Letter to the Editor
Primary Lung Adenocarcinoma With Enteric Morphology Associated With Primary Colon Adenocarcinoma
Adenocarcinoma primario de pulmón con morfología entérica asociado a un adenocarcinoma primario de colon
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An extensive irregular filling defect with inhomogeneous attenuation occupies the right main pulmonary artery and extends into the pulmonary artery branches, with increased vascular diameters (arrowheads). Note also the beaded aspect of a peripheral artery (arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Edson Marchiori, Gláucia Zanetti, Bruno Hochhegger" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Edson" "apellidos" => "Marchiori" ] 1 => array:2 [ "nombre" => "Gláucia" "apellidos" => "Zanetti" ] 2 => array:2 [ "nombre" => "Bruno" "apellidos" => "Hochhegger" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289615001970" "doi" => "10.1016/j.arbres.2015.05.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615001970?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915002074?idApp=UINPBA00003Z" "url" => 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"contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 750 "Ancho" => 1000 "Tamanyo" => 119091 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Diffuse plaques on the upper extremities.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Abdullah Şimşek, Halil Çelikten, İlhami Yapıcı" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Abdullah" "apellidos" => "Şimşek" ] 1 => array:2 [ "nombre" => "Halil" "apellidos" => "Çelikten" ] 2 => array:2 [ "nombre" => "İlhami" "apellidos" => "Yapıcı" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289615001945" "doi" => 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Hammoumi, Reda El Ochi, El Hassane Kabiri" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Mohammed-Massine" "apellidos" => "El Hammoumi" "email" => array:1 [ 0 => "hamoumimassine@hotmail.fr" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Reda" "apellidos" => "El Ochi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "El Hassane" "apellidos" => "Kabiri" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Mohamed V Military University Hospital, Rabat, Morocco" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Mohamed V Military University Hospital, Rabat, Morocco" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adenocarcinoma primario de pulmón con morfología entérica asociado a un adenocarcinoma primario de colon" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 750 "Ancho" => 1044 "Tamanyo" => 262534 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Adenocarcinomatous proliferation of lung parenchyma (Gx10). (B) Pathological view showing Lieberkuhnien glands (Gx20). (C) Pathological view showing positive anti-CK7 (Gx20).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Primary lung adenocarcinoma with enteric morphology is an extremely rare variant of primary invasive adenocarcinoma. It is characterized by predominant colorectal-like components (>50%) and the tumor cells must be negative for all immunohistochemical enteric differentiation markers, such as CK20, CDX2, and mucin 2 (MUC2).<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We report an exceptional case of a lung adenocarcinoma with enteric morphology associated with a primary colon adenocarcinoma. To our knowledge, no similar case has been reported in the literature.</p><p id="par0015" class="elsevierStylePara elsevierViewall">A 50-year-old man presented 2 months previously with severe anemia. Colonoscopy revealed moderately differentiated colon adenocarcinoma of the right colon with positive cytokeratine CK 7 and CK 20 and negative TTF-1 (thyroid transcription factor 1) on immunohistochemistry. Surgical resection of the digestive tumor, classified as T3N0M0, was performed through right colectomy and ileo-transverse side-to-side anastomosis. Simultaneously, in the lung, chest computed tomography revealed a 3.5<span class="elsevierStyleHsp" style=""></span>cm mass in the right lower lobe. Scan-guided biopsy showed a primitive lung adenocarcinoma with positive TTF-1 in the right lower lobe. The lung tumor was classified as T2N0M0. A lower right lobectomy with lymphadenectomy was performed successfully.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Morphologically, the lung tumor was described as whitish or gray-white with some focal areas of hemorrhage and necrosis. Histologically, prominent components of colorectal carcinoma-like glands with typical papillary structures were observed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a, b). On immunohistochemistry, anti-CK 7 and TTF-1 were positive. Anti-CK20 antibody, MUC2 and CDX2 were negative (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>c). Resected lymph nodes were negative for malignancy.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The patient did not receive adjuvant therapy and progress was uneventful until the ninth month, when he presented with isolated sternal metastasis from the surgically resected lung adenocarcinoma. Scheduled chemotherapy was reasonably well tolerated and toxicity was minimal. He continues to progress well after 6 months.</p><p id="par0030" class="elsevierStylePara elsevierViewall">When lung tumor cells are negative for any intestinal protein markers, the entity is called “lung adenocarcinoma with enteric morphology”.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Other morphological types, including the lepidic pattern, can suggest a differential diagnosis of colon cancer.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">On immunohistochemistry, anti-CK7 is generally positive. TTF-1 is positive in 50% of cases. Enteric differentiation is confirmed by positivity of at least 1 of the following markers: CK20, CDX2 and MUC2. If these 3 markers are negative, morphology is considered enteric. Other markers such as villin can be useful. Therefore, no EGFR, K-Ras and ALK gene mutation has ever been reported, in contrast to colon adenocarcinoma and other subtypes of lung adenocarcinoma<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In our particular case, the first challenge was to differentiate the primary lung adenocarcinoma with enteric morphology from colon adenocarcinoma metastasis. Meticulous, repeated examinations were performed and second opinions were obtained by the pathology team. The second challenge was the therapeutic strategy or the use of chemotherapy in the postoperative course.</p><p id="par0050" class="elsevierStylePara elsevierViewall">This association causes problems for diagnosing lung adenocarcinoma with enteric morphology, especially in cases where the immunohistochemical study would be superimposed on that of pulmonary metastasis of colon adenocarcinoma, and offers opportunities for molecular diagnostics, such as EGFR mutation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: El Hammoumi M.-M., El Ochi R., Kabiri E.H. Adenocarcinoma primario de pulmón con morfología entérica asociado a un adenocarcinoma primario de colon. Arch Bronconeumol. 2016;52:221.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 750 "Ancho" => 1044 "Tamanyo" => 262534 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Adenocarcinomatous proliferation of lung parenchyma (Gx10). (B) Pathological view showing Lieberkuhnien glands (Gx20). (C) Pathological view showing positive anti-CK7 (Gx20).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary pulmonary adenocarcinoma with enteric differentiation resembling metastatic colorectal carcinoma: a report of the second case negative for cytokeratin 7" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Hatanaka" 1 => "K. Tsuta" 2 => "K. Watanabe" 3 => "K. Sugino" 4 => "T. 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| 2020 January | 55 | 25 | 80 |
| 2019 December | 58 | 15 | 73 |
| 2019 November | 34 | 15 | 49 |
| 2019 October | 33 | 11 | 44 |
| 2019 September | 50 | 15 | 65 |
| 2019 August | 53 | 14 | 67 |
| 2019 July | 48 | 15 | 63 |
| 2019 June | 37 | 13 | 50 |
| 2019 May | 64 | 22 | 86 |
| 2019 April | 68 | 54 | 122 |
| 2019 March | 57 | 35 | 92 |
| 2019 February | 36 | 24 | 60 |
| 2019 January | 171 | 29 | 200 |
| 2018 December | 36 | 20 | 56 |
| 2018 November | 70 | 27 | 97 |
| 2018 October | 74 | 21 | 95 |
| 2018 September | 34 | 18 | 52 |
| 2018 May | 15 | 0 | 15 |
| 2018 April | 29 | 2 | 31 |
| 2018 March | 26 | 4 | 30 |
| 2018 February | 44 | 5 | 49 |
| 2018 January | 26 | 13 | 39 |
| 2017 December | 38 | 4 | 42 |
| 2017 November | 29 | 7 | 36 |
| 2017 October | 33 | 6 | 39 |
| 2017 September | 26 | 9 | 35 |
| 2017 August | 27 | 11 | 38 |
| 2017 July | 21 | 6 | 27 |
| 2017 June | 26 | 16 | 42 |
| 2017 May | 44 | 14 | 58 |
| 2017 April | 29 | 10 | 39 |
| 2017 March | 29 | 3 | 32 |
| 2017 February | 18 | 5 | 23 |
| 2017 January | 36 | 8 | 44 |
| 2016 December | 23 | 14 | 37 |
| 2016 November | 34 | 21 | 55 |
| 2016 October | 37 | 26 | 63 |
| 2016 September | 31 | 7 | 38 |
| 2016 August | 47 | 17 | 64 |
| 2016 July | 36 | 10 | 46 |
Show all
