Tuberc Respir Dis.  2008 Apr;64(4):318-323. 10.4046/trd.2008.64.4.318.

A Case of Adenocarcinoma Presenting a Solitary Pulmonary Nodule that Grows Slowly Over 10 Years

• Kwon KD
• Kim JH
• Kim DY
• Choi MH
• Choi JH
• Shin DW
• Choi JH
• Yi SH
• Yun JA
• Choi JS
• Na JO
• Seo KH
• Kim YH
• Oh MH

• KMID: 1970185
• DOI: http://doi.org/10.4046/trd.2008.64.4.318

Abstract

It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.

Keyword

Solitary pulmonary nodule; Slow growing lung cancer; Adenocarcinoma

MeSH Terms

Adenocarcinoma
Lung Neoplasms
Risk Factors
Solitary Pulmonary Nodule
Tuberculoma

Figure

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  Figure 1 Serial chest PAs show solitary pulmonary masses in left upper lobe. The mass was approximately 1.6 cm in size in 1997 and 3.5 cm in 2006 by slow growing. September, 1997 (A), November, 1998 (B), October, 1999 (C), May, 2004 (D), April, 2006 (E).

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  Figure 2 Conventional chest CT scan reveals solitary 3.5 cm sized lung mass in left upper lobe without lynphadenopathy. The distal porton of the mass shows an atelectasis.

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  Figure 3 PET-CT scan reveals hypermetabolic activity in the left upper lobe mass measured 3.5 cm. The contralateral hilar, subcarinal and interlobar lymph nodes are considered as benign conditions with the calculated SUVs less than 2.5.

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  Figure 4 Microscopic finding shows a well differentiated adenocarcinoma (H&E stain, ×200).

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