Two Lung Adenocarcinomas in the Same Lobe: Multiple Primaries or Intrapulmonary Metastasis?

Yoshimoto, Kentaro; Ishii, Genichiro; Nishimura, Mitsuyo; Hishida, Tomoyuki; Nagai, Kanji

doi:10.5761/atcs.cr.10.01652

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…According to Ono’s study, the sum value of the differences in the expression ratio of four proteins (p53, p16, p27, and c-erbB2) was evaluated in immunohistochemically stained specimens among multiple primary lung cancers and intrapulmonary metastasis [ 29 ]. Yoshimoto reported a case, diagnosed as double primaries, that is distinguished by EGFR gene mutation analysis [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“Different trend” in multiple primary lung cancer and intrapulmonary metastasis

et al. 2015

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BackgroundThe distinguishing of intrapulmonary metastatic tumors from multiple primary lung cancers is difficult but of great importance for the therapeutic management and prognosis of these patients.MethodsWe used genomic DNA analyzed by six microsatellites (D7S1824, D15S822, D2S1363, D10S1239, D6S1056, and D22S689) with PCR to identify discordant allelic variation from 12 patients. There are five patients with multiple primary lung cancers and seven patients who were diagnosed with intrapulmonary metastases from 850 patients with primary lung cancer in our hospital. The experiments were approved by the West China Hospital Ethics committee (No. 2013 (33)) and all patients agreed to participate in the study and signed an informed consent form.ResultsIn the group of metachronous lung tumor, three of five patients have different histological types and one of five patients have the same histological type which showed “contradictory trend”. The other one showed “unique trend”. In the second group (intrapulmonary metastasis lung tumor), one patient showed “contradictory trend” and the others showed “unique trend”.Conclusions“Different trends” are useful in discrimination of intrapulmonary metastasis lung cancer and multiple primary lung cancer even diagnosed with the histopathological evaluation.

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Section: Discussionmentioning

confidence: 99%

“Different trend” in multiple primary lung cancer and intrapulmonary metastasis

et al. 2015

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“…Adenocarcinoma in situ of the lung was frequently associated with EGFR gene mutation [15,16]. There is a case of multiple adenocarcinomas in situ of the lung having the same mutation of EGFR in common [17]. …”

Section: Resultsmentioning

confidence: 99%

A case of synchronous bilateral lung cancers: EML4-ALK positive adenocarcinoma in the right lung and adenocarcinoma in situ (the former bronchioloalveolar carcinoma) in the left lung

et al. 2013

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BackgroundRecently it has been revealed that lung adenocarcinomas with distinct gene mutations or fusions are associated with particular histopathological entities. For example, epidermal growth factor receptor (EGFR) gene mutations are often associated with well differentiated adenocarcinoma of the lung with bronchioloalveolar pattern. On the other hand, echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene in a subset of lung adenocarcinoma is related to mucinous cribriform histology.Case presentationReported herein is a case of synchronous EML4-ALK positive lung adenocarcinoma and adenocarcinoma in situ in the bilateral lungs of a 55-year-old Japanese woman. The woman had EML4-ALK positive lung adenocarcinoma in the right lower lung while adenocarcinoma in situ in the left upper lung, which was EML4-ALK negative.ConclusionTo our knowledge, this is the first report of synchronous, bilateral lung adenocarcinomas composed of EML4-ALK positive and negative ones.

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“…According to Martini's criteria, this case would be diagnosed as primary adenocarcinoma and its pulmonary metastasis. However, Junji et al reported a case of synchronous lung cancers that shared the same EGFR mutation [4]. Takuwa et al [5] reported a similar case of double primary cancers with identical histological findings.…”

Section: Discussionmentioning

confidence: 99%

Surgical algorithm for heterogeneous bilateral quadruple pulmonary nodules

Yang

Wang

Liu

et al. 2013

Interact CardioVasc Thorac Surg

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A 65-year old female with no history of smoking reported experiencing 6 months of tightness in the chest. Chest computed tomography showed two pulmonary nodules in the left upper lobe (one in S3 segment, the other in S4 segment), one nodule in the left lower lobe and a ground-glass opacity (GGO) in the right upper lobe. Synchronous bilateral thoracoscopic wedge resections of the lung were performed to investigate the nodules. Intraoperative frozen section pathology revealed that the two nodules in the left upper lobe were malignant, the nodule in the left lower lobe was a benign lesion and the GGO in the right upper lobe was an atypical adenomatous hyperplasia. As a result, a left upper lobectomy with lymph node dissection was performed. The final pathological diagnosis of the nodule in the left S3 segment was well differentiated adenocarcinoma (pT1bN0M0, IA), the nodule in the left S4 segment was moderately to poorly differentiated adenocarcinoma (pT1aN0M0, IA), the nodule in the left lower lobe was cryptococcal granuloma and the GGO in the right upper lobe was adenocarcinoma in situ. The patient is currently following a favourable course in her recovery. Here, we would like to share the surgical algorithm used for the treatment of heterogeneous bilateral quadruple pulmonary nodules.

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Two Lung Adenocarcinomas in the Same Lobe: Multiple Primaries or Intrapulmonary Metastasis?

Cited by 4 publications

References 7 publications

“Different trend” in multiple primary lung cancer and intrapulmonary metastasis

“Different trend” in multiple primary lung cancer and intrapulmonary metastasis

A case of synchronous bilateral lung cancers: EML4-ALK positive adenocarcinoma in the right lung and adenocarcinoma in situ (the former bronchioloalveolar carcinoma) in the left lung

Surgical algorithm for heterogeneous bilateral quadruple pulmonary nodules

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