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Recurrence of bronchioloalveolar carcinoma in donor lung after lung transplantation: microsatellite analysis demonstrates a recipient origin.

Abstract
Bronchioloalveolar carcinoma is a distinctive subtype of pulmonary adenocarcinoma, without effective therapy, although there have recently been some attempts to use lung transplantation. However, a high post-transplantation local recurrence rate is described with some controversy regarding the possible involved mechanisms, the main possibilities being the lymphatic spread and aerosolization. Presented herein is a case of a bilateral lung transplantation for a bilateral and pneumonic form of non-mucinous bronchioloalveolar carcinoma in a 43-year-old woman. The histological analysis of mediastinal lymph nodes during surgery did not show neoplastic cells. Thirty-five months after transplantation several nodular opacities in donor lungs were detected. Three pulmonary wedge resections were performed showing a non-mucinous bronchioloalveolar carcinoma with the same histological characteristics as the primary. Again, the mediastinal lymph nodes were tumor free. A complete microsatellites molecular analysis was performed to compare the primary and recurrent carcinoma using capillary electrophoresis, showing that the recurrent tumor was generated in a recipient cellular clone. The absence of lymph node metastasis and the molecular evidence of the recipient origin of the neoplasm supports the contamination of the new lungs at the time of implantation as being the reason for the high incidence of recurrence after lung transplantation in this kind of disease.
AuthorsJ Javier Gómez-Román, Clara Esparza Del Valle, M Teresa Zarrabeitia, José Cifrián Martínez, Felipe Zurbano Goñi, Roberto Mons Lera, Jorge Cuevas, J Fernando Val-Bernal
JournalPathology international (Pathol Int) Vol. 55 Issue 9 Pg. 580-4 (Sep 2005) ISSN: 1320-5463 [Print] Australia
PMID16143034 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • DNA, Neoplasm
Topics
  • Adenocarcinoma, Bronchiolo-Alveolar (genetics, pathology, surgery)
  • Adult
  • DNA Fingerprinting
  • DNA, Neoplasm (analysis)
  • Female
  • Humans
  • Lung Neoplasms (genetics, pathology, surgery)
  • Lung Transplantation
  • Microsatellite Repeats
  • Neoplasm Recurrence, Local (etiology)
  • Tissue Donors

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