A case of occult primary breast cancer with atypical endobronchial metastases
Maki Miyamotoa,* Shinobu Akagawaa Atsuhisa Tamuraa Junko Suzukia Kimihiko Masudaa Akira Hebisawab
aCenter for Pulmonary Diseases, NHO Tokyo National Hospital
bDepartment of Pathology, NHO Tokyo National Hospital
*Department of Pulmonary Medicine, Tokyo Metropolitan Tama Medical Center
A 50-year-old woman suffering from cough, sputum, and lumbago was admitted to our hospital. Chest radiograph showed diffuse reticular shadows in bilateral lower lung fields. Chest CT scan revealed multiple small nodules and interlobular septal thickening in peripheral lung fields. Bronchoscopy demonstrated multiple glossy white nodules on the bronchial mucosa extending from the distal trachea to the ostium of the right middle lobe. Multiple bronchial mucosal biopsies showed adenocarcinoma infiltrating the bronchial mucosa and permeating the mucosal lymphatics in a single file pattern. She presented with right axillary adenopathy, and an axillary nodes biopsy revealed metastasic adenocarcinoma positive for estrogen and progesterone receptors. As a result, breast cancer was diagnosed. She had no evident primary breast lesion. This was an occult breast cancer suspected after bronchoscopic examination. Bronchoscopic findings of this type of metastases are very rare.
Breast cancer Endobronchial metastasis Scirrhous carcinoma Occult cancer Metastatic lung tumor
Received 28 Dec 2011 / Accepted 13 Mar 2012
AJRS, 1(6): 531-535, 2012