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Small-cell lung cancer with lymphadenopathy in an 18-year-old female nonsmoker

Nature Clinical Practice Oncology volume 3, pages 399–403 (2006)Cite this article

Abstract

Background An asymptomatic 18-year-old female presented in December 2002 with a left pulmonary mass, and an enlarged mediastinum and left hilum, detected on a routine chest X-ray. She had never smoked, and had no history of exposure to known carcinogens, no history of serious illnesses and no family history of malignancy. Superficial lymph nodes were not palpable. A CT scan of the chest disclosed a round tumor in the left lower lobe and marked enlargement of the ipsilateral hilar and mediastinal lymph nodes.

Investigations CT scan of the chest, routine hematological study, sputum smear and culture for acid-fast bacilli, transbronchial lung biopsy, serum tumor markers, CT scan of the abdomen, MRI scan of the head, bone scintigraphy, lung function tests, blood gas analysis, pathological examination including hematoxylin–eosin staining and immunohistochemistry using chromogranin A, CD56 (neural cell adhesion molecule), and cytokeratin antibodies.

Diagnosis Limited-stage small-cell lung cancer (T1N2M0, clinical stage IIIA).

Management Etoposide plus cisplatin chemotherapy with concurrent accelerated hyperfractionated thoracic radiotherapy, left pneumonectomy and lymph-node dissection.

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Figure 1: The patient's chest X-ray and chest CT scan at the initial diagnosis.
Figure 2: The patient's transbronchial lung-biopsy specimen.

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Acknowledgements

We thank M Nagai for assistance with the preparation of the manuscript.

Author information

Authors and Affiliations

  1. chief resident in the Division of Medical Oncology,

    Kan Yonemori

  2. heads of the Division of Internal Medicine and Thoracic Oncology, at the National Cancer Center Hospital, Tokyo, Japan

    Hideo Kunitoh & Ikuo Sekine

Authors
  1. Kan Yonemori
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  2. Hideo Kunitoh
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  3. Ikuo Sekine
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Correspondence to Ikuo Sekine.

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The authors declare no competing financial interests.

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Yonemori, K., Kunitoh, H. & Sekine, I. Small-cell lung cancer with lymphadenopathy in an 18-year-old female nonsmoker. Nat Rev Clin Oncol 3, 399–403 (2006). https://doi.org/10.1038/ncponc0534

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