Omori Keitaro, Tetsuhara Kenichi, Hiramoto Hakubun, Shoda Hiroyasu, Sanefuji Hayato, Okamoto Naoki
Department of Internal Medicine, Kitakyushu General Hospital.
Nihon Kokyuki Gakkai Zasshi. 2010 Jul;48(7):497-501.
A 72-year-old man complained of dyspnea and epigastric pain. He was admitted to our hospital with progressive dyspnea and abnormal chest radiograph findings. Chest CT scan on admission showed multiple nodular shadows with and without air-bronchograms, vessels or cavitation. Transbronchial and percutaneous lung biopsy specimens demonstrated poorly differentiated carcinoma. Pulmonary metastases were suspected, but their primary origin was unknown. Chest and abdominal CT scans on the 18th hospital day showed a giant tumor of the small intestine and rapid progression of the pulmonary tumor, forming cavitation. The patient's condition worsened, and he died on the 51st hospital day. At autopsy, a final diagnosis of T-cell lymphoma of the small intestine and pulmonary metastases was obtained. This is a rare case which was found primarily based on the characteristic radiologic features of pulmonary metastases.