[Surgical treatment and pathological findings of hematological malignancies patients complicated with lung diseases.].
OBJECTIVE
To determine the pulmonary pathological changes in hematological malignancy patients with pulmonary complications.


METHODS
17 hematological malignancy patients underwent surgical treatment were evaluated retrospectively. The pathological changes of all the surgical specimens were examined postoperatively by standard hematoxylin and eosin (HE) staining.


RESULTS
Pathological examination confirmed: aspergillus infection in 9 patients, sub-acute inflammation (fibrosis and hematoma formation) in 3, and each in 1 of pulmonary infarction with granulomatous tissue in the periphery; granulomatous inflammation with calcified tubercle; alveolar dilation and hemorrhage, interstitial fibrosis and focal vasculitis; intercostal neurilemmoma; and moderate-differentiated adenocarcinoma accompanied by intrapulmonary metastasis. And several operative complications (1 case of fungal implantation, 3 pleural effusion and adhesions and 2 pulmonary hematoma) were occurred. The coincidence rate of pre- and post-operative diagnosis was 9/14 (64.3%). After surgery, 8 patients were received hematopoietic stem cell transplantation (HSCT, allo-gene or autologous), with 7 succeeded. On effective secondary antifungal prophylaxis, 4 of 5 patients of aspergillosis succeeded in transplantation with free from mycotic relapse, one patient died from fungal relapse.


CONCLUSIONS
Hematological malignancies with persistent and/or resistant pulmonary infection, hemoptysis, or unexplained lung diseases, should be treated in time by surgery operation to effectively eliminate residual disease and obtain a definitive diagnosis, so as to create a prerequisite condition for the following treatments. Moreover, the secondary antifungal prophylaxis can provide active roles for patients scheduled for chemotherapy and/or HSCT.
Tang
Xiao-Wen
XW
Department of Hematology, Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University and Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, suzhou 215006, China.
Huang
Hao-Yue
HY
Zhan
Sheng-Hua
SH
Sun
Xing-Wei
XW
Shi
Xiao-Lan
XL
Sun
Ai-Ning
AN
Shen
Zhen-Ya
ZY
Kang
Su-Ya
SY
Jin
Zheng-Ming
ZM
Qiu
Hui-Ying
HY
Miao
Miao
M
Fu
Zheng-Zheng
ZZ
Han
Yue
Y
Chen
Su-Ning
SN
Xue
Sheng-Li
SL
Ma
Xiao
X
Liu
Yue-Jun
YJ
Hu
Xiao-Hui
XH
Zhou
Hui-Fen
HF
Wu
De-Pei
DP
D001228:Aspergillosis / Q000175:diagnosis; D019337:Hematologic Neoplasms; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008171:Lung Diseases; D009364:Neoplasm Recurrence, Local