KURODA Hajime
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position   Professor
Article types Case report
Language English
Peer review Peer reviewed
Title A rare case of pulmonary lepidic metastasis in patient with branch-type intraductal papillary mucinous carcinoma of the pancreas.
Journal Formal name：Clinical journal of gastroenterology
Abbreviation：Clin J Gastroenterol
ISSN code：18657265/18657265
Domestic / ForeginForegin
Volume, Issue, Page 12(6),pp.621-625
Author and coauthor Sakuma Fumi†, Tsuchida Kohei, Minaguchi Takahito, Nagashima Kazunori, Izawa Naoya, Jinnai Hidehito, Sugaya Takeshi, Tominaga Keiichi, Goda Kenichi, Iijima Makoto, Machida Hiromi, Kuroda Hajime, Irisawa Atsushi
Publication date 2019/12
Summary Pulmonary lepidic metastasis from intraductal papillary mucinous carcinoma (IPMC) of the pancreas is extremely rare. The patient was a 50s-year old male who was hospitalized in the department of respiratory in our hospital for the evaluation of ground-glass opacities in both lungs on computed tomography (CT) imaging. Steroid therapy was administered, as interstitial pneumonia was suggested; however, there was no improvement. A transbronchial lung biopsy (TBLB) revealed the possibility of distant lung metastases. Abdominal CT revealed pancreatic cystic lesions; the patient was, therefore, referred to our department for further evaluation. Endoscopic ultrasound revealed large multi-cystic lesion with mural nodule and wall thickness. A subsequent pancreatic juice cytology under endoscopic retrograde cholangiopancreatography revealed adenocarcinoma. As this was consistent with the pathological findings shown on TBLB, IPMC metastasis to the lung was diagnosed. In this case, it was considered that pulmonary lepidic metastasis from IPMC by CT imaging and pathological findings. Although the cases of pulmonary lepidic metastasis from gastrointestinal cancer are rare, we should consider these pathological conditions when pneumonia-like infiltration observed on imaging studies does not respond to treatment.
DOI 10.1007/s12328-019-00993-9
PMID 31123981