대한흉부영상의학회 Weekly Chest Cases

Case No : 1483 Date 2026-03-23

Courtesy of Seo Jung Ahn, Soyeoun Lim / Ulsan University Hospital
Age/Sex 38 / M
Chief ComplaintLt. flank pain for 3 days; Current smoker

Figure 1
Figure 2
Figure 3
Figure 4

Diagnosis With Brief Discussion

Diagnosis: NUT Carcinoma
Radiologic Findings: Fig 1. Chest radiograph shows dense consolidation in left lower lobe with pleural effusion in left hemithorax
Fig 2. Contrast enhanced chest CT image shows arterial enhancing lobulated contoured mass in left lower lobe, with necrosis and atelectasis of left lower lobe.
Fig 3. Contrast enhanced chest CT image shows enlarged된 necrotized lymph nodes in subcarinal, Lt. hilar areas.
Fig 4. Contrast enhanced chest CT image shows enhancing lobulated contoured nodules in left pleura
Brief Review: Nuclear protein in testis (NUT) carcinoma is a rare, highly lethal malignancy characterized by genetic alterations in the NUTM1 gene. Typically, NUT carcinoma arises in squamous cells along the body's midline organs (head, neck, lungs), yet non-midline organ origins are also reported. The precise incidence of NUT carcoinoma remains undefined. A systematic review of 119 NUT carcinoma reported that nearly 50% of patients were adolescents or young adults (14–30 yrs), however it can occur in any age. Clinical presentation of NUT carcinoma also lacks specificity since the distribution is not strictly confined to midline organs, and it shows rapid growth, often over primarily related organs. Also, NUT is shows lack of pathognomonic histologic features due to its poor differentiation. Therefore it is suggested that if rapidly progressing tumor masses are found in midline regions such as the head/neck and thoracic cavity on imaging, NC should be given priority consideration and confirmed by timely biopsy, with recommendation of NUT IHC as an initial screening. There is no standard treatment for NUT carcinomas, with median survivial of 6.5–10.6 months
References: 1. Yu Zhang, Qi Zhang, Yue Hao et al. International guidelines on the diagnosis and treatment of NUT carcinoma. The Innovation 7(1): 101068, January 5, 2026
2. Jiaqian Yuan, Zhili Xu, Yong Guo et al. Diagnosis, Treatment and Prognosis of Primary Pulmonary NUT Carcinoma: A Literature Review Curr Oncol. 2022 Sep 22;29(10):6807–6815.
Keywords

No. of Applicants : 84

▶ Correct Answer : 10/84, 11.9%

- Kyoto University , Japan AKIHIKO SAKATA
- , Italy PAOLO BALDASSARI
- Other , Korea (South) SEONGSU KANG
- University of Yamanashi , Japan HIROYUKI MORISAKA
- , Japan SHUNJIRO NOGUCHI
- University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- Kyoto University , Japan SHO KOYASU
- Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
- Fukuoka university , Japan KEISUKE SATO
- Matsunami General Hospital , Japan TARO TAKEDA

▶ Correct Answer as Differential Diagnosis : 11/84, 13.1%

- The University of Tokyo Hospital , Japan ISSEI FUKUDA
- Kyoto University Hospital , Japan YUSUKE UTSUNOMIYA
- University of Yamanashi , Japan TAKAAKI HASHIMOTO
- The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- Nara Medical University , Japan AYA YAMADA
- Other , Korea (South) CHAEHUN LIM
- Osaka metropolitan university Hospital , Japan TATSUSHI OURA
- , Japan TOMOHIRO KAWAJI
- Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
- Ichinomiya Nishi Hospital , Japan Takao Kiguchi
- Ehime University , Japan TOMOHISA OKADA

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 1483 Date 2026-03-23

Discussion

No. of Applicants : 84