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. 2017 Sep 29;3(1):107.
doi: 10.1186/s40792-017-0384-1.

Squamous cell carcinoma of the lung showing a ground glass nodule on high-resolution computed tomography associated with pneumoconiosis: a case report

Yuriko Terada  1 , Masaaki Sato  2 , Hiroyuki Abe  3 , Hideki Kuwano  1 , Kazuhiro Nagayama  1 , Jun-Ichi Nitadori  1 , Masaki Anraku  1 , Jun Nakajima  1
Affiliations

Squamous cell carcinoma of the lung showing a ground glass nodule on high-resolution computed tomography associated with pneumoconiosis: a case report

Yuriko Terada et al. Surg Case Rep. .

Abstract

Background: Adenocarcinoma with lepidic growth pattern presents as a ground glass nodule (GGN) on high resolution computed tomography (CT), whereas peripheral pulmonary squamous cell carcinoma (SCC) usually presents as a solid nodule. We herein report a rare case of pulmonary SCC extending along the alveolar lumen representing as a GGN on a CT scan in a patient with pneumoconiosis.

Case presentation: A 77-year-old man with pneumoconiosis was found to have a gradually enlarging GGN in the right lower lobe of the lung on CT. An adenocarcinoma of the lung was suspected. The GGN was successfully resected by thoracoscopic segmentectomy. Pathological examination of the resected specimen was pathologically diagnosed as a stage IA SCC extending along the alveolar lumen. The patient had no evidence of recurrence 19 months after surgery.

Conclusions: SCC should be included in the differential diagnosis of peripherally located GGNs, especially in patients at high risk of SCC of the lung such as those with pneumoconiosis.

Keywords: Ground glass nodule; Lepidic growth; Lung cancer; Pneumoconiosis; Squamous cell carcinoma.

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Conflict of interest statement

Consent for publication

Written informed consent was obtained from the patient for the publication of this case report and the accompanying images.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
A series of computed tomography images of a squamous cell carcinoma with ground glass nodule. a Chest computed tomography (CT) image showing a 7-mm ground glass nodule (GGN) in the right lower lobe when the lesion was first noted. b Chest CT, obtained 1 year after a; the GGN has enlarged to 18 mm. c Chest CT image obtained 1.5 year after a; the GGN has enlarged to 24 mm and a solid component has developed. d In a semi-automated three-dimensional volumetric “GGN analysis” of c, the ground glass opacity component (green area, between −800 and −301 Hounsfield units) accounted for 64% of the tumor in contrast to the remaining solid component (purple area, ≧ −300 Hounsfield units)
Fig. 2
Fig. 2
Histopathological findings of the resected specimen. a The loupe image of the tumor. The inset shows an immunohistochemistry for p40 (×200), which was positive in the tumor cells. b A low-power view (×40) and c a high-power view (×200) of the area of carcinoma in situ. Tumor cells were spread along the alveolar wall. The basement membrane of the alveolar wall remained intact. d A low-power view (×40) and (e) a high-power view (×200) of the area in which carcinoma in situ and invasive carcinoma (arrows) coexisted. f A low-power view (×40) and g a high-power view (×200) of the area with invasive carcinoma. Stromal tumor cell invasion and stromal collagen fiber were observed. All the pictures are Hematoxylin and eosin stain except the immunohistochemical staining in the inset of a
See this image and copyright information in PMC

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