 |
Vol.57 No.6 contents | Japanese/English |
 | Full Text of PDF (2000K) Article in Japanese |
- Case Report -
A Resected Case of Pulmonary Enteric Adenocarcinoma
Aki Fujiwara1, Nozomu Iwashiro1, Noriko Kimura21Department of Surgery, 2Department of Pathology, Hakodate National Hospital, Japan
Background. Enteric adenocarcinoma has been newly categorized as a subtype of pulmonary adenocarcinoma in the WHO Tumour Classification 4th edition (2015) and General Rule for Lung Cancer (the 8th edition) of Japan. Distinguishing between pulmonary enteric adenocarcinoma and metastatic colorectal carcinoma is clinically important. Case. A man in his 60s with a history of upper lobectomy of the right lung for squamous cell carcinoma 15 years earlier was found to have an abnormal chest shadow at a medical checkup. Computed tomography showed a 1.5-cm nodule in his right lower lobe. We performed wedge resection of the right lung using video-assisted thoracoscopy under a diagnosis of primary lung carcinoma by the identification of adenocarcinoma cells in a bronchoscopic smear. The histological findings of the tumor showed papillotubular adenocarcinoma with central necrosis that resembled colorectal carcinoma. Immunohistochemical staining of the tumor was positive for CDX-2, negative for TTF-1, and focally positive for CK7 and CK20. He underwent a thorough checkup because these findings indicated metastatic colorectal carcinoma, but no malignancy was detected. We ultimately made diagnosis of pulmonary enteric adenocarcinoma and excluded metastasis of colorectal carcinoma. He remains free of relapse one year after surgery. Conclusion. The differential diagnosis between pulmonary enteric adenocarcinoma and metastatic colorectal carcinoma requires not only immunohistochemical staining but also systemic work-up, including an endoscopic examination.
key words: Pulmonary enteric adenocarcinoma, Lung carcinoma, Metastatic colorectal adenocarcinoma
Received: February 27, 2017
Accepted: June 29, 2017
JJLC 57 (6): 758-762, 2017
