Abstract
Background. We encountered a case of adenocarcinoma of hilar type lung cancer detected by sputurn cytology, with a unique tumor growth pattern. Case. A 58-year-old man complaining of a persistent cough had no tumor shadow on chest roentgenogram. However, sputum cytology revealed Class V malignant cells. Bronchoscopic findings showed faded white yellowish mucosa at the spur of the right B1, B2, B3 segmental bronchi. A computed tomograph showed only thickenings of the bronchial walls from the right upper lobe bronchus to the main bronchus. Bronchial biopsy of the dull spur revealed adenocarcinoma. Right sleeve upper lobectomy and lymph node dissection were performed, and the right main bronchus was excised just below the carina due to spread of cancer. The lesion was pathologically diagnosed as a well-differentiated papillary adenocarcinoma, located at the hilar portion of the lung, which had spread mainly in the mucosa from just below the carina and within 2 rings from the bifurcation of middle and lower bronchus and to the subsegmental bronchi of B1, B 2, B3 peripherally. Postoperative irradiation was administered and the patient has been free from cancer for 6 years after surgery. Conclusion. We report a rare case of mucosal spreading hilar adenocarcinoma of the lung. More cases need to be analyzed to elucidate the pathophsyology of this type of lung cancer.
