Journal of

Case Reports and Images in Pathology

 
  Table of Contents    
Case Report
 
Metachronous adenocarcinoma of lung mimicking metastatic papillary thyroid carcinoma: A case report
Lei Zhang1, Abbey Johnston1, Natalya Shlyakhova1, Fritz Lin1, Richard M. DeMay2, Di Lu1
1Department of Pathology, University of California at Irvine, Orange county, CA, USA.
2Department of Pathology, University of Chicago, Cytology division, Chicago, IL, USA.

Article ID: 100004Z11LZ2015
doi:10.5348/Z11-2015-4-CR-4

Address correspondence to:
Lei Zhang
MD PhD, 1200 Oppenheimer Tower
Los Angeles
CA 90024

Access full text article on other devices

  Access PDF of article on other devices

[HTML Full Text]   [PDF Full Text] [Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar]

How to cite this article:
Zhang L, Johnston A, Shlyakhova N, Lin F, DeMay R, Lu D. Metachronous adenocarcinoma of lung mimicking metastatic papillary thyroid carcinoma: A case report. J Case Rep Images Pathol 2015;1:17–21.


Abstract
Introduction: We report an unusual case of adenocarcinoma of lung metachronous with stage IVA papillary thyroid carcinoma. The two tumors are morphologically similar; and the later presence of lung mass could clinically masquerade as metastatic thyroid carcinoma. We discuss the challenges in clinical, imaging and pathologic diagnosis.
Case Report: A 64-year-old non-smoking female had a thyroidectomy and neck lymph node dissection for a stage IVA tumor with pathologic findings of one 2 mm microcarcinoma of left thyroid and six positive cervical lymph nodes. The post-surgical I131 whole body scan was negative and thyroglobulin is suppressed and stable (<1 ng/ml). One year later, she developed a ground glass and part-solid mass in the superior segment of left lower lobe of lung. The mass slowly grew increasing in size from 2.4 cm to 3.3 cm over 3 years. Biopsy of the lung lesion reveals morphologic features of nuclear inclusions and papillae similar to the previously diagnosed thyroid carcinoma. However, the spectrum of atypia, coarse chromatin and lepidic like growth pattern of tumor cells raise suspicion of adenocarcinoma from lung primary. Immunohistochemical study further confirmed that the lung and thyroid lesions were two different tumors.
Conclusion: Despite the history of advanced papillary thyroid carcinoma, secondary lung cancer should be considered when the postoperative serum thyroglobulin levels are consistently low. Appreciation of cytopathologic details helps differentiating lung primary cancer from thyroid metastasis.

Keywords: Lymph node metastasis, Metachronous adenocarcinoma of lung, Papillary thyroid carcinoma, Thyroglobulin


[HTML Full Text]   [PDF Full Text]

Author Contributions
Lei Zhang – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Abbey Johnston – Acquisition of data, Analysis and interpretation of data, Final approval of the version to be published
Natalya Shlyakhova – Acquisition of data, Analysis and interpretation of data, Final approval of the version to be published
Fritz Lin – Acquisition of data, Analysis and interpretation of data, Final approval of the version to be published
Richard M. DeMay – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Di Lu – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Lei Zhang et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



  Home line About the Journal line Aim and Scope line Open Access line Archives
Apply as Editor line Apply as Reviewer line Submit Reviews - Editors line Submit Reviews - Reviewers
Instructions for Authors line Templates to Use line Copyright Form line Author Checklist
Online Submission line Email Submission line Submit Revision line Submit All Forms line Submit Page Proofs
Terms of Service line Privacy policy line Disclaimer line FAQ line Contact: Journal line Contact: Edorium Journals line Site Map
 
  Copyright © 2017. Edorium. All rights reserved.