title: An autopsy case of cytokeratin 7-positive minute adenocarcinoma of the lung with systemic metastases.
abstract: We describe a 60-year-old woman with leg pain. Although metastatic bone tumor and atypical cells mimicking signet-ring cells in the bone marrow picture were observed, systemic survey revealed no primary lesion. The patient died two months after admission from systemic progress of the disease. Autopsy revealed a small focus of adenocarcinoma within the right upper lobe of the lung and systemic metastases without any particular changes in the gastrointestinal tract. The tumor cells of the lung were diffusely positive for cytokeratin 7, whereas cytokeratin 20 immunoreactivity was weak and focal, and that supported the lung origin of the present tumor. Moreover, the tumor cells in the bone marrow showed a similar pattern in immunoreactivity. These findings suggest that cytokeratin 7 and cytokeratin 20 immunoreactivity is helpful for the premortem diagnosis of the metastatic tumor of unknown origin.
authors.affiliation: Third Department of Internal Medicine, University of Tokushima School of Medicine.
authors.forename: Y
authors.initials: Y
authors.lastname: Ise
authors.forename: H
authors.initials: H
authors.lastname: Yanagawa
authors.forename: T
authors.initials: T
authors.lastname: Hirose
authors.forename: K
authors.initials: K
authors.lastname: Tani
authors.forename: S
authors.initials: S
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: E
authors.initials: E
authors.lastname: Takeuchi
authors.forename: K
authors.initials: K
authors.lastname: Maniwa
authors.forename: E
authors.initials: E
authors.lastname: Shimizu
authors.forename: F
authors.initials: F
authors.lastname: Ogushi
authors.forename: T
authors.initials: T
authors.lastname: Sano
authors.forename: S
authors.initials: S
authors.lastname: Sone
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001853:Bone Marrow / Q000737:chemistry; D001859:Bone Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging / Q000556:secondary*; D018279:Carcinoma, Signet Ring Cell / Q000737:chemistry / Q000556:secondary*; D004064:Digestive System / Q000737:chemistry; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging; D006801:Humans; D007633:Keratins / Q000032:analysis*; D008168:Lung / Q000737:chemistry; D008175:Lung Neoplasms / Q000737:chemistry*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009382:Neoplasms, Unknown Primary / Q000737:chemistry / Q000175:diagnosis*; D009928:Organ Specificity; D020033:Protein Isoforms / Q000032:analysis*; D011877:Radionuclide Imaging
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D020033:Protein Isoforms; D007633:Keratins