Kohno H, Baba M, Fujisawa T, Shiba M, Nomoto Y, Shibuya K, Saitoh H, Toyozaki T, Hiroshima K, Ohwada H
Department of Pathology, Institute of Pulmonary Cancer Research, Chiba University School of Medicine, Japan.
Surg Today. 1999;29(8):803-6. doi: 10.1007/BF02482333.
A 30-year-old woman was admitted to our hospital for investigation of an abnormal shadow in the right pulmonary hilus on a chest X-ray film. A percutaneous needle biopsy was performed, which revealed pulmonary blastoma. A right upper lobectomy was performed and the pathological stage was confirmed to be IIIa (T3N0M0). An analysis of preoperative cytological specimens showed that epithelial tumor cells with thin cytoplasm were either tubular or papillary, while some mesenchymal tumor cells with elliptic and spindle-shaped nuclei were also found in the necrotic background. Thus, pulmonary blastoma should be considered when a two-cell pattern consisting of both epithelial and mesenchymal components is observed. DNA analysis was performed on previously identified areas of the epithelial or sarcomatous components, using a microdissection method. An analysis of the p53 gene by the single-strand conformation polymorphysm method showed an abnormal band with shifted mobility of exon 8 in only the sarcomatous component.
一名30岁女性因胸部X线片显示右肺门异常阴影而入院。进行了经皮针吸活检，结果显示为肺母细胞瘤。行右上肺叶切除术，病理分期确认为Ⅲa期（T3N0M0）。术前细胞学标本分析显示，胞质薄的上皮肿瘤细胞呈管状或乳头状，同时在坏死背景中也发现了一些核呈椭圆形和梭形的间充质肿瘤细胞。因此，当观察到由上皮和间充质成分组成的双细胞模式时，应考虑肺母细胞瘤。采用显微切割法对先前确定的上皮或肉瘤成分区域进行DNA分析。通过单链构象多态性方法对p53基因进行分析，结果显示仅在肉瘤成分中外显子8的迁移率发生改变，出现异常条带。
