title: Pulmonary adenocarcinoma complicated with pulmonary infarction presented as intrapulmonary metastases: a report of a case.
abstract: Pulmonary adenocarcinoma complicated with a pulmonary infarction presenting as an intrapulmonary metastasis is relatively rare. We present a case of pulmonary infarction manifesting as intrapulmonary metastases of lung cancer. A previously healthy 59-year-old woman was admitted to our hospital for evaluation of abnormal shadows in the right lower lung field. Laboratory tests showed no abnormalities except for a slight elevation of carcinoembryonic antigens (CEAs). Computed tomography (CT) of the chest revealed a hilar mass lesion with parenchymal lesions in the periphery of the right lower lobe, highly suspected to be a pulmonary adenocarcinoma with intrapulmonary metastases. A diagnosis of pulmonary adenocarcinoma was confirmed by a transbronchial brushing examination. A right middle and lower bilobectomy with mediastinal lymph node dissection was due to hilar lymphadenopathy and a lower lobe invasion of the main tumor. Histopathological findings of the resected specimens revealed poorly differentiated adenocarcinoma of the lung with N1 (number 11i and 12 l) disease and multiple pulmonary infarctions with coagulation necrosis and recanalization. Our case suggests that pulmonary infarction associated with lung cancer should be considered as one important cause of peripheral pulmonary nodules.
authors.affiliation: Division of Chest Surgery, First Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Kadokura
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Kamio
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kitami
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Fujisawa
authors.forename: Tamio
authors.initials: T
authors.lastname: Kushihashi
authors.forename: Akira
authors.initials: A
authors.lastname: Shiokawa
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed