An autopsy case of systemic sclerosis with small cell carcinoma of the lung

: We report an autopsy of a 69-year-old woman who had systemic sclerosis with small cell carcinoma of the lung. She had interstitial pneumonia associated with systemic sclerosis and was admitted to our hospital because of acute on chronic respiratory failure due to a respiratory tract infection. Although she was treated with antibiotics, artificial respiration, and so on, she died 54 days after admission of exacerbation of respiratory failure. Histopathological examination at autopsy revealed intermediate cell type small cell carcinoma of the lung and usual interstitial pneumonia. It is generally said that the most common type of lung cancer associated with systemic sclerosis is adenocarcinoma or alveolar cell carcinoma, and that small cell carcinoma is rare. No autopsy case of systemic sclerosis with small cell carcinoma of the lung has ever been reported in Japan. Small cell carcinoma of the lung is more responsive to chemotherapy and radiotherapy than other histological types of lung cancer. Patients with small cell lung cancer are generally treated with chemotherapy alone or a combination of chemotherapy and radiotherapy. It is important to remember that the lung cancers that may be complicated with systemic sclerosis include not only adenocarcinoma and alveolar cell carcinoma but also small cell carcinoma of the lung, because the histological type may dictate the treatment.