Clinical Image
Atypical Metastasis of Lung Adenocarcinoma
Metástasis atípicas de adenocarcinoma de pulmón
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(C) Hematoxylin and eosin-stained section of lung (400×). (D) Tumor cells with positive CK5/6 staining (100×). (E) Neoplastic cells with positive staining for pancytokeratin AE1/AE3 (100×). (F) Neoplastic cells P40 positive (100×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Oriana Salamo, Sujith V. Cherian, Rosa M. Estrada-Y-Martin" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Oriana" "apellidos" => "Salamo" ] 1 => array:2 [ "nombre" => "Sujith V." "apellidos" => "Cherian" ] 2 => array:2 [ "nombre" => "Rosa M." "apellidos" => "Estrada-Y-Martin" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921003165?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000010/v1_202110020725/S1579212921003165/v1_202110020725/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212921002895" "issn" => "15792129" "doi" => "10.1016/j.arbr.2021.07.002" "estado" => "S300" "fechaPublicacion" => "2021-10-01" "aid" => "2414" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57:649" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "A normal chest <span class="elsevierStyleSmallCaps">X</span>-ray does not rule out the patient’s version" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "649" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una radiografía de tórax normal no excluye la versión del paciente" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1078 "Ancho" => 1750 "Tamanyo" => 191359 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Posteroanterior and lateral chest X-ray with no changes. A) CT reconstruction of the chest showing the pull tab in the intermediate bronchus (arrow) in a coronal slice. B) Proximal tip of the pull tab embedded in the distal third of the intermediate bronchus. C) Endoscopic view after removal of the pull tab, showing persistent proximal and distal granulation tissue forming a septum. D) Pull tab.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elena Forcén, María José Bernabé, Roberto Larrosa-Barrero" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Elena" "apellidos" => "Forcén" ] 1 => array:2 [ "nombre" => "María José" "apellidos" => "Bernabé" ] 2 => array:2 [ "nombre" => "Roberto" "apellidos" => "Larrosa-Barrero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289620300533" "doi" => "10.1016/j.arbres.2020.01.021" "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/S0300289620300533?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002895?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000010/v1_202110020725/S1579212921002895/v1_202110020725/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Atypical Metastasis of Lung Adenocarcinoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "650" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ângela Dias Cunha, Marta Sousa, Paula Sousa" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ângela" "apellidos" => "Dias Cunha" "email" => array:1 [ 0 => "angelamdcunha@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Marta" "apellidos" => "Sousa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Paula" "apellidos" => "Sousa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Pneumology, Centro Hospitalar Tondela-Viseu, Viseu, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Gastroenterology, Centro Hospitalar Tondela-Viseu, Viseu, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis atípicas de adenocarcinoma de pulmón" ] ] "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" => 616 "Ancho" => 1500 "Tamanyo" => 212138 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) On the posterior side of the gastric lower body, a deep ulcer with elevated edges was observed, with an extension of about 5<span class="elsevierStyleHsp" style=""></span>cm – biopsies of the edges were performed. (B) and (C) Hematoxylin-and-eosin staining of the gastric lesion showed a papillary pattern and cohesive neoplastic cells forming irregular gland-like tubular structures, findings compatible with poorly differentiated adenocarcinoma. The positivity of (D) thyroid transcription factor 1 (TTF-1) and (E) cytokeratin 7 (CK-7) stained in brown was determined by immunohistochemistry.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 67-year-old woman, current smoker (25 pack-years), with stage IV lung adenocarcinoma diagnosed 18 months before, under chemotherapy, presented to the emergency department with progressive dysphagia, abdominal pain, nausea and vomiting in the last 15 days. Laboratory data revealed hypochromic and microcytic anemia (hemoglobin 7.4<span class="elsevierStyleHsp" style=""></span>g/dL). Esophagogastroduodenoscopy showed an extensive ulcerated lesion with elevated irregular borders in the posterior wall of the gastric lower body (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A); biopsies were obtained, and pathological examination of specimens demonstrated poorly differentiated invasive adenocarcinoma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C). In the immunohistochemical studies, tumor cells were positive for thyroid transcription factor 1 (TTF-1) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D) and cytokeratin 7 (CK-7) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E); and negative for cytokeratin 20 (CK-20), consistent with metastasis from lung adenocarcinoma. As the patient's general condition was quickly deteriorating and considering her poor overall performance status, best supportive care management was the recommended treatment. She died 21 months after the initial diagnosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Metastasis to gastrointestinal tract from lung cancer is uncommon with reported incidences ranging from 0.5% to 10%. The specific occurrence of gastric metastasis ranges from 0.2 to 0.5% thus representing a very rare event. Immunochemistry is a very useful tool for differentiating primary gastric cancer from gastric metastasis in equivocal cases.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">No funding.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of Interests</span><p id="par0020" class="elsevierStylePara elsevierViewall">No conflicts of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of Interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "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" => 616 "Ancho" => 1500 "Tamanyo" => 212138 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) On the posterior side of the gastric lower body, a deep ulcer with elevated edges was observed, with an extension of about 5<span class="elsevierStyleHsp" style=""></span>cm – biopsies of the edges were performed. (B) and (C) Hematoxylin-and-eosin staining of the gastric lesion showed a papillary pattern and cohesive neoplastic cells forming irregular gland-like tubular structures, findings compatible with poorly differentiated adenocarcinoma. The positivity of (D) thyroid transcription factor 1 (TTF-1) and (E) cytokeratin 7 (CK-7) stained in brown was determined by immunohistochemistry.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastro-intestinal metastasis of primary lung carcinoma: Clinical presentations and outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.J. Yang" 1 => "J.J. Hwang" 2 => "W.Y. Kang" 3 => "I.W. Chong" 4 => "T.H. Wang" 5 => "C.C. Sheu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.lungcan.2006.08.007" "Revista" => array:6 [ "tituloSerie" => "Lung Cancer." "fecha" => "2006" "volumen" => "54" "paginaInicial" => "319" "paginaFinal" => "323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17010474" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary lung cancer presenting with gastrointestinal tract involvement: Clinicopathologic and immunohistochemical features in a series of 18 consecutive cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Rossi" 1 => "A. Marchioni" 2 => "E. Romagnani" 3 => "F. Bertolini" 4 => "L. Longo" 5 => "A. Cavazza" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Thorac Oncol." "fecha" => "2007" "volumen" => "2" "paginaInicial" => "115" "paginaFinal" => "120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17410025" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005700000010/v1_202110020725/S1579212921003153/v1_202110020725/en/main.assets" "Apartado" => array:4 [ "identificador" => "60604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000010/v1_202110020725/S1579212921003153/v1_202110020725/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921003153?idApp=UINPBA00003Z" ]
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