Korean J Radiol.  2014 Oct;15(5):646-650. 10.3348/kjr.2014.15.5.646.

Synchronous Triple Primary Lung Cancers: A Case Report

• Yoon HJ
• Lee HY
• Han J
• Choi YL

• KMID: 1734951
• DOI: http://doi.org/10.3348/kjr.2014.15.5.646

Abstract

Synchronous primary lung cancers are relatively rare. The accurate diagnosis remains challenging, despite of the routine use of bronchoscopy and computed tomography (CT) of the chest. Herein we report a case of synchronous triple primary cancers of the right lung in a 72-year-old male patient in whom each tumor presented distinct CT imaging findings.

Keyword

Neoplasms, multiple primary; Lung; Multidetector computed tomography

MeSH Terms

Adenocarcinoma/*diagnosis/pathology/radiography
Adenocarcinoma, Mucinous/*diagnosis/pathology/radiography
Aged
Bronchoscopy
Carcinoma, Squamous Cell/*diagnosis/pathology/radiography
Diagnosis, Differential
Humans
Lung Neoplasms/*diagnosis/pathology/radiography
Male
Neoplasm Staging
Neoplasms, Multiple Primary
Positron-Emission Tomography
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 72-year-old man with synchronous triple primary lung cancers. A, B. Posteroanterior (A) and lateral (B) chest radiographs reveal 4.0-cm ill-defined mass in right lower lobe (arrows). Lung window images (window level, -500 Hounsfield unit [HU]; window width, 1500 HU) of CT scan (2.5-mm slice thickness) of thorax and corresponding microscopic features at low magnification (hematoxylin and eosin stain, × 5 [× 1 in inset]). C. Anterior basal segment of right lower lobe is showing 4.2 cm irregular cavitary lesion. D. This lesion was confirmed to be squamous cell carcinoma with moderate differentiation exhibiting nests of polygonal cells with pink cytoplasm and distinct cell borders. E. 3.8-cm parenchymal low-attenuating consolidative lesion is at posterior-basal segment of right lower lobe. F. This lesion was confirmed to be invasive mucinous adenocarcinoma composed of glands lined by tall columnar mucin-containing cells. G. 2.5-cm well-defined part-solid nodular lesion is at posterior segment of right upper lobe. H. It revealed adenocarcinoma with moderate differentiation and acinar pattern showing acini of polyhedral cells.

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