PULMONARY PUZZLE
Pulmonary puzzle
| The first 150 words of the full text of this article appear below. |
ANSWER
From the question on page 193.
A CT-guided biopsy of the right lung tumour revealed adenocarcinoma with a positive stain of thyroid transcription factor-1. A complete staging investigation composed of CT scans of the head and the chest including the upper abdomen and a whole body bone scan revealed T2N0M0 stage IB disease. An episode of pre-core mutant hepatitis B flare developed. Lamivudine was initiated. Right upper lobe lobectomy was postponed for 3 months after the recovery of liver function. Unfortunately, postoperative pathology staging revealed T2N2M0 stage IIIA disease. The patient is currently receiving adjuvant chemotherapy.
Synchronous primary pulmonary MALToma and adenocarcinoma are extremely rare. There is only one case reported in the English literature.1 Primary pulmonary non-Hodgkin’s lymphoma is rare and accounts for 3.6% of all extranodal lymphomas; of these, 69–78% are MALTomas.2 The aetiology of synchronous malignancies is unclear, with environmental and genetic factors playing a part.1 Patients
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Thorax 2008 63: 193.[Extract] [Full Text] [PDF]
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