title: Unsuspected Lung Pathology in Autopsies of Children with Cancer.
abstract: BACKGROUND
  Although pulmonary involvement is common in patients with cancer, its frequency and nature is seldom reported in the medical literature.
  
  
  OBJECTIVE
  To determine the frequency and type of lung pathological conditions revealed by autopsy in children with cancer.
  
  
  METHODS
  All reports from autopsies performed in children with cancer from 1989 to 2012 in a pediatric hospital were reviewed.
  
  
  RESULTS
  In the analyzed period, 118 autopsies (10.2% of all autopsies) corresponded to children who died with cancer; 76 had complete information and were included in the analysis. Children were seen in the Hematology (41 cases) or the Oncology (35 cases) services. Their median age at decease was 7 years (range, 15 days to 16.1 years) and 46.1% were females. Main diagnoses were acute lymphoblastic (31 patients) or myeloblastic (10 patients) leukemias and tumors of the central nervous system (12 patients). A pathological respiratory condition was diagnosed antemortem in 31 (40.8%) patients, and at autopsy in 62 (81.6%) cases. Omitted diagnoses occurred in 58 (76.3%) children, being pneumonia (24 cases) and pulmonary hemorrhage (23 cases) the most frequent omissions. Nine patients had clinically unsuspected tumor infiltration or metastases.
  
  
  CONCLUSIONS
  In these children with cancer, more than 80% of autopsies revealed some lung pathology, mainly of infectious or hemorrhagic nature. Thus, pulmonary involvement should be investigated in all children with cancer in a timely and intentional manner.
authors.affiliation: Research Unit in Respiratory Diseases, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: María Elena Y
authors.initials: ME
authors.lastname: Furuya
authors.affiliation: Service of Pathology, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Alicia
authors.initials: A
authors.lastname: Rodríguez-Velasco
authors.affiliation: Service of Hematology, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Rodríguez-Zepeda
authors.affiliation: Service Oncology, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Enrique
authors.initials: E
authors.lastname: López-Aguilar
authors.affiliation: Research Unit in Respiratory Diseases, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Mario H
authors.initials: MH
authors.lastname: Vargas
authors.affiliation: Service of Pre-School, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Martha
authors.initials: M
authors.lastname: Sciandra-Rico
authors.affiliation: Service of School Children, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Rocío
authors.initials: R
authors.lastname: Cárdenas-Navarrete
authors.affiliation: Neonatal Intensive Care Unit, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Olivia
authors.initials: O
authors.lastname: Madrigal-Muñiz
authors.affiliation: Neonatal Intensive Care Unit, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Carina
authors.initials: C
authors.lastname: Feria-Kaiser
authors.affiliation: Services Infants/Toddlers, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Elba E
authors.initials: EE
authors.lastname: Delgado-González
authors.affiliation: Research Unit in Clinical Epidemiology, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Villasís-Keeverz
mesh_terms: D000293:Adolescent; D001344:Autopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000473:pathology