Lung adenocarcinoma mimicking pulmonary fibrosis-a case report

Abstract

BackgroundLung cancer is usually presented with cough, dyspnea, pain and weight loss, which is overlapping with symptoms of other lung diseases such as pulmonary fibrosis. Pulmonary fibrosis shows characteristic reticular and nodular pattern, while lung cancers are mostly presented with infiltrative mass, thick-walled cavitations or a solitary nodule with spiculated borders. If the diagnosis is established based on clinical symptoms and CT findings, it would be a misapprehension.Case presentationWe report a case of lung adenocarcinoma whose symptoms as well as clinical images overlapped strongly with pulmonary fibrosis. The patient’s non-productive cough, progressive dyspnea, restrictive pattern of pulmonary function test and CT scans (showing reticular interstitial opacities) were all indicative of pulmonary fibrosis. The patient underwent a treatment consisting of corticosteroids and antibiotics, to no avail. Histopathology of the lung showed that the patient suffered from mucinous adenocarcinoma. Albeit the immunohistochemical staining was not consistent with lung adenocarcinoma, tumor’s morphological characteristics were consistent, and were used to make the definitive diagnosis.ConclusionGiven the fact that radiography cannot always make a clear-cut difference between pulmonary fibrosis and lung adenocarcinomas, and that clinical symptoms often overlap, histological examination should be considered as gold standard for diagnosis of lung adenocarcinoma.

Clinical significance and biological function of fucosyltransferase 2 in lung adenocarcinoma

“…Lung cancer, the most frequently occurring type of cancer, is the leading cause of cancer-related deaths worldwide, with an annual mortality rate of 18% worldwide [ 1 ]. Over 80% of lung cancer cases are non-small cell lung cancer (NSCLC), including adenocarcinoma, adenosquamous cell carcinoma, squamous cell carcinoma, and large cell carcinoma [ 2 - 3 ]. Lung adenocarcinoma is currently the predominant histological subtype of NSCLC, and the average 5-year survival rate of NSCLC is still around 15%.…”

Remote Adipose Tissue-Derived Stromal Cells of Patients with Lung Adenocarcinoma Generate a Similar Malignant Microenvironment of the Lung Stromal Counterpart

“…Lung fbrosis may be a prerequisite for the development of lung adenocarcinoma [49] and so is the perpetuating infammatory condition which fosters the most suitable biological background for tumor progression [50]. Profbrotic markers (alpha-smooth muscle actin, fbrillar collagens, SMAD3) expressed in histological samples of patients with lung cancer, are correlated to low survival [51].…”

“…The grade of fibrosis in lung cancer is a key issue and represents the modification of a permissive microenvironment induced by the continuous crosstalk between tumor and cancer-associated fibroblasts (as part of the stromal fraction), which leads to the manipulation of the extracellular matrix components and to the transition towards the epithelial-mesenchymal traits [ 48 ]. Lung fibrosis may be a prerequisite for the development of lung adenocarcinoma [ 49 ] and so is the perpetuating inflammatory condition which fosters the most suitable biological background for tumor progression [ 50 ]. Profibrotic markers (alpha-smooth muscle actin, fibrillar collagens, SMAD3) expressed in histological samples of patients with lung cancer, are correlated to low survival [ 51 ].…”

“Remote adipose tissue-derived stromal cells of patients with lung adenocarcinoma generate a similar malignant microenvironment of the lung stromal counterpart”

“…The grade of fibrosis in lung cancer is a key issue and represents the modification of a permissive microenvironment induced by the continuous crosstalk between tumor and cancer-associated fibroblasts (as part of the stromal fraction), which leads to the manipulation of the extracellular matrix components and to the transition towards the epithelial-mesenchymal traits [42]. Lung fibrosis may be a prerequisite for the development of lung adenocarcinoma [43] and so is the perpetuating inflammatory condition which fosters the most suitable biological background for tumor progression [44]. Pro-fibrotic markers (alpha-smooth muscle actin, fibrillar collagens, SMAD3) expressed in histological samples of patients with lung cancer, are correlated to low survival [45].…”