J Korean Rheum Assoc.  2010 Sep;17(3):272-277.

A Case of Cutaneous Leukocytoclastic Vasculitis Presenting as the First Symptom of Adenosquamous Carcinoma of the Lung

• Kim HO
• Kim HC
• Ko GH
• Jang I
• Kang MG
• Park HO
• Hur J
• Lee SI

Abstract

Leukocytoclastic vasculitis (LV) is a systemic inflammatory disorder involving the small vessels. The exact cause of LV remains unknown, yet malignancy has been considered as a causative factor for LV. We experienced a 60-year-old male with purpura on his extremities. Computed tomography of the chest showed a mass lesion that was suspected to be a non-small-cell lung cancer and the biopsy revealed an adenosquamous carcinoma. There has been no report of LV associated with adenosquamous carcinoma of the lung in Korea. Thus, we report here on this case along with a review of the relevant articles.

Keyword

Leukocytoclastic vasculitis; Lung cancer; Adenosquamous carcinoma

MeSH Terms

Biopsy
Carcinoma, Adenosquamous
Extremities
Humans
Korea
Lung
Lung Neoplasms
Male
Middle Aged
Purpura
Thorax
Vasculitis
Vasculitis, Leukocytoclastic, Cutaneous
Vasculitis, Leukocytoclastic, Cutaneous

Figure

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  Fig. 1. Purpuric lesions on the lower extremities.

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  Fig. 2. (A) Chest PA shows fibrotic change with calcification in the right lung apical area and calcified pleural plaque in the left lower lung zone as the sequela of pulmonary tuberculosis. (B) Contrast enhanced CT shows about a 2 cm sized heterogeneous low attenuating mass lesion in the right lower lobe (posterior to the liver dome) (arrow).

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  Fig. 3. (A) The dermal small vessels show swelling of the endothelial cells. The outline of the blood vessels appears indistinct due to the infiltration of inflammatory cells around the blood vessels (arrow). The infiltrate consists mainly of neutrophils and a small number of eosinophils and mononuclear cells. There is fragmentation of nuclei (leukocytoclasis) (dotted arrow). (B) The lung cancer shows components of both squamous cell carcinoma (arrow) and adenocarcinoma (dotted arrow) (Hematoxylin-Eosin Stain, A X 400, B X 100).

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