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Pulmonary metastasis of distal cholangiocarcinoma with multiple cavities in bilateral lungs: A case report.

ABSTRACT: Cholangiocarcinoma is a type of malignant tumor derived from the epithelium of the bile duct. Cases of cholangiocarcinoma metastasis to the lung are rare, especially those with imaging features of multiple cavities in bilateral lungs. Here, we report a case of a patient who had previously undergone radical resection of primary distal cholangiocarcinoma 18?months ago. Transbronchoscopic lung biopsy of the right lung and biopsy of the left supraclavicular lymph node were performed for pathology confirmation, as well as immunohistochemistry. Multiple cavity shadows in bilateral lungs and enlarged lymph nodes were found on the computed tomography (CT) scan obtained 18?months postoperatively. No obviously enlarged lymph nodes were observed under the carina and beside the aortic arch, whereas enlarged lymph nodes were found above the left clavicle. Biopsy of lung and supraclavicular lymph nodes confirmed metastatic adenocarcinoma. Immunohistochemistry showed that it originated from the digestive tract and had the same homology as cholangiocarcinoma (CK19 +, Villin +). Cholangiocarcinoma can be transferred to the lung and the left supraclavicular lymph nodes through the lymphatic pathway by characteristic jumping lymph node metastases. Diffuse cystic change is a specific CT manifestation of the lymphatic lung metastasis of cholangiocarcinoma.

SUBMITTER: Zhai N

PROVIDER: S-EPMC7529578 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Pulmonary metastasis of distal cholangiocarcinoma with multiple cavities in bilateral lungs: A case report.

Zhai Nailiang N Zhai Nailiang N Liu Jinping J Xu Pan P Liu Bo B Fan Yichu Y Lv Changjun C

Thoracic cancer 20200904 10

Cholangiocarcinoma is a type of malignant tumor derived from the epithelium of the bile duct. Cases of cholangiocarcinoma metastasis to the lung are rare, especially those with imaging features of multiple cavities in bilateral lungs. Here, we report a case of a patient who had previously undergone radical resection of primary distal cholangiocarcinoma 18 months ago. Transbronchoscopic lung biopsy of the right lung and biopsy of the left supraclavicular lymph node were performed for pathology co ...[more]

PMID: 32885606

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Project description:IntroductionThe simultaneous rupture of both distal biceps tendons is a rare clinical entity that is difficult to treat and can have poor outcomes. A variety of treatment and rehabilitation options exist and have been reported for single sided and staged bilateral repairs, but none have described an approach for acute bilateral ruptures. Repairing distal biceps tendon ruptures using a single anterior incision and a cortical suspensory button technique has become increasingly popular in recent years. We present a report of our surgical approach using an endobutton technique and rehabilitation algorithm for this unusual injury pattern.Case presentationA 43-year-old Caucasian man presented with acute onset bilateral elbow pain while lifting a large sheet of drywall off the ground. He initially felt a 'pop' on the right and almost immediately felt another on the left after having to quickly shift the weight. He was unable to continue working and sought medical attention. His pain was predominantly in his bilateral antecubital fossae and he had significant swelling and ecchymoses. His clinical examination demonstrated no palpable tendon, a retracted biceps muscle belly, and clear supination weakness. Magnetic resonance imaging was performed and showed bilateral distal biceps tendon ruptures with retraction on both sides. After discussion with our patient, we decided that both sides would be repaired using a single anterior incision with endobutton fixation, first his right followed by his left six weeks later.ConclusionOverall, our patient did very well and had returned to full manual work by our last follow-up at 30 months. Although he was never able to return to competitive recreational hockey and was left with mild lateral antebrachial cutaneous nerve dysesthesias on his right, he felt he was at 85% of his premorbid level of function. We describe what we believe to be, to the best of our knowledge, the first case of simultaneous bilateral distal biceps tendon ruptures successfully treated with a single-incision endobutton technique, which represents a valid option in managing this difficult problem.

Dataset Information

Pulmonary metastasis of distal cholangiocarcinoma with multiple cavities in bilateral lungs: A case report.

Publications

Pulmonary metastasis of distal cholangiocarcinoma with multiple cavities in bilateral lungs: A case report.

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