Tuberc Respir Dis.  2010 Feb;68(2):93-96. 10.4046/trd.2010.68.2.93.

A Case of Papillary Adenocarcinoma Presenting with Multiple Cysts

• Chon S
• Kim YJ
• Kyung SY
• An CH
• Lee SP
• Park JW
• Jeong SH
• Cho EK
• Sung YM
• Kim NR

• KMID: 2050591
• DOI: http://doi.org/10.4046/trd.2010.68.2.93

Abstract

A 23-year old woman was admitted to our hospital with hemoptysis. The chest X-ray showed reticulonodular opacity and multiple cysts throughout the entire lung field. The chest CT scan revealed numerous bilateral cysts with various sizes, some of them with thickened walls. An open lung wedge resection was performed. The resected specimen showed scattered small nodules, 0.3 to 0.6 cm in size. Microscopically, each nodule was composed of atypical glands with an occasional papillary architecture spreading to the alveolar septa, which were morphologically consistent with a papillary adenocarcinoma with a bronchioloalveolar carcinoma growth pattern. Immunochemically, the tumor cells were negative for the S-100 protein. The patient was diagnosed with an adenocarcinoma of the lung. A variety of diseases can produce or mimic multiple, thin-walled cysts in the lung. Lung cancer with multiple cysts is quite rare. Nevertheless, adenocarcinoma should be a diagnostic consideration. We report a case of a multiple cystic adenocarcinoma of the lung.

Keyword

Lung Neoplasms; Adenocarcinoma; Cysts

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Bronchiolo-Alveolar
Adenocarcinoma, Papillary
Female
Hemoptysis
Humans
Hydrazines
Lung
Lung Neoplasms
S100 Proteins
Thorax
Hydrazines
S100 Proteins

Figure

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  Figure 1 High-resolution CT images at the level of the carina (A) and right inferior pulmonary vein (B) reveal numerous bilateral cysts of various size, some of them with thickened walls.

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  Figure 2 (A) Histological examination shows scattered small nodules (arrows) (H&E stain, ×100). (B) In high power field view, tumor shows proliferation of papillary adenocarcinoma with lepidic growth pattern (H&E stain, ×400).

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  Figure 3 After 4th cycle chemotherapy, volumetric CT images at the level of the carina (A) and right inferior pulmonary vein (B) demonstrate multiple thin-walled cysts that are enlarged in the interim.

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