2016 Volume 55 Issue 6 Pages 395-400
Background : Herein, we report a case of TX lung cancer that was successfully diagnosed by liquid based cytology (LBC) from metastatic mandibular and thyroid lesions.
Case : A woman in her 80 s presented to us with the chief complaint of swelling and pain of her right cheek. CT and MRI examinations revealed tumor masses in the right mandible and atlas. FDG accumulation was observed in the masses of the right mandible and atlas, with nodular accumulation also observed in the left lobe of the thyroid gland. A plain x-ray of the chest and chest CT were normal. No abnormal accumulation in the chest was observed on FDG-PET. The LBC sample obtained from the right mandible demonstrated cohesive tumor cells with a hobnail-like structure. Immunostaining showed positive results for TTF-1 and Napsin A. Similar tumor cells were identified in the FNA LBC sample from the left lobe of the thyroid gland. In addition, EGFR L858R gene mutations were detected from FNA LBC sample. Immunostaining of the biopsy specimen obtained from the right mandibular tumor revealed positive staining of the tumor cells for TTF-1 and Napsin A. Thus, the patient was finally diagnosed as having TX lung adenocarcinoma.
Conclusion : The results in this patient encourage us to actively use LBC methods for analyzing even patients with carcinoma of unknown primary.
