{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T02:22:40Z","timestamp":1788056560316,"version":"build-2784847793"},"reference-count":11,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Prog Transpl"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>Introduction: Incidentally detected malignancies in lung explants portend risk of early cancer recurrence and metastases with posttransplant immunosuppression. We present a series of lung transplant recipients with previously unverified malignancies in native lung explants. Design: We reviewed the histopathology, radiographic imaging, and management of lung explant malignancies at our institution over 10 years (2011-2020). Endpoints were survival and allograft rejection. Results: An explant malignancy was found in 1.3% (11\/855) of lung transplant recipients (6 [55%] men; median age 68 years; 6 [55%] ex-smokers [median pack-years, 25]). Nine (82%) were adenocarcinoma, 1 (9%) was squamous cell carcinoma (SCC), and 1 (9%) was follicular lymphoma. Three patients (27%) had multifocal involvement (\u22653 lobes), 4 (36%) had nodal involvement, and the median (range) tumor size was 2.7 (0.4-19) cm. The median interval between last imaging and transplant was 58 (29-144) days. Mycophenolate mofetil was discontinued or reduced in all; everolimus was used in 2 patients, and cisplatin-pemetrexed chemotherapy was used in 2 patients. The prevalence of acute cellular rejection and chronic rejection was 27% and 9%, respectively. Lung recipients with cancer had significantly lower survival than those without (36.4% vs 67.3%, p\u2009=\u20090.002); median survival was 27 (17, 65) months in 4 recipients who were alive and cancer-free at the end of the study period. Conclusions: Unidentified malignancies, commonly adenocarcinoma, can be detected in explanted native lungs. Pneumonectomy may be curative in SCC, lymphoproliferative disorders, and stage I adenocarcinoma. Modulating immunosuppression to prevent allograft rejection and tumor proliferation is warranted.<\/jats:p>","DOI":"10.1177\/15269248221122876","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T03:24:58Z","timestamp":1662521098000},"page":"332-339","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Incidentally Detected Malignancies in Lung Explants"],"prefix":"10.1177","volume":"32","author":[{"given":"Deepika","family":"Razia","sequence":"first","affiliation":[{"name":"Pulmonary and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"},{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwini","family":"Arjuna","sequence":"additional","affiliation":[{"name":"Pulmonary and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"},{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Trahan","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"},{"name":"Radiology Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary F.","family":"Hahn","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"},{"name":"Pathology Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesham","family":"Abdelrazek","sequence":"additional","affiliation":[{"name":"Pulmonary and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"},{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"Omar","sequence":"additional","affiliation":[{"name":"Pulmonary and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"},{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofya","family":"Tokman","sequence":"additional","affiliation":[{"name":"Pulmonary and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"},{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Samad","family":"Hashimi","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"},{"name":"Thoracic Surgery and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Huang","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"},{"name":"Thoracic Surgery and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"},{"name":"Thoracic Surgery and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-9109","authenticated-orcid":false,"given":"Ross M.","family":"Bremner","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"},{"name":"Thoracic Surgery and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5036-2921","authenticated-orcid":false,"given":"Rajat","family":"Walia","sequence":"additional","affiliation":[{"name":"Pulmonary and Lung Transplantation Division, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA"},{"name":"Creighton University School of Medicine- Phoenix Campus, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"bibr1-15269248221122876","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.09.001"},{"key":"bibr2-15269248221122876","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.11.05"},{"key":"bibr3-15269248221122876","first-page":"65","volume":"9","author":"Albano D","year":"2018","journal-title":"Lung Cancer 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