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Published on: May 20, 2020
Unsuspected Lung Pathology in Autopsies of Children with Cancer
María Elena Y Furuya1, Alicia Rodríguez-Velasco2, María Carmen Rodríguez-Zepeda3
1Research Unit in Respiratory Diseases, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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.
