A Case of Lung Adenocarcinoma with Enteric Features showing Calcification on CT

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  • Tsuchiya Nanae
    Department of Radiology, Graduate School of Medical Science, University of the Ryukyus
  • Miyagi Kazuya
    Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Graduate School of Medical Science, University of the Ryukyus
  • Fujita Jiro
    Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Graduate School of Medical Science, University of the Ryukyus
  • Atsumi Eriko
    Division of Pathology, National Hospital Organization, Okinawa National Hospital
  • Aoyama Hajime
    Department of Pathology and Oncology, Graduate School of Medical Science, University of the Ryukyus Department of Pathology, Heartlife Hospital
  • Yasutomi Yuiko
    Department of Pathology and Oncology, Graduate School of Medical Science, University of the Ryukyus
  • Kusada Takeaki
    Department of Radiology, Graduate School of Medical Science, University of the Ryukyus
  • Murayama Sadayuki
    Department of Radiology, Graduate School of Medical Science, University of the Ryukyus Department of Radiology, Urasoe General Hospital

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Other Title
  • CTにて石灰化を認めた腸型の特徴を有する肺腺がんの1例

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<p>Background. Pulmonary enteric-type adenocarcinoma is a rare type of non-small-cell lung cancer showing a histological pattern mimicking metastatic colorectal cancer. Case. A man in his 60s was referred to our hospital because of an abnormal shadow on a chest radiograph during follow-up for prostate cancer. Chest computed tomography (CT) showed a 55-mm mass with multiple small calcifications in the left upper lobe. The peripheral area of the left upper lobe showed obstructive atelectasis. Fluorodeoxyglucose (FDG)-positron emission tomography (PET) showed an increased FDG uptake in the mass of the left upper lobe (maximum standardized uptake value [SUVmax] 12.7), mediastinal lymphadenopathy, and left supraclavicular lymphadenopathy. A bronchoscopy specimen showed tumors that formed ducts composed of tall columnar cells. Immunohistochemical staining demonstrated CK7 (-), CK20 (focally+), TTF-1 (-), CDX2 (+), and Napsin A (-) expression. The findings indicated pulmonary enteric-type adenocarcinoma or metastatic colorectal carcinoma. The tumor was diagnosed as adenocarcinoma with enteric features (cT2bN3M0, cStage IIIB), as no evidence of a tumor was found elsewhere by colonoscopy. He underwent chemoradiotherapy. Subsequent CT revealed shrinkage of the tumor. Conclusion. We encountered a case of lung adenocarcinoma with enteric features which showed calcification on CT. The CT findings of pulmonary enteric-type adenocarcinoma are similar to the imaging findings for invasive pulmonary adenocarcinoma and metastatic colorectal cancer. Distinguishing between these two entities by imaging alone is difficult.</p>

Journal

  • Haigan

    Haigan 61 (7), 979-984, 2021-12-20

    The Japan Lung Cancer Society

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