Yamada Ryusei, Oguri Nobuyuki, Kawano Fumiya, Inomata Mayu, Sato Yuichiro, Maeda Ryo
Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.
Int J Surg Case Rep. 2024 Oct;123:110260. doi: 10.1016/j.ijscr.2024.110260. Epub 2024 Sep 14.
Pulmonary colloid adenocarcinoma is an extremely rare subtype of lung adenocarcinoma. Owing to its rarity, the detailed clinical features of colloid adenocarcinoma remain largely unknown. This report describes a case of early-stage colloid adenocarcinoma that recurred soon after resection, including its radiological findings.
During a routine checkup, a chest roentgenogram revealed an abnormal shadow in the right upper lung field of an asymptomatic 68-year-old man. Computed tomography (CT) showed a well-defined, low-attenuation nodule in the right upper lobe. Right upper lobectomy with mediastinal lymph node dissection was performed. The postoperative histopathological diagnosis indicated pulmonary colloid adenocarcinoma. The pathological stage was classified as T1bN0M0 (stage IA2). Follow-up CT 1 year after the resection revealed an enlarged supraclavicular lymph node and pulmonary nodule in the right lower lobe. Both lesions appeared as well-defined solitary hypoattenuated tumors with minimal enhancement on CT images. Excisional biopsies of both tumors were performed to obtain a definitive diagnosis. Both tumors consisted of abundant mucin in which some tumor cells were floating and were diagnosed as colloid adenocarcinoma recurrences.
Although colloid adenocarcinoma is generally considered to have indolent clinical behavior, it can recur even in early-stage cases.
Colloid adenocarcinoma is a distinct variant of lung adenocarcinoma, characterized by well-circumscribed mucinous lesions with alveolar wall destruction caused by mucin pools and scant tumor cells. The treatment strategy for colloid adenocarcinoma should follow the guidelines for primary lung cancer.
肺黏液腺癌是肺腺癌中极为罕见的一种亚型。由于其罕见性，黏液腺癌的详细临床特征在很大程度上仍不为人知。本报告描述了一例早期黏液腺癌患者，其在切除术后不久复发，包括其影像学表现。
在一次常规体检中，胸部X线片显示一名无症状的68岁男性右上肺野有异常阴影。计算机断层扫描（CT）显示右上叶有一个边界清晰的低密度结节。行右上叶切除并纵隔淋巴结清扫术。术后组织病理学诊断为肺黏液腺癌。病理分期为T1bN0M0（IA2期）。切除术后1年的随访CT显示右锁骨上淋巴结肿大及右下叶肺结节。两个病灶在CT图像上均表现为边界清晰的孤立性低密度肿瘤，增强不明显。对两个肿瘤均进行了切除活检以明确诊断。两个肿瘤均由大量黏液组成，其中一些肿瘤细胞漂浮其中，诊断为黏液腺癌复发。
尽管黏液腺癌通常被认为具有惰性的临床行为，但即使在早期病例中也可能复发。
黏液腺癌是肺腺癌的一种独特变体，其特征为边界清晰的黏液性病变，伴有黏液池导致的肺泡壁破坏及少量肿瘤细胞。黏液腺癌的治疗策略应遵循原发性肺癌的指南。
