title: Synchronous double primary lung cancers via p53 pathway induced by heavy smoking.
abstract: Differences in the histological manifestation of synchronous lung cancers are rare. Synchronous multiple primary lung cancers (SMPLC) are associated with long-term tobacco use, which could independently lead to mutations in the p53 and K-ras genes. We present the case of an 82-year-old man who smoked 30 cigarettes daily for the past 60 years. CT of the chest showed a right upper lobe mass. Bronchoscopy revealed an intra-lumen nodular lesion in the right lower lobe bronchus. The diagnoses of small cell lung carcinoma (SCLC) of the right upper lobe and non-small cell lung carcinoma (NSCLC) of the right lower lobe were confirmed by the morphologic features and the detected immunoreactivity. Immunohistochemical analyses showed a strong positive reaction for p53 in samples of the SCLC and NSCLC. The cancers had a different phenotype, but similar genetic abnormalities may have developed due to the carcinogens in the cigarettes.
authors.affiliation: Division of Pulmonary and Critical Care, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Cheng-Chih
authors.initials: CC
authors.lastname: Lin
authors.forename: Chih-Feng
authors.initials: CF
authors.lastname: Chian
authors.forename: Wann-Cherng
authors.initials: WC
authors.lastname: Perng
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Cheng
mesh_terms: D000369:Aged, 80 and over; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000209:etiology* / Q000235:genetics; D016158:Genes, p53 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000209:etiology* / Q000235:genetics; D008297:Male; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000209:etiology* / Q000235:genetics; D010641:Phenotype; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000209:etiology* / Q000235:genetics; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors