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Bronchogenic carcinoma complicating lung transplantation
S M Arcasoy1, C Hersh, J D Christie
1Division of the Pulmonary, Allergy and Critical Care Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104-4283, USA. arcasoy@mail.med.upenn.edu
Summary
Lung transplant recipients face a 2.4% risk of developing bronchogenic carcinoma (lung cancer) in their native lungs. This cancer often progresses rapidly, mimicking infection, and has poor survival rates.
Area of Science:
- Pulmonary Medicine
- Transplant Oncology
- Thoracic Surgery
Background:
- Malignancy is a known complication following solid-organ transplantation.
- Limited data exists on bronchogenic carcinoma incidence and clinical course in lung transplant recipients.
Observation:
- A retrospective study identified 6 lung transplant recipients with bronchogenic carcinoma.
- The incidence of lung cancer was 2.4% in this cohort.
- All affected patients had a history of smoking (average 79 pack-years).
Findings:
- Lung cancers were non-small cell histology, originating in native lungs.
- Diagnosis occurred at transplant (3 patients) or post-transplant (3 patients).
- Four patients presented with rapid progression mimicking infection; 1- and 2-year survival rates were 33% and 17%.
Implications:
- Lung transplant recipients are susceptible to developing bronchogenic carcinoma in native lungs.
- Rapid disease progression, sometimes resembling infection, is common.
- Bronchogenic carcinoma must be considered in the differential diagnosis of native lung abnormalities post-transplant.