Korean J Nephrol.
2010 Nov;29(6):787-791.
A Case of Pulmonary Adenocarcinoma Developed on a Previous Lesion from Microscopic Polyangiitis
- Affiliations
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- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. skimim@plaza.snu.ac.kr
- 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- 3Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
Abstract
- This report examines a patient with pulmonary adenocarcinoma that developed on a previous lesion from microscopic polyangiitis. A 59-year-old woman had been diagnosed with microscopic polyangiitis in October of 1988 based on her clinical symptoms and serological tests, which were positive for anti-neutrophil cytoplasmic antibodies. Her glomerulonephritis had been well controlled with low-dose prednisolone. She presented in October of 2005 with vague chest discomfort and dyspnea on exertion. Physical examination was unremarkable. A non-contrast computed tomography (CT) scan of the chest showed patch ground-glass opacity at the right lower lobe of the lung. Because we did not believe the lesion to be a definite malignancy, we decided to follow up with chest images over a short interval. During the 18 months following the images, the lesion did not change. However, the opacity of the lesion increased slightly over the last two months, and a non-contrast CT scan of the chest was therefore performed. A CT scan showed persistent ground-glass opacity with a slightly solid portion. To diagnose the previous finding and possibly to provide treatment, a right lower lobectomy of the lung via video-assisted thoracoscopic surgery was performed. The pathologic review of the resected lung revealed an adenocarcinoma, stage pT1N0. After one year, fluorodeoxyglucose positron emission tomography was performed, and no evidence of a recurrent malignancy was found.
MeSH Terms
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Adenocarcinoma
Antibodies, Antineutrophil Cytoplasmic
Dyspnea
Female
Follow-Up Studies
Glomerulonephritis
Humans
Lung
Microscopic Polyangiitis
Middle Aged
Physical Examination
Positron-Emission Tomography
Prednisolone
Serologic Tests
Thoracic Surgery, Video-Assisted
Thorax
Antibodies, Antineutrophil Cytoplasmic
Prednisolone
