Qilu Hospital of Shandong University

Biphasic structures, which are composed of outer basal cells and inner glandular cells, are frequently indicative of salivary gland-type tumors or benign lesions, such as bronchial adenoma, within the lung. However, the occurrence of a biphasic structure in lung cancer is rarely reported and can lead to significant challenges and confusion in diagnosis, particularly in biopsy specimens. In our study, we collected eight lung epithelial tumors that presented with a distinct biphasic structure component and examined their clinicopathological characteristics. Histological examination revealed that the biphasic structure component, often intermingled with conventional squamous cell carcinoma or adenocarcinoma, was defined by basal cells encircling the glandular epithelium. Immunohistochemical analysis demonstrated a distinctive peripheral p40 staining pattern in the biphasic structure component. Genetic analysis identified driver mutations in seven out of eight patients, which are typically associated with conventional pulmonary adenocarcinomas, including EGFR L858R, EGFR 19-del, EGFR 20-ins, and KRAS mutations. The presence of biphasic structure components in these cases confirms a genuine form of lung cancer, likely representing a variant of lung adenocarcinoma. This study's findings enhance the understanding of lung cancer's morphological diversity and caution against prematurely dismissing the malignancy potential of pulmonary epithelial lesions based solely on the presence of basal cells, especially with biopsy specimens.

This study presents a modified platysma myocutaneous flap technique for reconstructing extensive laryngeal defects in patients with advanced-stage transglottic laryngeal carcinoma. A retrospective cohort analysis was conducted on patients undergoing organ-preserving partial laryngectomy followed by reconstruction using a modified platysma flap. Primary endpoints included decannulation rate and 3-year overall survival. Functional recovery of respiration, swallowing, and phonation was evaluated using validated scales. Sixty patients (mean age: 62.85 ± 6.09 years) were enrolled across two centers. The overall decannulation rate was 85.0%, with significantly higher success rates observed in the partial laryngectomy group (p < 0.05). The 3-year survival rate was 78.3%. Swallowing and phonatory functions were well preserved, with median scores of 2 and 1, respectively. The technique was associated with a low incidence of flap-related complications (13.3%) and favorable mucosalization outcomes. The modified platysma flap offers a practical and effective reconstructive strategy for laryngeal defects in advanced carcinoma, achieving satisfactory respiratory decannulation and preservation of laryngeal function with minimal morbidity.