Author of

• 11001

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  P1.24 - Poster Session 1 - Clinical Care (ID 146)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11034

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    P1.24-033 - A rare case: lung cancer and multiple myeloma (ID 2407)

    09:30 - 09:30  |  Author(s): S. Yılmaz
    • Abstract

    Background
    A multiple myeloma (MM) is a malignant disease of plasma cells, which manifests as one or more of lytic bone lesions, monoclonal protein in the blood and/or urine and disease in the bone marrow. The most typical thoracic manifestation of multiple myeloma is bony involvement of the thoracic cage. Other manifestations include pneumonia, intra-parenchymal mass lesions, mediastinal lymphadenopathy, interstitial pattern like reticulonodular shadows and intrapulmonary calcification. The diagnosis of a secondary solid neoplasm in patients with MM is uncommon, and it is debatable whether the MM itself is a risk factor for the incidence of a secondary solid neoplasm.

    Methods
    62 year-old men, former heavy smoker ,treated pulmonary tuberculosis(1977), autologous bone marrow transplantation (BMT) for MM two years ago.He admitted complaints of fever, cough,sputum and nigth sweats for a month. Physical examination was remarkable moderate pallor. Routıne serum biochemistry parameters were within normal limits except hemoglobin (6.6 gm/dl),ESR was 84 mm in the first hour.Chest xray and computed tomography (CT )showed multiple, bilateral,various size, well-circumscribed pulmonary nodules, containing calcification solid nodul 2 cm in diameter and periferal consolidatıon ın the rigth upper lob . Previous chest radiographs and CT had revealed the presence bilateral multiple nodules and low uptake18F‑fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) ( suv max:2.4).

    Results
    The patient underwent wedge resectıon rigth upper lobe for evaluating nodules three years ago.Histological examination demonstared weak -granulom formation and nodüles consisting dystrophic calcification ,multifocal hyalinisation and ossification It was considered sequelae of tuberculosis. Follow –up imaging studies increased in size,the number of pulmonary nodules and newly rigth 8th and left 6th rib hypermetabolik uptake in PET.CT -guided transthoracic needle aspiratıon biopsy performed the increasing nodul in the rigth upper lobe diagnosed adenocarcinoma.The patient is still alive and on follow-up.

    Conclusion
    Studies have shown that people who have had allogeneic transplants have a higher risk of second cancer than people who got a different type of stem cell transplant. In this case it is difficult to conclude whether TB sequelae caused lung cancer or the lung cancer simply associated in a patient with previously known pulmonary TB. Initial diagnosis of tuberculosis in such patients often misleads the physician to abandon further work-up resulting in overlooking or delayed diagnosis of the lung neoplasm,thus affecting their outcome