Department of Respiratory Medicine, Kyorin University School of Medicine, Shinkawa Mitaka City,Tokyo, JapanJapan
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A 74-year-old man visited to our hospital due to severe visual disturbance in his left eye for recent one month. Fundoscopy demonstrated the serous retinal detachment at the nose side of the left eye (Figure 1A, arrows).
Open Journal PUBLISHERS Illustration A Case of Choroidal Metastasis from Small-Cell Lung Carcinoma * Manami Inoue, MD; Takeshi Saraya, MD, PhD*; Miku Oda, MD; Masachika Fujiwara, MD, PhD; Hajime Takizawa, MD, PhD Department of Respiratory Medicine, Kyorin University School of Medicine, Shinkawa Mitaka City,Tokyo, Japan * *Corresponding author Takeshi Saraya, MD, PhD Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka City,Tokyo 181-8611, Japan; Tel/Fax: +81(0)-422-44-0671; E-mail: sara@yd5.so-net.ne.jp Article information th th th th Received: February 15 , 2018; Revised: June 14 , 2018; Accepted: July 14 , 2018; Published: July 17 , 2018 Cite this article Inoue M, SarayaT, Oda M, Fujiwara M, Takizawa H. A case of choroidal metastasis from small-cell lung carcinoma. Cancer Stud Mol Med Open J. 2018; 4(1): 11-12. doi: 10.17140/CSMMOJ-4-124 OveRvIew
onstrated the serous retinal detachment at the nose side of the left eye (Figure 1A, arrows).
At the same time, chest X-ray demonstrated a mass mea- suring 4 cm in size at the left lower lung field (Figure 2, arrow) and thoracic computed tomography (CT) depicted the mediastinal lymphadenopathies. On Hematoxylin-Eosin stain, both specimens obtained from right B10 by transbronchial lung biopsy (Figure 3A, 400X) and subcarinal lymphnodes (Figure 3B, 400X) by endobron- chial ultrasound-guided transbronchial needle aspiration demon- strated abundant atypical cells with high nuclear cytoplasmic ratio. Those cells were positive for both CD56 (Figure 3C, 400X) and TTF-1 (Figure 3D, 400X), he was thus diagnosed with small cell lung carcinoma (SCLC).
For further exploring the reason for loss of visual acuity,
contrast enhanced head magnetic resonance imaging (MRI) was performed. The MRI on axial, coronal, and sagittal T1 weighted images demonstrated the enhanced crescent shaped tumor (Figure 1B, 1C, 1D, arrow heads) with non-enhanced soft tissue (Figure 1B, 1D, arrows), which corresponded to retinal detachment and choroidal metastasis, respectively. Previous studies described that the incidence of ocular metastasis in patients with lung carcino- 1 2 ma ranged from 61 to 21%2 in post or antemortem examination.
Choroid is the blood-rich tissue where the most preferable area in ocular metastasis. Physicians should be aware of the choroidal 3,4 metastasis as the initial manifestation of lung carcinoma.3,4 cc Copyright 2018 by Saraya T. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which allows to copy, redistribute, remix, transform, and reproduce in any medium or format, even commercially, provided the original work is properly cited. Cancer Stud Mol Med Open J. 2018; 4(1): 11-12. doi: 10.17140/CSMMOJ-4-124 ReFeReNeCeS
Figure 3. Figure 3. On Hematoxylin-Eosin Stain, Biopsied Specimens Obtained from Right B10 (Fig. 3A, 400X) and Subcarinal Lymphnodes (Fig, 3B, 400X) Revealed Abundant Atypical Cells with High Nuclear Cytoplasmic Ratio.Those Cells were Positive for Both CD56 (Fig 1. Bloch RS, Gartner S. The incidence of ocular metastatic car- 3C, 400X) and TTF-1 (Fig. 3D, 400X), Suggesting Small Cell Lung Carcinoma.
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