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The first case of gland inclusion in an intrapulmonary lymph node: a mimic of metastasis
Chenglong Wang1, Yijia Cao1, Min Zeng1
1Department of Pathology, Chongqing Hospital of Traditional Chinese Medicine, 6 Seventh Panxi Branch Road, Jiangbei District, Chongqing, 400021, China.
Background:
Lymph node inclusions are foci of ectopic tissue in lymph nodes, which were reported in different areas of the body. However, inclusions in the mediastinal lymph node are rare. Here, we report the first case of glandular inclusion within the parenchyma of the intrapulmonary lymph node in a patient with primary lung adenocarcinoma.
Case Presentation:
A computed tomography (CT) scan showed a solid pulmonary nodule in the right upper lobe in a 44-year-old man. After a fine needle aspiration biopsy diagnosis of adenocarcinoma, lobectomy and lymph dissection were performed. Histological sections of the lung demonstrated a papillary predominant adenocarcinoma and one intrapulmonary lymph node, which displayed glandular inclusion occupying the node parenchyma. The gland inclusion was very similar to metastasis, but was formed by two layers of epithelial cells, and the abluminal cells were positive for P63, P40, and CK5/6. The patient has remained alive without recurrence and metastasis at the last follow-up before publication.
Conclusions:
It is very important to correctly diagnose a lymph node inclusion for proper clinical management.
