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Taimei Tachibana
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EP1.09 - Pathology (ID 199)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.09-16 - A Case of Pulmonary Primary Enteric Adenocarcinoma Diagnosed Preoperatively (Now Available) (ID 1376)
08:00 - 18:00 | Presenting Author(s): Taimei Tachibana
- Abstract
Background
Pulmonary primary enteric adenocarcinoma(PEA) is a extremely rare subtype of lung cancer, which is defined in the new edition of 2015 WHO classification. Its histopathological and immunohistochemical feature is close to colorectal carcinoma, and it is important to distinguish between PEA and metastasis from colorectal carcinoma. In the paper, we present a case of PEA diagnosed before surgery.
Method
Case report
Result
A 72-year-old male was attending our hospital for rheumatoid arthritis, Thirty eight mm nodule in diameter was pointed out at the right S9 lung area by follow-up CT of interstitial pneumonia. The patient was refered to our department and TBLB was performed. Histopathological examination revealed that the tumor formes ducts composed of tall columnar cells. Immunohistochemical stains demonstrated positive for CK20, Cdx-2 and negative for CK7, TTF-1 and NapsinA. These findings were suggested metastatic colorectal carcinoma of the lung. However, additional clinical examinations, including FDG-PET/CT, gastroscopy and colonoscopy, did not reveal any existance of tumor elsewhere. The CEA level was 20 ng/ml. The patient was given a diagnosis of primary lung cancer, Pulmonary primary enteric adenocarcinoma staged as cT2aN0M0 stageIB was considered and right lower lobectomy with systemic lymph node dissection was performed. Final histopathological findings of the tumor was same as colorectal carcinoma. Immunohistochemical examinations were also the same as TBLB specimens. The final diagnosis was PEA and the staged as pT2aN0M0 stageIB.
Conclusion
PEA is difficult to confirm histopathologically or immunohistologically, and it is necessary to deny the existence of gastro intestinal carcinoma. At present, treatment of PEA should be conducted as primary lung cancer, including operation. It is thought that the biologic and clinical feature of PEA becomes crear by accumulation of more cases.
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EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.15-27 - One Case of Mucinous Carcinoma of Thymus Caused Bone Marrow Metastasis (ID 1574)
08:00 - 18:00 | Author(s): Taimei Tachibana
- Abstract
Background
Primary mucinous adenocarcinoma of the thymus is extremely rare neoplasm. Most thymic carcinomas metastasize to the mediastinal lymph node, pleura, pericardium and diaphragm. And distant metastasis to the extrathoracic organs such as liver, bone or kidney is considered rare. In this case, mucinous carcinoma of the thymus caused bone marrow metastasis and multiple bone metastasis is very rare.
Method
Case report
Result
A 51-year-old man. He was pointed out fecal occult blood test positive by medical checkup, and he was diagnosed the sigmoid colon cancer. After undergoing surgery for colon cancer, he was admitted to our hospital for treatment of mediastinal tumor. An anterior mediastinal tumor was pointed out by preoperative examinations.
Computed tomography (CT) showed a tumor with maximum diameter of 55mm at the anterior mediastinam, including calcification and contrast effect and swollen lymph node. Thymoma or thymic cancer were suspected, so we surgical resection of mediastinal tumor and lymph node dissection were performed. Result of frozen section diagnosis was adenocarcinoma with mucinous component.
Pathological findings showed that most of the tumor was a mucin component, and atypical cells with a small duct formed inside the mucin, signet ring cells were found. Immunohistochemistry, the neoplastic cells were positive for CK7 and CK20. Based on these features, diagnosis of this tumor was mucinous adenocarcinoma of thymus. Pathological stage was T2N1M0 stageIII.
Two months after operation, radiation was performed at anterior mediastinum and one week after radiation compression fracture of lumbar vertebra was present. And five months after operation, pancytopenia was present. Examination of bone marrow aspiration biopsy was performed, and the cancer cells were detected. Bone marrow metastasis originated from thymic cancer was diagnosed as a result of comparing pathological features of the colon cancer and thymic cancer.
Primary thymic adenocarcinoma is very rare and about 2.7% of all thymic carcinoma. Furthermore, only 16 cases have been reported and there have been no reported cases of thymic mucinous carcinoma caused bone marrow metastasis.
Conclusion
In this paper, we report a very rare and valuable case with consideration of some literature review.
