Cutaneous metastasis from carcinoma of lung
A 65-year-old male who was a chronic smoker for the last 30 years presented with generalized weakness, breathlessness, occasional hemoptysis, and multiple cutaneous nodules (8 in number) all over the body since two months. The nodules were present over the chest (2), abdomen (1), back (2), face (1), and both the extremities (2). They were of varying sizes, ranging from 2 to 6 cm and were firm, nontender, and mobile. Some of them were infected []. Systemic examination was normal except for the presence of occasional crepitations and rhonchi. A clinical diagnosis of chronic obstructive pulmonary disease (COPD) with cutaneous lymphoma or soft tissue tumor was made.\nHematological investigations revealed the following:\nHb (hemoglobin): 14.4 gm%; TLC (total leukocyte count): 19,100/cmm; DLC (differential leukocyte count): P87L10E0M03.\nESR (erythrocyte sedimentation rate): 28 mm at the end of one hour.\nSputum examination was negative for malignant cells.\nChest X-ray (CXR) and computed tomography (CT) showed neoplastic right lung and bronchial mass with secondary cavitation.\nExcision biopsy of the noninfected nodule from the back was done and the specimen was received by the department of pathology.\nOn gross examination, it was an irregular tissue measuring 6×3.5×1 cm with a nodule 3 cm in diameter which was surrounded by adipose tissue and muscle.\nThe cut section of the nodule was grayish white and firm in consistency.\nThe histopathological sections from the nodule showed metastatic deposits from squamous cell carcinoma, moderately differentiated (grade II) [Figures and ].