An Autopsy Case of Lepidic Pulmonary Metastasis from Cholangiocarcinoma

We herein report the first case of pulmonary metastasis with lepidic growth that originated from cholangiocarcinoma. A 77-year-old man was admitted to our hospital due to exertional dyspnea and liver dysfunction. Computed tomography showed widespread infiltration and a ground-glass opacity in the lung and dilation of the intrahepatic bile duct. The pulmonary lesion progressed rapidly, and the patient died of respiratory failure. Cholangiocarcinoma and lepidic pulmonary metastasis were pathologically diagnosed by an autopsy. Lepidic pulmonary growth is an atypical pattern of metastasis, and immunopathological staining is useful to distinguish pulmonary metastasis from extrapulmonary cancer and primary pulmonary adenocarcinoma.

[1]  H. Arakawa,et al.  A case of lepidic pulmonary metastasis from adenocarcinoma of the gallbladder mimicking acute interstitial pneumonia. , 2005, Clinical radiology.

[2]  J. Goo,et al.  Atypical pulmonary metastases: spectrum of radiologic findings. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[3]  P. Chu,et al.  Cytokeratin 7 and Cytokeratin 20 Expression in Epithelial Neoplasms: A Survey of 435 Cases , 2000, Modern Pathology.

[4]  M. Gaeta,et al.  Air-space pattern in lung metastasis from adenocarcinoma of the GI tract. , 1996, Journal of computer assisted tomography.

[5]  H. Nakata,et al.  CT of pulmonary metastases with pathological correlation. , 1995, Seminars in ultrasound, CT, and MR.

[6]  S. D. Davis,et al.  CT evaluation for pulmonary metastases in patients with extrathoracic malignancy. , 1991, Radiology.

[7]  F. Clayton.  Bronchioloalveolar carcinomas. Cell types, patterns of growth, and prognostic correlates , 1986, Cancer.

[8]  Pagani Jj,et al.  Imaging bone metastases. , 1982 .

[9]  C. Foster,et al.  Mucus‐secreting ‘alveolar‐cell’ tumour of the lung: a histochemical comparison of tumours arising within and outside the lung , 1980, Histopathology.

[10]  M. B. Rosenblatt,et al.  Primary and metastatic bronciolo-alveolar carcinoma. , 1967, Diseases of the chest.

[11]  P. Illei,et al.  Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma. , 2010, Human pathology.

[12]  R. Okita,et al.  Multiple ground-glass opacity in metastasis of malignant melanoma diagnosed by lung biopsy. , 2005, The Annals of thoracic surgery.

[13]  I. Lee.  Pulmonary metastases. , 1956, Diseases of the chest.