Limits...
Tonsillar metastasis of small cell lung cancer in a patient with idiopathic pulmonary fibrosis: a case report.

Kim EJ, Kim SR, Jin Gang S, Park SY, Han YM, Lee YC - Medicine (Baltimore) (2015)

Bottom Line: Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of lung cancer.In addition, the majority of them are located in IPF-associated fibrotic peripheral lesions.However, in following-up, he expired due to respiratory failure by an acute exacerbation of IPF 3 months after the diagnosis.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Internal Medicine (EJK), Asan Medical Center, University of Ulsan College of Medicine, Seoul; Department of Internal Medicine and Research Center for Pulmonary Disorders (SRK, SJG, SYP, YCL), Chonbuk National University Medical School; Department of Radiology (YMH), Chonbuk National University Medical School; and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital (SRK, SYP, YMH, YCL), Jeonju, South Korea.

ABSTRACT
Small cell lung cancer (SCLC) metastasizes widely, but palatine tonsil is an extremely unusual site for metastasis. Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of lung cancer. However, the most common histological findings among patients of lung cancer with IPF are known as non-SCLC such as adenocarcinoma and squamous cell carcinoma. In addition, the majority of them are located in IPF-associated fibrotic peripheral lesions. A 77-year-old man visited for 1-month persistent cough and dyspnea, with inspiratory dry crackles on both lower lung fields and a large oval mass in his throat. Chest computed tomography revealed 2 masses in the left lower lobe, 1 mass in the right upper lobe, and multiple enlarged mediastinal lymph nodes of the lung accompanying with IPF, which were diagnosed as SCLC pathologically. Very interestingly, the tonsillar mass was also confirmed as the metastatic lesion of SCLC. Chemotherapy for SCLC and medical treatment for IPF were applied. However, in following-up, he expired due to respiratory failure by an acute exacerbation of IPF 3 months after the diagnosis. In this current report, we describe, for the first time, a case of tonsillar metastasis of SCLC with IPF detected simultaneously in a 77-year-old man.

Show MeSH

Related in: MedlinePlus

High-resolution computed tomography showed 1 mass in the right upper lobe (A), 2 masses in the left lower lobe (B), and honeycomb appearance in subpleural area of both lower lobe (C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4554164&req=5

Figure 2: High-resolution computed tomography showed 1 mass in the right upper lobe (A), 2 masses in the left lower lobe (B), and honeycomb appearance in subpleural area of both lower lobe (C).

Mentions: High-resolution computed tomography of chest showed 2 masses in the left lower lobe, 1 mass in the right upper lobe, and multiple enlarged mediastinal lymph nodes of the lung (Figure 2). One of the left lower lobe masses was 4.4 × 4.0 cm sized in superior and lateral segments, and the other was 5.7 × 3.7 cm sized with fibrosis in subpleural region. A right upper lobe mass was 2.1 × 1.5 cm sized. Also, there was typical honeycomb appearance with traction bronchiectasis and ground-glass opacity pattern, predominantly in subpleural areas of both lower lobes. Under suspicion of lung cancer and usual interstitial pneumonia that is pathological equivalent to IPF, further workup was started to confirm the diagnosis.


Tonsillar metastasis of small cell lung cancer in a patient with idiopathic pulmonary fibrosis: a case report.

Kim EJ, Kim SR, Jin Gang S, Park SY, Han YM, Lee YC - Medicine (Baltimore) (2015)

High-resolution computed tomography showed 1 mass in the right upper lobe (A), 2 masses in the left lower lobe (B), and honeycomb appearance in subpleural area of both lower lobe (C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554164&req=5

Figure 2: High-resolution computed tomography showed 1 mass in the right upper lobe (A), 2 masses in the left lower lobe (B), and honeycomb appearance in subpleural area of both lower lobe (C).
Mentions: High-resolution computed tomography of chest showed 2 masses in the left lower lobe, 1 mass in the right upper lobe, and multiple enlarged mediastinal lymph nodes of the lung (Figure 2). One of the left lower lobe masses was 4.4 × 4.0 cm sized in superior and lateral segments, and the other was 5.7 × 3.7 cm sized with fibrosis in subpleural region. A right upper lobe mass was 2.1 × 1.5 cm sized. Also, there was typical honeycomb appearance with traction bronchiectasis and ground-glass opacity pattern, predominantly in subpleural areas of both lower lobes. Under suspicion of lung cancer and usual interstitial pneumonia that is pathological equivalent to IPF, further workup was started to confirm the diagnosis.

Bottom Line: Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of lung cancer.In addition, the majority of them are located in IPF-associated fibrotic peripheral lesions.However, in following-up, he expired due to respiratory failure by an acute exacerbation of IPF 3 months after the diagnosis.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Internal Medicine (EJK), Asan Medical Center, University of Ulsan College of Medicine, Seoul; Department of Internal Medicine and Research Center for Pulmonary Disorders (SRK, SJG, SYP, YCL), Chonbuk National University Medical School; Department of Radiology (YMH), Chonbuk National University Medical School; and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital (SRK, SYP, YMH, YCL), Jeonju, South Korea.

ABSTRACT
Small cell lung cancer (SCLC) metastasizes widely, but palatine tonsil is an extremely unusual site for metastasis. Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of lung cancer. However, the most common histological findings among patients of lung cancer with IPF are known as non-SCLC such as adenocarcinoma and squamous cell carcinoma. In addition, the majority of them are located in IPF-associated fibrotic peripheral lesions. A 77-year-old man visited for 1-month persistent cough and dyspnea, with inspiratory dry crackles on both lower lung fields and a large oval mass in his throat. Chest computed tomography revealed 2 masses in the left lower lobe, 1 mass in the right upper lobe, and multiple enlarged mediastinal lymph nodes of the lung accompanying with IPF, which were diagnosed as SCLC pathologically. Very interestingly, the tonsillar mass was also confirmed as the metastatic lesion of SCLC. Chemotherapy for SCLC and medical treatment for IPF were applied. However, in following-up, he expired due to respiratory failure by an acute exacerbation of IPF 3 months after the diagnosis. In this current report, we describe, for the first time, a case of tonsillar metastasis of SCLC with IPF detected simultaneously in a 77-year-old man.

Show MeSH
Related in: MedlinePlus