Professional exposure to goats increases the risk of pneumonic-type lung adenocarcinoma: results of the IFCT-0504-Epidemio study.

Pneumonic-type lung adenocarcinoma (P-ADC) represents a distinct subset of lung cancer with specific clinical, radiological, and pathological features. Given the weak association with tobacco-smoking and the striking similarities with jaagsiekte sheep retrovirus (JSRV)-induced ovine pulmonary adenocarcinoma, it has been suggested that a zoonotic viral agent infecting pulmonary cells may predispose to P-ADC in humans. Our objective was to explore whether exposure to domestic small ruminants may represent a risk factor for P-ADC.

Diffuse alveolar hemorrhage in immunocompetent patients: etiologies and prognosis revisited.

Background: Diffuse alveolar hemorrhage (DAH) represents a diagnostic challenge of acute respiratory failure. Prompt identification of the underlying cause of DAH and initiation of appropriate treatment are required in order to prevent acute respiratory failure and irreversible loss of renal function. More than 100 causes of DAH have been reported.

[Which platform to support a personalized lung cancer treatment?].

Considerable progress has been achieved in the understanding of lung cancer biology. Molecular driver mutations have been identified and different targeted therapies have been developed. Thus, the management of small size biopsies is essential and needs a strong collaboration between the different medical partners, particularly pulmonologist, pathologist, molecular biologist and oncologist.

Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): a phase 2b/3 randomised trial.

Background: Afatinib, an irreversible ErbB-family blocker, has shown preclinical activity when tested in EGFR mutant models with mutations that confer resistance to EGFR tyrosine-kinase inhibitors. We aimed to assess its efficacy in patients with advanced lung adenocarcinoma with previous treatment failure on EGFR tyrosine-kinase inhibitors.

Methods: In this phase 2b/3 trial, we enrolled patients with stage IIIB or IV adenocarcinoma and an Eastern Cooperative Oncology Group performance (ECOG) performance score of 0-2 who had received one or two previous chemotherapy regimens and had disease progression after at least 12 weeks of treatment with erlotinib or gefitinib.

Routine administration of a single dose of cisplatin ≥ 75 mg/m2 after short hydration in an outpatient lung-cancer clinic.

Background: Cisplatin is a pivotal drug in combined chemotherapy for non-small cell and small-cell lung cancers (NSCLC or SCLC), but its renal toxicity limits its use. Current guidelines recommend 24 h hydration: thus hospitalization is required. The aim of this retrospective study was to confirm the safety of short hydration before giving an intermediate-to-high dose of cisplatin in an outpatient clinic.

Serial computed tomography and lung function testing in pulmonary Langerhans' cell histiocytosis.

Little is known about longitudinal lung function variation in patients with pulmonary Langerhans' cell histiocytosis (LCH). The contribution of serial lung computed tomography (CT) to managing these patients has not been evaluated. This long-term retrospective study included 49 patients who were serially evaluated by lung CT and pulmonary function tests.

[When pneumonia does not respond to antibiotic therapy].

The favorable pneumonia outcome with antibiotics according to the recommendations is defined by improving clinical symptoms in 48-72 hours followed by their normalization within less than 10 days. This is different to stop progression of radiological abnormalities that can be delayed for 48-72 hours and moreover to radiological normalization which may require 4 to 8 weeks. The non favorable outcome, 48-72 hours after a first line of antibiotic therapy results in the vast majority of cases, from an infection: the pneumonia is not or poorly treated.

Early prediction of in-hospital mortality of patients with hemoptysis: an approach to defining severe hemoptysis.

Background: The severity of hemoptysis is usually assessed on the amount of blood expectorated, although no threshold has been agreed upon. Respiratory or hemodynamic failures are additional severity criteria but occur in few cases.

Objectives: Early identification of the in-hospital mortality determinants might be helpful to best characterize severe hemoptysis.

Idiopathic interstitial lung disease with anti-SSA antibody.

Objectives: Consensus is lacking on the immunological tests to perform for diagnosis of interstitial lung diseases (ILDs). In particular, the value of detecting anti-SSA antibody in this context is unknown. We aimed to determine whether the detection of anti-SSA antibody in patients with ILD can identify a subgroup of patients with CTD.

Factors associated with long-term survival of patients with advanced non-small cell lung cancer.

Background And Objective: Only a small proportion of patients with advanced non-small cell lung cancer (NSCLC) have a life expectancy greater than 2 years. The aim of this study was to identify the factors associated with long-term survival of patients with advanced NSCLC.

Methods: Patients who had received chemotherapy for stage IIIb or IV NSCLC that was not amenable to radiotherapy were studied retrospectively.

Skin toxicities compromise prolonged pemetrexed treatment.

Introduction: Pemetrexed is approved to treat non-small cell lung cancer and has an overall favorable toxicity profile. A case of pemetrexed-induced cutaneous adverse events (CAE), i.e.

Insulin-like growth factor-1 receptor inhibition overcomes gefitinib resistance in mucinous lung adenocarcinoma.

The appropriate selection of patients is a major challenge in the treatment of non-small cell lung cancer (NSCLC) with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). Prospective trials in adenocarcinoma demonstrated that the mucinous subtype presents a poorer outcome under EGFR-TKI treatment than the non-mucinous subtype. Our aim was to determine the molecular characteristics associated with resistance to EGFR-TKIs in mucinous and non-mucinous adenocarcinoma.

Cross-validation study for epidermal growth factor receptor and KRAS mutation detection in 74 blinded non-small cell lung carcinoma samples: a total of 5550 exons sequenced by 15 molecular French laboratories (evaluation of the EGFR mutation status for the administration of EGFR-TKIs in non-small cell lung carcinoma [ERMETIC] project--part 1).

Introduction: The Evaluation of the epidermal growth factor receptor (EGFR) Mutation status for the administration of EGFR-Tyrosine Kinase Inhibitors in non-small cell lung Carcinoma (NSCLC) (ERMETIC) project part 1 assessed the accuracy of EGFR and KRAS mutations detection in NSCLC among 15 French centers.

Methods: The 15 ERMETIC centers selected 74 NSCLC surgical specimens from previously untreated patients. Paraffin and paired frozen DNA were sequenced for EGFR exons 18 to 21 and KRAS exon 2 by an external molecular laboratory, yielding a gold standard.

Clonality and phenotyping analysis of alveolar lymphocytes is suggestive of pulmonary MALT lymphoma.

Background: Mucosa-associated lymphoid tissue (MALT) lymphoma, a low-grade B-cell extranodal lymphoma, is the most frequent subset of primary pulmonary lymphoma (PPL). It often associates with connective tissue disease (CTD). We aimed to evaluate the impact of concomitant CTD on diagnostic value of flow cytometry and genetic clonality analyses for the diagnostic of MALT lymphoma.

[Bronchiolar-alveolar carcinoma: From concept to innovative therapeutic strategies].

Bronchioloalveolar carcinoma (BAC) is a primary pulmonary adenocarcinoma (ADC) developped from the terminal respiratory unit. Its restrictive definition adopted by the 1999 WHO pathological classification needs a complete tumor resection to exclude any signs of histological invasion. Although IIIB-IV tumors were excluded from the strict WHO definition of BAC, the first international workshop on BAC in 2004 had focussed on the need to include in the same spectrum of disease pure BAC and ADC with BAC feature (ADC-WBF).

The spectrum of malignancies in HIV-infected patients in 2006 in France: the ONCOVIH study.

Since no large descriptive studies of incident cancers in HIV-infected patients are available in France, the nationwide cross-sectional ONCOVIH study aimed to prospectively report new malignancies diagnosed in HIV-infected patients in cancer centers and HIV/AIDS centers. We estimated the number of cancers in France for the year 2006 using the capture-recapture methods with two sources: ONCOVIH and the FHDH ANRS-CO4 cohort, as well as the completeness of the sources. Incidence and relative risks (RR) to the general population were estimated.

A case of phospholipase A₂ receptor-positive membranous nephropathy preceding sarcoid-associated granulomatous tubulointerstitial nephritis.

We report the case of a 29-year-old man with membranous nephropathy that was associated with a sarcoidosic granulomatous tubulointerstitial nephritis, but was without an apparent calcium metabolism disorder. Corticosteroid treatment was associated with remission of nephrotic syndrome. We discuss the relationship between membranous nephropathy and sarcoidosis based on the close appearance of the 2 diseases and the detection of phospholipase A₂ receptor in glomerular immune deposits.

Treatment of recurrent respiratory papillomatosis lung involvement by cidofovir infusion.

Lung parenchyma involvement in recurrent respiratory papillomatosis (RRP) is rare, can be severe, and has variable outcomes. Although several reports have described the effects of different drugs (interferon alpha, indol-3-carbinol, cidofovir, etc.), there is no standard treatment for lung involvement in respiratory papillomatosis.

Release of metal particles from needles used for transbronchial needle aspiration.

Background: Although mediastinoscopy is still the gold standard for diagnosis of mediastinal lymphadenopathy, minimally invasive procedures have been developed: transbronchial needle aspiration (TBNA) using a flexible bronchoscope (conventional TBNA) or linear echoendoscope (endobronchial ultrasound [EBUS]) allowing real-time guided lymph node aspiration. The observation of contamination of samples by foreign particles led us to determine the frequency and the nature of this material and to identify its origin.

Methods: From June 2007 to November 2008, 141 consecutive patients underwent conventional TBNA (n = 84) or EBUS-guided TBNA (EBUS-TBNA) (n = 57).

Alveolar haemorrhage in the immunocompetent host: a scale for early diagnosis of an immune cause.

Background: Diffuse alveolar haemorrhage (DAH) is a life-threatening condition due to immune and non-immune causes. Early identification of an underlying immune disorder is essential in order to initiate appropriate treatment.

Objective: The purpose of this study was to identify early predictive factors of an immune cause of DAH.