Bhardwaj Richa, Bhardwaj Gaurav, Gautam Arun, Karagozian Raffi
Resident, Department of Internal Medicine, University of Connecticut, Farmington, Connecticut, USA.
Research Student, Department of Internal Medicine, University of Connecticut, Farmington, Connecticut, USA.
J Clin Diagn Res. 2017 Jun;11(6):OD13-OD14. doi: 10.7860/JCDR/2017/27040.10090. Epub 2017 Jun 1.
Gastrointestinal (GI) metastasis from primary lung cancer is a rare clinical finding. Lung cancer most often metastasizes to the brain, bone, liver, and adrenal glands; with gastrointestinal involvement being very rare. We report a case of a 39-year-old female with a diagnosis of poorly differentiated Squamous Cell Carcinoma (SCC) of the lung presenting with dizziness and melena. Esophagogastroduodenoscopy (EGD) showed a bleeding mass in the stomach. Final biopsy report and Immunohistochemistry (IHC) of the specimen were consistent with SCC lung metastasis. While it is imperative to have a high clinical suspicion for GI metastasis in patients with primary lung cancer presenting with GI symptoms, it may be challenging to establish diagnosis. Endoscopy along with pathology and immunohistochemistry play a crucial role in differentiating primary GI malignancies from metastasis.
原发性肺癌的胃肠道转移是一种罕见的临床发现。肺癌最常转移至脑、骨、肝和肾上腺;胃肠道受累非常罕见。我们报告一例39岁女性,诊断为低分化肺鳞状细胞癌,表现为头晕和黑便。食管胃十二指肠镜检查(EGD)显示胃内有一出血性肿物。标本的最终活检报告和免疫组织化学(IHC)结果与肺鳞状细胞癌转移相符。对于出现胃肠道症状的原发性肺癌患者,高度临床怀疑胃肠道转移至关重要,但确诊可能具有挑战性。内镜检查结合病理和免疫组织化学在鉴别原发性胃肠道恶性肿瘤与转移瘤方面起着关键作用。