title: Non-Mucinous Lepidic Predominant Adenocarcinoma Presenting with Extensive Aerogenous Spread.
abstract: An extremely rare case of non-mucinous lepidic-predominant invasive adenocarcinoma (LPA) showing extensive aerogenous spread with apneumonic presentationis reported. A 73-year-old woman was referred to our hospital because of an infiltrative shadow on chest xray. Chest computed tomography revealed extensive ground glass opacities in the right lower lobe, which was accompanied by infiltrative shadow with apneumonic presentation.Invasive mucinous adenocarcinoma was presumed, and a partial resection of the right lower lobe was done. Histopathological examination revealed lepidic growth-predominant invasive adenocarcinoma with Clara type tumor cells, and there were innumerable aerogenous metastases also consisting of Clara cells. Because Alcian Blue and periodic acid-Schiff staining disclosed no mucus, the tumor was diagnosed as a non-mucinous LPA. The patient showed a poor response to 5 courses of pemetrexed, and she died one year after the diagnosis due to cancer progression. Nonmucinous LPA showed a rare presentation characterized by extensive aerogenous spread followed by a poor prognosis.
authors.affiliation: Department of Thoracic Surgery, Fujieda Municipal General Hospital , Fujieda.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takanashi
authors.affiliation: Department of Pathology, Fujieda Municipal General Hospital.
authors.forename: Shogo
authors.initials: S
authors.lastname: Tajima
authors.affiliation: Department of Respiratory Medicine, Fujieda Municipal General Hospital , Fujieda.
authors.forename: Masaru
authors.initials: M
authors.lastname: Tsukui
authors.affiliation: Department of Tumor Pathology.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Shinmura
authors.affiliation: Department of Thoracic Surgery, Fujieda Municipal General Hospital , Fujieda.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Hayakawa
authors.affiliation: Department of Thoracic Surgery, Fujieda Municipal General Hospital , Fujieda.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Thoracic Surgery, Fujieda Municipal General Hospital , Fujieda.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Neyatani
authors.affiliation: Department of Surgery 1, Hamamatsu University School of Medicine , Hamamatsu, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Funai
keywords: Aerogenous spread; Invasive mucinous adenocarcinoma; Non-mucinous lepidic-predominant adenocarcinoma