title: Single primary lung cancer consisting of three cancer cell types (small cell carcinoma, adenocarcinoma, and squamous cell carcinoma) in which each had metastasized to different lymph nodes.
abstract: We report a case of a 70-year-old male smoker with a single primary tumor 2.5 x 3.0 cm in size in the right lung lower lobe. A transbronchial lung biopsy revealed squamous cell carcinoma of the lung. We performed right lower lobectomy with lymph node dissection (ND2a). The resected specimen consisted of three different cell types; small cell carcinoma, adenocarcinoma and squamous cell carcinoma (in a ratio of 70: 20: 10). Each cancer cell types had metastasized to different lymph nodes. The final diagnosis was a combined small cell carcinoma in the lung. Combined small cell carcinoma is uncommon, but is nevertheless a well-described diagnostic category in lung cancers.
authors.affiliation: Departments of Chest Surgery, Thoracic and Cardiovascular Surgery, Kanazawa Medical University, 1-1 Uchinada-machi, Kawakita-gun, Ishikawa 920-0293, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Shikata
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Ueda
authors.forename: Shuji
authors.initials: S
authors.lastname: Tsuchishima
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Yoh
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsubara
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D000368:Aged; D018288:Carcinoma, Small Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D011013:Pneumonectomy