Clinical and morphological case of lung cancer with generalized metastases to the internal organs

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Abstract

Lung cancer has occupied a leading position in the structure of cancer morbidity and mortality throughout the world for many years. Lifetime diagnosis is often difficult due to the absence of any defining signs of cancer, and it is quite difficult to track the first signs of lung cancer. This is justified by the fact that the lungs are completely devoid of nerve endings and the presence of 26% of healthy lung tissue is sufficient to provide the body with the required amount of oxygen. Prolonged absence of clinical manifestations leads to late seeking medical help, which is often fatal. Description of the case. A 65-year-old patient who died at home was referred for a postmortem examination. The sectional study revealed signs of peripheral cancer of the right lung with multiple metastases in all fields of the lungs, in the liver, spleen, pancreas, with no metastases in the lymph nodes. Histological examination revealed extensive areas of tumor tissue, consisting of solid structures with glandular differentiation of tumor tissue of various sizes and shapes, with round and oval atypical nuclei. There was a pronounced polymorphism of cells, with a large number of pathological mitoses. Thrombi were detected in the lumen of the segmental and small branches of the pulmonary artery. Thus, the presented case is of particular interest for practicing physicians due to the fact that with adenocarcinoma of the lung, there were no characteristic metastases to the lymph nodes. Hematogenous metastasis occurred with the development of generalized metastases to the internal organs.

About the authors

Olga V. Vorobeva

Ulianov Chuvash State University

Author for correspondence.
Email: olavorobeva@mail.ru
ORCID iD: 0000-0003-3259-3691

Сand. Sci. (Med.)

Russian Federation, Cheboksary

References

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Supplementary files

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2. Fig. 1. Microscopic findings of lung adenocarcinoma, consisting of polymorphic cells with atypical hyperchromatic nuclei, with infiltrative growth and necrosis. Hematoxylin and eosin staining, 900×.

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3. Fig. 2. Microscopic image of tumor tissue forming glandular structures with polymorphic atypical cells and pathological mitoses, with vessel tumor emboli, cricoid-like cells are presented. Hematoxylin and eosin staining, 900×.

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4. Fig. 3. Microscopic image of the obstructive thrombus: the vessel lumen is obturated by masses consisting of intertwining fibrin strands and erythrocytes, most of them are hemolyzed. Hematoxylin and eosin staining, 400×.

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5. Fig. 4. Among the atrophied hepatic cord, complexes of tumor cells with the formation of glandular structures and the areas of hemorrhage are presented. Hematoxylin and eosin staining, 900×.

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6. Fig. 5. Microscopic image of tumor tissue, presented by the polymorphic cells, with pathologic mitoses and areas of fibrosis in the tumor stroma. Tumor cells integrate into the pancreas, forming the glandular structures. Hematoxylin and eosin staining, 400×.

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