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Vol.52 No.1 contents | Japanese/English |
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- Case Report -
Pneumonic-type Adenocarcinoma with Dissemination Similar to That of Bronchioloalveolar Carcinoma
Ryuta Fukai1, Hironori Sagara2, Yukinori Sakao3, Hideaki Miyamoto4, Toshimasa Uekusa5, Kenji Suzuki61Department of Thoracic and Cardiovascular Surgery, 2Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Japan, 3Department of Thoracic Surgical Oncology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Japan, 4Department of General Thoracic Surgery, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Japan, 5Department of Pathology, Japan Labour Health and Welfare Organization, Kanto Rosai Hospital, Japan, 6Department of Thoracic Surgery, Juntendo University School of Medicine, Japan
Background. Aerogenous dissemination commonly occurs in bronchioloalveolar carcinoma, but only rarely occurs in pulmonary adenocarcinoma. Adenocarcinoma with this dissemination pattern has been reported as a pneumonic-type adnocarcinoma. Case. A 65-year-old man was referred to our hospital with bloody sputum and we diagnosed pulmonary adenocarcinoma by sputum cytology. A chest X-ray film showed pneumonia-like consolidation in the right lower lobe. Computed tomography demonstrated an infiltrative shadow with a cyst formation in the right lower lobe, and a slightly abnormal shadow in the right middle lobe. We performed right lower lobectomy and lymphadenectomy, but did not resect the right middle lobe as no evidence of abnormal findings were observed macroscopically at operation. The pathological stage of the lesion was pT2N0M0, stage IB. After 4 months, the indistinct lesion in the middle lobe had enlarged. Furthermore, new lesions appeared in the contralateral lung, although the patient was being given oral uracil-tegafur. Subsequently, he received repeated chemotherapy consisting of various regimens, but he died due to the progression of lung adenocarcinoma 1 year and 5 months after the surgery. Conclusion. Pneumonic-type adenocarcinoma is a rare type of pulmonary adenocarcinoma characterized by aerogenous dissemination which is similar to bronchioloalveolar carcinoma. Chest physicians should recognize that the clinical course is different from that of usually encountered adenocarcinoma, and its prognosis is poor.
key words: Pneumonic-type adenocarcinoma, Aerogenous dissemination, Bronchioloalveolar carcinoma, Pulmonary metastasis
Received: July 21, 2011
Accepted: January 6, 2012
JJLC 52 (1): 49-53, 2012
