Contralateral cervicomediastinal lymph node metastases from clinically occult adenocarcinoma of the lung.
A 69-year-old woman with a right cervical lymphadenopathy presented with an adenocarcinoma on excisional biopsy. Computed tomography (CT) scans and a positron emission tomography scan demonstrated that the tumor was localized in the right paratracheal and cervical region. A clinical diagnosis of lung cancer arising from an unknown primary site was made based on the radiologic and immunohistochemical findings. Serial CT scans showed a growing nodule in the left apex from pinpoint size to 1 cm in diameter after several months, which was defined as the primary site at autopsy. The finding of a clinically occult lung cancer directly spreading to the contralateral mediastinal and cervical nodes by skipping ipsilateral hilar and mediastinal nodes is rare.
Hoshikawa
Mayumi
M
Division of Respiratory Medicine, Tokyo Metropolitan Geriatric Hospital, Japan.
Mochizuki
Hideaki
H
Saito
Mio
M
Noguchi
Toshiyuki
T
Sawabe
Motoji
M
Takahashi
Hideki
H
D000368:Aged; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods