Lung Metastases of Pancreatic Adenocarcinoma Masquerading as Temporary Improvement of Bilateral Diffuse Lung Opacities Following Treatment for Interstitial Lung Disease.
- 1Department of Respiratory Medicine Kyoto Katsura Hospital Kyoto Japan.
Abstract
A 75-year-old man presented with bilateral ground-glass opacities (GGOs) and consolidation on computed tomography (CT). Bronchoalveolar lavage revealed no pathogens or malignant cells. Acute exacerbation of interstitial lung disease was suspected because of rapidly progressive respiratory failure, but steroid pulse therapy was ineffective. After cyclophosphamide treatment, CT showed transient improvement of GGOs and consolidation. Subsequently, worsening bilateral opacities and abnormalities of the main pancreatic duct were detected on CT and magnetic resonance imaging. These radiological findings and sputum cytology indicated lung metastases from pancreatic adenocarcinoma. The autopsy demonstrated lung metastases of pancreatic ductal carcinoma with extensive organizing pneumonia (OP). Although lung metastases from pancreatic cancer are occasional, diffuse bilateral opacities mimicking interstitial lung disease are rare. Improvement after prednisolone and cyclophosphamide may have reflected effects on both OP and metastases. Lung metastases should remain an important differential diagnosis even when bilateral GGOs and consolidation respond to treatment.
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BibTeX
@article{kusunoki2026lung,
title = {{Lung Metastases of Pancreatic Adenocarcinoma Masquerading as Temporary Improvement of Bilateral Diffuse Lung Opacities Following Treatment for Interstitial Lung Disease.}},
author = {Saki Kusunoki and Miki Tasato and Akihiko Sokai and Toshiyuki Iwata and Yasuyuki Hayashi and Naoaki Yasuda and Ikumi Kashiwagi and Takashi Nishimura},
journal = {Respirology case reports},
year = {2026},
month = oct,
doi = {10.1002/rcr2.70795},
url = {https://europepmc.org/article/MED/42924177},
note = {CC BY},
}
RIS
TY - JOUR
TI - Lung Metastases of Pancreatic Adenocarcinoma Masquerading as Temporary Improvement of Bilateral Diffuse Lung Opacities Following Treatment for Interstitial Lung Disease.
AU - Saki Kusunoki
AU - Miki Tasato
AU - Akihiko Sokai
AU - Toshiyuki Iwata
AU - Yasuyuki Hayashi
AU - Naoaki Yasuda
AU - Ikumi Kashiwagi
AU - Takashi Nishimura
PY - 2026
DA - 2026/10/22
JO - Respirology case reports
DO - 10.1002/rcr2.70795
UR - https://europepmc.org/article/MED/42924177
AB - A 75-year-old man presented with bilateral ground-glass opacities (GGOs) and consolidation on computed tomography (CT). Bronchoalveolar lavage revealed no pathogens or malignant cells. Acute exacerbation of interstitial lung disease was suspected because of rapidly progressive respiratory failure, but steroid pulse therapy was ineffective. After cyclophosphamide treatment, CT showed transient improvement of GGOs and consolidation. Subsequently, worsening bilateral opacities and abnormalities of the main pancreatic duct were detected on CT and magnetic resonance imaging. These radiological findings and sputum cytology indicated lung metastases from pancreatic adenocarcinoma. The autopsy demonstrated lung metastases of pancreatic ductal carcinoma with extensive organizing pneumonia (OP). Although lung metastases from pancreatic cancer are occasional, diffuse bilateral opacities mimicking interstitial lung disease are rare. Improvement after prednisolone and cyclophosphamide may have reflected effects on both OP and metastases. Lung metastases should remain an important differential diagnosis even when bilateral GGOs and consolidation respond to treatment.
SN - 2051-3380
ER -