Metastatic colorectal micropapillary carcinoma presenting as lymphangitic lung carcinomatosis
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CASE REPORT
Metastatic colorectal micropapillary carcinoma presenting as lymphangitic lung carcinomatosis Carlos A. Lopez‑Garcia1 · Irean Garcia‑Hernandez1 · Dulce María López‑Sotomayor2 · Claudia Martínez‑Amador2 · Alejandra Rodríguez‑Prado2 · Eduardo Esteban‑Zubero3 · Moises A. Alatorre‑Jimenez4 · Antonio Dono5 · José Eduardo Pérez‑Saucedo1 Received: 14 January 2020 / Accepted: 28 September 2020 © Japanese Society of Gastroenterology 2020
Abstract Pulmonary lymphangitic carcinomatosis denotes the infiltration of tumor cells into the lung parenchymal lymphatic channels. Breast, lung, stomach, and colon adenocarcinoma are the most common origin of this invasion pattern. The micropapillary variant of colorectal adenocarcinoma has a high rate of lymph node metastases and poor overall survival. A 49 year-old man with a 6 months history of persistent cough and a relevant occupational chemical exposure had a computed tomography that showed bilateral interstitial lung infiltrates. The lung biopsy demonstrated a micropapillary adenocarcinoma with diffusely obstruction of the lung parenchymal lymphatics. The immunohistochemistry confirmed a colorectal origin. The colonoscopy evidenced a mass with identical morphology. Colorectal micropapillary carcinoma with metastatic lung lymphangitic carcinomatosis can occur, as a persistent cough, as presenting symptom in extraordinarily rare cases. To the best of our knowledge, this is the first case of an alive patient with colorectal metastatic micropapillary carcinoma presenting with lymphangitic lung carcinomatosis. Keywords Lymphangitic lung carcinomatosis · Lung metastasis · Micropapillary colorectal carcinoma · Metastatic cancer · Colon Abbreviations WHO World health organization CT Computed tomography CK7 Cytokeratin 7 CK20 Cytokeratin 20
CDH17 Cadherin-17 TTF1 Thyroid transcription factor-1 MUC5AC Mucin 5AC p63 Tumor protein p63 EMA Epithelial membrane antigen
* José Eduardo Pérez‑Saucedo [email protected]
Antonio Dono [email protected]
Carlos A. Lopez‑Garcia [email protected]
1
Tecnologico de Monterrey, Hospital San Jose, Tec Salud, Av. Morones Prieto #3000 Pte, Col. Los Doctores, CP 64710 Monterrey, Nuevo León, México
2
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Av. Morones Prieto #3000 Pte, Col. Los Doctores, CP 64710 Monterrey, Nuevo León, México
Claudia Martínez‑Amador [email protected]
3
Department of Emergency, Hospital San Pedro, Calle Piqueras, 98, 26006 Logroño, La Rioja, Spain
Alejandra Rodríguez‑Prado [email protected]
4
Department of Pediatrics, SUNY Downstate, 450 Clarkson Avenue, Box 49, Brooklyn, NY 11203, USA
Eduardo Esteban‑Zubero [email protected]
5
Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center At Houston, Medical School, 6431 Fannin, Suite 7.146 Houston, Houston, TX 77030, USA
Irean Garcia‑Hernandez [email protected] Dulce María López‑Sotomayor [email protected]
Moises A. Alatorre‑Jimenez moises.alatorreji
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