Patient is 74 years old.
Date of birth - 05.02.1941
Blood group - A (II) Rh (+)
In 2012, in the patient was diagnosed - peripheral tumor of the lower lobe of the left lung.
04.07.2012 to the patient was provided operation – thoracotomy from the left side, the radical lower lobectomy, lymph node dissection, drainage of pleural cavity. The Type R 0.
Histological examination of the operational material - in the lower lobe of the left lung - moderately differentiated squamous cell carcinoma with necrotic areas 2.5 cm in diameter. Bronchopulmonary lymph nodes and lymph nodes groups 6,7,8,11 – without metastases. Separately marked area in the lower lobe - fibrosis. Edge of resection - without tumor.
The postoperative period was without complications.
For several years patient was under the supervision of an urologist because of the increase in PSA levels. During the biopsy (05.08.2013) - diagnosed cancer of the prostate.
19.11.2013 to the patient was provided operation - a radical prostatectomy with saving of nervous innervation.
Histological examination of the surgical material – small acinar prostate adenocarcinoma, Gleason score - 3 + 4 = 7, 30% of the lesions, mainly on the periphery from the left side with perivascular proliferation on the background of glandular - stromal hyperplasia with multiple foci of PIN - 2, chronic prostatitis with pronounced inflammatory component.
19.08.2015 to the patient was provided operation –rethoracotomy from the left side. Marginal resection of the left upper lobe with resection of the adventition of the aorta.
The next examinations of lung tissue show different results:
Pathomorphological examination(04.09.2015) - peripheral adenocarcinoma G3 (tumor cells CK7, TTF1,CK18 - positive, CK5/6,synaptofizyn,chromohranin, PSA, PSMA - negative, p63 - weak focal positive) of upper lobe of left lung, 3,5 cm in widest dimension. Margin of the resection - beyond the tumor. Primary operating material for comparative analysis is not delivered.
Pathomorphological examination (18.09.2015) - low differentiated squamous keratinized lung cancer. 9 lymph nodes - without metastases.
Cytology (16.10.2015)blood,fibroblastic and histiocytic - macrophage cells. Tumor cells are not found.
Pathomorphological examination (29.10.2015) - small areas of lung parenchyma with focal fibrosis. Morphological studies of previously removed lung tumor tissue are not delivered.
Patient - Chmelevsky Vladymyr.
The patient needs a qualified diagnostics and the final establishment of the correct diagnosis.