2006 Volume 46 Issue 7 Pages 823-827
Background. We often encounter cases of lung cancer accompanied by localized ground glass opacity (GGO) surrounding the main tumor. Here, we report a case of lung cancer which showed widespread GGO surrounding the main tumor. Case. A 57-year-old man was referred to our hospital because of an abnormal shadow on his chest X-ray film. Computed tomography of the thorax revealed a 25-mm solid tumor in the right lower lobe and widespread GGO, 80 mm in diameter, around the main tumor. We diagnosed it as lung cancer (cT2N0M0, stage IB) and performed right middle and lower bilobectomy. During the operation, we found lymphangiectasis in the visceral pleura of the right lower lobe, a small nodule of pulmonary metastasis in the right S2, and the metastasis to the hilar lymph node (#11i). The final diagnosis was poorly differentiated adenocarcinoma (pT1N1M1). No malignant cell could be identified in the area of GGO around the main tumor, where we could see lymphangiectasis, capillary dilation, and an accumulation of erythrocytes and macrophages in the alveolar space. It was suggested that lymphostasis and hemostasis due to the metastatic hilar lymph node resulted in localized pulmonary edema. Conclusion. We experienced a case of lung cancer which showed widespread GGO surrounding the main tumor. The widespread GGO in this case was thought to be caused by localized pulmonary edema due to the metastatic hilar lymph node.
