title: [A case of suspected lung metastasis of pancreatic carcinoma with bronchorrhea similar to bronchioloalveolar carcinoma].
abstract: There have been only a few reports of bronchorrhea in patients with metastatic pulmonary carcinoma. We report a case of suspected lung metastasis of pancreatic carcinoma with bronchorrhea, which was radiologically similar to bronchioloalveolar carcinoma. A 67-year-old man who had previously undergone surgical resection of pancreatic carcinoma was admitted because of a progressive cough producing copious amounts of serous sputum. A chest radiograph on admission revealed an infiltrative shadow with air bronchograms and ground glass opacities in the left middle and lower lung fields. A chest CT scan revealed a consolidative shadow with air bronchograms and bubble-like lucencies similar to bronchioloalveolar carcinoma in the left lower lobe. The histopathological features of the specimen obtained by transbronchial biopsy revealed adenocarcinoma with a pattern identical to that of the pancreatic carcinoma. Immunohistochemical staining with anti-SP-A antibody was entirely negative but those with anti-CA 19-9, Dupan 2 and CA 50 were positive in both lung and pancreatic tumors. These results strongly suggest that the pulmonary carcinoma was a metastasis of cystic adenocarcinoma of the pancreas. In summary, for a definitive diagnosis of bronchioloalveolar carcinoma, extrapulmonary adenocarcinoma as a primary site should first be ruled out.
authors.affiliation: Second Department of Internal Medicine, Oita Medical University, Hasama-machi, Oita, 879-5593, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Mito
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Yamakami
authors.forename: Kenji
authors.initials: K
authors.lastname: Kashima
authors.forename: Syunji
authors.initials: S
authors.lastname: Mizunoe
authors.forename: Issei
authors.initials: I
authors.lastname: Tokimatsu
authors.forename: Tomoku
authors.initials: T
authors.lastname: Ichimiya
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Hiramatsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nagai
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kadota
authors.forename: Masaru
authors.initials: M
authors.lastname: Nasu
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000556:secondary*; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging*; D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism / Q000556:secondary*; D008297:Male; D010190:Pancreatic Neoplasms / Q000473:pathology*; D013902:Radiography, Thoracic; D013183:Sputum / Q000378:metabolism*; D014057:Tomography, X-Ray Computed