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Kwon, Kim, Kim, Choi, Choi, Shin, Choi, Yi, Yun, Choi, Na, Seo, Kim, and Oh: A Case of Adenocarcinoma Presenting a Solitary Pulmonary Nodule that Grows Slowly Over 10 Years
Roentgenogram of the Issue
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(4): 318-323.

Published online: 30 April 2008

DOI: https://doi.org/10.4046/trd.2008.64.4.318

A Case of Adenocarcinoma Presenting a Solitary Pulmonary Nodule that Grows Slowly Over 10 Years

Ki Du Kwon, M.D.1, Ji Hyeong Kim, M.D.1, Dae Yong Kim, M.D.1, Moon Han Choi, M.D.1, Jae Huk Choi, M.D.1, Dong Won Shin, M.D.1, Jong Hyo Choi, M.D.1, Sul Hee Yi, M.D.1, Jin A Yun, M.D.1, Jae Sung Choi, 1, Ju Ok Na, M.D.1, Ki Hyun Seo, M.D.1, Yong Hoon Kim, M.D.1, Mi Hae Oh, M.D.2

1Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.

2Department of Pathology, Soonchunhyang University College of Medicine, Cheonan, Korea.

Address for correspondence: Jae Sung Choi, M.D. Department of Internal Medicine, Soonchunhyang University College of Medicine, 23-20, Bongmyeong-dong, Cheonan 330-721, Korea. Phone: 82-41-570-2114, Fax: 82-41-573-3734, cjssch@hanmail.net

Received 14 February 2008       Accepted 4 April 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.

Keywords: Solitary pulmonary nodule, Slow growing lung cancer, Adenocarcinoma

Figures and Tables

Figure 1
Serial chest PAs show solitary pulmonary masses in left upper lobe. The mass was approximately 1.6 cm in size in 1997 and 3.5 cm in 2006 by slow growing. September, 1997 (A), November, 1998 (B), October, 1999 (C), May, 2004 (D), April, 2006 (E).
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Figure 2
Conventional chest CT scan reveals solitary 3.5 cm sized lung mass in left upper lobe without lynphadenopathy. The distal porton of the mass shows an atelectasis.
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Figure 3
PET-CT scan reveals hypermetabolic activity in the left upper lobe mass measured 3.5 cm. The contralateral hilar, subcarinal and interlobar lymph nodes are considered as benign conditions with the calculated SUVs less than 2.5.
trd-64-318-g003
Figure 4
Microscopic finding shows a well differentiated adenocarcinoma (H&E stain, ×200).
trd-64-318-g004

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