Objective To investigate the clinicopathologic features of congenital cystic adenomatoid malformation (CCAM) of lung in adults. Methods The clinical and pathological characteristics of two cases of CCAM of lung in adults from November 19, 2012 to February 12, 2014 were analyzed, and relevant literatures were reviewed. Results Both of the two patients were males who were 59 years and 60 years old respectively. Both of them presented with respiratory symptoms such as productive cough, hemoptysis and fever. The lesions in the two cases were about 4.0 cm×3.0 cm×1.5 cm and 5.0 cm×5.0 cm×3.0 cm in size respectively. Both had a cystic appearance and involved unilateral lobes of the lung. Histologically, normal pulmonary alveoli were replaced by different size of cysts composed of adenomatoid hyperplastic bronchioles. The inner cystic wall was lined by pseudostratified ciliated columnar epithelium, and the cystic wall contained smooth muscle and elastic tissue, but no cartilage. In one of our cases, mucous cells could be seen in part of the inner cystic wall, with focal atypical hyperplasia. Conclusions CCAM of the lung is a rare congenital developmental anomaly, which typically manifests in neonates and infants, but extremely rare in adults. The diagnosis of CCAM in adults depends on clinical features, imaging changes and histopathological characteristics.
ObjectiveTo investigate the role of PI3K/AKT/mTOR signaling pathway in skeletal muscle atrophy in rats with chronic obstructive pulmonary diseases(COPD). MethodsPassive cigarette smoking was used to establish COPD model.The protein expression of PI3K, total mTOR, phosphorylated-mTOR, total GSK-3β, phosphorylated-GSK-3β, total 4E-BP1, phosphorylated-4E-BP1, total p70S6K1 and phosphorylated-p70S6K1 in extensor digitorum longus of rats were measured by Western blot. ResultsThe protein expression of PI3K was not significantly different between two groups(P > 0.05).Compared with the control group, the protein expression of total mTOR, phosphorylated-mTOR, total GSK-3β, and phosphorylated-GSK-3βincreased significantly in the COPD group(P < 0.05).The protein expression of total 4E-BP1 and total p70S6K1 were not significantly different between two groups(P > 0.05).While the protein expression of phosphorylated-4E-BP1 and phosphorylated-p70S6K1 significantly increased in the COPD group(P < 0.05). ConclusionThe protein expressions of PI3K/AKT/mTOR signaling pathway in extensor digitorum longus increased significantly in COPD rats, suggesting that the activity of PI3K/AKT/mTOR signaling pathway increased, which may be one of the compensatory mechanism of skeletal muscle atrophy in COPD.
ObjectiveTo explore the value of bronchoscopy alveolar lavage cytology in diagnosis of pulmonary fungus infection and distinguishing colonization from true fungal infections. MethodsA retrospective analysis was conducted on the patients with positive fungi results in bronchoalveolar lavage cytology admitted in Shanghai Xinhua Hospital between January 2009 and December 2013.Clinical,radiological,bronchoalveolar lavage and histopathology findings were recorded and analyzed. ResultsFungi were found in alveolar lavage fluid in 60 cases.The most common fungal organism identified was Aspergillus,followed by Candida and Cryptococcosis.Twenty-seven cases (45.00%) by lung biopsy pathology were diagnosed as pulmonary fungal infection and 33 cases (55.00%) were diagnosed as lung bacteria colonization.Aspergillus was found in 35 cases (58.33%),as pathogenic bacteria in 12 cases (34.28%),and colonization bacteria in 23 cases (65.72%).Candida was found in 13 cases (21.67%),as pathogenic bacteria in 3 cases (23.08%),and colonization bacteria in 10 cases (76.92%).Ten cases of Cryptococcus and 2 cases of pulmonary sporozoan were all as pathogenic bacteria.Most cases of Aspergillus and Candida in cytological specimens presented as a pulmonary mass or endobrochial growth and were diagnosed as carcinomas in biopsy specimens,so bacteria colonization should be considered in these cases first of all.All cases of Pneumocystis with bilateral ground glass infiltrates and cryptococcosis with parenchymal mass lesion in radiology represented true infection.The coincidence rate of bronchoscopy alveolar lavage cytology and histopathology was 45%. ConclusionAspergillus and Candida species are the most common fungal organisms in the bronchoscopy alveolar lavage.Fluid cytological examination is an important diagnostic modality for pulmonary mycoses,however it is important to correlate with clinical,bronchoscopy and biopsy findings for accurate diagnosis and appropriate management.