array:24 [
  "pii" => "S1579212915002116"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2015.06.010"
  "estado" => "S300"
  "fechaPublicacion" => "2016-04-01"
  "aid" => "1202"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2015"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2016;52:221"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2453
    "formatos" => array:3 [
      "EPUB" => 133
      "HTML" => 1709
      "PDF" => 611
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289615001969"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2015.05.012"
      "estado" => "S300"
      "fechaPublicacion" => "2016-04-01"
      "aid" => "1202"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2016;52:221"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 14489
        "formatos" => array:3 [
          "EPUB" => 120
          "HTML" => 13497
          "PDF" => 872
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
        "titulo" => "Adenocarcinoma primario de pulm&#243;n con morfolog&#237;a ent&#233;rica asociado a un adenocarcinoma primario de colon"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "221"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Primary lung adenocarcinoma with enteric morphology associated with primary colon adenocarcinoma"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 754
                "Ancho" => 1045
                "Tamanyo" => 264114
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Proliferaci&#243;n adenocarcinomatosa del par&#233;nquima pulmonar &#40;G&#215;10&#41;&#46; B&#41; Imagen anatomopatol&#243;gica que muestra gl&#225;ndulas de Lieberk&#252;hn &#40;Gx20&#41;&#46; C&#41; Imagen anatomopatol&#243;gica que muestra positividad anti-CK7 &#40;G&#215;20&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Mohammed-Massine El Hammoumi, Reda El Ochi, El Hassane Kabiri"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Mohammed-Massine"
                "apellidos" => "El Hammoumi"
              ]
              1 => array:2 [
                "nombre" => "Reda"
                "apellidos" => "El Ochi"
              ]
              2 => array:2 [
                "nombre" => "El Hassane"
                "apellidos" => "Kabiri"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212915002116"
          "doi" => "10.1016/j.arbr.2015.06.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915002116?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615001969?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005200000004/v1_201603270531/S0300289615001969/v1_201603270531/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212915002074"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2015.06.006"
    "estado" => "S300"
    "fechaPublicacion" => "2016-04-01"
    "aid" => "1203"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2016;52:222"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1693
      "formatos" => array:3 [
        "EPUB" => 144
        "HTML" => 1114
        "PDF" => 435
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "The Role of Imaging in Suspected Pulmonary Artery Tumors"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "222"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Rol de las pruebas de imagen en las sospechas de tumor de arteria pulmonar"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 695
              "Ancho" => 995
              "Tamanyo" => 84983
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Axial contrast-enhanced chest computed tomography of a 35-year-old woman with dyspnea&#44; chest pain&#44; and hemoptysis over several months&#46; An extensive irregular filling defect with inhomogeneous attenuation occupies the right main pulmonary artery and extends into the pulmonary artery branches&#44; with increased vascular diameters &#40;arrowheads&#41;&#46; Note also the beaded aspect of a peripheral artery &#40;arrows&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Edson Marchiori, Gl&#225;ucia Zanetti, Bruno Hochhegger"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Edson"
              "apellidos" => "Marchiori"
            ]
            1 => array:2 [
              "nombre" => "Gl&#225;ucia"
              "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" => "/15792129/0000005200000004/v2_201604010234/S1579212915002074/v2_201604010234/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212915002098"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2015.06.008"
    "estado" => "S300"
    "fechaPublicacion" => "2016-04-01"
    "aid" => "1200"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2016;52:220"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1959
      "formatos" => array:3 [
        "EPUB" => 128
        "HTML" => 1335
        "PDF" => 496
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letters</span>"
      "titulo" => "Isolated Cutaneous Sarcoidosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "220"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sarcoidosis cut&#225;nea aislada"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 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&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Abdullah &#350;im&#351;ek, Halil &#199;elikten, &#304;lhami Yap&#305;c&#305;"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Abdullah"
              "apellidos" => "&#350;im&#351;ek"
            ]
            1 => array:2 [
              "nombre" => "Halil"
              "apellidos" => "&#199;elikten"
            ]
            2 => array:2 [
              "nombre" => "&#304;lhami"
              "apellidos" => "Yap&#305;c&#305;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289615001945"
        "doi" => "10.1016/j.arbres.2015.04.013"
        "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/S0300289615001945?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915002098?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005200000004/v2_201604010234/S1579212915002098/v2_201604010234/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Primary Lung Adenocarcinoma With Enteric Morphology Associated With Primary Colon Adenocarcinoma"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#44;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "221"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Mohammed-Massine El Hammoumi, Reda El Ochi, El Hassane Kabiri"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Mohammed-Massine"
            "apellidos" => "El Hammoumi"
            "email" => array:1 [
              0 => "hamoumimassine&#64;hotmail&#46;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">&#42;</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 Cirug&#237;a Tor&#225;cica&#44; Mohamed V Military University Hospital&#44; Rabat&#44; Morocco"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Anatom&#237;a Patol&#243;gica&#44; Mohamed V Military University Hospital&#44; Rabat&#44; Morocco"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Faculty of Medicine and Pharmacy&#44; Mohamed V University&#44; Rabat&#44; Morocco"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Adenocarcinoma primario de pulm&#243;n con morfolog&#237;a ent&#233;rica asociado a un adenocarcinoma primario de colon"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 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">&#40;A&#41; Adenocarcinomatous proliferation of lung parenchyma &#40;Gx10&#41;&#46; &#40;B&#41; Pathological view showing Lieberkuhnien glands &#40;Gx20&#41;&#46; &#40;C&#41; Pathological view showing positive anti-CK7 &#40;Gx20&#41;&#46;</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&#46; It is characterized by predominant colorectal-like components &#40;&#62;50&#37;&#41; and the tumor cells must be negative for all immunohistochemical enteric differentiation markers&#44; such as CK20&#44; CDX2&#44; and mucin 2 &#40;MUC2&#41;&#46;<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&#46; To our knowledge&#44; no similar case has been reported in the literature&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A 50-year-old man presented 2 months previously with severe anemia&#46; Colonoscopy revealed moderately differentiated colon adenocarcinoma of the right colon with positive cytokeratine CK 7 and CK 20 and negative TTF-1 &#40;thyroid transcription factor 1&#41; on immunohistochemistry&#46; Surgical resection of the digestive tumor&#44; classified as T3N0M0&#44; was performed through right colectomy and ileo-transverse side-to-side anastomosis&#46; Simultaneously&#44; in the lung&#44; chest computed tomography revealed a 3&#46;5<span class="elsevierStyleHsp" style=""></span>cm mass in the right lower lobe&#46; Scan-guided biopsy showed a primitive lung adenocarcinoma with positive TTF-1 in the right lower lobe&#46; The lung tumor was classified as T2N0M0&#46; A lower right lobectomy with lymphadenectomy was performed successfully&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Morphologically&#44; the lung tumor was described as whitish or gray-white with some focal areas of hemorrhage and necrosis&#46; Histologically&#44; prominent components of colorectal carcinoma-like glands with typical papillary structures were observed &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#44; b&#41;&#46; On immunohistochemistry&#44; anti-CK 7 and TTF-1 were positive&#46; Anti-CK20 antibody&#44; MUC2 and CDX2 were negative &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>c&#41;&#46; Resected lymph nodes were negative for malignancy&#46;</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&#44; when he presented with isolated sternal metastasis from the surgically resected lung adenocarcinoma&#46; Scheduled chemotherapy was reasonably well tolerated and toxicity was minimal&#46; He continues to progress well after 6 months&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">When lung tumor cells are negative for any intestinal protein markers&#44; the entity is called &#8220;lung adenocarcinoma with enteric morphology&#8221;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Other morphological types&#44; including the lepidic pattern&#44; can suggest a differential diagnosis of colon cancer&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">On immunohistochemistry&#44; anti-CK7 is generally positive&#46; TTF-1 is positive in 50&#37; of cases&#46; Enteric differentiation is confirmed by positivity of at least 1 of the following markers&#58; CK20&#44; CDX2 and MUC2&#46; If these 3 markers are negative&#44; morphology is considered enteric&#46; Other markers such as villin can be useful&#46; Therefore&#44; no EGFR&#44; K-Ras and ALK gene mutation has ever been reported&#44; in contrast to colon adenocarcinoma and other subtypes of lung adenocarcinoma<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In our particular case&#44; the first challenge was to differentiate the primary lung adenocarcinoma with enteric morphology from colon adenocarcinoma metastasis&#46; Meticulous&#44; repeated examinations were performed and second opinions were obtained by the pathology team&#46; The second challenge was the therapeutic strategy or the use of chemotherapy in the postoperative course&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">This association causes problems for diagnosing lung adenocarcinoma with enteric morphology&#44; especially in cases where the immunohistochemical study would be superimposed on that of pulmonary metastasis of colon adenocarcinoma&#44; and offers opportunities for molecular diagnostics&#44; such as EGFR mutation&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; El Hammoumi M&#46;-M&#46;&#44; El Ochi R&#46;&#44; Kabiri E&#46;H&#46; Adenocarcinoma primario de pulm&#243;n con morfolog&#237;a ent&#233;rica asociado a un adenocarcinoma primario de colon&#46; Arch Bronconeumol&#46; 2016&#59;52&#58;221&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 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">&#40;A&#41; Adenocarcinomatous proliferation of lung parenchyma &#40;Gx10&#41;&#46; &#40;B&#41; Pathological view showing Lieberkuhnien glands &#40;Gx20&#41;&#46; &#40;C&#41; Pathological view showing positive anti-CK7 &#40;Gx20&#41;&#46;</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&#58; a report of the second case negative for cytokeratin 7"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Hatanaka"
                            1 => "K&#46; Tsuta"
                            2 => "K&#46; Watanabe"
                            3 => "K&#46; Sugino"
                            4 => "T&#46; Uekusa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.prp.2010.07.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pathol Res Pract"
                        "fecha" => "2011"
                        "volumen" => "207"
                        "paginaInicial" => "188"
                        "paginaFinal" => "191"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20727680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary enteric adenocarcinoma with villin brush border immunoreactivity&#58; a case report and literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Lin"
                            1 => "Y&#46; Zhao"
                            2 => "H&#46; Li"
                            3 => "X&#46; Xing"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3978/j.issn.2072-1439.2012.06.06"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Dis"
                        "fecha" => "2013"
                        "volumen" => "5"
                        "paginaInicial" => "E17"
                        "paginaFinal" => "E20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23372961"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency of driver mutations in lung adenocarcinoma from female never-smokers varies with histologic subtypes and age at diagnosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Zhang"
                            1 => "Y&#46; Sun"
                            2 => "Y&#46; Pan"
                            3 => "C&#46; Li"
                            4 => "L&#46; Shen"
                            5 => "Y&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/1078-0432.CCR-11-2511"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Cancer Res"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "1947"
                        "paginaFinal" => "1953"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22317764"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High incidence of EGFR mutations in Korean men smokers with no intratumoral heterogeneity of lung adenocarcinomas&#58; correlation with histologic subtypes&#44; EGFR&#47;TTF-1 expressions&#44; and clinical features"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;L&#46; Sun"
                            1 => "H&#46; Seol"
                            2 => "H&#46;J&#46; Lee"
                            3 => "S&#46;B&#46; Yoo"
                            4 => "H&#46; Kim"
                            5 => "X&#46; Xu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/JTO.0b013e3182381515"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Oncol"
                        "fecha" => "2012"
                        "volumen" => "7"
                        "paginaInicial" => "323"
                        "paginaFinal" => "330"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22237264"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005200000004/v2_201604010234/S1579212915002116/v2_201604010234/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "49861"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Scientific letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005200000004/v2_201604010234/S1579212915002116/v2_201604010234/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915002116?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 52. Issue 4.
Pages 221 (April 2016)
Letter to the Editor
Full text access
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
Visits
8146
Mohammed-Massine El Hammoumia,c,
Corresponding author
hamoumimassine@hotmail.fr

Corresponding author.
, Reda El Ochib, El Hassane Kabiria,c
a Servicio de Cirugía Torácica, Mohamed V Military University Hospital, Rabat, Morocco
b Servicio de Anatomía Patológica, Mohamed V Military University Hospital, Rabat, Morocco
c Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text
To the Editor,

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).1

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.

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 3.5cm 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.

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 (Fig. 1a, b). On immunohistochemistry, anti-CK 7 and TTF-1 were positive. Anti-CK20 antibody, MUC2 and CDX2 were negative (Fig. 1c). Resected lymph nodes were negative for malignancy.

Fig. 1.

(A) Adenocarcinomatous proliferation of lung parenchyma (Gx10). (B) Pathological view showing Lieberkuhnien glands (Gx20). (C) Pathological view showing positive anti-CK7 (Gx20).

(0.25MB).

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.

When lung tumor cells are negative for any intestinal protein markers, the entity is called “lung adenocarcinoma with enteric morphology”.

Other morphological types, including the lepidic pattern, can suggest a differential diagnosis of colon cancer.1,2

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 adenocarcinoma3,4

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.

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.

References
[1]
K. Hatanaka, K. Tsuta, K. Watanabe, K. Sugino, T. Uekusa.
Primary pulmonary adenocarcinoma with enteric differentiation resembling metastatic colorectal carcinoma: a report of the second case negative for cytokeratin 7.
Pathol Res Pract, 207 (2011), pp. 188-191
[2]
D. Lin, Y. Zhao, H. Li, X. Xing.
Pulmonary enteric adenocarcinoma with villin brush border immunoreactivity: a case report and literature review.
[3]
Y. Zhang, Y. Sun, Y. Pan, C. Li, L. Shen, Y. Li, et al.
Frequency of driver mutations in lung adenocarcinoma from female never-smokers varies with histologic subtypes and age at diagnosis.
Clin Cancer Res, 18 (2012), pp. 1947-1953
[4]
P.L. Sun, H. Seol, H.J. Lee, S.B. Yoo, H. Kim, X. Xu, et al.
High incidence of EGFR mutations in Korean men smokers with no intratumoral heterogeneity of lung adenocarcinomas: correlation with histologic subtypes, EGFR/TTF-1 expressions, and clinical features.
J Thorac Oncol, 7 (2012), pp. 323-330

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.

Copyright © 2015. SEPAR
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?