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Vol.57 No.6 contents | Japanese/English |
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- Case Report -
Lung Adenocarcinoma in Autoimmune Pulmonary Alveolar Proteinosis
Yasutaka Hachiya1, Shoichi Nakamura1, Senichirou Mori2, Naomasa Inoue2, Kosuke Makihara3, Kazuyoshi Uchihashi31Department of Surgery, 2Department of Respiratory Medicine, 3Department of Pathology, Kyushu Rosai Hospital, Japan
Background. Autoimmune pulmonary alveolar proteinosis is a rare and intractable disease. Few studies have reported the association of autoimmune pulmonary alveolar proteinosis with lung cancer. We herein report a rare case of pulmonary alveolar proteinosis combined with lung cancer that was detected during a routine medical examination. Case. A 64-year-old woman presented to our hospital with an abnormal shadow in the left upper lung field that was revealed during a chest X-ray examination. A biopsy specimen of the nodule of the left apical region was obtained by bronchoscopy in our hospital's pulmonology department; however, the results were not conclusive, and the patient was referred to our department for surgery. The preoperative bronchoscopic lung biopsy specimen showed pulmonary alveolar proteinosis at the site of the ground glass opacity in the upper lobes of both lungs. The patient's respiratory function was normal and no symptoms were present; thus, surgery was performed to treat the left lung nodule without treating the pulmonary alveolar proteinosis. A pathological examination during surgery identified pulmonary adenocarcinoma; hence, thoracoscopic left upper lobectomy and ND2a-2 lymph node dissection were performed. The pathological stage was pT2aN0M0, pStage IB. The pulmonary alveolar proteinosis was not exacerbated during surgery. Adjuvant chemotherapy was administered, and follow-up is being continued. Conclusion. Autoimmune pulmonary alveolar proteinosis is caused by the dysfunction of alveolar macrophages by GM-CSF autoantibodies, which suggests that it is involved in carcinogenesis. The accumulation of further cases is therefore necessary.
key words: Autoimmune pulmonary alveolar proteinosis, Lung adenocarcinoma, Surgical resection
Received: April 17, 2017
Accepted: July 22, 2017
JJLC 57 (6): 769-774, 2017
