DİFFÜZPARANKİMAL AKCİĞER HASTALIĞINI TAKLİT EDEN ADENOKARSİNOM OLGUSU

Yıl 2017, Cilt: 31 Sayı: 3, 197 - 199, 01.12.2017

Nafiye Yılmaz Elif Yilmazel Uçar Ömer Araz Adem Karaman Metin Akgün

Öz

Adenokarsinom tüm akciğer kanserlerinin yaklaşık yarısını oluşturan, küçük hücreli dışı akciğer kanserinin de majör histopatolojik alt tipidir. 59 yaşında erkek hasta ilerleyici dispne ve nonproduktif öksürük şikâyetiyle başvurdu. Hasta sigara kullanmamış ve fizik muayenesi normal idi. Akciğer röntgeninde iki taraflı nodüler opasiteler ve akciğer tomografisinde multiple nekrobiyotik nodüller izlendi. Diffüz parankimal akciğer hastalığı veya pulmoner enfeksiyon şüphesi ile hastaya bronkoskopi yapıldı. Transbronşiyal biyopsi sonucu papiller adenokarsinom olarak geldi. Hasta klinik olarak evre 4 olduğu için kemoterapi uygulandı. Adenokarsinom alt tipleri nadir durumlarda atipik radyolojik ve klinik seyir gösterebilir. Akciğer adenokarsinomu radyolojik olarak buzlu cam dansitesi ve multiple nekrobiyotik nodüller şeklinde görülebilir.

Anahtar Kelimeler

Adenokarsinom, radyoloji, diffüz parankimal akciğer hastalığı

AN UNUSUAL CASE OF ADENOCARCINOMA OF THE LUNG PRESENTING LIKE DIFFUSE PARENCHYMAL LUNG DISEASE

Öz

Adenocarcinoma is one of the major histopathological types of non-small-cell lung cancer, accounting for almost half of all lung cancers. A 59-year-old male was admitted to the hospital with complaints of progressive dyspnea and non-productive cough. He was non-smoker and physical examination found normal. A chest Xray showed bilateral nodular opacities and chest computed tomography (CT) scan revealed multiple necrobiotic nodules. The patient underwent bronchoscopy with the suspicion of diffuse parenchymal lung disease or infectious disease. The patient underwent bronchoscopy with the suspicion of diffuse parenchymal lung disease or infectious disease. Transbronchial biopsy (TBB) revealed a papillary predominant adenocarcinoma. His clinical stage was stage IV and the patient was given chemotherapy. Adenocarcinoma subtypes might present with atypical radiological and clinical course on rare occasions. Lung adenocarcinoma might present as ground glass opacity and multiple necrobiotic nodules radiologically.

Anahtar Kelimeler

Adenocarcinoma, radiology, diffuse parenchymal lung disease

Kaynakça

• 1. Huang SF. [Comments on International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society (IASLC/ATS/ERS) International Multidisciplinary Classification of Lung Adenocarcinoma (2011)]. Zhonghua Bing Li Xue Za Zhi. 2011; 40:793-6.
• 2. Nitadori J, Bograd AJ, Kadota K, et al. Impact of micropapillary histologic subtype in selecting limited resection vs lobectomy for lung adenocarcinoma of 2cm or smaller. J Natl Cancer Inst 2013; 105: 1212-20.
• 3. Suyeon Chon, Yu Jin Kim, Sun Young Kyung,et al. A Case of Papillary Adenocarcinoma Presenting with Multiple Cysts. Tuberculosis and Respiratory Diseases 2010; 68: 93-6.
• 4. Lan CC, Wu HC, Lee CH, Huang SF, Wu YK. Lung cancer with unusual presentation as a thinwalled cyst in a young nonsmoker. J Thorac Oncol 2010; 5: 1481-2.