Perre Anthony, Markman Maurie
Cancer Treatment Centers of America, Eastern Regional Medical Center, Philadelphia, Pa., USA.
Case Rep Oncol. 2011 Sep;4(3):592-6. doi: 10.1159/000335346. Epub 2011 Dec 14.
The screening of patients with a known primary extrathoracic malignancy for pulmonary metastasis may result in the identification of solitary or multiple pulmonary nodules. Radiologic features of these pulmonary nodules may suggest a diagnosis, but these features cannot reliably distinguish between benign and malignant etiologies. We present the case of a patient, diagnosed with carcinosarcoma of the bladder, who was found to have multiple pulmonary nodules by CT evaluation. Physical examination of the patient demonstrated the presence of cervical and axillary lymphadenopathy. An excisional biopsy of an axillary lymph node confirmed the diagnosis of Hodgkin's lymphoma. This case report demonstrates that radiographic information obtained by CT scan must be carefully correlated with the history and physical examination of the patient. This case report also demonstrates the importance of diagnostic biopsy of pulmonary nodularity discovered in patients with a known primary extrathoracic malignancy. The assumption that these pulmonary nodules represented metastatic malignancies would have had crucial prognostic and therapeutic implications.
对已知原发性胸外恶性肿瘤患者进行肺转移筛查可能会发现孤立或多发的肺结节。这些肺结节的放射学特征可能提示诊断,但这些特征无法可靠地区分良性和恶性病因。我们报告一例诊断为膀胱癌肉瘤的患者,通过CT评估发现其有多个肺结节。对该患者的体格检查发现有颈部和腋窝淋巴结病。对一个腋窝淋巴结进行切除活检确诊为霍奇金淋巴瘤。本病例报告表明,通过CT扫描获得的影像学信息必须与患者的病史和体格检查仔细关联。本病例报告还证明了对已知原发性胸外恶性肿瘤患者中发现的肺结节进行诊断性活检的重要性。认为这些肺结节代表转移性恶性肿瘤的假设会产生关键的预后和治疗意义。