J Korean Soc Radiol.  2015 Oct;73(4):225-229. 10.3348/jksr.2015.73.4.225.

Synchronous Triple Primary Lung Cancer: A Rare Case with Radiologic-Pathologic Correlation

• Lee J
• Lee S
• Park HS
• Park CH
• Kim TH

• KMID: 2068712
• DOI: http://doi.org/10.3348/jksr.2015.73.4.225

Abstract

Synchronous multiple primary lung cancer is uncommon. They present at the same time, but are distinct and have different histologic features. Synchronous triple primary lung cancer is rare and only few cases have been reported previously. We described a case of synchronous triple primary lung cancers in an asymptomatic 64-year-old man that showed different radiologic features of lung tumors on chest computed tomography images. Anatomical resection and histological analysis revealed 3 different types of lung carcinoma with radiologic-pathologic correlation.

MeSH Terms

Humans
Lung Neoplasms*
Lung*
Middle Aged
Multidetector Computed Tomography
Neoplasms, Multiple Primary
Thorax

Figure

• 

  Fig. 1 A rounded solid nodule in the right lower lobe superior segment of the lung (lesion 1). A. An initial axial computed tomography (CT) scan shows a 0.7 mm solid nodule (arrow). B. A 9-month follow-up CT image shows an enlargement of the nodule in right lower lobe (RLL) superior segment to 1.8 cm with evidence of lobulation and spicule formation (arrow). C. A positron emission tomography-CT image shows 18F-fluorodeoxyglucose uptake (standardized uptake value = 7.4) in lesion 1 (arrow). D. Macroscopic examination of the superior segment of the RLL of the lung reveals a 1.6 cm solid mass (arrow). E. This lesion was confirmed as adenocarcinoma composed of solid and micropapillary patterns (× 200).

• 

  Fig. 2 A ground-glass opacity nodule in the right lower lobe (RLL) lateral basal segment of the lung (lesion 2). A. On an axial computed tomography (CT) scan, a 1.4 cm subsolid nodule (arrow) is detected at the basal segment of the RLL. B. There is no change in the lesion size on a 9-month follow-up CT image (arrow). C. A positron emission tomography-CT image shows that there was no focal 18F-fluorodeoxyglucose uptake by the nodule (arrow). D. A gross image in the lateral basal segment of the RLL of the lung reveals a 1.0 cm ill-defined nodule with discoloration (arrow). E. Lesion 2 was confirmed as adenocarcinoma, acinar predominant type (× 200).

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  Fig. 3 A cavitary nodular lesion in the left upper lobe (LUL) of the lung (lesion 3). A. A 1.2 cm irregular-shaped cavitary nodular lesion without calcification (arrow) is located in LUL on an axial computed tomography (CT) image. B. CT images taken at a 9-month follow-up indicate that lesion size is increased to 1.4 cm (arrow). C. A positron emission tomography-CT image shows focal 18F-fluorodeoxyglucose uptake (standardized uptake value = 3.8) in this lesion (arrow). D. On gross findings, a solid mass in the wedge resection specimen of the LUL of the lung extends to the resection margin. E. This lesion was confirmed as moderately differentiated squamous cell carcinoma (× 200).

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