Adenocarcinoma with mediastinal lymph node involvement developed from a pure ground grass nodule during 14 years. Issue 5 (25th April 2023)

• Record Type: Journal Article
• Authors: Miura, Hiroyuki; Miura, Jun; Goto, Shinichi; Yamamoto, Tomoko
• Is Part Of: Respirology case reports. Volume 11:Issue 5(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2023-04-25
• Subjects: computed tomography -- long‐term follow‐up -- lung adenocarcinoma -- pure ground grass nodule -- tumour progression; Respiratory organs -- Diseases -- Periodicals; 616.2005
• DOI: 10.1002/rcr2.1152
• Languages: English
• ISSNs: 2051-3380

Abstract

Abstract: A 69‐year‐old female Japanese patient presented with an abnormal shadow on chest computed tomography (CT). She had received a mastectomy 14 years prior. Under the diagnosis of primary lung cancer, left upper lobectomy was conducted. Pathology showed a lepidic adenocarcinoma with mediastinal lymph node metastases with pT2aN2M0. Upon retrospective analysis, the chest CT at the time of mastectomy depicted a ground‐glass nodule (GGN) of less than 20 mm. Over the previous 10.5 years, the concentration of the central part of the GGN increased. Conclusively, a pure GGN developed into lung adenocarcinoma with mediastinal lymph node involvement over 14 years. She had bone metastases 4 years after the lobectomy but has survived for five and a half years after surgery with treatment with osimertinib. Comparison readings of films should be performed throughout the patient's clinical history to detect subtle shadow alterations indicative of tumour progression. Abstract : We had an interesting case of a pure ground‐glass nodule that developed into lung adenocarcinoma with mediastinal lymph node involvement over 14 years. Here we report the temporal change in the opacity of the GGN and the concept of image interpretation.