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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

Pancreatic cancer with pulmonary metastasis exhibiting a variety of pulmonary shadows and requiring a differential diagnosis from invasive mucinous adenocarcinoma: a case report

Miho Hayakawaa  Hisatoshi Hijikataa  Hiroki Tomitaa  Masashi Kawanamia  Takeo Kutsunab  Hisashi Wakayamaa 

aDepartment of Respiratory Medicine, Japanese Red Cross Nagoya Daini Hospital
bDepartment of Respiratory Medicine, Daido Hospital

ABSTRACT

The patient was a 73-year-old female whose chief complaint was fatigue. Thoracic computed tomography (CT) revealed nodular shadows in both lungs and consolidation predominantly in the lower lobes. We performed a transbronchial lung biopsy and made a diagnosis of invasive mucinous adenocarcinoma. Initially, primary lung cancer was suspected, but positron emission tomography-CT showed abnormal accumulation in the pancreatic body as well, and we performed endoscopic ultrasound-guided fine needle aspiration and made a diagnosis of adenocarcinoma. Because the immunostaining findings in the pulmonary and pancreatic tissue matched (CK7-positive, CK20-, TTF-1-, SP-A-negative), and the DU-PAN-2 and SPan-1 values were high, we made a diagnosis of pancreatic cancer with pulmonary metastasis. Tumor markers and immunostaining, especially the CK7/CK20 phenotype, were useful in helping to make the differential diagnosis between invasive mucinous adenocarcinoma and pancreatic cancer with pulmonary metastasis.

KEYWORDS

Pulmonary metastasis  Pancreatic cancer  Lepidic metastasis  Invasive mucinous adenocarcinomam  Cytokeratin 

Received 26 Mar 2018 / Accepted 27 Jun 2018

AJRS, 7(5): 311-315, 2018

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