대한흉부영상의학회 Korean Society of Thoracic Radiology GuerBet

대한흉부영상의학회 Weekly Case 메뉴

Close

대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
Advanced Search..

Close

Weekly Chest CasesArchive of Old Cases

Case No : 846 Date 2014-01-13

  • Courtesy of Song Soo Kim / Chungnam National University College of Medicine
  • Age/Sex 33 / F
  • Chief ComplaintCough, sputum, fever, and pleuritic chest pain for a week. PHx: Congenital pulmonary airway malformation(Dx in 2008)
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6
  • Figure 7

Diagnosis With Brief Discussion

Diagnosis
Lung cancer (adenocarcinoma, mucinous type)
Radiologic Findings
Fig 1. Chest PA shows consolidation with inner air-fluid level in right lower lung field and patchy and nodular consolidation in left mid lung field.
Fig 2-5. CT scans show an consolidation with cavity in RLL and ill defined nodular and patchy consolidation in LUL and RML.
Fig.6-7 After bilobectomy of RML and RLL, CT scans show increased extent of consolidation in LUL and RML.
Brief Review
Mucinous adenocarcinoma
1.Distinguished from nonmucinous adenocarcinomas
- mucinous tumor cell population : tall columnar cells with abundant apical mucin and small basally oriented nuclei
2.Lepidic pattern is common
- most have invasive component
3.When multifocal, often multilobar
-Female(58%), non-smoker(55%)
-CK7 (+) (~88%), CK20 (+) (~54%), TTF-1 (-) (~83%)
-KRAS mutation (~76%), no EGFR mutation (~3%)
4.Limited studies about treatment
: due to new classification system and rare incidence
- according to WHO 2004 classification
: surgery for resectable disease is mainstay treatment of BAC
5. Widely variable CT findings
- consolidation
- air bronchogram
- CT angiogram
- multifocal and sometimes multilobar solid and subsolid (part-solid or nonsolid) nodules or masses
: tend to be centrilobular or bronchocentric
- lower lobe predominance is common
: both the localized and multifocal forms
References
1.Austin JH et al. Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology. 2013 Jan;266(1):62-71
2.Lee SM et al. A new classification of adenocarcinoma: what the radiologists need to know. Diagn Interv Radiol. 2012 Nov-Dec;18(6):519-26
3. Loachimescu OC et al. From cystic pulmonary airway malformation, to bronchioloalveolar carcinoma and adenocarcinoma of the lung. Eur Respir J 2005;26:1181-7
Keywords
Lung, Malignant tumor,

No. of Applicants : 64

▶ Correct Answer : 16/64,  25.0%
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - National Hospital Organization Okinawa Hospital , Japan Yasuji Oshiro
  • - kanto Rosai Hp , Japan Takana Yamakawa
  • - Kyoto University , Japan Akihiko Sakata
  • - Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
  • - i.r.c.c.s.istituto scientifico romagnolo per lo studio e cura dei tumori , Italy Alice Rossi
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - ICD,MCH CALICUT , India rikhy krishnan
  • - CHU Saint Pierre , Belgium Abd Alla Fares
  • - Eren T캇p Merkezi Istanbul , Turkey Armagan Sarac
  • - Research Hospital, The Institute of Medical Science, The University of Tokyo , Japan Toshihiro Furuta
  • - C.B.H. Dpt of Imaging- "Clinica Mater Dei" BARI , Italy Carlo Florio
  • - Private sector , Greece Vasilios Tzilas
  • - Teikyo University Mizonokuchi Hospital , Japan Noriko Kobayashi
▶ Correct Answer as Differential Diagnosis : 16/64,  25.0%
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - University of British Columbia , Canada Amr Ajlan
  • - UWO , Canada S Lee
  • - Myongji hospital , Korea (South) Ji Ye Lee
  • - James Paget Hospital , U.K , United Kingdom nabil mahmood
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - IRSA La Rochelle , France Denis Chabassiere
  • - CAC Rennes , France nicolas gautier
  • - Teikyo University Mizonokuchi Hospital , Japan Kaoru Sumida
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - GHICL , France manuel toledano
  • - Medicheck health care , Korea (South) Chae Lim
  • Top
  • Back

Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

This website is optimized for IE 10 and above.