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Tomokazu Omori



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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  |  Author(s): Tomokazu Omori

      • Abstract
      • Slides

      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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