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Metastatic Adenocarcinoma of the Lung

Blitz JB - MedPix (2006)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Metastatic Adenocarcinoma of the Lung

History: Chief complaint: 47 y/o male presented in Nov 2005 with pain in right anterior thigh. X-ray revealed a mass in the femur and adjacent soft tissue. Partial surgical resection of mass revealed adenocarcinoma. Subsequent PET scan indicated increased uptake at several locations in the right lung. Patient had a history of pulmonary nodules dating to 2003/2004. However a PET conducted in August of 2004 was negative except for minimal uptake in one pulmonary nodule. Serial X-rays showed no changes in these nodules through mid 2005. Patient was diagnosed with metastatic adenocarcinoma of the right lung and referred to oncology for radiation and chemotherapy. PMX: • Nephrolithiasis • Hyperlipidemia PSHX: • Right neck lymph node resection (benign) at 22 yo • Cholestectomy in 2004 SocHx: • >1PPD for 20 years • No ETOH FMHX: • Sister (smoker) died of lung cancer in 1979 • Sister (non-smoker) died of lunger cancer at 40 yo • Sister (non-smoker) died of lung cancer at 62 yo • Brother (smoker) diagnosed with head and neck cancer 2006 Meds: • Percocet Allergies: • Aspirin - upset stomach

Findings: Chest and abdominal CT on 13 April 2006 revealed the following in comparison with an August 2004 chest and abdominal CT: • Progression of right hilar adenopathy and enlargement of the pleural-based soft tissue mass along the posteromedial aspect of the right lower lobe. • Pulmonary parenchyma demonstrates enlargement of multiple right lower lobe pulmonary nodules. • The pancreas, spleen, adrenal glands, and kidneys are normal. • Soft tissue in the bilateral gluteal regions are normal. Chest and abdomal CT on 16 August 2006 after 4 months of chemotherapy and radiation revealed the following in comparison with the 13 April 2006 study: • Subcarinal lymphadenopathy is demonstrated and increased from previous study. • Associated rib destruction is demonstrated. • Associated endobronchial narrowing is demonstrated extending to the right lower lobe. • No pulmonary nodules are seen in the left lung. • Interval development of bilateral adrenal masses. • Soft tissue masses are demonstrated within the mesentery. • Interval development of right gluteal mass

Ddx: Metastatic Adenocarcinoma of the Lung Metastatic Small Cell Cancer of the Lung Metastatic Squamous Cell Cancer of the Lung Other Metastatic Cancer

Dxhow: Pathology

Exam: Not applicable

No MeSH data available.


13 April Abdominal CT demonstrating normal adrenal glands.
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MPX1201_synpic30963: 13 April Abdominal CT demonstrating normal adrenal glands.


Metastatic Adenocarcinoma of the Lung

Blitz JB - MedPix (2006)

13 April Abdominal CT demonstrating normal adrenal glands.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1201&req=5

MPX1201_synpic30963: 13 April Abdominal CT demonstrating normal adrenal glands.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Metastatic Adenocarcinoma of the Lung

History: Chief complaint: 47 y/o male presented in Nov 2005 with pain in right anterior thigh. X-ray revealed a mass in the femur and adjacent soft tissue. Partial surgical resection of mass revealed adenocarcinoma. Subsequent PET scan indicated increased uptake at several locations in the right lung. Patient had a history of pulmonary nodules dating to 2003/2004. However a PET conducted in August of 2004 was negative except for minimal uptake in one pulmonary nodule. Serial X-rays showed no changes in these nodules through mid 2005. Patient was diagnosed with metastatic adenocarcinoma of the right lung and referred to oncology for radiation and chemotherapy. PMX: • Nephrolithiasis • Hyperlipidemia PSHX: • Right neck lymph node resection (benign) at 22 yo • Cholestectomy in 2004 SocHx: • >1PPD for 20 years • No ETOH FMHX: • Sister (smoker) died of lung cancer in 1979 • Sister (non-smoker) died of lunger cancer at 40 yo • Sister (non-smoker) died of lung cancer at 62 yo • Brother (smoker) diagnosed with head and neck cancer 2006 Meds: • Percocet Allergies: • Aspirin - upset stomach

Findings: Chest and abdominal CT on 13 April 2006 revealed the following in comparison with an August 2004 chest and abdominal CT: • Progression of right hilar adenopathy and enlargement of the pleural-based soft tissue mass along the posteromedial aspect of the right lower lobe. • Pulmonary parenchyma demonstrates enlargement of multiple right lower lobe pulmonary nodules. • The pancreas, spleen, adrenal glands, and kidneys are normal. • Soft tissue in the bilateral gluteal regions are normal. Chest and abdomal CT on 16 August 2006 after 4 months of chemotherapy and radiation revealed the following in comparison with the 13 April 2006 study: • Subcarinal lymphadenopathy is demonstrated and increased from previous study. • Associated rib destruction is demonstrated. • Associated endobronchial narrowing is demonstrated extending to the right lower lobe. • No pulmonary nodules are seen in the left lung. • Interval development of bilateral adrenal masses. • Soft tissue masses are demonstrated within the mesentery. • Interval development of right gluteal mass

Ddx: Metastatic Adenocarcinoma of the Lung Metastatic Small Cell Cancer of the Lung Metastatic Squamous Cell Cancer of the Lung Other Metastatic Cancer

Dxhow: Pathology

Exam: Not applicable

No MeSH data available.