A Case of Well-differentiated Lung Adenocarcinoma Presenting as Honeycomb-like Lung

Mitamura Yuki, Isobe Kazutoshi, Ito Takafumi, Otsuka Hajime, Tochigi Naobumi, Homma Sakae

doi:10.2482/haigan.54.778

Background. Honeycomb lung is primarily observed in patients with progressive idiopathic pulmonary fibrosis (IPF). Case. A 63-year-old man reported to our hospital for an assessment of honeycomb-like changes in the right lung lower lobe detected on chest computed tomography (CT). IPF was diagnosed based on the imaging findings and elevation of the serum KL-6 level. The patient subsequently underwent bronchoscopy, as the honeycomb-like changes were unilateral and there was no evidence of malignancy. The findings suggested atypical IPF, and he remained under observation. Six months after the bronchoscopy procedure, chest CT showed an increase in the size of the nodule in the honeycomb-like tissue, and the patient underwent right lower lobectomy. The pathological analysis of the surgical specimen showed the infiltration of cancer cells with fibrosis in the nodule extending from the region of the right lower lobe that corresponded to the area identified on chest CT. The honeycomb-like tissue was confirmed to be well-differentiated adenocarcinoma and displayed an alveolar replacement pattern in the emphysematous lung. Fibrosis with alveolar collapse and muscularization, a characteristic finding of interstitial pneumonia, was not observed. Conclusions. The present findings suggest that honeycomb-like changes on CT may be caused by well-differentiated adenocarcinoma in the emphysematous lung.

A Case of Well-differentiated Lung Adenocarcinoma Presenting as Honeycomb-like Lung

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