J Lung Cancer.  2012 Dec;11(2):108-110. 10.6058/jlc.2012.11.2.108.

A Case of Lung Squamous Cell Carcinoma Mimicking Benign Solitary Cyst

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea. ctlee@snu.ac.kr
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 3Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 4Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 5Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Abstract

Lung cancer with cyst formation is a rare entity. We report a 63-year-old man who underwent surgical treatment of primary lung cancer, which mimics benign solitary cyst. We incidentally found his pulmonary cyst by a low dose chest tomography and followed up for 2 years. Rapid growth of cyst and focal wall thickening evoke us to have a suspicion of its malignancy. Left lower lobectomy via video-assisted thoracoscopic surgery was performed without any preoperative pathologic confirmation. The postoperative pathological finding revealed squamous cell carcinoma with carcinoma in situ on the cyst wall. We emphasize the need for physicians to be aware of the potential of lung cancer in patients with growing pulmonary cyst.

Keyword

Lung neoplasms; Cysts; Squamous cell carcinoma

MeSH Terms

Bone Cysts
Carcinoma in Situ
Carcinoma, Squamous Cell
Humans
Lung
Lung Neoplasms
Thoracic Surgery, Video-Assisted
Thorax

Figure

  • Fig. 1 The initial chest computed tomography (CT) scan showed a thin-walled cystic lesion in the left lower lobe. The cystic lesion had grown up during follow-up duration. After two years, the chest CT scan showed newly developed eccentric wall thickening and part solid component on the cyst (A, initial CT; B, after one year; C, after two years).

  • Fig. 2 (A) Gross appearance of resected specimen. Cystic lesion with irregular border was found. (B) Pathologic finding showed a squamous cell carcinoma that focally invaded the lung parenchyma (black arrow). Those were surrounded by carcinoma in situ on the cyst wall (white arrow) (H&E, ×40). (C) Tumor cells showed hyperchromatic nuclei and intercellular bridge, characteristics of squamous cell carcinoma (H&E, ×100).


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