title: Recurrent lung cancer in the mediastinum noticed after a living-donor lobar lung transplantation.
abstract: We describe a case of lung cancer in a living-donor lobar lung transplantation (LDLLT) recipient that was identified because of a recurrence in the mediastinum. The patient was a 55-year-old woman who had undergone bilateral LDLLT for nonspecific interstitial pneumonia. She developed dyspnea upon exertion at 15 months after transplantation and was diagnosed as suffering from chronic rejection. A computed tomography scan also revealed enlarged mediastinal lymph nodes (LNs) that were subsequently confirmed as poorly differentiated squamous cell carcinomas. Retrospectively, a small tumor was found in the explanted right lung tissue, the microscopic findings of which were similar to those of the mediastinal lesion. A whole body examination revealed no other lesions; thus we resected the LNs and subsequently irradiated the mediastinum. Recurrent disease appeared in her transplanted lungs 10 months after resection of the LNs, and she died of pneumonia with chronic rejection 2 years and 7 months after transplantation.
authors.affiliation: Department of Cancer and Thoracic Surgery, and Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Toyooka
authors.forename: Naohisa
authors.initials: N
authors.lastname: Waki
authors.forename: Megumi
authors.initials: M
authors.lastname: Okazaki
authors.forename: Katsuya
authors.initials: K
authors.lastname: Kato
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamane
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oto
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Sano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D002454:Cell Differentiation; D017809:Fatal Outcome; D005260:Female; D006084:Graft Rejection / Q000209:etiology*; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000601:surgery*; D019520:Living Donors; D008175:Lung Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008479:Mediastinal Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D013249:Sternum / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome