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Vol.44 No.7 contents | Japanese/English |
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- Case Report -
A Case of Squamous Cell Carcinoma Depicted on Computed Tomography as a Consolidation Superimposed on Pulmonary Fibrosis
Akitoshi Saito1,2, Katsura Ozawa3, Masahisa Miyazawa4Department of 1Radiology, 3Respiratory Medicine, 4Thoracic Surgery, Kofu Municipal Hospital, Japan, 2Department of Radiology, Yamanashi University, Japan
Background. It is difficult to diagnose lung carcinomas associated pulmonary fibrosis because they are often demonstrated as consolidations on computed tomography. Case. A 68 year-old man was admitted to our hospital with a fever and a cough. The chest CT demonstrated honeycomb lung in the subpleural region of the both inferior lobes, suggesting pulmonary fibrosis. Consolidation was superimposed on the honeycombing in the right basal segment. Although the sputum cytology was suspicious of squamous cell carcinoma, the consolidation was diagnosed to be due to pneumonia complicated by pulmonary fibrosis because the carcinoma in situ of the larynx was detected, and the patient was treated with antibiotics. However, since it slightly increased in size after one month, the consolidation was suspected to be a neoplasm. Bronchoscopic lavage of right B9 and B10 revealed the squamous cell carcinoma. The consolidation in the right lower lobe was diagnosed as squamous cell carcinoma, and a right lower lobectomy was performed. Histological findings revealed that moderately differentiated squamous cell carcinoma formed a conglomerate scattered in the extensive fibrosis and there was parietal pleural invasion. It was classified as T3N0M0, stage IIB. Conclusion. When diagnosing lung carcinomas accompanied by pulmonary fibrosis on the CT, it is necessary to be aware that the morphologic findings are different from carcinoma which occurs in the normal lung.
key words: Squamous cell carcinoma, Consolidation, Pulmonary fibrosis
Received: August 12, 2004
Accepted: October 13, 2004
JJLC 44 (7): 785-789, 2004
