Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Apr 1;62(7):1049-1054.
doi: 10.2169/internalmedicine.0203-22. Epub 2022 Sep 6.

Lung Cancer Complicated by Relapsing Polychondritis

Sosuke Arakawa  1 , Makoto Nakao  1 , Kazuki Sone  1 , Shuntaro Hayashi  1 , Masahiro Sugihara  1 , Yuya Hirata  1 , Mamiko Kuriyama  1 , Norihisa Takeda  1 , Kazuhiro Ohtakara  2 , Yoshimi Horikawa  2 , Hideki Muramatsu  1
Affiliations
Case Reports

Lung Cancer Complicated by Relapsing Polychondritis

Sosuke Arakawa et al. Intern Med. .

Abstract

A 77-year-old man presented with a 1-month history of cough, pharyngeal discomfort, and weight loss. Chest radiography revealed a mass shadow in the right upper lung field. Bronchoscopy showed multiple white nodules along the tracheal cartilage ring. Although adenocarcinoma cells were detected in the mass, several biopsy specimens of the tracheal lesions exhibited no malignancy. 18F-fluorodeoxyglucose positron emission tomography revealed an intense accumulation in the mass, nasal septum, and tracheal cartilage. Furthermore, anti-type II collagen antibody levels were elevated. We finally diagnosed him with lung cancer complicated by relapsing polychondritis. Treatment with oral prednisolone was initiated, followed by sequential chemoradiotherapy for lung cancer.

Keywords: chemotherapy; lung cancer; radiotherapy; relapsing polychondritis.

PubMed Disclaimer

Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
A: Bronchoscopy showing tracheal redness and edema of the tracheal mucosa and multiple white nodules (arrow) along the tracheal cartilage ring, except for the membranous portion. B-D: PET/CT to evaluate the lung cancer staging origin showing the uptake in the mass of the right upper lobe (arrowhead) and in the nasal septum and tracheal cartilage (arrow). CT: computed tomography, PET: positron emission tomography
Figure 2.
Figure 2.
Pathological examination findings. A: Biopsy specimens obtained from the mass of the right upper lobe showed adenocarcinoma cells forming glandular lumen [Hematoxylin and Eosin (H&E) staining, ×200]. B: Specimens of the tracheal lesions showed infiltration of inflammatory cells, such as plasma cells and lymphocytes into the interstitial stroma (H&E staining, ×200).
Figure 3.
Figure 3.
Follow-up PET/CT and bronchoscopy findings. A: PET/CT showing a decrease in uptake, such as the nasal septum and tracheal cartilage, except for the primary tumor and right lower paratracheal mediastinal lymph node. B: Bronchoscopy showed that the multiple white nodules had nearly disappeared. CT: computed tomography, PET: positron emission tomography
Figure 4.
Figure 4.
The 1-year clinical course of this case from the first medical examination. The serum level of CRP markedly improved after the initiation of steroid therapy. Sequential chemoradiotherapy was administered, and the serum level of CEA also decreased. NSAIDs: nonsteroidal anti-inflammatory drugs, CRP: C-reactive protein, CEA: carcinoembryonic antigen, CBDCA: carboplatin, PEM: pemetrexed
Figure 5.
Figure 5.
Axial planning CT images depicting isodose distributions for definitive radiotherapy. The doses to the trachea and bilateral main bronchi (arrows) along with the esophagus, spinal cord, and bilateral lung parenchyma are reduced by VMAT optimization, while a sufficient dose is given to the primary tumor and lymph node metastases. The absorbed dose scale is in Gray (Gy). CT: computed tomography, VMAT: volumetric-modulated arc therapy
See this image and copyright information in PMC

References

    1. Dion J, Costedoat-Chalumeau N, Sène D, et al. . Relapsing polychondritis can be characterized by three different clinical phenotypes: analysis of a recent series of 142 patients. Arthritis Rheumatol 68: 2992-3001, 2016. - PubMed
    1. Letko E, Zafirakis P, Baltatzis S, Voudouri A, Livir-Rallatos C, Foster CS. Relapsing polychondritis: a clinical review. Semin Arthritis Rheum 31: 384-395, 2002. - PubMed
    1. Hebbar M, Brouillard M, Wattel E, et al. . Association of myelodysplastic syndrome and relapsing polychondritis: further evidence. Leukemia 9: 731-733, 1995. - PubMed
    1. Raida BS, Yosra C, Faten F, et al. . A relapsing polychondritis and malignancies: a case report and review of literature. J Dermatol Res Ther 2: 041, 2016.
    1. Myers B, Gould J, Dolan G. Relapsing polychondritis and myelodysplasia: a report of two cases and review of the current literature. Clin Lab Haematol 22: 45-48, 2000. - PubMed

Publication types