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Clinical Journal of Gastroenterology

, Volume 12, Issue 6, pp 621–625 | Cite as

A rare case of pulmonary lepidic metastasis in patient with branch-type intraductal papillary mucinous carcinoma of the pancreas

  • Fumi Sakuma
  • Kohei Tsuchida
  • Takahito Minaguchi
  • Kazunori Nagashima
  • Naoya Izawa
  • Hidehito Jinnai
  • Takeshi Sugaya
  • Keiichi Tominaga
  • Kenichi Goda
  • Makoto Iijima
  • Hiromi Machida
  • Hajime Kuroda
  • Atsushi IrisawaEmail author
Case Report
  • 84 Downloads

Abstract

Pulmonary lepidic metastasis from intraductal papillary mucinous carcinoma (IPMC) of the pancreas is extremely rare. The patient was a 50s-year old male who was hospitalized in the department of respiratory in our hospital for the evaluation of ground-glass opacities in both lungs on computed tomography (CT) imaging. Steroid therapy was administered, as interstitial pneumonia was suggested; however, there was no improvement. A transbronchial lung biopsy (TBLB) revealed the possibility of distant lung metastases. Abdominal CT revealed pancreatic cystic lesions; the patient was, therefore, referred to our department for further evaluation. Endoscopic ultrasound revealed large multi-cystic lesion with mural nodule and wall thickness. A subsequent pancreatic juice cytology under endoscopic retrograde cholangiopancreatography revealed adenocarcinoma. As this was consistent with the pathological findings shown on TBLB, IPMC metastasis to the lung was diagnosed. In this case, it was considered that pulmonary lepidic metastasis from IPMC by CT imaging and pathological findings. Although the cases of pulmonary lepidic metastasis from gastrointestinal cancer are rare, we should consider these pathological conditions when pneumonia-like infiltration observed on imaging studies does not respond to treatment.

Keywords

Lepidic metastasis Lung metastasis IPMC 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  • Fumi Sakuma
    • 1
  • Kohei Tsuchida
    • 1
  • Takahito Minaguchi
    • 1
  • Kazunori Nagashima
    • 1
  • Naoya Izawa
    • 1
  • Hidehito Jinnai
    • 1
  • Takeshi Sugaya
    • 1
  • Keiichi Tominaga
    • 1
  • Kenichi Goda
    • 1
  • Makoto Iijima
    • 1
  • Hiromi Machida
    • 2
  • Hajime Kuroda
    • 2
  • Atsushi Irisawa
    • 1
    Email author
  1. 1.Department of GastroenterologyDokkyo Medical UniversityShimotsugaJapan
  2. 2.Department of PathologyDokkyo Medical UniversityShimotsugaJapan

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