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Lung Scar: A Reason to Worry?
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A4039 - Lung Scar: A Reason to Worry?
Author Block: H. Yasin1, H. S. Al-Jaroushi2, H. E. Mohamed3; 1Internal Medicine, West Virginia University Charleston Division, Charleston, WV, United States, 2PULMCCM, West Virginia University Charleston Division, Charleston, WV, United States, 3Pulmonology and Critical Care Medicine, West Virginia University Charleston Division, Charleston, WV, United States.
Introduction: Lung cancer is the most common cause of death from cancer in the United States. Though lung cancer is commonly associated with cigarette smoking, non-smokers account for twenty per cent of deaths from lung cancer. A relationship between pulmonary scarring and lung cancer has been recognized for many decades but more evidence is needed to strengthen this association. Herein, we report a case of metastatic lung adenocarcinoma which originated from a peripheral lung scar.
Case: A 34 years old non-smoker male with a past medical history of left lower lobe lung scar secondary to a pulmonary contusion from a motor vehicle accident in 2012 was admitted with increased shortness of breath and cough for over a week. A computed tomography (CT) angiography of the chest demonstrated bilateral pulmonary emboli, left lower lobe mass, left lung septal thickening with trace pleural effusion and mediastinal lymphadenopathy. A CT guided biopsy of the mass was performed and the pathology showed lung adenocarcinoma.
Discussion: Lung scar cancer (LSC) was first reported by Friedrich in 1939. It originates around peripheral scars in the lung resulting from a variety of infections, injuries, and lung diseases. It is hypothesized that localized inflammatory processes associated with scarring promote the subsequent development of lung cancer. It is predominantly adenocarcinoma. Most of the literature available on LSCs is from published case reports or case series. It has poor prognosis because it metastasizes from relatively small lesions. Our case further endorses that pulmonary scarring can potentially lead to the development of lung cancer. Through this case, we want to highlight the need for evidence to determine the morbidity or mortality benefit from monitoring this patient population with periodic imaging.
Author Block: H. Yasin1, H. S. Al-Jaroushi2, H. E. Mohamed3; 1Internal Medicine, West Virginia University Charleston Division, Charleston, WV, United States, 2PULMCCM, West Virginia University Charleston Division, Charleston, WV, United States, 3Pulmonology and Critical Care Medicine, West Virginia University Charleston Division, Charleston, WV, United States.
Introduction: Lung cancer is the most common cause of death from cancer in the United States. Though lung cancer is commonly associated with cigarette smoking, non-smokers account for twenty per cent of deaths from lung cancer. A relationship between pulmonary scarring and lung cancer has been recognized for many decades but more evidence is needed to strengthen this association. Herein, we report a case of metastatic lung adenocarcinoma which originated from a peripheral lung scar.
Case: A 34 years old non-smoker male with a past medical history of left lower lobe lung scar secondary to a pulmonary contusion from a motor vehicle accident in 2012 was admitted with increased shortness of breath and cough for over a week. A computed tomography (CT) angiography of the chest demonstrated bilateral pulmonary emboli, left lower lobe mass, left lung septal thickening with trace pleural effusion and mediastinal lymphadenopathy. A CT guided biopsy of the mass was performed and the pathology showed lung adenocarcinoma.
Discussion: Lung scar cancer (LSC) was first reported by Friedrich in 1939. It originates around peripheral scars in the lung resulting from a variety of infections, injuries, and lung diseases. It is hypothesized that localized inflammatory processes associated with scarring promote the subsequent development of lung cancer. It is predominantly adenocarcinoma. Most of the literature available on LSCs is from published case reports or case series. It has poor prognosis because it metastasizes from relatively small lesions. Our case further endorses that pulmonary scarring can potentially lead to the development of lung cancer. Through this case, we want to highlight the need for evidence to determine the morbidity or mortality benefit from monitoring this patient population with periodic imaging.
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