A Case of Non-mucin-producing Well Differentiated Papillary Adenocarcinoma of the Lung With a 12-Year Clinical History Before Operation.

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Background. There have been very few reports of slow-growing adenocarcinomas, all of which consisted of bronchial gland cell type or goblet cell type with mucin-production. We report a case of well differentiated papillary adenocarcinoma without mucin-production and a long clinical history before operation. Case. A 75-year-old woman was admitted to our hospital because of bloody sputum and an abnormal shadow of the left lung. The shadow had been pointed out 12-years previously, nevertheless, she had not received a detailed examination. Chest CT showed a consolidation, measuring 7× 4× 3cm in size, in the left S4. The lesion was diagnosed as adenocarcinoma by transbronchial biopsy and brushing cytology, and left upper lobectomy with nodal dissection was performed. Histologically, most of the tumor showed bronchiolo alveolar growth without fibrous scar formation, but the central part, measuring 1.5cm in diameter, showed papillary growth of cancer cells which resembled bronchial surface epithelial cells and Clara cells without mucin-production. Conclusion. Our case was a rare slow-growing adenocarcinoma with bronchiolo-alveolar growth, non-mucin-production and a long clinical history before operation.
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