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Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities

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Title: Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities
Authors: Abe, Yuki Browse this author
Suzuki, Masaru Browse this author →KAKEN DB
Tsuji, Kosuke Browse this author
Sato, Mineyoshi Browse this author
Kimura, Hirokazu Browse this author →KAKEN DB
Kimura, Hiroki Browse this author →KAKEN DB
Nagaoka, Kentaro Browse this author
Takakuwa, Emi Browse this author
Matsuno, Yoshihiro Browse this author →KAKEN DB
Konno, Satoshi Browse this author →KAKEN DB
Keywords: Gastric cancer
Metastatic lung tumor
Mucinous adenocarcinoma
Diffuse ground-glass opacities
Signet-ring cell carcinoma
Issue Date: 2020
Publisher: Elsevier
Journal Title: Respiratory Medicine Case Reports
Volume: 30
Start Page: 101104
Publisher DOI: 10.1016/j.rmcr.2020.101104
Abstract: Most metastatic lung tumors display well-defined, round, multiple nodular shadows, whereas the presence of diffuse ground-glass opacities on chest computed tomography generally suggests non-malignant conditions. Here, we report an unusual case of pulmonary metastasis from gastric cancer in which diffuse ground-glass opacities were observed in all lung segments. A 59-year-old man with a 3-month history of worsening chest pain and shortness of breath was referred to the pulmonary clinic. Chest computed tomography revealed low attenuation areas, suggesting emphysema, along with diffuse ground-glass opacities and interlobular septal thickening in both lungs. A transbronchial lung biopsy specimen revealed signet-ring cell carcinoma infiltrating the alveolar septa. Immunohistochemical staining of the cancer cells was positive for CDX-2, cytokeratin 7, and cytokeratin 20, and negative for surfactant apoprotein-A, TTF-1, and Napsin A. Gastrointestinal endoscopy revealed an ulcerative tumor in the stomach, and a biopsy from the tumor demonstrated malignant cells with similar morphology and immunophenotypes as those in the lungs. The final diagnosis was diffuse lung metastasis from gastric cancer. Our case shows that although multiple, well-defined nodules are typically considered to be the classic presentation of pulmonary metastasis, clinicians should also be aware of the possibility of pulmonary metastasis presenting as diffuse ground-glass opacities.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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