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Abstract

Unsuspected Lung Pathology in Autopsies of Children with Cancer

VOLUME 69 - NUMBER 1 / January - February (Original articles)  doi: 10.24875/RIC.17002098

María Elena Y. Furuya, Research Unit in Respiratory Diseases, , Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Alicia Rodríguez-Velasco, Service of Pathology, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Carmen Rodríguez-Zepeda, Service of Hematology, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Enrique López-Aguilar, Service of Oncology, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Mario H. Vargas, Medical Research Unit in Respiratory Diseases, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social; Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
Martha Sciandra-Rico, Service of Pre-School, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Rocío Cárdenas-Navarrete, Service of School Children, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Olivia Madrigal-Muñiz, Neonatal Intensive Care Unit, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Carina Feria-Kaiser, Neonatal Intensive Care Unit, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Elba E. Delgado-González, Service of Infants/Toddlers, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Miguel Ángel Villasís-Keever, Research Unit in Clinical Epidemiology. 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.

Keywords: Cancer. Lung pathology. Autopsy. Necropsy.

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