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H. Haneda
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P1.17 - Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies (ID 703)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.17-005 - Pure Red Cell Aplasia Associated with Thymoma: A Report of a Single-Center Experience (ID 8644)
09:30 - 09:30 | Author(s): H. Haneda
- Abstract
Background:
Acquired pure red cell aplasia (PRCA) associated with thymoma is relatively rare and relevant reports are limited. The optimal treatment and expected clinical outcomes are not yet standardized.
Method:
We have experienced 8 patients with PRCA in 146 patients who underwent surgical resection of thymoma at Nagoya City University Hospital between 2004 and 2015. These patients were retrospectively reviewed.
Result:
There were 5 males and 3 females, with a mean age at PRCA diagnosis of 61 years old (range 49-80 years). One patient had a complication of myasthenia gravis. Extended thymectomy (n=4) and thymectomy (n=4) was undergone in 8 patients with thymoma. In WHO classification of thymoma, subtypes were diagnosed as A (n=1), B2 (n=5), and B3 (n=2). According to the Masaoka’s classification, stages were classified into II (n=1), III (n=2), IVa (n=3), and IVb (n=2). Complete resection was achieved macroscopically in only 4 patients. Five patients received preoperative chemotherapy using cytotoxic agents (n=1) and high-dosed steroid (n=4). Postoperative radiotherapy was given in 6 patients. Recurrence of thymoma occurred in 3 patients who underwent complete resection. Six patients were diagnosed with PRCA after surgical resection of thymoma (range 1-88 months, median 56.5 months), 2 patients before 60 months and 1month of surgical resection. Ciclosporin was used for PRCA in 6 patients with or without corticosteroid and immunosuppressive agents were not used in the other 2 patients only with occasional transfusion. As treatment-related complications of ciclosporin, pneumonia was seen in 5 patients and renal insufficiency in 1 patient of 6 patients who received it. Follow-up period ranged 9-137 months (median 49.5 months) after PRCA diagnosis. Two patients obtained complete remission of anemia by ciclosporin with and without corticosteroid. Two patients remained transfusion-dependent. Four patients have died. In one patient, ciclosporin could be stopped because of complete remission of anemia. However, re-administration of ciclosporin was needed following 6 years interruption. Main causes of the death were diagnosed as pneumonia (n=2), thymoma (n=1), and cardiac failure (n=1).
Conclusion:
PRCA associated with thymoma was diagnosed postoperatively in three quarter patients. We should pay attention to the occurrence of PRCA even after the resection of thymoma especially in patients with incomplete resection or advanced disease. Ciclosporin was effective for PRCA, but treatment-related complications occurred, particularly as pneumonia. As treatment for PRCA associated with thymoma and its complications were combined complexly, it is not easy to treat PRCA associated with thymoma.
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P2.17 - Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies (ID 718)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.17-001 - Pulmonary Inflammatory Myofibroblastic Tumor with TPM4-ALK Translocation (ID 7971)
09:30 - 09:30 | Author(s): H. Haneda
- Abstract
Background:
ALK is a receptor tyrosine kinase that was discovered in anaplastic large cell lymphoma in the form of a fusion protein. To pick-up the patients with ALK-rearrangements is important to select the individual therapy as ALK inhibitor for mainly lung adenocarcinoma. There are several fusion partners with ALK 3’ region.
Method:
A 35-year-old woman with a short-breath and cough was referred and admitted taking a therapy for lung tumor in our hospital. By the bronchoscopic biopsy, she was suspected pulmonary IMT, but correct diagnosis was not indicated. Right upper wedge lobectomy was done. By the pathological examination of the permanent surgical resected tissue, the final diagnosis was pulmonary IMT.
Result:
The immunohistochemistry of ALK by using the iAEP method was positive. We extracted the RNA from frozen surgical resected tumor tissue, and prove the TPM4-ALK by 5’ RACE and RT-PCR. The preoperative bronchial biopsy specimen was also found positive for anti-ALK immunohistochemistry with iAEP method.
Conclusion:
The molecular therapeutic drug was expected as personalized therapy for the tumor with ALK translocation as oncogenic driver. We should examine the ALK protein expression and translocation about the cases of lung cancer and IMT by using adequate ALK immunohistochemistry system. We experienced a case of pulmonary IMT with TPM4-ALK translocation.
