Kim Eo Jin, Kim So Ri, Jin Gang Su, Park Seung Yong, Han Young Min, Lee Yong Chul
From the Department of Internal Medicine (EJK), Asan Medical Center, University of Ulsan College of Medicine, Seoul; Department of Internal Medicine and Research Center for Pulmonary Disorders (SRK, SJG, SYP, YCL), Chonbuk National University Medical School; Department of Radiology (YMH), Chonbuk National University Medical School; and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital (SRK, SYP, YMH, YCL), Jeonju, South Korea.
Medicine (Baltimore). 2015 Feb;94(7):e565. doi: 10.1097/MD.0000000000000565.
Small cell lung cancer (SCLC) metastasizes widely, but palatine tonsil is an extremely unusual site for metastasis. Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of lung cancer. However, the most common histological findings among patients of lung cancer with IPF are known as non-SCLC such as adenocarcinoma and squamous cell carcinoma. In addition, the majority of them are located in IPF-associated fibrotic peripheral lesions. A 77-year-old man visited for 1-month persistent cough and dyspnea, with inspiratory dry crackles on both lower lung fields and a large oval mass in his throat. Chest computed tomography revealed 2 masses in the left lower lobe, 1 mass in the right upper lobe, and multiple enlarged mediastinal lymph nodes of the lung accompanying with IPF, which were diagnosed as SCLC pathologically. Very interestingly, the tonsillar mass was also confirmed as the metastatic lesion of SCLC. Chemotherapy for SCLC and medical treatment for IPF were applied. However, in following-up, he expired due to respiratory failure by an acute exacerbation of IPF 3 months after the diagnosis. In this current report, we describe, for the first time, a case of tonsillar metastasis of SCLC with IPF detected simultaneously in a 77-year-old man.
小细胞肺癌（SCLC）广泛转移，但腭扁桃体是极其罕见的转移部位。特发性肺纤维化（IPF）与肺癌风险增加相关。然而，IPF患者中肺癌最常见的组织学表现为非小细胞肺癌，如腺癌和鳞状细胞癌。此外，它们大多位于IPF相关的纤维化周边病变处。一名77岁男性因持续1个月的咳嗽和呼吸困难前来就诊，双下肺野有吸气性干啰音，喉部有一个大的椭圆形肿物。胸部计算机断层扫描显示左肺下叶有2个肿物，右肺上叶有1个肿物，伴有IPF的肺部多个纵隔淋巴结肿大，病理诊断为SCLC。非常有趣的是，扁桃体肿物也被确认为SCLC的转移灶。对SCLC进行了化疗，并对IPF进行了药物治疗。然而，在随访中，他在诊断后3个月因IPF急性加重导致呼吸衰竭死亡。在本报告中，我们首次描述了一名77岁男性同时检测出SCLC伴IPF扁桃体转移的病例。
