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Vol.56 No.4 contents | Japanese/English |
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- Case Report -
Synchronous Resection of Pulmonary Metastases from Pancreatic Carcinoma with Lepidic Growth That Required Differentiation from Pulmonary Mucinous and Primary Pulmonary Adenocarcinomas: a Case Report
Naoki Yanagawa1, Masami Abiko2, Satoshi Shiono2, Mitsumasa Osakabe1, Shin-ya Ogata1, Gen Tamura31Department of Diagnostic Pathology, 2Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Japan, 3Department of Laboratory Medicine, Asahi General Hospital, Japan
Background. The incidence rate of multiple cancers is now increasing due to the improvement of treatments, the development of medical technology, and aging. Case. A 75-year-old woman had a history of surgical resection of pancreatic carcinoma. During the follow-up, abnormal shadows on the lung field were observed. Chest computed tomography revealed a mass 10 mm in diameter with relatively clear borders and ground-glass patterns in the right S2, and small round masses 5 mm in diameter in the right S5 and S8. A partial resection was performed for the three lung masses. A histopathological examination revealed that the mass in S2 had lepidic tumor growth and resembled Clara cells. It was diagnosed as non-mucinous adenocarcinoma in situ. In contrast, while the masses in S5 and S8 also showed lepidic tumor growth, they had large numbers of columnar cells with mucin production and a shift of the nucleus to the basal side. To differentiate pulmonary mucinous adenocarcinoma from metastases of pancreatic adenocarcinoma, a mutation analysis of KRAS was performed. A KRAS gene mutation (G12D) was detected in the primary pancreatic carcinoma and the tumors in S5 and S8. Conclusion. We encountered a case of synchronous resection of pulmonary metastases of pancreatic carcinoma with lepidic growth that required differentiation from pulmonary mucinous and pulmonary adenocarcinomas.
key words: Metastatic lung tumor, Primary pulmonary adenocarcinoma, Pancreatic carcinoma, Synchronous resection
Received: February 7, 2016
Accepted: April 26, 2016
JJLC 56 (4): 284-289, 2016
