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Vol.58 No.2 contents | Japanese/English |
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- Case Report -
A Case of the Primary Lung Cancer with a Simple Hepatic Inflammatory Pseudotumor Resembling Liver Metastasis
Naoya Nishioka1, Yoshiko Kaneko1, Sachi Harita1, Takayuki Nakano1, Yusuke Chihara1, Koichi Takayama11Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Japan
Background. The clinical staging of lung cancer is performed using radiological imaging; however, it is often difficult to identify metastasis using this method. Case. The subject of this study was a 54-year-old man. Ultrasonography during a medical examination revealed a single liver nodule. Contrast-enhanced computed tomography (CT) and positron emission tomography (PET)-CT revealed an additional nodule in the patient's left lung. He was subsequently referred to our hospital with a diagnosis of primary advanced lung cancer and liver metastasis. We performed lung biopsy with bronchoscopy and diagnosed the lung nodule as an adenocarcinoma; however, the liver nodule showed a different accumulation pattern from the primary lesion on PET-CT and we suspected that the liver nodule was not metastasis from adenocarcinoma. We performed a liver biopsy to identify whether the liver lesion was metastatic. No malignant findings were observed and only a few infiltrating lymphocytes were identified. In addition, abdominal CT revealed that the liver lesion had decreased in size over the course of 1 month. Accordingly, we diagnosed the liver lesion as a hepatic inflammatory pseudotumor and chemoradiotherapy was administered instead of chemotherapy alone. Conclusion. The detection of hepatic inflammatory pseudotumors or metastases by medical imaging alone is often difficult. In such cases, aggressive biopsy is recommended for accurate clinical staging.
key words: Primary lung cancer, Hepatic inflammatory pseudotumor, Liver metastasis
Received: November 1, 2017
Accepted: January 22, 2018
JJLC 58 (2): 116-121, 2018
