title: Rapid-growth lung cancer associated with a pulmonary giant bulla: a case report.
abstract: A giant bulla of the lung is suggested as a risk factor for lung cancer. Here we report a case with lung cancer in a giant bulla, which showed rapid progression. A 57-year-old man, who had a history of heavy smoking, was admitted to our hospital due to hemoptysis. A chest X-ray revealed a giant bulla with a ground glass shadow and a high fluid level in the right upper lung. Sputum cytology was negative for malignant cells. A chest X-ray a month later showed increases of the size of the radio-opaque shadow and of the air-fluid retention, suggesting pulmonary hemorrhage from the giant bulla. Limited resection or lobectomy was indicated, but pneumonectomy was performed due to the severe air-leak. Macroscopically, a multiple nodular tumor arose from the bulla wall, which might be related to blood flow and necrotic tissue. The postoperative pathological diagnosis was papillary adenocarcinoma. Unfortunately, the patient developed a recurrence of carcinoma in the pleuroperitoneal cavity and died at 2.5 months after the operation. Based on this report and review of other cases in the literature, we should keep in mind the rapid progression of lung cancer in association with an emphysematous bulla.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Shinzo
authors.initials: S
authors.lastname: Takamori
authors.forename: Keisuke
authors.initials: K
authors.lastname: Miwa
authors.forename: Mari
authors.initials: M
authors.lastname: Fukunaga
authors.forename: Kanetaka
authors.initials: K
authors.lastname: Maeshiro
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Matsuo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000150:complications* / Q000473:pathology; D001768:Blister / Q000150:complications* / Q000473:pathology; D006801:Humans; D008171:Lung Diseases / Q000150:complications* / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged