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Multiple primary lung cancer versus intrapulmonary metastatic cancer: A case of multiple pulmonary nodules

机译：多发性原发性肺癌与肺内转移性癌症：多种肺结节的情况

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A preoperative chest computed tomography examination of the right breast in a 52-year-old woman with breast cancer revealed multiple nodules in both lungs. The nodule in the apical segment of the upper lobe of the right lung was larger, at a diameter of approximately 2.1 cm. The patient underwent resection of the right breast, followed by thoracoscopic wedge resection of four pulmonary nodules. Hematoxylin and eosin staining and immunohistochemistry showed that the nodules in the apical and anterior segments of the upper lobe and the paravertebral nodule in the lower lobe of the right lung were primary adenocarcinoma, and the subpleural nodule in the lower lobe of the right lung was infiltrated with inflammatory cells. Exon sequencing was conducted in the resected tissue samples and blood specimens. According to the characteristics of the somatic mutations, the nodule in the apical segment of the upper lobe of the right lung was primary lung adenocarcinoma, the nodule in the anterior segment of the upper lobe and the paravertebral nodule in the lower lobe of the right lung were intrapulmonary metastatic cancer, and the subpleural nodule in the lower lobe of the right lung indicated early stage tumor progression. This case provides new evidence that conducting gene detection in multiple tissue samples from patients who have undergone resection may assist to determine the relationship among multiple nodules in the lung to exclude lung metastasis of breast cancer. ? 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
机译：在一个52岁女性的乳腺癌中，术前胸部计算断层扫描检查右乳房在两种肺部揭示了多种结节。右肺的上叶的顶点的结节较大，直径为约2.1cm。病人接受了右乳房切除，然后是四个肺结核的胸腔镜楔切除。苏木精和曙红染色和免疫组织化学表明，上叶的顶点和前瓣的前瓣和前瓣的前瓣的结节是初级腺癌，右肺下叶中的封闭性结节被渗透炎症细胞。在切除的组织样品和血液标本中进行外显子测序。根据体细胞突变的特点，右肺上叶的顶孔中的结节是原发性肺腺癌，在右肺下叶中的上叶的前瓣和椎旁结节中的结节和椎板结节是血管内转移性癌症，右肺部下叶中的副结节表明了早期肿瘤进展。本例提供了新的证据，即在经过切除切除的患者中进行多种组织样本中的基因检测可以有助于确定肺中多个结节之间的关系，以排除乳腺癌的肺转移。 ？ 2018年的作者。中国肺部肿瘤集团和约翰瓦里和儿子澳大利亚发表的胸癌

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