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Vol.40 No.2 contents | Japanese/English |
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- Case Report -
A slowly progressive adenocarcinoma of the lung detected by change of density of the shadow
Tomonori Nakasone, Hiroyoshi Ayabe*Department of Surgery, Mitsubishi Heavy Indusries Ltd., Nagasaki Shipyard Hospital Section, *First Department of Surgery, Nagasaki University School of Medicine, Nagasaki
Background: There have been very few reports describing slowly progressive adenocarcinomas. We here present the case with a review of the literature. Case: A 1.5 cm ill-defined faint round shadow was pointed out in the right middle lung field on a chest X-ray film of a 74-year-old woman in 1993. Chest CT scan revealed a low density oval shadow in right S2. The shadow was followed up as an inflammatory disease. Chest CT scan in January 1999 revealed a solid high density area in the low density shadow. The high density area was thought to be lung cancer associated with inflammatory disease. CT-guided percutaneous lung biopsy revealed malignant findings. Right upper lobectomy was performed with mediastinal lymph node dissection (R2a). Microscopically the solid high density area on the chest CT was moderately differentiated papillary adenocarcinoma, but the circumferential low density area was well differentiated papillary adenocarcinoma. Metastasis to mediastinal lymph node #11 was recognized. The pathological staging was T1N1M0, stage IIA. Conclusion: Our case was a slow progressive adenocarcinoma of the lung with a 6-year clinical history detected by the change of density of the shadow on chest CT.
key words: Slow growing, Adenocarcinoma of the lung, Density of shadow
Received: November 11, 1999
Accepted: February 28, 2000
JJLC 40 (2): 143-147, 2000
