A case of lung adenocarcinoma complicated by pulmonary talcosis occurring in a patient employed in the confectionery industry

Pathol Int. 2019 Apr;69(4):229-234. doi: 10.1111/pin.12772. Epub 2019 Feb 18.

Abstract

A 73-year-old Japanese man, who worked at a confectionery company for more than 20 years, was diagnosed with a 28 mm nodular lesion in the superior lobe of the right lung by whole-body computed tomography examination. A biopsy revealed the presence of adenocarcinoma. With a diagnosis of a primary lung cancer, a right upper lobectomy was performed. A nodular lesion, 25 × 23 mm in size, was observed in the upper right lobe lung field, and was diagnosed histopathologically as a papillary adenocarcinoma. In addition, fibrous scars in the central part of the tumor showed numerous Langhans and/or foreign body giant cells, and histiocytic cells that had phagocytized numerous small transparent crystals, together with coal powder deposition. The extracted crystals were observed with a scanning electron microscope, and although plate-like structures were observed, ferruginous bodies suggestive of asbestos were not found. The crystals were demonstrated to be talc by powder X-ray diffraction. Herein, we investigated a case of lung adenocarcinoma in a patient with talcosis, with discussions based on a literature search. This collision of talcosis and lung adenocarcinoma adds to an increasing body of knowledge on an apparent association between talc and cancer cases.

Keywords: adenocarcinoma of lung; occupational disease; talc.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung / complications
  • Adenocarcinoma of Lung / diagnostic imaging*
  • Adenocarcinoma of Lung / pathology
  • Aged
  • Air Pollutants, Occupational / adverse effects*
  • Biopsy
  • Candy
  • Diagnosis, Differential
  • Humans
  • Lung / pathology
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Male
  • Microscopy, Electron, Scanning
  • Occupational Exposure*
  • Pneumoconiosis / complications
  • Pneumoconiosis / diagnostic imaging*
  • Pneumoconiosis / pathology
  • Talc / adverse effects*
  • Tomography, X-Ray Computed
  • X-Ray Diffraction

Substances

  • Air Pollutants, Occupational
  • Talc