Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities
Most metastatic lung tumors display well-defined, round, multiple nodular shadows, whereas the presence of diffuse ground-glass opacities on chest computed tomography generally suggests non-malignant conditions. Here, we report an unusual case of pulmonary metastasis from gastric cancer in which dif...
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doaj-9602368c2735445f9bb9b84e804a8dab2020-11-25T03:42:17ZengElsevierRespiratory Medicine Case Reports2213-00712020-01-0130101104Lung metastasis from gastric cancer presenting as diffuse ground-glass opacitiesYuki Abe0Masaru Suzuki1Kosuke Tsuji2Mineyoshi Sato3Hirokazu Kimura4Hiroki Kimura5Kentaro Nagaoka6Emi Takakuwa7Yoshihiro Matsuno8Satoshi Konno9Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Corresponding author. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Surgical Pathology, Hokkaido University Hospital, Sapporo, JapanDepartment of Surgical Pathology, Hokkaido University Hospital, Sapporo, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanMost metastatic lung tumors display well-defined, round, multiple nodular shadows, whereas the presence of diffuse ground-glass opacities on chest computed tomography generally suggests non-malignant conditions. Here, we report an unusual case of pulmonary metastasis from gastric cancer in which diffuse ground-glass opacities were observed in all lung segments. A 59-year-old man with a 3-month history of worsening chest pain and shortness of breath was referred to the pulmonary clinic. Chest computed tomography revealed low attenuation areas, suggesting emphysema, along with diffuse ground-glass opacities and interlobular septal thickening in both lungs. A transbronchial lung biopsy specimen revealed signet-ring cell carcinoma infiltrating the alveolar septa. Immunohistochemical staining of the cancer cells was positive for CDX-2, cytokeratin 7, and cytokeratin 20, and negative for surfactant apoprotein-A, TTF-1, and Napsin A. Gastrointestinal endoscopy revealed an ulcerative tumor in the stomach, and a biopsy from the tumor demonstrated malignant cells with similar morphology and immunophenotypes as those in the lungs. The final diagnosis was diffuse lung metastasis from gastric cancer. Our case shows that although multiple, well-defined nodules are typically considered to be the classic presentation of pulmonary metastasis, clinicians should also be aware of the possibility of pulmonary metastasis presenting as diffuse ground-glass opacities.http://www.sciencedirect.com/science/article/pii/S2213007120301301Gastric cancerMetastatic lung tumorMucinous adenocarcinomaDiffuse ground-glass opacitiesSignet-ring cell carcinoma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuki Abe Masaru Suzuki Kosuke Tsuji Mineyoshi Sato Hirokazu Kimura Hiroki Kimura Kentaro Nagaoka Emi Takakuwa Yoshihiro Matsuno Satoshi Konno |
spellingShingle |
Yuki Abe Masaru Suzuki Kosuke Tsuji Mineyoshi Sato Hirokazu Kimura Hiroki Kimura Kentaro Nagaoka Emi Takakuwa Yoshihiro Matsuno Satoshi Konno Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities Respiratory Medicine Case Reports Gastric cancer Metastatic lung tumor Mucinous adenocarcinoma Diffuse ground-glass opacities Signet-ring cell carcinoma |
author_facet |
Yuki Abe Masaru Suzuki Kosuke Tsuji Mineyoshi Sato Hirokazu Kimura Hiroki Kimura Kentaro Nagaoka Emi Takakuwa Yoshihiro Matsuno Satoshi Konno |
author_sort |
Yuki Abe |
title |
Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities |
title_short |
Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities |
title_full |
Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities |
title_fullStr |
Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities |
title_full_unstemmed |
Lung metastasis from gastric cancer presenting as diffuse ground-glass opacities |
title_sort |
lung metastasis from gastric cancer presenting as diffuse ground-glass opacities |
publisher |
Elsevier |
series |
Respiratory Medicine Case Reports |
issn |
2213-0071 |
publishDate |
2020-01-01 |
description |
Most metastatic lung tumors display well-defined, round, multiple nodular shadows, whereas the presence of diffuse ground-glass opacities on chest computed tomography generally suggests non-malignant conditions. Here, we report an unusual case of pulmonary metastasis from gastric cancer in which diffuse ground-glass opacities were observed in all lung segments. A 59-year-old man with a 3-month history of worsening chest pain and shortness of breath was referred to the pulmonary clinic. Chest computed tomography revealed low attenuation areas, suggesting emphysema, along with diffuse ground-glass opacities and interlobular septal thickening in both lungs. A transbronchial lung biopsy specimen revealed signet-ring cell carcinoma infiltrating the alveolar septa. Immunohistochemical staining of the cancer cells was positive for CDX-2, cytokeratin 7, and cytokeratin 20, and negative for surfactant apoprotein-A, TTF-1, and Napsin A. Gastrointestinal endoscopy revealed an ulcerative tumor in the stomach, and a biopsy from the tumor demonstrated malignant cells with similar morphology and immunophenotypes as those in the lungs. The final diagnosis was diffuse lung metastasis from gastric cancer. Our case shows that although multiple, well-defined nodules are typically considered to be the classic presentation of pulmonary metastasis, clinicians should also be aware of the possibility of pulmonary metastasis presenting as diffuse ground-glass opacities. |
topic |
Gastric cancer Metastatic lung tumor Mucinous adenocarcinoma Diffuse ground-glass opacities Signet-ring cell carcinoma |
url |
http://www.sciencedirect.com/science/article/pii/S2213007120301301 |
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