested in combination for the prevention of lung cancer.

Authors
Liby, K; Black, CC; Royce, DB; Williams, CR; Risingsong, R; Yore, MM; Liu, X; Honda, T; Gribble, GW; Lamph, WW; Sporn, TA; Dmitrovsky, E; Sporn, MB
MLA Citation
Liby, K, Black, CC, Royce, DB, Williams, CR, Risingsong, R, Yore, MM, Liu, X, Honda, T, Gribble, GW, Lamph, WW, Sporn, TA, Dmitrovsky, E, and Sporn, MB. "The rexinoid LG100268 and the synthetic triterpenoid CDDO-methyl amide are more potent than erlotinib for prevention of mouse lung carcinogenesis." Mol Cancer Ther 7.5 (May 2008): 1251-1257.
PMID
18483313
Source
pubmed
Published In
Molecular cancer therapeutics
Volume
7
Issue
5
Publish Date
2008
Start Page
1251
End Page
1257
DOI
10.1158/1535-7163.MCT-08-0023

PET of hypoxia and perfusion with 62Cu-ATSM and 62Cu-PTSM using a 62Zn/62Cu generator.

OBJECTIVE: Copper-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) and copper-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (Cu-PTSM) are being studied as potential markers of hypoxia and perfusion, respectively. The use of short-lived radionuclides (e.g., 62Cu) has advantages for clinical PET, including a lower radiation dose than long-lived radionuclides and serial imaging capability. A 62Zn/62Cu microgenerator and rapid synthesis kits now provide a practical means of producing 62Cu-PTSM and 62Cu-ATSM on-site. Tumors can be characterized with 62Cu-PTSM, 62Cu-ATSM, and 18F-FDG PET scans during one session. We present the initial clinical data in two patients with lung neoplasms. CONCLUSION: Hypoxia and perfusion are important parameters in tumor physiology and can have major implications in diagnosis, prognosis, treatment planning, and response to therapy. We have shown the feasibility of performing 62Cu-ATSM and 62Cu-PTSM PET together with FDG PET/CT during a single imaging session to provide information on both perfusion and hypoxia and tumor anatomy and metabolism.

Authors
Wong, TZ; Lacy, JL; Petry, NA; Hawk, TC; Sporn, TA; Dewhirst, MW; Vlahovic, G
MLA Citation
Wong, TZ, Lacy, JL, Petry, NA, Hawk, TC, Sporn, TA, Dewhirst, MW, and Vlahovic, G. "PET of hypoxia and perfusion with 62Cu-ATSM and 62Cu-PTSM using a 62Zn/62Cu generator." AJR Am J Roentgenol 190.2 (February 2008): 427-432.
PMID
18212229
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
190
Issue
2
Publish Date
2008
Start Page
427
End Page
432
DOI
10.2214/AJR.07.2876

Review and recent development of angle-resolved low-coherence interferometry for detection of precancerous cells in human esophageal epithelium

The combination of low-coherence interferometry with angle-resolved light scattering measurements has been shown to be a powerful method for determining the structure of cell nuclei within intact tissue samples. The nuclear morphology data have been used as a biomarker of neoplastic change in a wide range of settings. Here, we review the development of angle-resolved lowcoherence interferometry (a/LCI) for assessing the health status of human esophageal epithelial tissues based on depth-resolved measurements of the morphology of cell nuclei. The design and implementation of clinical instrumentation are reviewed, and results from ex vivo human tissue measurements are presented to validate the capabilities of the technique. In addition to the review of earlier papers, new results are presented, which demonstrate the first application of a portable a/LCI system with a flexible endoscopic probe to assessing depth-resolved nuclear morphology in a clinical setting. High sensitivity for the detection of precancerous tissues is demonstrated. © 2008 IEEE.

Authors
Brown, WJ; Pyhtila, JW; Terry, NG; Chalut, KJ; D'Amico, TA; Sporn, TA; Obando, JV; Wax, A
MLA Citation
Brown, WJ, Pyhtila, JW, Terry, NG, Chalut, KJ, D'Amico, TA, Sporn, TA, Obando, JV, and Wax, A. "Review and recent development of angle-resolved low-coherence interferometry for detection of precancerous cells in human esophageal epithelium." IEEE Journal on Selected Topics in Quantum Electronics 14.1 (2008): 88-96.
Source
scival
Published In
IEEE Journal of Selected Topics in Quantum Electronics
Volume
14
Issue
1
Publish Date
2008
Start Page
88
End Page
96
DOI
10.1109/JSTQE.2007.913969

Recommendations for the reporting of pleural mesothelioma.

It has been evident for decades that pathology reports are very variable even within a single institution. Standardization of reporting is the optimal way to ensure that information necessary for patient management, prognostic and predictive factor assessment, grading, staging, analysis of outcomes, and tumor registries is included in pathology reports. In recent years, 2 societies (first the Association of Directors of Anatomic and Surgical Pathology [ADASP] and then the College of American Pathologists [CAP]) have undertaken to publish guidelines for the reporting of common cancers. The CAP assigned multidisciplinary groups of pathologists, surgeons, radiation, and medical oncologists to develop the protocols. Other pathologists and clinicians then reviewed them. After those reviews the protocols were reviewed by multiple CAP committees and finally approved by the Board of Governors. The ADASP, in contrast, chose a pathologist expert in each filed to assemble a group from within the pathology community (with clinician input if desired) to write specific cancer protocols. These were then approved by the ADASP council and subsequently by the membership. Although both societies began the process at approximately the same time, the streamlined approach adopted by the ADASP enabled them to publish years earlier in pathology journals frequented by anatomic pathologists. Although the formats are somewhat different, the contents are essentially the same. The American College of Surgery Commission on Cancer (COC) accredits cancer centers in the United States. Recently, the COC decided to require elements, deemed as essential by the CAP, to be described in all pathology reports in their accredited cancer centers as of January 2004. Importantly, they do not require that the specific CAP protocols or synoptic reports be used. The ADASP has updated all of its protocols to comply with the COC requirements in the form of 37 uniform checklists. The checklists use the staging criteria sited in the American Joint Committee on Cancer 2002 Staging Manual (sixth edition) but include a variety of other references listed in each of the checklists. Moreover, the checklists are formatted for ease of use. They may be used as templates for uniform reporting and are designed to be compatible with voice-activated transcription. The different elements in these revised ADASP diagnostic checklists have been divided into required and optional. The term required in this context only signifies compliance with the COC guidelines. The ADASP realizes that specimens and practices vary, and it will not be possible to report these elements in every case. However, the ADASP hopes that pathologists will find these checklists to be useful in daily clinical practice, while facilitating compliance with the new COC requirements.

Authors
Butnor, KJ; Sporn, TA; Ordonez, NG; Association of Directors of Anatomic and Surgical Pathology,
MLA Citation
Butnor, KJ, Sporn, TA, Ordonez, NG, and Association of Directors of Anatomic and Surgical Pathology, . "Recommendations for the reporting of pleural mesothelioma." Hum Pathol 38.11 (November 2007): 1587-1589.
PMID
17276491
Source
pubmed
Published In
Human Pathology
Volume
38
Issue
11
Publish Date
2007
Start Page
1587
End Page
1589
DOI
10.1016/j.humpath.2006.11.008

Broncholith removal using cryotherapy during flexible bronchoscopy: a case report.

Pulmonary broncholithiasis can cause a management dilemma depending on its location and the possible involvement of vascular structures. Many patients undergo rigid bronchoscopy or surgical interventions for the removal of broncholiths. In this case report, we describe a 38-year-old white man with a history of performing warehouse demolitions who presented with chronic cough, dyspnea on exertion, and recurrent pneumonia. Imaging studies revealed hilar and mediastinal calcifications, as well as a calcification in the right middle lobe bronchus. Flexible bronchoscopy revealed a mobile obstructing calcified mass in the right middle lobe bronchus. Attempts at removing the mass with forceps were unsuccessful. Instead, the mass was removed using cryotherapy with minimal bleeding and complete resolution of the obstruction. Pathologic examination confirmed that the mass was a broncholith, and stains revealed the presence of histoplasma fungal forms. Partially attached broncholiths can be removed safely using flexible bronchoscopy with the aid of cryotherapy.

Authors
Reddy, AJ; Govert, JA; Sporn, TA; Wahidi, MM
MLA Citation
Reddy, AJ, Govert, JA, Sporn, TA, and Wahidi, MM. "Broncholith removal using cryotherapy during flexible bronchoscopy: a case report." Chest 132.5 (November 2007): 1661-1663.
PMID
17998368
Source
pubmed
Published In
Chest
Volume
132
Issue
5
Publish Date
2007
Start Page
1661
End Page
1663
DOI
10.1378/chest.07-0739

Follicular dendritic cell sarcoma of the mediastinum.

Authors
Leipsic, JA; McAdams, HP; Sporn, TA
MLA Citation
Leipsic, JA, McAdams, HP, and Sporn, TA. "Follicular dendritic cell sarcoma of the mediastinum." AJR Am J Roentgenol 188.6 (June 2007): W554-W556.
PMID
17515347
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
188
Issue
6
Publish Date
2007
Start Page
W554
End Page
W556
DOI
10.2214/AJR.04.1530

The synthetic triterpenoids CDDO-methyl ester and CDDO-ethyl amide prevent lung cancer induced by vinyl carbamate in A/J mice.

We report the first use of new synthetic triterpenoids to prevent lung cancer in experimental animals. Female A/J mice were treated with the mutagenic carcinogen vinyl carbamate, which induces adenocarcinoma of the lung in all animals within 16 weeks. If mice were fed either the methyl ester or the ethyl amide derivative of the synthetic triterpenoid 2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oic acid (CDDO-ME and CDDO-EA, respectively), beginning 1 week after dosing with carcinogen, the number, size, and severity of lung carcinomas were markedly reduced. The mechanisms of action of CDDO-ME and CDDO-EA that are germane to these in vivo findings are the following results shown here in cell culture: (a) suppression of the ability of IFN-gamma to induce de novo formation of nitric oxide synthase in a macrophage-like cell line RAW264.7, (b) induction of heme oxygenase-1 in these RAW cells, and (c) suppression of phosphorylation of the transcription factor signal transducers and activators of transcription 3 as well as induction of apoptosis in human lung cancer cell lines.

Authors
Liby, K; Royce, DB; Williams, CR; Risingsong, R; Yore, MM; Honda, T; Gribble, GW; Dmitrovsky, E; Sporn, TA; Sporn, MB
MLA Citation
Liby, K, Royce, DB, Williams, CR, Risingsong, R, Yore, MM, Honda, T, Gribble, GW, Dmitrovsky, E, Sporn, TA, and Sporn, MB. "The synthetic triterpenoids CDDO-methyl ester and CDDO-ethyl amide prevent lung cancer induced by vinyl carbamate in A/J mice." Cancer Res 67.6 (March 15, 2007): 2414-2419.
PMID
17363558
Source
pubmed
Published In
Cancer Research
Volume
67
Issue
6
Publish Date
2007
Start Page
2414
End Page
2419
DOI
10.1158/0008-5472.CAN-06-4534

Gene expression profiling of familial and sporadic interstitial pneumonia.

RATIONALE: Idiopathic interstitial pneumonia (IIP) and its familial variants are progressive and largely untreatable disorders with poorly understood molecular mechanisms. Both the genetics and the histologic type of IIP play a role in the etiology and pathogenesis of interstitial lung disease, but transcriptional signatures of these subtypes are unknown. OBJECTIVES: To evaluate gene expression in the lung tissue of patients with usual interstitial pneumonia or nonspecific interstitial pneumonia that was either familial or nonfamilial in origin, and to compare it with gene expression in normal lung parenchyma. METHODS: We profiled RNA from the lungs of 16 patients with sporadic IIP, 10 with familial IIP, and 9 normal control subjects on a whole human genome oligonucleotide microarray. RESULTS: Significant transcriptional differences exist in familial and sporadic IIPs. The genes distinguishing the genetic subtypes belong to the same functional categories as transcripts that distinguish IIP from normal samples. Relevant categories include chemokines and growth factors and their receptors, complement components, genes associated with cell proliferation and death, and genes in the Wnt pathway. The role of the chemokine CXCL12 in disease pathogenesis was confirmed in the murine bleomycin model of lung injury, with C57BL/6(CXCR4+/-) mice demonstrating significantly less collagen deposition than C57BL/6(CXCR4+/+) mice. Whereas substantial differences exist between familial and sporadic IIPs, we identified only minor gene expression changes between usual interstitial pneumonia and nonspecific interstitial pneumonia. CONCLUSIONS: Taken together, our findings indicate that differences in gene expression profiles between familial and sporadic IIPs may provide clues to the etiology and pathogenesis of IIP.

Authors
Yang, IV; Burch, LH; Steele, MP; Savov, JD; Hollingsworth, JW; McElvania-Tekippe, E; Berman, KG; Speer, MC; Sporn, TA; Brown, KK; Schwarz, MI; Schwartz, DA
MLA Citation
Yang, IV, Burch, LH, Steele, MP, Savov, JD, Hollingsworth, JW, McElvania-Tekippe, E, Berman, KG, Speer, MC, Sporn, TA, Brown, KK, Schwarz, MI, and Schwartz, DA. "Gene expression profiling of familial and sporadic interstitial pneumonia." Am J Respir Crit Care Med 175.1 (January 1, 2007): 45-54.
PMID
16998095
Source
pubmed
Published In
American journal of respiratory and critical care medicine
Volume
175
Issue
1
Publish Date
2007
Start Page
45
End Page
54
DOI
10.1164/rccm.200601-062OC

Recommendations for the reporting of pleural mesothelioma.

Authors
Butnor, KJ; Sporn, TA; Ordonez, NG; Association of Direstors of Anatomic and Surgical Pathology (ADASP),
MLA Citation
Butnor, KJ, Sporn, TA, Ordonez, NG, and Association of Direstors of Anatomic and Surgical Pathology (ADASP), . "Recommendations for the reporting of pleural mesothelioma." Virchows Arch 450.1 (January 2007): 15-23.
PMID
17334801
Source
pubmed
Published In
Virchows Archiv
Volume
450
Issue
1
Publish Date
2007
Start Page
15
End Page
23
DOI
10.1007/s00428-006-0301-7

Recommendations for the reporting of pleural mesothelioma

Authors
Butnor, KJ; Sporn, TA; Ordonez, NG
MLA Citation
Butnor, KJ, Sporn, TA, and Ordonez, NG. "Recommendations for the reporting of pleural mesothelioma." American Journal of Clinical Pathology 127.1 (2007): 15-19.
PMID
17145632
Source
scival
Published In
American Journal of Clinical Pathology
Volume
127
Issue
1
Publish Date
2007
Start Page
15
End Page
19
DOI
10.1309/6A30YQHBMTHEJTEM

Giant cell interstitial pneumonia associated with nitrofurantoin.

A case of giant cell interstitial pneumonia (GIF) that occurred in association with exposure to nitrofurantoin is presented. While the diagnosis of GIP is confirmed by histopathology, this diagnosis can be supported by the findings of bizarre multinucleated giant cells (MGC), elevated T lymphocytes, and a low T lymphocyte helper/suppressor ratio in the bronchoalveolar lavage fluid (BALF). Recognition of GIP as a rare manifestation of nitrofurantoin toxicity is important because prompt therapy may be associated with a favorable outcome.

Authors
Hargett, CW; Sporn, TA; Roggli, VL; Hollingsworth, JW
MLA Citation
Hargett, CW, Sporn, TA, Roggli, VL, and Hollingsworth, JW. "Giant cell interstitial pneumonia associated with nitrofurantoin." Lung 184.3 (May 2006): 147-149.
PMID
16902839
Source
pubmed
Published In
Lung
Volume
184
Issue
3
Publish Date
2006
Start Page
147
End Page
149
DOI
10.1007/s00408-005-2574-z

Physician subsidies for tobacco advertising.

Authors
Roggli, VL; Piantadosi, CA; MacIntyre, NR; Young, SL; Kussin, PS; Steele, MP; Carraway, MS; Welty-Wolf, KE; Govert, JA; McMahon, TJ; Palmer, SM; Sporn, TA; Ghio, AJ
MLA Citation
Roggli, VL, Piantadosi, CA, MacIntyre, NR, Young, SL, Kussin, PS, Steele, MP, Carraway, MS, Welty-Wolf, KE, Govert, JA, McMahon, TJ, Palmer, SM, Sporn, TA, and Ghio, AJ. "Physician subsidies for tobacco advertising." Am J Respir Crit Care Med 173.2 (January 15, 2006): 246-. (Letter)
PMID
16391304
Source
pubmed
Published In
American journal of respiratory and critical care medicine
Volume
173
Issue
2
Publish Date
2006
Start Page
246
DOI
10.1164/ajrccm.173.2.246

Clinical and pathologic features of familial interstitial pneumonia.

RATIONALE: Several lines of evidence suggest that genetic factors and environmental exposures play a role in the development of pulmonary fibrosis. OBJECTIVES: We evaluated families with 2 or more cases of idiopathic interstitial pneumonia among first-degree family members (familial interstitial pneumonia, or FIP), and identified 111 families with FIP having 309 affected and 360 unaffected individuals. METHODS: The presence of probable or definite FIP was based on medical record review in 28 cases (9.1%); clinical history, diffusing capacity of carbon monoxide (DL(CO)), and chest X-ray in 16 cases (5.2%); clinical history, DL(CO), and high-resolution computed tomography chest scan in 191 cases (61.8%); clinical history and surgical lung biopsy in 56 cases (18.1%); and clinical history and autopsy in 18 cases (5.8%). RESULTS: Older age (68.3 vs. 53.1; p < 0.0001), male sex (55.7 vs. 37.2%; p < 0.0001), and having ever smoked cigarettes (67.3 vs. 34.1%; p < 0.0001) were associated with the development of FIP. After controlling for age and sex, having ever smoked cigarettes remained strongly associated with the development of FIP (odds ratio(adj), 3.6; 95% confidence interval, 1.3-9.8). Evidence of aggregation of disease was highly significant (p < 0.001) among sibling pairs, and 20 pedigrees demonstrated vertical transmission, consistent with autosomal dominant inheritance. Forty-five percent of pedigrees demonstrated phenotypic heterogeneity, with some pedigrees demonstrating several subtypes of idiopathic interstitial pneumonia occurring within the same families. CONCLUSIONS: These findings suggest that FIP may be caused by an interaction between a specific environmental exposure and a gene (or genes) that predisposes to the development of several subtypes of idiopathic interstitial pneumonia.

Authors
Steele, MP; Speer, MC; Loyd, JE; Brown, KK; Herron, A; Slifer, SH; Burch, LH; Wahidi, MM; Phillips, JA; Sporn, TA; McAdams, HP; Schwarz, MI; Schwartz, DA
MLA Citation
Steele, MP, Speer, MC, Loyd, JE, Brown, KK, Herron, A, Slifer, SH, Burch, LH, Wahidi, MM, Phillips, JA, Sporn, TA, McAdams, HP, Schwarz, MI, and Schwartz, DA. "Clinical and pathologic features of familial interstitial pneumonia." Am J Respir Crit Care Med 172.9 (November 1, 2005): 1146-1152.
PMID
16109978
Source
pubmed
Published In
American journal of respiratory and critical care medicine
Volume
172
Issue
9
Publish Date
2005
Start Page
1146
End Page
1152
DOI
10.1164/rccm.200408-1104OC

A 73-year-old woman with a cough.

Authors
Hurwitz, LM; McAdams, HP; Sporn, TA
MLA Citation
Hurwitz, LM, McAdams, HP, and Sporn, TA. "A 73-year-old woman with a cough." Chest 128.2 (August 2005): 1018-1021.
PMID
16100201
Source
pubmed
Published In
Chest
Volume
128
Issue
2
Publish Date
2005
Start Page
1018
End Page
1021
DOI
10.1378/chest.128.2.1018

Bilateral pulmonary nodules in a 37-year-old woman with malignant melanoma. Pulmonary Langerhans cell histiocytosis (eosinophilic granuloma).

Authors
Brownlee, NA; Mahar, A; Sporn, TA
MLA Citation
Brownlee, NA, Mahar, A, and Sporn, TA. "Bilateral pulmonary nodules in a 37-year-old woman with malignant melanoma. Pulmonary Langerhans cell histiocytosis (eosinophilic granuloma)." Arch Pathol Lab Med 129.5 (May 2005): e136-e137.
PMID
15859663
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
129
Issue
5
Publish Date
2005
Start Page
e136
End Page
e137
DOI
10.1043/1543-2165(2005)1292.0.CO;2

The spectrum of Kit (CD117) immunoreactivity in lung and pleural tumors: a study of 96 cases using a single-source antibody with a review of the literature.

CONTEXT: The development of successful chemotherapeutic agents directed against the Kit receptor tyrosine kinase protein has generated intense interest in the Kit (CD117) immunoreactivity of various neoplasms. Immunoreactivity for Kit in small cell lung carcinoma (SCLC) has been well established. However, data on Kit immunostaining in other lung tumors is limited. Likewise, while solitary fibrous tumors of the gastrointestinal tract have been examined for Kit expression, the Kit staining characteristics of their counterpart in the pleura, namely, localized fibrous tumor, are not well known. OBJECTIVE: To characterize the Kit immunohistochemical profiles of major types of lung and pleural tumors. DESIGN: We stained 60 lung carcinomas, including 11 SCLCs, 4 large cell neuroendocrine carcinomas, 22 squamous cell carcinomas, 23 adenocarcinomas, 11 pulmonary carcinoid tumors, 19 pleural malignant mesotheliomas, and 6 localized pleural fibrous tumors with a commonly used polyclonal Kit antibody. RESULTS: Small cell lung carcinomas demonstrated Kit staining in 82% of cases, nearly all of which demonstrated moderate to intense immunoreactivity. Immunostaining was observed in 25% of large cell neuroendocrine carcinomas. Focal staining was observed in 9% of squamous cell carcinomas and 17% of adenocarcinomas. None of the pulmonary carcinoid tumors were immunoreactive. Moderately intense immunostaining was present in 50% of localized fibrous tumors. Malignant mesotheliomas were nonimmunoreactive for Kit in 95% of cases. CONCLUSION: Non-small cell lung carcinomas showed very limited expression of Kit. Lung tumors with neuroendocrine differentiation exhibited a wide spectrum of Kit immunoreactivity, ranging from rare in pulmonary carcinoid tumors to frequent in SCLC. The high frequency of Kit immunostaining in SCLC has important potential therapeutic implications. Demonstration of Kit positivity in some localized fibrous tumors in this study contrasts with absent immunoreactivity in solitary fibrous tumors of the gastrointestinal tract. The paucity of Kit staining in malignant mesothelioma suggests these tumors are unlikely to respond to currently available tyrosine kinase inhibitors.

Authors
Butnor, KJ; Burchette, JL; Sporn, TA; Hammar, SP; Roggli, VL
MLA Citation
Butnor, KJ, Burchette, JL, Sporn, TA, Hammar, SP, and Roggli, VL. "The spectrum of Kit (CD117) immunoreactivity in lung and pleural tumors: a study of 96 cases using a single-source antibody with a review of the literature." Arch Pathol Lab Med 128.5 (May 2004): 538-543. (Review)
PMID
15086281
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
128
Issue
5
Publish Date
2004
Start Page
538
End Page
543
DOI
10.1043/1543-2165(2004)128<538:TSOKCI>2.0.CO;2

Giant cell tumor of rib masquerading as thymoma: a diagnostic pitfall in needle core biopsy of the mediastinum.

Giant cell tumor of bone is rarely seen in the rib, where it may present as a mediastinal mass. The diagnosis of giant cell tumor of bone is generally straightforward by fine-needle aspiration or needle core biopsy, but sampling problems may lead to confusion with other neoplasms or inflammatory processes. Here, we report a case of giant cell tumor of rib presenting as a mediastinal mass in a 36-year-old man. Because of inadequate sampling and inaccurate clinical information, the tumor was initially mistaken for thymoma. When the mass failed to respond to conventional chemotherapy, additional tissue was obtained and a giant cell tumor was diagnosed. Consequently, definitive therapy was delayed. The case illustrates an important diagnostic pitfall in the biopsy of mediastinal masses.

Authors
Volmar, KE; Sporn, TA; Toloza, EM; Martinez, S; Dodd, LG; Xie, HB
MLA Citation
Volmar, KE, Sporn, TA, Toloza, EM, Martinez, S, Dodd, LG, and Xie, HB. "Giant cell tumor of rib masquerading as thymoma: a diagnostic pitfall in needle core biopsy of the mediastinum." Arch Pathol Lab Med 128.4 (April 2004): 452-455.
PMID
15043459
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
128
Issue
4
Publish Date
2004
Start Page
452
End Page
455
DOI
10.1043/1543-2165(2004)128<452:GCTORM>2.0.CO;2

Pathologic quiz case: a 53-year-old man with chest pain and cough. Malignant (diffuse) pleural mesothelioma, biphasic variant, with heterologous differentiation.

Authors
Schneider, F; Volmar, KE; Sporn, TA
MLA Citation
Schneider, F, Volmar, KE, and Sporn, TA. "Pathologic quiz case: a 53-year-old man with chest pain and cough. Malignant (diffuse) pleural mesothelioma, biphasic variant, with heterologous differentiation." Arch Pathol Lab Med 128.1 (January 2004): 107-108.
PMID
14692825
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
128
Issue
1
Publish Date
2004
Start Page
107
End Page
108
DOI
10.1043/1543-2165(2004)128<107:PQC>2.0.CO;2

Tracheobronchopathia osteochondroplastica in a dog

Authors
Sellon, RK; Johnson, JL; Leathers, CW; Sporn, T; Beckley, JC
MLA Citation
Sellon, RK, Johnson, JL, Leathers, CW, Sporn, T, and Beckley, JC. "Tracheobronchopathia osteochondroplastica in a dog." Journal of Veterinary Internal Medicine 18.3 (2004): 359-362.
PMID
15188825
Source
scival
Published In
Journal of Veterinary Internal Medicine
Volume
18
Issue
3
Publish Date
2004
Start Page
359
End Page
362
DOI
10.1892/0891-6640(2004)18<359:TOIAD>2.0.CO;2

Pathologic Quiz Case: A 53-Year-Old Man with Chest Pain and Cough

Authors
Schneider, F; Volmar, KE; Sporn, TA
MLA Citation
Schneider, F, Volmar, KE, and Sporn, TA. "Pathologic Quiz Case: A 53-Year-Old Man with Chest Pain and Cough." Archives of Pathology and Laboratory Medicine 128.1 (2004): 107-108.
Source
scival
Published In
Archives of Pathology and Laboratory Medicine
Volume
128
Issue
1
Publish Date
2004
Start Page
107
End Page
108

Beryllium detection in human lung tissue using electron probe X-ray microanalysis.

Chronic berylliosis is an uncommon disease that is caused by the inhalation of beryllium particles, dust, or fumes. The distinction between chronic berylliosis and sarcoidosis can be difficult both clinically and histologically, as both entities can have similar presentations and exhibit nonnecrotizing granulomatous inflammation of the lungs. The diagnosis of chronic berylliosis relies on a history of exposure to beryllium, roentgenographic evidence of diffuse nodular disease, and demonstration of beryllium hypersensitivity by ancillary studies, such as lymphocyte proliferation testing. Additional support may be gained by the demonstration of beryllium in lung tissue. Unlike other exogenous particulates, such as asbestos, detection of beryllium in human lung tissue is problematic. The low atomic number of beryllium usually makes it unsuitable for conventional microprobe analysis. We describe a case of chronic berylliosis in which beryllium was detected in lung tissue using atmospheric thin-window energy-dispersive X-ray analysis (ATW EDXA). A woman with a history of occupational exposure to beryllium at a nuclear weapons testing facility presented with progressive cough and dyspnea and a nodular pattern on chest roentgenograph. Open lung biopsy showed nonnecrotizing granulomatous inflammation that was histologically indistinguishable from sarcoidosis. Scanning electron microscopy and ATW EDXA demonstrated particulates containing beryllium within the granulomas. This application of EDXA offers significant advantages over existing methods of beryllium detection in that it is nondestructive, more widely available, and can be performed using routine paraffin sections.

Authors
Butnor, KJ; Sporn, TA; Ingram, P; Gunasegaram, S; Pinto, JF; Roggli, VL
MLA Citation
Butnor, KJ, Sporn, TA, Ingram, P, Gunasegaram, S, Pinto, JF, and Roggli, VL. "Beryllium detection in human lung tissue using electron probe X-ray microanalysis." Mod Pathol 16.11 (November 2003): 1171-1177.
PMID
14614058
Source
pubmed
Published In
Modern Pathology
Volume
16
Issue
11
Publish Date
2003
Start Page
1171
End Page
1177
DOI
10.1097/01.MP.0000094090.90571.ED

Multiple lung nodules in a woman with a history of melanoma.

A 61-year-old Caucasian female presented with a 6-week history of dry persistent cough. She had no shortness of breath, chest pain, fever, chills, or weight loss. She had been diagnosed with melanoma on the left thigh 6 months earlier. It was a spindle cell variant, Clark's grade III, with maximal thickness of 0.5 mm. At the time of diagnosis of melanoma, there was no evidence of metastasis on chest radiographs or computed tomography (CT) of the abdomen and pelvis. Treatment of her melanoma was limited to surgical excision with no subsequent radiation or chemotherapy. Other significant past medical history included hypertension, hypothyroidism, and bilateral breast augmentation. She had a 40 pack-year history of smoking.

Authors
Taylor, JL; Quiñones Maymí, DM; Sporn, TA; McAdam, HP; Wahidi, MM
MLA Citation
Taylor, JL, Quiñones Maymí, DM, Sporn, TA, McAdam, HP, and Wahidi, MM. "Multiple lung nodules in a woman with a history of melanoma." Respiration 70.5 (September 2003): 544-548.
PMID
14665785
Source
pubmed
Published In
Respiration; international review of thoracic diseases
Volume
70
Issue
5
Publish Date
2003
Start Page
544
End Page
548

Pathologic quiz case: a 54-year-old man with multiple pulmonary nodules.

Authors
Volmar, KE; Sporn, TA; Cummings, TJ
MLA Citation
Volmar, KE, Sporn, TA, and Cummings, TJ. "Pathologic quiz case: a 54-year-old man with multiple pulmonary nodules." Arch Pathol Lab Med 127.7 (July 2003): e319-e320.
PMID
12823071
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
127
Issue
7
Publish Date
2003
Start Page
e319
End Page
e320
DOI
10.1043/1543-2165(2003)1272.0.CO;2

Exposure to brake dust and malignant mesothelioma: a study of 10 cases with mineral fiber analyses.

OBJECTIVES: A large number of workers in the USA are exposed to chrysotile asbestos through brake repair, yet only a few cases of malignant mesothelioma (MM) have been described in this population. Epidemiologic and industrial hygiene studies have failed to demonstrate an increased risk of MM in brake workers. We present our experience of MM in individuals whose only known asbestos exposure was to brake dust and correlate these findings with lung asbestos fiber burdens. METHODS: Consultation files of one of the authors were reviewed for cases of MM in which brake dust was the only known asbestos exposure. Lung fiber analyses were performed using scanning electron microscopy (SEM) in all cases for which formalin-fixed or paraffin-embedded lung tissue was available. RESULTS: Ten cases of MM in brake dust-exposed individuals were males aged 51-73 yr. Nine cases arose in the pleura and one in the peritoneum. Although the median lung asbestos body count (19 AB/g) is at our upper limit of normal (range 0-20 AB/g), half of the cases had levels within our normal range. In every case with elevated asbestos fiber levels by SEM, excess commercial amphibole fibers were also detected. Elevated levels of chrysotile and non-commercial amphibole fibers were detected only in cases that also had increased commercial amphibole fibers. CONCLUSIONS: Brake dust contains exceedingly low levels of respirable chrysotile, much of which consists of short fibers subject to rapid pulmonary clearance. Elevated lung levels of commercial amphiboles in some brake workers suggest that unrecognized exposure to these fibers plays a critical role in the development of MM.

Authors
Butnor, KJ; Sporn, TA; Roggli, VL
MLA Citation
Butnor, KJ, Sporn, TA, and Roggli, VL. "Exposure to brake dust and malignant mesothelioma: a study of 10 cases with mineral fiber analyses." Ann Occup Hyg 47.4 (June 2003): 325-330.
PMID
12765873
Source
pubmed
Published In
The Annals of Occupational Hygiene (Elsevier)
Volume
47
Issue
4
Publish Date
2003
Start Page
325
End Page
330

Human parainfluenza virus giant cell pneumonia following cord blood transplant associated with pulmonary alveolar proteinosis.

Giant cell pneumonia secondary to human parainfluenza virus 3 has been reported only rarely in immunocompromised hosts. The few cases documented after bone marrow transplant have resulted in significant morbidity and mortality. To our knowledge, this entity has not been described following umbilical cord blood transplant. Pulmonary alveolar proteinosis, a rare condition that has been reported with increasing frequency in association with immunocompromise and infections, has not been documented in the setting of either umbilical cord blood transplant or human parainfluenza viral infection. We report what we believe is the first documented case of giant cell pneumonia caused by human parainfluenza virus 3 in an umbilical cord blood transplant recipient. To our knowledge, a unique associated feature of this case, a pulmonary alveolar proteinosis-like reaction, has not been reported previously in association with human parainfluenza virus pneumonia.

Authors
Butnor, KJ; Sporn, TA
MLA Citation
Butnor, KJ, and Sporn, TA. "Human parainfluenza virus giant cell pneumonia following cord blood transplant associated with pulmonary alveolar proteinosis." Arch Pathol Lab Med 127.2 (February 2003): 235-238.
PMID
12562244
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
127
Issue
2
Publish Date
2003
Start Page
235
End Page
238
DOI
10.1043/0003-9985(2003)127<235:HPVGCP>2.0.CO;2

Oxidative stress and inflammation contribute to lung toxicity after a common breast cancer chemotherapy regimen.

Delayed pulmonary toxicity syndrome after high-dose chemotherapy (HDC) and autologous hematopoietic support occurs in up to 64% of women with advanced-stage breast cancer. Using a similar, but nonmyeloablative, HDC treatment regimen in mice, we found both immediate and persistent lung injury, coincident with marked decreases in lung tissue glutathione reductase activity and accompanied by increases in lung oxidized glutathione, bronchoalveolar lavage (BAL) lipid peroxidation, and BAL total cell counts. Most interestingly, at 6 wk, BAL total cell counts had increased fourfold, with lymphocyte cell counts increasing >11-fold. A single supplemental dose of glutathione prevented early lung injury at 48 h but showed no lung-protective effects at 6 wk, whereas single doses of other thiol-sparing agents (Ethyol and glutathione monoethyl ester) showed no benefit. These data suggest that this HDC regimen results in acute and persistent lung toxicity, induced in part by oxidative stress, that culminates with an acute lung cellular inflammatory response. Continuous glutathione supplementation and/or attenuation of the delayed pulmonary inflammatory response may prove beneficial in preventing lung toxicity after the use of these chemotherapeutic agents.

Authors
Abushamaa, AM; Sporn, TA; Folz, RJ
MLA Citation
Abushamaa, AM, Sporn, TA, and Folz, RJ. "Oxidative stress and inflammation contribute to lung toxicity after a common breast cancer chemotherapy regimen." Am J Physiol Lung Cell Mol Physiol 283.2 (August 2002): L336-L345.
PMID
12114195
Source
pubmed
Published In
American journal of physiology. Lung cellular and molecular physiology
Volume
283
Issue
2
Publish Date
2002
Start Page
L336
End Page
L345
DOI
10.1152/ajplung.00012.2002

Tremolite and mesothelioma.

BACKGROUND: Exposure to chrysotile dust has been associated with the development of mesothelioma and recent studies have implicated contaminating tremolite fibers as the likely etiological factor. Tremolite also contaminates talc, the most common non-asbestos mineral fiber in our control cases. METHODS: We examined 312 cases of mesothelioma for which fiber burden analyses of lung parenchyma had been performed by means of scanning electron microscopy to determine the content of tremolite, non-commercial amphiboles, talc and chrysotile. The vast majority of these patients were exposed to dust from products containing asbestos. RESULTS: Tremolite was identified in 166 of 312 cases (53%) and was increased above background levels in 81 cases (26%). Fibrous talc was identified in 193 cases (62%) and correlated strongly with the tremolite content (P < 0.0001). Chrysotile was identified in only 32 cases (10%), but still correlated strongly with the tremolite content (P < 0.0001). Talc levels explained less of the tremolite deviance for cases with an increased tremolite level than for cases with a normal range tremolite level (22 versus 42%). In 14 cases (4.5%) non-commercial amphibole fibers (tremolite, actinolite and/or anthophyllite) were the only fiber types found above background. CONCLUSIONS: We conclude that tremolite in lung tissue samples from mesothelioma victims derives from both talc and chrysotile and that tremolite accounts for a considerable fraction of the excess fiber burden in end-users of asbestos products.

Authors
Roggli, VL; Vollmer, RT; Butnor, KJ; Sporn, TA
MLA Citation
Roggli, VL, Vollmer, RT, Butnor, KJ, and Sporn, TA. "Tremolite and mesothelioma." Ann Occup Hyg 46.5 (July 2002): 447-453.
PMID
12176759
Source
pubmed
Published In
The Annals of Occupational Hygiene (Elsevier)
Volume
46
Issue
5
Publish Date
2002
Start Page
447
End Page
453

Pulmonary complications associated with Kawasaki disease.

Authors
Voynow, JA; Schanberg, L; Sporn, T; Kredich, D
MLA Citation
Voynow, JA, Schanberg, L, Sporn, T, and Kredich, D. "Pulmonary complications associated with Kawasaki disease." J Pediatr 140.6 (June 2002): 786-787. (Letter)
PMID
12072892
Source
pubmed
Published In
The Journal of Pediatrics
Volume
140
Issue
6
Publish Date
2002
Start Page
786
End Page
787

Malignant mesothelioma and occupational exposure to asbestos: a clinicopathological correlation of 1445 cases.

Asbestos exposure is indisputably associated with development of mesothelioma. However, relatively few studies have evaluated the type of occupational exposure in correlation with asbestos fiber content and type. This study reports findings in 1445 cases of mesothelioma with known exposure history; 268 of these also had fiber burden analysis. The 1445 cases of mesothelioma were subclassified into 23 predominant occupational or exposure categories. Asbestos body counts per gram of wet lung tissue were determined by light microscopy. Asbestos fiber content and type were determined by scanning electron microscopy and energy dispersive x-ray analysis. Results were compared with a control group of 19 lung tissue samples. Ninety-four percent of the cases occurred among 19 exposure categories. Median asbestos body counts and levels of commercial and noncommercial amphibole fibers showed elevated levels for each of these 19 categories. Chrysotile fibers were detectable in 36 of 268 cases. All but 2 of these also had above-background levels of commercial amphiboles. When compared to commercial amphiboles, the median values for noncommercial amphibole fibers were higher in 4 of the 19 exposure groups. Most mesotheliomas in the United States fall into a limited number of exposure categories. Although a predominant occupation was ascertained for each of these cases, there was a substantial overlap in exposure types. All but 1 of the occupational categories analyzed had above-background levels of commercial amphiboles. Commercial amphiboles are responsible for most of the mesothelioma cases observed in the United States.

Authors
Roggli, VL; Sharma, A; Butnor, KJ; Sporn, T; Vollmer, RT
MLA Citation
Roggli, VL, Sharma, A, Butnor, KJ, Sporn, T, and Vollmer, RT. "Malignant mesothelioma and occupational exposure to asbestos: a clinicopathological correlation of 1445 cases." Ultrastruct Pathol 26.2 (March 2002): 55-65.
PMID
12036093
Source
pubmed
Published In
Ultrastructural Pathology (Informa)
Volume
26
Issue
2
Publish Date
2002
Start Page
55
End Page
65
DOI
10.1080/01913120252959227

Malignant Mesothelioma and Occupational Exposure to Asbestos: An Analysis of 1445 Cases

MLA Citation
"Malignant Mesothelioma and Occupational Exposure to Asbestos: An Analysis of 1445 Cases." January 1, 2002.
Source
crossref
Published In
The Annals of Occupational Hygiene (Elsevier)
Publish Date
2002
DOI
10.1093/annhyg/46.suppl_1.150

Outcome of lung transplantation in patients with mycetomas.

BACKGROUND: Lung transplantation has become an acceptable treatment option for many end-stage lung diseases. Pulmonary mycetomas are found in patients with end-stage lung diseases, especially sarcoidosis. The clinical course and long-term outcome of these patients after transplantation remains unknown. METHODS: We reviewed retrospectively the pathology reports of the explanted lungs from all lung and heart-lung transplantations performed at our institution between January 20, 1992, and June 26, 2000. Patients were included in our study if mycetomas were present on the specimens. Information on transplant date and type, diagnosis, information on antifungal therapy and fungal infections pretransplant and posttransplant, and clinical course after transplantation was recorded. RESULTS: Mycetomas were present in 3.0% of transplant recipients (9 of 303 patients). The underlying pulmonary diagnoses were sarcoidosis (six patients), and emphysema, idiopathic pulmonary fibrosis, and pneumoconiosis (one patient each). Seven patients received bilateral lung transplants, one patient received a heart/lung transplant, and one patient received a single lung transplant. Aspergillus was isolated from culture in five patients pretransplant and from five patients posttransplant. Six patients received treatment with itraconazole, or IV or inhaled amphotericin B prior to transplantation. All patients who survived transplantation received posttransplant antifungal therapy. Four patients died in the first month after transplantation. Two patients died at 17 months and 24 months posttransplant, respectively; one patient received a second transplant 30 months later; and two patients are alive and free from fungal infections 17 months and 18 months, respectively, after transplantation. All of the medium-term survivors received lengthy therapy with inhaled and systemic amphotericin B and itraconazole before and after transplantation. CONCLUSIONS: Lung transplant recipients with mycetomas have significantly reduced posttransplant survival. Careful selection of patients and aggressive antifungal therapies before and after transplantation have led to improved outcomes in patients with mycetomas. Additional research is needed to define the best therapeutic strategy for these patients during transplantation.

Authors
Hadjiliadis, D; Sporn, TA; Perfect, JR; Tapson, VF; Davis, RD; Palmer, SM
MLA Citation
Hadjiliadis, D, Sporn, TA, Perfect, JR, Tapson, VF, Davis, RD, and Palmer, SM. "Outcome of lung transplantation in patients with mycetomas." Chest 121.1 (January 2002): 128-134.
PMID
11796441
Source
pubmed
Published In
Chest
Volume
121
Issue
1
Publish Date
2002
Start Page
128
End Page
134

Detection of beryllium in human lung tissue using energy dispersive X-ray analysis

Authors
Ingram, P; Butnor, KJ; Sporn, TA; Roggli, VL
MLA Citation
Ingram, P, Butnor, KJ, Sporn, TA, and Roggli, VL. "Detection of beryllium in human lung tissue using energy dispersive X-ray analysis." Microscopy and Microanalysis 8.SUPPL. 2 (2002): 918-919.
Source
scival
Published In
Microscopy and Microanalysis
Volume
8
Issue
SUPPL. 2
Publish Date
2002
Start Page
918
End Page
919

Oxidative stress and inflammation contribute to lung toxicity after a common breast cancer chemotherapy regimen

Delayed pulmonary toxicity syndrome after high-dose chemotherapy (HDC) and autologous hematopoietic support occurs in up to 64% of women with advanced-stage breast cancer. Using a similar, but nonmyeloablative, HDC treatment regimen in mice, we found both immediate and persistent lung injury, coincident with marked decreases in lung tissue glutathione reductase activity and accompanied by increases in lung oxidized glutathione, bronchoalveolar lavage (BAL) lipid peroxidation, and BAL total cell counts. Most interestingly, at 6 wk, BAL total cell counts had increased fourfold, with lymphocyte cell counts increasing >11-fold. A single supplemental dose of glutathione prevented early lung injury at 48 h but showed no lung-protective effects at 6 wk, whereas single doses of other thiol-sparing agents (Ethyol and glutathione monoethyl ester) showed no benefit. These data suggest that this HDC regimen results in acute and persistent lung toxicity, induced in part by oxidative stress, that culminates with an acute lung cellular inflammatory response. Continuous glutathione supplementation and/or attenuation of the delayed pulmonary inflammatory response may prove beneficial in preventing lung toxicity after the use of these chemotherapeutic agents.

Authors
Abushamaa, AM; Sporn, TA; Folz, RJ
MLA Citation
Abushamaa, AM, Sporn, TA, and Folz, RJ. "Oxidative stress and inflammation contribute to lung toxicity after a common breast cancer chemotherapy regimen." American Journal of Physiology - Lung Cellular and Molecular Physiology 283.2 27-2 (2002): L336-L345.
Source
scival
Published In
American journal of physiology. Lung cellular and molecular physiology
Volume
283
Issue
2 27-2
Publish Date
2002
Start Page
L336
End Page
L345

Pulmonary apical cap.

Authors
Butnor, KJ; Sporn, TA; Roggli, VL
MLA Citation
Butnor, KJ, Sporn, TA, and Roggli, VL. "Pulmonary apical cap." Am J Surg Pathol 25.10 (October 2001): 1344-. (Letter)
PMID
11688476
Source
pubmed
Published In
American Journal of Surgical Pathology
Volume
25
Issue
10
Publish Date
2001
Start Page
1344

Well-differentiated papillary mesothelioma.

Well-differentiated papillary mesothelioma is an unusual variant of epithelial mesothelioma considered to be of low malignant potential. The majority of previously reported cases developed in the peritoneum of young women without a history of asbestos exposure. The authors report 14 cases of well-differentiated papillary mesothelioma, seven of which originated in the pleura, six in the peritoneum, and one in the tunica vaginalis. Eleven of the patients were male and three were female, with an average age at presentation of 58 years (range 32-82 years). Six of the patients had a quantifiable history of asbestos exposure. Of the nine cases with complete follow-up, six had clinically indolent disease, one showed resolution after adjuvant chemotherapy, one pursued an aggressive course, and one died of other causes. These findings indicate that well-differentiated papillary mesothelioma is a rare variant of mesothelioma with a variable clinical prognosis that is etiologically related to asbestos exposure in some cases.

Authors
Butnor, KJ; Sporn, TA; Hammar, SP; Roggli, VL
MLA Citation
Butnor, KJ, Sporn, TA, Hammar, SP, and Roggli, VL. "Well-differentiated papillary mesothelioma." Am J Surg Pathol 25.10 (October 2001): 1304-1309.
PMID
11688466
Source
pubmed
Published In
American Journal of Surgical Pathology
Volume
25
Issue
10
Publish Date
2001
Start Page
1304
End Page
1309

Fine needle aspiration cytology of mucinous cystadenocarcinoma of the lung: report of a case with radiographic and histologic correlation.

BACKGROUND: Mucinous cystadenocarcinoma of the lung is an uncommon tumor. Because it contains relatively few neoplastic cells relative to the amount of mucin produced, diagnosis of this entity, particularly on small specimens, is exceedingly difficult. CASE: The diagnosis of adenocarcinoma was made on transthoracic fine needle aspiration from a patient with a right upper lobe lung mass. Abundant mucoid material suggested a mucin-producing neoplasm. Histopathology revealed a mucinous cystadenocarcinoma with focal mucinous bronchoalveolar carcinoma. CONCLUSION: The presence of copious extracellular mucin in fine needle aspirates from the lung otherwise diagnostic of adenocarcinoma should raise the possibility of a mucinous tumor. In particular, the diagnosis of mucinous cystadenocarcinoma may be suggested in cases that have a cystic appearance on imaging studies.

Authors
Butnor, KJ; Sporn, TA; Dodd, LG
MLA Citation
Butnor, KJ, Sporn, TA, and Dodd, LG. "Fine needle aspiration cytology of mucinous cystadenocarcinoma of the lung: report of a case with radiographic and histologic correlation." Acta Cytol 45.5 (September 2001): 779-783.
PMID
11575661
Source
pubmed
Published In
Acta cytologica
Volume
45
Issue
5
Publish Date
2001
Start Page
779
End Page
783

Sarcoidosis induced by interferon therapy.

Authors
Ravenel, JG; McAdams, HP; Plankeel, JF; Butnor, KJ; Sporn, TA
MLA Citation
Ravenel, JG, McAdams, HP, Plankeel, JF, Butnor, KJ, and Sporn, TA. "Sarcoidosis induced by interferon therapy." AJR Am J Roentgenol 177.1 (July 2001): 199-201.
PMID
11418426
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
177
Issue
1
Publish Date
2001
Start Page
199
End Page
201
DOI
10.2214/ajr.177.1.1770199

Amiodarone and cyclophosphamide: potential for enhanced lung toxicity.

Antineoplastic therapy can be associated with drug-induced lung toxicity. With the increasing use of amiodarone for cardiac dysrhythmias there is an increasing possibility of its combined use with chemotherapies for various malignancies. We report a patient on long-term amiodarone who developed biopsy-proven drug-induced lung toxicity after receiving high-dose cyclophosphamide, at a time-frame much shorter than would have been predicted with cyclophosphamide alone. The potential for enhanced lung toxicity secondary to combination of amiodarone and cyclophosphamide is discussed.

Authors
Bhagat, R; Sporn, TA; Long, GD; Folz, RJ
MLA Citation
Bhagat, R, Sporn, TA, Long, GD, and Folz, RJ. "Amiodarone and cyclophosphamide: potential for enhanced lung toxicity." Bone Marrow Transplant 27.10 (May 2001): 1109-1111.
PMID
11438830
Source
pubmed
Published In
Bone Marrow Transplantation
Volume
27
Issue
10
Publish Date
2001
Start Page
1109
End Page
1111
DOI
10.1038/sj.bmt.1703039

The prognostic value of molecular marker analysis in patients treated with trimodality therapy for esophageal cancer.

The purpose of this study was to define the prognostic value of a group of molecular tumor markers in a well-staged population of patients treated with trimodality therapy for esophageal cancer. The original pretreatment paraffin-embedded endoscopic esophageal tumor biopsy material was obtained from 118 patients treated with concurrent cisplatin + 5-fluorouracil (5-FU) + 45 Gy radiation followed by resection from 1986 until 1997 at the Duke University Comprehensive Cancer Center. Three markers of possible platinum chemotherapy association [metallothionein (MT), glutathione S-transferase-pi (GST-pi), P-glycoprotein (P-gp or multidrug resistance)] and one marker of possible 5-FU association [thymidylate synthase (TS)] were measured using immunohistochemistry. The median cancer-free survival was 25.0 months, with a significantly improved survival for the 38 patients who had a complete response (P < 0.001). High-level expression of GST-pi, P-gp, and TS were associated with a decreased survival. MT was not significant in this population. Multivariate analysis identified high-level expression in two of the platinum markers (GST-pi and P-gp) and the 5-FU marker TS as independent predictors of early recurrence and death. In conclusion, this investigation measured three possible markers associated with platinum and one possible marker associated with 5-FU in a cohort of esophageal cancer patients. Independent prognostic significance was observed, which suggests that it may be possible to predict which patients may benefit most from trimodality therapy. These data need to be reproduced in a prospective investigation.

Authors
Harpole, DH; Moore, MB; Herndon, JE; Aloia, T; D'Amico, TA; Sporn, T; Parr, A; Linoila, I; Allegra, C
MLA Citation
Harpole, DH, Moore, MB, Herndon, JE, Aloia, T, D'Amico, TA, Sporn, T, Parr, A, Linoila, I, and Allegra, C. "The prognostic value of molecular marker analysis in patients treated with trimodality therapy for esophageal cancer." Clin Cancer Res 7.3 (March 2001): 562-569.
PMID
11297249
Source
pubmed
Published In
Clinical cancer research : an official journal of the American Association for Cancer Research
Volume
7
Issue
3
Publish Date
2001
Start Page
562
End Page
569

Loss of heterozygosity at the mannose 6-phosphate insulin-like growth factor 2 receptor (M6P/IGF2R) locus predisposes patients to radiation-induced lung injury.

PURPOSE: To investigate the relationship between loss of heterozygosity (LOH) at the mannose 6-phosphate/insulin-like growth factor 2 receptor (M6P/IGF2R) gene locus and the development of radiation-induced lung injury. MATERIAL AND METHODS: Thirty-five lung cancer patients with both stored plasma for Transforming Growth Factor beta1 (TGFbeta1) analysis and sufficient quantities of archival pathology tissue to screen for LOH were studied. All patients had been treated with thoracic radiotherapy for their malignancy and had radiographically detectable tumor present before beginning radiotherapy. Tumor and normal cells were microdissected from archival lung cancer pathology specimens. Two polymorphisms in the 3' untranslated region of the M6P/IGF2R were used to screen for LOH. Plasma TGFbeta1 levels were measured using acid-ethanol extraction and an ELISA. TGFbeta1 and M6P/IGF2R protein expression was estimated by immunofluorescence and immunohistochemical staining. Symptomatic radiation pneumonitis was scored according to National Cancer Institute Common Toxicity Criteria without knowledge of the results of TGFbeta or LOH analyses. RESULTS: Of the 35 patients, 10 were homozygous for this polymorphism (noninformative) and were excluded. Of the 25 informative patients, 13 had LOH. Twelve of 13 patients with LOH had increased pretreatment plasma TGFbeta1 levels, vs. 3/12 patients without LOH (p < 0.01). A decrease or loss of M6P/IGF2R protein in the malignant cell accompanied by increased latent TGFbeta1 protein in extracellular matrix and tumor stroma was found in tumors with LOH, suggesting that this mutation resulted in loss of function of the receptor. Seven of 13 (54%) LOH patients developed symptomatic radiation-induced lung injury vs. 1/12 (8%) of patients without LOH (p = 0.05). CONCLUSION: Loss of the M6P/IGF2R gene strongly correlates with the development of radiation pneumonitis after thoracic radiotherapy (RT). Furthermore, patients with LOH (in the setting of measurable tumor) are much more likely to have elevated plasma TGFbeta, suggesting an inability to normally process this cytokine. Thus, loss of the M6P/IGF2R gene may predispose patients to the development of radiation-induced lung injury.

Authors
Kong, FM; Anscher, MS; Sporn, TA; Washington, MK; Clough, R; Barcellos-Hoff, MH; Jirtle, RL
MLA Citation
Kong, FM, Anscher, MS, Sporn, TA, Washington, MK, Clough, R, Barcellos-Hoff, MH, and Jirtle, RL. "Loss of heterozygosity at the mannose 6-phosphate insulin-like growth factor 2 receptor (M6P/IGF2R) locus predisposes patients to radiation-induced lung injury." Int J Radiat Oncol Biol Phys 49.1 (January 1, 2001): 35-41.
PMID
11163495
Source
pubmed
Published In
International Journal of Radiation Oncology, Biology, Physics
Volume
49
Issue
1
Publish Date
2001
Start Page
35
End Page
41

Epithelioid hemangioendothelioma of the pleura: clinical and radiologic features.

OBJECTIVE: The purpose of our study was to describe the clinical and radiologic features of epithelioid hemangioendothelioma of the pleura. CONCLUSION: Pleural epithelioid hemangioendothelioma is an uncommon malignancy that typically affects older men, who present with chest pain and dyspnea. This lesion manifests on chest radiographs and CT scans with unilateral pleural fluid and nodular pleural thickening and appears similar to diffuse pleural carcinomatosis or mesothelioma.

Authors
Crotty, EJ; McAdams, HP; Erasmus, JJ; Sporn, TA; Roggli, VL
MLA Citation
Crotty, EJ, McAdams, HP, Erasmus, JJ, Sporn, TA, and Roggli, VL. "Epithelioid hemangioendothelioma of the pleura: clinical and radiologic features." AJR Am J Roentgenol 175.6 (December 2000): 1545-1549.
PMID
11090371
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
175
Issue
6
Publish Date
2000
Start Page
1545
End Page
1549
DOI
10.2214/ajr.175.6.1751545

Pulmonary drug toxicity: radiologic and pathologic manifestations.

Pulmonary drug toxicity is increasingly being diagnosed as a cause of acute and chronic lung disease. Numerous agents including cytotoxic and noncytotoxic drugs have the potential to cause pulmonary toxicity. The clinical and radiologic manifestations of these drugs generally reflect the underlying histopathologic processes and include diffuse alveolar damage (DAD), nonspecific interstitial pneumonia (NSIP), bronchiolitis obliterans organizing pneumonia (BOOP), eosinophilic pneumonia, obliterative bronchiolitis, pulmonary hemorrhage, edema, hypertension, or veno-occlusive disease. DAD is a common manifestation of pulmonary drug toxicity and is frequently caused by cytotoxic drugs, especially cyclophosphamide, bleomycin, and carmustine. It manifests radiographically as bilateral hetero- or homogeneous opacities usually in the mid and lower lungs and on high-resolution computed tomographic (CT) scans as scattered or diffuse areas of ground-glass opacity. NSIP occurs most commonly as a manifestation of carmustine toxicity or of toxicity from noncytotoxic drugs such as amidarone. At radiography, it appears as diffuse areas of heterogeneous opacity, whereas early CT scans show diffuse ground-glass opacity and late CT scans show fibrosis in a basal distribution. BOOP, which is commonly caused by bleomycin and cyclophosphamide (as well as gold salts and methotrexate), appears on radiographs as hetero- and homogeneous peripheral opacities in both upper and lower lobes and on CT scans as poorly defined nodular consolidation, centrilobular nodules, and bronchial dilatation. Knowledge of these manifestations and of the drugs most frequently involved can facilitate diagnosis and institution of appropriate treatment.

Authors
Rossi, SE; Erasmus, JJ; McAdams, HP; Sporn, TA; Goodman, PC
MLA Citation
Rossi, SE, Erasmus, JJ, McAdams, HP, Sporn, TA, and Goodman, PC. "Pulmonary drug toxicity: radiologic and pathologic manifestations." Radiographics 20.5 (September 2000): 1245-1259. (Review)
PMID
10992015
Source
pubmed
Published In
Radiographics : a review publication of the Radiological Society of North America, Inc
Volume
20
Issue
5
Publish Date
2000
Start Page
1245
End Page
1259
DOI
10.1148/radiographics.20.5.g00se081245

A 63-year-old woman with a 2-month history of dyspnea.

Authors
Rossi, SE; McAdams, HP; Erasmus, JJ; Sporn, TA
MLA Citation
Rossi, SE, McAdams, HP, Erasmus, JJ, and Sporn, TA. "A 63-year-old woman with a 2-month history of dyspnea." Chest 117.5 (May 2000): 1505-1507.
PMID
10807843
Source
pubmed
Published In
Chest
Volume
117
Issue
5
Publish Date
2000
Start Page
1505
End Page
1507

Hypersensitivity pneumonitis.

Authors
Matar, LD; McAdams, HP; Sporn, TA
MLA Citation
Matar, LD, McAdams, HP, and Sporn, TA. "Hypersensitivity pneumonitis." AJR Am J Roentgenol 174.4 (April 2000): 1061-1066.
PMID
10749251
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
174
Issue
4
Publish Date
2000
Start Page
1061
End Page
1066
DOI
10.2214/ajr.174.4.1741061

Pictorial essay. Hypersensitivity pneumonitis

Authors
Matar, LD; McAdams, HP; Sporn, TA
MLA Citation
Matar, LD, McAdams, HP, and Sporn, TA. "Pictorial essay. Hypersensitivity pneumonitis." American Journal of Roentgenology 174.4 (2000): 1061-1066.
Source
scival
Published In
American Journal of Roentgenology
Volume
174
Issue
4
Publish Date
2000
Start Page
1061
End Page
1066

Laparoscopy and mesothelioma.

Malignant mesothelioma is a well-recognized long-term sequela of chronic asbestos exposure. Asbestos use in the United States began in the 1950s and was widespread until the mid-1970s. Although currently only 2.2 cases per million population per year are diagnosed, disease incidence is increasing because of the long latency of this neoplasm. A latency of 15-50 years means that a higher incidence of this neoplasm can be anticipated in the future. The authors report a patient with peritoneal mesothelioma and no known prior exposure to asbestos. The diagnosis was confirmed by exploratory laparoscopy, which entailed biopsies of the diaphragm and of the peritoneal and abdominal walls, and by cytologic evaluation of 700 ml ascitis fluid. At present, exploratory laparoscopy offers the quickest, safest, and least invasive way to confirm the clinical diagnosis of peritoneal malignant mesothelioma.

Authors
Stamat, JC; Chekan, EG; Ali, A; Ko, A; Sporn, TA; Eubanks, WS
MLA Citation
Stamat, JC, Chekan, EG, Ali, A, Ko, A, Sporn, TA, and Eubanks, WS. "Laparoscopy and mesothelioma." J Laparoendosc Adv Surg Tech A 9.5 (October 1999): 433-437.
PMID
10522541
Source
pubmed
Published In
Journal of Laparoendoscopic & Advanced Surgical Techniques
Volume
9
Issue
5
Publish Date
1999
Start Page
433
End Page
437
DOI
10.1089/lap.1999.9.433

Cystic fibrosis: usefulness of thoracic CT in the examination of patients before lung transplantation.

PURPOSE: To evaluate the usefulness of thoracic computed tomography (CT) in the pre-lung transplantation examination of patients with cystic fibrosis (CF). MATERIALS AND METHODS: Fifty-six patients (age range, 12-42 years) with CF were evaluated for possible lung transplantation from 1991 to 1997. Twenty-six of these patients underwent bilateral lung transplantation, 19 were awaiting transplantation at the time of the study, seven died before transplantation, and four were excluded for psychosocial concerns. Preoperative chest radiographic and CT findings were reviewed and correlated with clinical, operative, and pathology records. RESULTS: In seven patients, discrete, 1-2-cm pulmonary nodules were detected at CT. Five of these patients underwent transplantation; the nodules were found to be mucous impactions. No malignancy was found in any of the patients who underwent transplantation. Pretransplantation sputum cultures grew Aspergillus fumigatus in seven patients, none of whom had radiologic findings suggestive of Aspergillus infection. Radiographic or CT findings were suggestive of mycetoma in five cases, but no such tumors were found at transplantation. The accuracies of chest radiography and CT for the detection of pleural disease in 48 hemithoraces were 81% (n = 39) and 69% (n = 33), respectively. The radiologic findings of pleural thickening did not influence the surgical approach in any patient. CONCLUSION: Thoracic CT has little utility in the routine pre-lung transplantation examination of patients with CF.

Authors
Marom, EM; McAdams, HP; Palmer, SM; Erasmus, JJ; Sporn, TA; Tapson, VF; Davis, RD; Goodman, PC
MLA Citation
Marom, EM, McAdams, HP, Palmer, SM, Erasmus, JJ, Sporn, TA, Tapson, VF, Davis, RD, and Goodman, PC. "Cystic fibrosis: usefulness of thoracic CT in the examination of patients before lung transplantation." Radiology 213.1 (October 1999): 283-288.
PMID
10540673
Source
pubmed
Published In
Radiology
Volume
213
Issue
1
Publish Date
1999
Start Page
283
End Page
288
DOI
10.1148/radiology.213.1.r99oc12283

Pulmonary cholesterol granulomas in patients with pulmonary artery hypertension: chest radiographic and CT findings.

OBJECTIVE: We describe the chest radiographic and CT findings of pulmonary cholesterol granulomas in patients with pulmonary artery hypertension. CONCLUSION: Histopathologic evidence of cholesterol granulomas was found in five (25%) of 20 patients with severe pulmonary hypertension. In three of these five patients, the granulomas manifested on chest radiographs and CT as small centrilobular nodules mimicking the appearance of sarcoidosis, bronchiolitis, hypersensitivity pneumonitis, or aspiration.

Authors
Nolan, RL; McAdams, HP; Sporn, TA; Roggli, VL; Tapson, VF; Goodman, PC
MLA Citation
Nolan, RL, McAdams, HP, Sporn, TA, Roggli, VL, Tapson, VF, and Goodman, PC. "Pulmonary cholesterol granulomas in patients with pulmonary artery hypertension: chest radiographic and CT findings." AJR Am J Roentgenol 172.5 (May 1999): 1317-1319.
PMID
10227509
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
172
Issue
5
Publish Date
1999
Start Page
1317
End Page
1319
DOI
10.2214/ajr.172.5.10227509

Lentil aspiration pneumonia: radiographic and CT findings.

Aspiration of leguminous vegetables can cause a granulomatous pneumonitis know as lentil aspiration pneumonia that manifest on radiologic studies with small, poorly defined nodular opacities. We report two cases of lentil aspiration pneumonia that manifested with nodules up to 1.0 cm in diameter on radiographs and CT, simulating metastases.

Authors
Marom, EM; McAdams, HP; Sporn, TA; Goodman, PC
MLA Citation
Marom, EM, McAdams, HP, Sporn, TA, and Goodman, PC. "Lentil aspiration pneumonia: radiographic and CT findings." J Comput Assist Tomogr 22.4 (July 1998): 598-600. (Review)
PMID
9676451
Source
pubmed
Published In
Journal of Computer Assisted Tomography
Volume
22
Issue
4
Publish Date
1998
Start Page
598
End Page
600

Parapneumonic empyema. A pitfall in diagnosis.

Two patients eventually shown to have empyema were encountered in which the initial thoracentesis revealed fluid compatible with either a simple or a complicated parapneumonic effusion. In both cases, the diagnosis of empyema was made by a second thoracentesis done at a close interval of time from a different site. Therefore, the physician should approach parapneumonic effusions systematically, and remember that in some cases, multiple thoracenteses may be required to make the correct diagnosis of an empyema.

Authors
Read, CA; Sporn, TA; Yeager, H
MLA Citation
Read, CA, Sporn, TA, and Yeager, H. "Parapneumonic empyema. A pitfall in diagnosis." Chest 101.6 (June 1992): 1712-1713.
PMID
1600797
Source
pubmed
Published In
Chest
Volume
101
Issue
6
Publish Date
1992
Start Page
1712
End Page
1713
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