Two Cases of Pancreatic Cancer with Lung Metastasis

• Published in: The Journal of the Japan Society for Respiratory Endoscopy Vol. 43; no. 5; pp. 485 - 490
• Main Authors: Goto, Yoshihiko, Imai, Miyuu, Kosai, Sachiyo, Sakagami, Takuro, Iyonaga, Kazuhiro
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Respiratory Endoscopy 25.09.2021
• Subjects: Lepidic growth pattern; Lung metastasis; Pancreatic cancer; Subepithelial infiltration of the respiratory tract; Thoracoscopic lung biopsy
• ISSN: 0287-2137; 2186-0149
• DOI: 10.18907/jjsre.43.5_485

Background. We herein report two cases with unique patterns of lung metastasis from pancreatic cancer. Case 1. A 69-year-old man was referred to our hospital for a detailed examination of dry cough and dyspnea. Chest computed tomography (CT) showed multi-located infiltrative and nodular opacities along the broncho-vascular bundle. As he did not respond to antimicrobial treatment, bronchoscopy was performed. Multi-located bronchial subepithelial lesions were revealed. A direct biopsy led to a diagnosis of adenocarcinoma. Through contrast-enhanced CT of the whole body, we diagnosed him with pancreatic cancer and lung metastasis mainly due to subepithelial invasion of the respiratory tract. Case 2. A 49-year-old man who had originally been healthy visited our hospital due to an abnormal chest shadow at a medical examination. Chest CT showed diffuse rough granular and small patchy opacities that were diffusely localized with a random pattern. A transbronchial biopsy did not lead to a diagnosis, and diffuse shadow worsened with the appearance of dry cough during follow-up. A thoracoscopic lung biopsy led to a diagnosis of mucinous adenocarcinoma showing alveolar epithelial replacement growth. Contrast-enhanced CT of the whole body revealed an irregular mass in the pancreas. Through endoscopic ultrasound-guided fine needle aspiration, the diagnosis of pancreatic cancer was obtained. Pathologically, we diagnosed him with diffuse lung metastasis of pancreatic cancer. Conclusion. We experienced two cases of pancreatic cancer with various modes of lung metastasis, through both imaging and pathological findings. We herein report these valuable cases.