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A.F. Cicek
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-041 - Synchronous Lung Cancers, Squamous Cell and Adenocarcinoma Coexistence, Case Report (ID 255)
09:30 - 09:30 | Author(s): A.F. Cicek
- Abstract
Background:
Synchronous lung cancers are simultaneously diagnosed, physically distinct and separate lung cancers which have no common lymphatics with the primary tumor and may have same or different histology with the primary neoplasms. Although radiological imaging techniques guide in terms of initial diagnosis, histopathological evidence is required for definitive diagnosis of synchronous multiplee primary lung cancers. Early diagnosis represents the only chance to obtain a surgical cure in these patients.
Methods:
not applicable
Results:
Here, we present a case with synchronous multiplee primary lung cancers in whom both tumors are diagnosed simultaneously. A 69 year-old male patient with cough and left-sided chest pain complaints and 90 pack / year history of active smoking admitted to our clinic. Thoracic CT of the patient revealed a pleural-based mass in the right lower lobe and another mass on the left lung which is associated with the hilum and caused atelectasis in the distal airways. Diagnostic bronchoscopy was performed to the patient and separate biopsies were taken from the both lesions. Histological sections obtained from the bronchoscopic biopsy specimens revealed that there was an infiltrative tumor in both right and left lung. In right lung, the tumor composed of abortive glandular structures and single cell infiltrations within the desmoplastic stroma. The second tumor (left lung) was consist of solid islands composed of atypical squamous cells with eosinophilic cytoplasm and darkly basophilic nuclei. Histochemically, in the first tumor, neoplastic cells had intracytoplasmic vacuoles stained by mucicarmin indicating a feature of adenocarcinoma whereas there were no cells containing mucin vacuoles in the second tumor. Immunohistochemical study has supported the histological and histochemical findings. The tumor on the right side showed a diffuse immunoreactivity by CK7 which is a highly spesific marker for adenocarcinomas whereas the tumor on the left side was stained by the basal cell markers such as CK5/6 and p63 which are highly specific markers for squamous cell carcinoma. Briefly, histopathologic examination of the biopsies from left upper lobe and right lower lobe revealed squamous cell lung carcinoma and adenocarcinoma, respectively. Thereupon oncologic PET examination was performed for screening and evaluating if there is another primary tumor site for adenocarcinoma. In PET examination, FDG uptakes of extrapulmonary tissues were considered to be normal. Thus both lesions thought to be primary lung tumors.
Conclusion:
Our case is a good example of simultaneously detected synchronous primary tumors of the lung and we reported this case in order to emphasize the possibility of another primary tumor in the cases which are initially thought to be metastatic lesions and for sure the need of biopsies separately.
