 |
Vol.44 No.1 contents | Japanese/English |
 | Full Text of PDF (189K) Article in Japanese |
- Case Report -
A Case of Small Bowel Metastasis From Lung Adenocarcinoma Diagnosed by Immunostaining for TTF-1
Kazue Fujita1, Takeyuki Kurihara1, Yoshihiro Honda1, Niro Okimoto11Division of Respiratory Diseases, Department of Internal Medicine, Kawasaki Medical School Kawasaki Hospital, Japan
Background. Metastasis of lung cancer to the small bowel is uncommon and symptomatic small bowel metastasis requires a surgical approach. However preoperative diagnosis of small bowel metastasis is difficult. Case. A 60-year-old man was given a diagnosis of unresectable lung cancer (adenocarcinoma, stage IIIB) in November 2001, and received chemotherapy until January 2002. In early March, he was readmitted due to severe right lower abdominal pain. His chest roentgenogram showed free air under the diaphragm and an abdominal computed tomographic scan revealed wall thickening of the small bowel and localized intra-abdominal fluid. From the clinical course, laboratory data and CT scan findings, we considered this case to be perforative peritonitis due to a metastatic small bowel tumor from lung cancer. Therefore, an emergency laparotomy was performed, revealing two tumors in the ileum, one accompanied by perforation with peritonitis. They were histologically diagnosed as metastases of lung cancer to the small bowel by immunostaining for thyroid transcription factor-1 (TTF-1). Conclusion. Metastasis of lung cancer to the small bowel is uncommon and previous reports have shown preoperative diagnosis of small bowel metastasis to be difficult. In our experience, abdominal computed tomographic scan was useful to detect the presence of small bowel metastasis and perforative peritonitis preoperatively, and immunohistochemical study for TTF-1 was also useful to confirm intestinal metastatic lesions from lung cancer.
key words: Lung adenocarcinoma, Small bowel metastasis, Thyroid transcription factor-1
Received: January 15, 2003
Accepted: December 10, 2003
JJLC 44 (1): 49-54, 2004
