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Weekly Chest CasesArchive of Old Cases

Case No : 777 Date 2012-09-17

  • Courtesy of Jin Young Kim, Byung Hak Rho / Dongsan medical center, Keimyung university
  • Age/Sex 69 / F
  • Chief ComplaintCoughing & sputum for 5 months
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Figure 1

Diagnosis With Brief Discussion

Diagnosis
Invasive mucinous adenocarcinoma
Radiologic Findings
Brief Review
Adenocarcinoma represents the most common histologic subtype worldwide, accounting for almost half of all lung cancer. Recent new adenocarcinoma classification provides uniform terminology and diagnostic criteria, especially for bronchioloalveolar carcinoma (BAC). According to new classification, variants include invasive mucinous adenocarcinoma (formerly mucinous BAC), colloid, fetal, and enteric adenocarcinoma.
Mucinous adenocarcinoma and lymphoma are malignant neoplasms that may present as chronic consolidations. Lymphangitis carcinomatosa and metastasis are rare causes of the entity. Mucinous adenocarcinoma tumors grow along the alveolar wall without destroying the underlying architecture, so-called lepidic growth, combined with copious secretion of mucin, which results in consolidations.
Invasive mucinous adenocarcinoma, formerly called mucinous BAC, is characteristically seen as nodule or air-space consolidations. This may accompany ground-glass opacity. After administration of an intravenous iodinated contrast agent, vessels are well shown traversing these regions (CT angiogram sign). Adenocarcinoma may spread through the airways and mimic pneumonia with patchy peribronchial or lobar consolidations.
References
1. Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol 2011; 6:244-285.
2. Goo JM, Park CM, Lee HJ. Ground-glass nodules on chest CT as imaging biomarkers in the management of lung adenocarcinoma. AJR Am J Roentgenol 2011; 196:533-543.
3. Gaeta M, Vinci S, Minutoli F, et al. CT and MRI findings of mucin-containing tumors and pseudotumors of the thorax: pictorial review. Eur Radiol 2002; 12:181-189.
Keywords
lung, malignant tumor,

No. of Applicants : 80

▶ Correct Answer : 24/80,  30.0%
  • - Goa Medical College , India Paresh Desai
  • - radiologist, aditya imaging centre , India vivek patel
  • - Kurashiki Seijin-byo Center , Japan Akihiro Tada
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - GM InHospital , Korea (South) Ju Won Lee
  • - Kyung Hee Universitiy Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - GHICL , France manuel toledano
  • - Kohka Public Hospital , Japan Akitoshi Inoue
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - izmir hospital , Turkey bakhtiar bakhshi
  • - Vitalife Clinics , Pune , India. , India Rahul Deshmukh
  • - Asan Medical Center , Korea (South) Sang Min Lee
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Asan Medical Center , Korea (South) Eunyoung Kim
  • - Asan Medical Center , Korea (South) Ji Eun Kim
  • - Kyungpook National University Hospital , Korea (South) Jaekwang Lim
  • - Radiology University of Messina , Italy Michele Gaeta
  • - All India Institute of Medical Sciences , India Jitesh Ahuja
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - China Medical University , Chia-Yi Christian Hospital ,Taiwan, R.O.C. , Taiwan Jun Jun Yeh
  • - Saint Malo , France jean-baptiste Noel
  • - CAC Rennes , France nicolas gautier
  • - Babaeski Devlet Hastanesi , Turkey Umut Ugur
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
▶ Correct Answer as Differential Diagnosis : 29/80,  36.3%
  • - University of British Columbia , Canada Amr Ajlan
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Seosan Medical Center , Korea (South) Sang Min Lee
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - James Paget Hospital , U.K , United Kingdom nabil mahmood
  • - UWO , Canada S Lee
  • - Asan medical center , Korea (South) Sang Young Oh
  • - ASAN MEDICAL CENTER , Korea (South) CHONG HYUN SUH
  • - Asan Medical Center , Korea (South) Hye Jeon Hwang
  • - Samsung Medical Center , Korea (South) Chae Jin Jeong
  • - XiangYa hospital , China Xia Yu
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - Chungbuk National University Hospital , Korea (South) Su Jeong Hyun
  • - Chungbuk univertisy hospital , Korea (South) Soohyun Lee
  • - Chungbuk University Hospital , Korea (South) Yunhee Jang
  • - chungbuk national university hospital , Korea (South) soojung lee
  • - CBNUH , Korea (South) jihyung lee
  • - H�pital du Sacr , Canada Andrea Ojanguren
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - SCGH , Australia Yuranga Weerakkody
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Alswaida- zaid alsherity hospital , Syria jehad alakabani
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Radnet Teleradiology Istanbul , Turkey Armagan Sarac
  • - NIMS, HYDERABAD , India bhaskar kakarla
  • - IRSA , France, Metropolitan BIGOT
  • - royal melbourne hospital , Australia kimchi kings
  • - All India Institute of medical sciences , India Justin Moses
▶ Semi-Correct Answer : 2/80,  2.5%
  • - Heart Center Pontica , Bulgaria VLADISLAV RUSINOV
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
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