Japanese Journal of Clinical Oncology, Vol 28, Issue 8 492-496, Copyright © 1998 by Foundation for Promotion of Cancer Research
A Tamura, A Hebisawa, K Fukushima, H Yotsumoto and M Mori
BACKGROUND: Obstructive pneumonia, a synonym for endogenous lipoid
pneumonia, is often seen in patients with lung cancer, but details of this
condition are still uncertain. METHODS: To elucidate the features of
obstructive pneumonia, we radiopathologically studied 147 patients with
lung cancer that had been resected. RESULTS: Gross inspection of the
resected materials revealed evidence of endogenous lipoid pneumonia in 33
of the 147 patients with radiography that corresponded to obstructive
pneumonia. We classified the 33 cases into three types as follows: (1) type
I lipoid pneumonia, localized to the lung parenchyma distal to an airway
obstructed by a tumor (23 cases); (2) type II lipoid pneumonia, features of
type I lipoid pneumonia and consecutively spreading to the adjacent segment
whose airway was not affected (five cases); (3) type III lipoid pneumonia,
features of type II lipoid pneumonia and spreading to the isolated segments
(five cases). Lipoid pneumonia was found in 16 of 89 (18%) adenocarcinoma
cases and in 17 of 55 (31%) squamous cell carcinoma cases. In type I lipoid
pneumonia, squamous cell carcinoma cases were predominant over
adenocarcinoma cases (14 vs nine cases), but in type III lipoid pneumonia,
adenocarcinoma cases predominated (four vs one case). Further, in cases of
type III lipoid pneumonia, radiographs frequently revealed that lung
cancers were cavitated. CONCLUSION: Lipoid pneumonia in lung cancer may be
associated with factors that play a larger role than the cancer alone. It
can be speculated that transbronchial dissemination of breakdown products
of adenocarcinoma cells, including mucin, may contribute to the spread of
the non-obstructive component of lipoid pneumonia, because the local
physical effect of obstructed bronchus does not affect the non-obstructive
component.
ORIGINAL ARTICLE
Lipoid pneumonia in lung cancer: radiographic and pathological features
Department of Respiratory Diseases, Tokyo National Chest Hospital, Japan.
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