INTRODUCTION:Lung cancer is among leading causes of death worldwide. Different histological types of the lung carcinoma show significant differences in behavior.OBJECTIVES:The aim of this study is to determine the distribution patterns of metastases of different lung cancer histological types in autopsied individuals.METHODS:Protocols from all autopsies performed at the Institute of Pathology from 2008 till 2014 were reviewed retrospectively, and information on individuals' age, sex, histological type of primary lung cancer, presence and location of metastases, and causes of death were recorded.RESULTS:More than 90% of the individuals with lung cancer metastases were older than 50 years (mean age: 64.5 ± 10.3), with two-fold male predominance. The most frequent histological type in both sexes was adenocarcinoma (48%). Although, in general, hematogenous metastases were mostly found in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Metastases in adrenal glands derived mostly from adenocarcinoma and large-cell carcinoma. Metastases in the intestines most frequently originated from large-cell carcinoma (P = 0.01). Metastatic complications and bronchopneumonia were the most frequent causes of death.CONCLUSIONS:While, overall, the most frequent hematogenous metastases occur in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Knowing distribution of metastases is essential for making algorithms of treatment, as well as for improving clinical assessment of the patients with unclear clinical findings and suspicion on occult primary lung cancer.
A 13-year-old girl with epigastric pain and abdominal distention was admitted to emergency room. Abdominal ultrasonography (US) revealed a multilocular giant cystic mass in the pancreas (Fig. 1). Abdominal magnetic resonance imaging (MRI) showed multiple cystic lesions in the pancreas. Septa, solid component, or contrast-enhancement was not detected in the cysts (Fig. 2). Normal pancreas parenchyma was only observed in the head and uncinate process. No pathological findings were found in other abdominal organs. Aspiration biopsy from the dominant cyst revealed fluid with pancreatic enzyme activity. Surgery for cyst evacuation was refused. Follow-up at 1 year with no treatment was uneventful.Isolated polycystic pancreas disease (PPD) is an extremely rare entity, with only a few reported cases (1-8). Patients with PPD are usually asymptomatic, but can present with abdominal distention and abdominal pain. Rarely jaundice, vomiting or acute pancreatitis may present (3). Pancreatic cystic lesions are classified as neoplastic and non-neoplastic cysts. Non-neoplastic pancreatic cysts are also described as retention cysts, congenital developmental cysts, enteric duplication cysts, abscesses, walled-off pancreatic necrosis, pseudocysts, and hydatid cysts. US and MRI can help differentiate malignant from benign pancreatic cysts. Multiple simple cysts, which diffusely involve pancreas on imaging studies suggest congenital-developmental cysts.
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