title: [Gastrointestinal metastasis from a primary adenocarcinoma of the lung presenting with acute abdominal pain].
abstract: Symptomatic gastro-intestinal metastasis in lung cancer is extremely rare and only a few case reports have been published. Here, we report a case with lung adenocarcinoma that presented with acute abdominal pain, nausea and vomiting due to duodenum, jejunum, and colon obstruction by the gastro-intestinal metastasis. The patient underwent colonoscopy and the pathologic report was adenocarcinoma. When there are similar histologic findings in both colon and pulmonary lesion, the question is whether both lesions are primary cancer or the colon lesions are metastases from lung cancer. Microscopic examination of a conventional pathologic section was not sufficient to make this determination. Immunohistochemistry was positive for thyroid transcription factor-1 (TTF-1) and cytokeratin 7 (CK7), and negative for cytokeratin 20 (CK20) and caudal-related homeobox transcription factor-2 (CDX-2) on colon mucosa specimen. Accordingly, we used immunohistochemical marker for differential diagnosis of primary adenocarcinoma of the lung with gastro-intestinal metastasis.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, 1 Dongdaesin-dong 3-ga, Seo-gu, Busan 602-103, Korea.
authors.forename: Chien Ter
authors.initials: CT
authors.lastname: Hsing
authors.forename: Ha Yeon
authors.initials: HY
authors.lastname: Kim
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Han
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Lee
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Chang
authors.forename: Seok Reyol
authors.initials: SR
authors.lastname: Choi
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Jeong
mesh_terms: D015746:Abdominal Pain; D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D000071616:CDX2 Transcription Factor; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005770:Gastrointestinal Neoplasms / Q000473:pathology* / Q000556:secondary; D018398:Homeodomain Proteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D053554:Keratin-20 / Q000378:metabolism; D053552:Keratin-7 / Q000378:metabolism; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000378:metabolism; D000074482:Thyroid Nuclear Factor 1; D014057:Tomography, X-Ray Computed; D014157:Transcription Factors / Q000378:metabolism
chemical_list: D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins; D053554:Keratin-20; D053552:Keratin-7; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors