Author of

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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

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    P1.24-034 - Cystic and cavitary appearance:an usual form of pulmonary metastasis of primer lung adenocarcinoma (ID 3040)

    09:30 - 09:30  |  Author(s): N. Ürer
    • Abstract

    Background
    Cystic and cavitary pulmonary lesions are abnormalities encountered on chest radiography and computed tomography (CT).Malignant lesions, including metastases, rarely present as cystic and cavitary lesions.Due to rarity such cases ,we report here a case of unusual form of pulmonary metastasis of primer lung adenocarcinoma

    Methods
    A 82-year old female patient admitted to hospital with complaints of dry cough,progressive dsypnea for a month .Her past history was unremarkable. Physical exam was normal.Chest X-ray revealed bilateral diffuse multpil cavitary and cystic lesions In routine laboratory tests, all were normal excepting Hb:10.7 g/dl, CRP:43 The thorax CT showed bilateral diffuse cysticand cavitary lesions in 1-3 cm diameter, with no thoracic lymphadenopathy . As the multiple lung nodules were suspected to be metastatic, 18F‑fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was conducted, which revealed that the nodules had mild uptake of 18F‑FCG ,a metabolic behaviour consistent with bening aetiologies diseases according to the nuclear medicine report.

    Results
    Bronchoscopy with bronchial lavage was performed. Cytology was negative for malignancy. Repeat CT scan of chest showed increase in size of lung lesions and new right-sided pleural effusion .CT-guide transthoracic needle aspiratıon biopsy was performed. The pathological examination revealed a metastasis of adenocarcinoma ,however histological differentiation of primary pulmonary adenocarcinoma from metastatic adenocarcinoma is sometimes difficult because of their phenotypic similarities So immunohistochemistry (IHC) was performed, the IHC of lung tumor: cytokeratin 20 (CK20)(-), cytokeratin7(CK7)(+), thyroid transcription factor(TTF)(-)Because of PET CT was no showed extrathoracic uptake,It was considered primary lung adenocarcinoma for final diagnosis.

    Conclusion
    One of the most important differences in the differential diagnosis of cystic or cavitary lung lesions is the distinction between malignant and benign aetiologies. Primary lung cancer is a common disease, cavitation being detected by CT for up to 22% of primary lung cancers but for near 11% by plain thoracic radiography. However pulmonary metastases can rarely cavitate, with a reported incidence less than 4% on chest radiographs [2]. Even cavitary lung metastases are rare and benign differential diagnosis are more common, clinician should be careful in neoplastic context and investigation should be done In rarity such cases ,we report here a case of unusual form of pulmonary metastasis of primer lung adenocarcinoma