Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case report
Abstract Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH), a rare condition, is characterized by pathological proliferation of neuroendocrine cells. Some of them are localized to the airway mucosa, and others locally infiltrate to form tumorlets and nodules. Here, we present a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-11-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.14662 |
| _version_ | 1811256262350864384 |
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| author | Sho Inomata Yuki Matsumura Yasuyuki Kobayashi Hikaru Yamaguchi Masayuki Watanabe Yuki Ozaki Satoshi Muto Naoyuki Okabe Yutaka Shio Hiroyuki Suzuki |
| author_facet | Sho Inomata Yuki Matsumura Yasuyuki Kobayashi Hikaru Yamaguchi Masayuki Watanabe Yuki Ozaki Satoshi Muto Naoyuki Okabe Yutaka Shio Hiroyuki Suzuki |
| author_sort | Sho Inomata |
| collection | DOAJ |
| description | Abstract Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH), a rare condition, is characterized by pathological proliferation of neuroendocrine cells. Some of them are localized to the airway mucosa, and others locally infiltrate to form tumorlets and nodules. Here, we present a patient with lung adenocarcinoma accompanied by DIPNECH, making the latter difficult to distinguish from multiple pulmonary metastases. The patient, a 72‐year‐old Japanese woman, was diagnosed as having stage IVA lung adenocarcinoma because she had multiple nodules in both lungs. Mutation of epidermal growth factor receptor gene having been found in the primary tumor, treatment with osimertinib was started. This resulted in shrinkage of the primary tumor, but not the multiple pulmonary nodules. To determine whether these lung nodules were indeed lung metastases, we performed right upper lobectomy with lymphadenectomy and wedge resection of the right lower lobe. On pathological examination, the primary tumor was diagnosed as invasive adenocarcinoma, whereas the multiple pulmonary nodules were diagnosed as DIPNECH manifesting as tumorlets. Therefore, the final diagnosis was stage IA1 lung adenocarcinoma accompanied by DINPECH. The patient had no recurrences 1 year after the operation without any additional treatment. This is a rare case of lung adenocarcinoma accompanied by DIPNECH presenting as multiple pulmonary nodules. DIPNECH should be included in the differential diagnosis of multiple pulmonary nodules. |
| first_indexed | 2024-04-12T17:38:25Z |
| format | Article |
| id | doaj.art-3230c1a58b1e403c91e1417cce836bc1 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-12T17:38:25Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-3230c1a58b1e403c91e1417cce836bc12022-12-22T03:22:53ZengWileyThoracic Cancer1759-77061759-77142022-11-0113213076307910.1111/1759-7714.14662Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case reportSho Inomata0Yuki Matsumura1Yasuyuki Kobayashi2Hikaru Yamaguchi3Masayuki Watanabe4Yuki Ozaki5Satoshi Muto6Naoyuki Okabe7Yutaka Shio8Hiroyuki Suzuki9Department of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Diagnostic Pathology Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanDepartment of Chest Surgery Fukushima Medical University Fukushima JapanAbstract Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH), a rare condition, is characterized by pathological proliferation of neuroendocrine cells. Some of them are localized to the airway mucosa, and others locally infiltrate to form tumorlets and nodules. Here, we present a patient with lung adenocarcinoma accompanied by DIPNECH, making the latter difficult to distinguish from multiple pulmonary metastases. The patient, a 72‐year‐old Japanese woman, was diagnosed as having stage IVA lung adenocarcinoma because she had multiple nodules in both lungs. Mutation of epidermal growth factor receptor gene having been found in the primary tumor, treatment with osimertinib was started. This resulted in shrinkage of the primary tumor, but not the multiple pulmonary nodules. To determine whether these lung nodules were indeed lung metastases, we performed right upper lobectomy with lymphadenectomy and wedge resection of the right lower lobe. On pathological examination, the primary tumor was diagnosed as invasive adenocarcinoma, whereas the multiple pulmonary nodules were diagnosed as DIPNECH manifesting as tumorlets. Therefore, the final diagnosis was stage IA1 lung adenocarcinoma accompanied by DINPECH. The patient had no recurrences 1 year after the operation without any additional treatment. This is a rare case of lung adenocarcinoma accompanied by DIPNECH presenting as multiple pulmonary nodules. DIPNECH should be included in the differential diagnosis of multiple pulmonary nodules.https://doi.org/10.1111/1759-7714.14662diffuse idiopathic pulmonary neuroendocrine cell hyperplasiaepidermal growth factor receptorlung adenocarcinomatyrosine kinase inhibitor |
| spellingShingle | Sho Inomata Yuki Matsumura Yasuyuki Kobayashi Hikaru Yamaguchi Masayuki Watanabe Yuki Ozaki Satoshi Muto Naoyuki Okabe Yutaka Shio Hiroyuki Suzuki Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case report Thoracic Cancer diffuse idiopathic pulmonary neuroendocrine cell hyperplasia epidermal growth factor receptor lung adenocarcinoma tyrosine kinase inhibitor |
| title | Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case report |
| title_full | Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case report |
| title_fullStr | Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case report |
| title_full_unstemmed | Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case report |
| title_short | Lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules: A case report |
| title_sort | lung adenocarcinoma coexisting with diffuse idiopathic pulmonary neuroendocrine cell hyperplasia manifesting as multiple pulmonary nodules a case report |
| topic | diffuse idiopathic pulmonary neuroendocrine cell hyperplasia epidermal growth factor receptor lung adenocarcinoma tyrosine kinase inhibitor |
| url | https://doi.org/10.1111/1759-7714.14662 |
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