Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Non-Small Cell Lung Cancer in a Respiratory Bronchiolitis Associated Interstitial Lung Disease Patient

호흡 세기관지염 연관 간질성 폐질환환자에서 확인된 비소세포폐암 1예

  • Jhun, Byung-Woo (Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Da-Min (Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Ji-Hyeon (Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jung, Hyun-Ae (Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Song, Lim-Hwa (Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Han, Joung-Ho (Departments of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Man-Pyo (Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 전병우 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 김다민 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 박지현 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 정현애 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 송림화 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 한정호 (성균관대학교 의과대학 삼성서울병원 병리학교실) ;
  • 정만표 (성균관대학교 의과대학 삼성서울병원 내과학교실)
  • Received : 2011.05.30
  • Accepted : 2011.06.22
  • Published : 2011.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Respiratory bronchiolitis-associated interstitial lung disease is one of the smoking-related interstitial lung diseases. Histopathologically, it shows respiratory bronchiolitis, which is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles, accompanying peribronchiolar inflammation. Clinically, it is presented with respiratory symptoms such as a cough, sputum and dyspnea on exertion. It is well known that the incidence of malignancy in interstitial lung disease is high, but in respiratory bronchiolitis-associated interstitial lung disease the report of accompanying malignancy is rare. Here we report a case of a 60-year-old male heavy smoker presented with a cough, sputum and clubbing finger. A chest computed tomography (CT) of the patient did not show any shadow suspected of malignancy, but adenocarcinoma was found on a transbronchial lung biopsy and on a surgical lung biopsy with respiratory bronchiolitis-associated interstitial lung disease.

Keywords

References

  1. Niewoehner DE, Kleinerman J, Rice DB. Pathologic changes in the peripheral airways of young cigarette smokers. N Engl J Med 1974;291:755-8. https://doi.org/10.1056/NEJM197410102911503
  2. Myers JL, Veal CF Jr, Shin MS, Katzenstein AL. Respiratory bronchiolitis causing interstitial lung disease. A clinicopathologic study of six cases. Am Rev Respir Dis 1987;135:880-4. https://doi.org/10.1164/arrd.1987.135.4.880
  3. Rao RN, Goodman LR, Tomashefski JF Jr. Smoking-related interstitial lung disease. Ann Diagn Pathol 2008; 12:445-57. https://doi.org/10.1016/j.anndiagpath.2008.10.001
  4. Patel RR, Ryu JH, Vassallo R. Cigarette smoking and diffuse lung disease. Drugs 2008;68:1511-27. https://doi.org/10.2165/00003495-200868110-00004
  5. Portnoy J, Veraldi KL, Schwarz MI, Cool CD, Curran- Everett D, Cherniack RM, et al. Respiratory bronchiolitis- interstitial lung disease: long-term outcome. Chest 2007;131:664-71. https://doi.org/10.1378/chest.06-1885
  6. Ozawa Y, Suda T, Naito T, Enomoto N, Hashimoto D, Fujisawa T, et al. Cumulative incidence of and predictive factors for lung cancer in IPF. Respirology 2009;14:723-8. https://doi.org/10.1111/j.1440-1843.2009.01547.x
  7. Izumi M, Takayama K, Yabuuchi H, Abe K, Nakanishi Y. Incidence of hypertrophic pulmonary osteoarthropathy associated with primary lung cancer. Respirology 2010;15:809-12. https://doi.org/10.1111/j.1440-1843.2010.01769.x
  8. Scheidl S, Kovacs G, Stacher E, Popper H, Olschewski H. A 55-year-old craftsman with dyspnea and clubbing: a case report. Cases J 2009;2:8579. https://doi.org/10.4076/1757-1626-2-8579
  9. Tomita K, Caramori G, Lim S, Ito K, Hanazawa T, Oates T, et al. Increased p21(CIP1/WAF1) and B cell lymphoma leukemia-x(L) expression and reduced apoptosis in alveolar macrophages from smokers. Am J Respir Crit Care Med 2002;166:724-31. https://doi.org/10.1164/rccm.2104010
  10. Mavridou D, Laws D. Respiratory bronchiolitis associated interstitial lung disease (RB-ILD): a case of an acute presentation. Thorax 2004;59:910-1. https://doi.org/10.1136/thx.2003.011080