대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Diagnosis

NUT carcinoma

Radiologic Findings

NUT carcinoma (NC), also known as NUT midline carcinoma, defined by rearrangements of the gene NUT, is a type of rare cancer that can grow anywhere in the body. Usually, it is found in the head, neck, and lungs. NC grows from the squamous cells in the body, which are cells that make up the skin and lining of some organs, like the lungs and stomach. It is highly aggressive and rare, poorly differentiated subtype of squamous cell carcinoma. Relevant investigations for direct or indirect detection of NUTM1 gene rearrangements, including immunohistochemistry, should be considered in patients with malignant lung tumors that often have small cell morphology and may show evidence of squamoid morphology, especially when the clinical features are atypical for squamous cell carcinoma (young age, light or never smoking history).
CT imaging of primary pulmonary NMC, although not necessarily specific, appears to have some characteristic features that are consistent across the cases in this study. All cases presented with a large primary lung mass (≥5cm in diameter) that was confluent with hilar and mediastinal adenopathy, often associated with postobstructive atelectasis and ipsilateral pleural involvement. Notably, the contralateral lung was essentially spared in all cases. Bones were the most common site of extrathoracic involvement.

Brief Review

References

1 Sholl LM, Nishino M, Pokharel S, Mino-Kenudson M, French CA, Janne PA, Lathan C. Primary Pulmonary NUT Midline Carcinoma: Clinical, Radiographic, and Pathologic Characterizations. J Thorac Oncol. 2015 Jun;10(6):951-9.
2.Bair RJ, Chick JF, Chauhan NR, French C, Madan R. Demystifying NUT midline carcinoma: radiologic and pathologic correlations of an aggressive malignancy. AJR Am J Roentgenol. 2014 Oct;203(4):W391-9.

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