A Case of the Bronchiolo-alveolar Cell Carcinoma Presenting Multiple Cavities and Synchronous Gastric Cancer

Abstract

A 68-year-old female complained of coughing with sputum since September 1989 and visited her local doctor on November 13. A 7.0×4.0 cm cavity with a niveau and multiple small ringed shadows around it in the right lower lobe were observed on her chest X-ray film. She was admitted on January 5, 1990. No sign of malignancy was found by bronchoscopy or other examinations. The preoperative diagnosis was bronchogenic cyst with a niveau and scattered lesions, due to some infection. Right lower lobectomy was performed on January 25, 1990. The histopathological examination of the specimen revealed bronchiolo-alveolar cell carcinoma. One month after the operation, distal gastrectomy was performed because of a synchronous gastric cancer. Histopathological examination of the gastric specimen showed poorly differentiated adenocarcinoma. Invasion of the cancer was within the proper muscle layer and no metastasis to the lymph nodes was observed. There have been only eight reported cases of primary lung cancer showing multiple cavitations. Six of them were bronchiolo-alveolar cell carcinomas, in which the cavities were found in the bilateral lung at diagnosis, and no surgical treatment was performed. This case showed a very unusual image with multiple cavities were localized within one lobe. © 1992, The Japan Lung Cancer Society. All rights reserved.