Fujiwara K, Segawa Y, Takigawa N, Kishino D, Ida M, Eguchi K, Nakata M, Saeki H, Mandai K
Department of Internal Medicine, National Shikoku Cancer Center Hospital, Matsuyama.
Intern Med. 2000 Oct;39(10):834-8. doi: 10.2169/internalmedicine.39.834.
We describe two cases of atypical carcinoid of the thymus. One was an 82-year-old woman with complaints of nonproductive cough and back pain, and the other a 64-year-old woman with no symptoms. Computed tomography scans of the chest in both cases revealed a large mass in the anterior mediastinum. Multiple metastases to bone and liver were also noted in the former case. Histological examination of their tumors revealed that the tumor cells were arranged in a nested, trabecular, or pseudorosette pattern, with increased numbers of mitoses, nuclear pleomorphism, and presence of necrosis. In addition, immunohistochemically, the cells stained for neuron-specific enolase, synaptophysin and chromogranin A. Combination chemotherapy consisting of carboplatin and etoposide was performed as initial chemotherapy in the former case and as adjuvant therapy in the latter. The former patient achieved a short-term partial response. It is important to differentiate atypical carcinoid from other thymic tumors, since such tumors including thymoma have a much better prognosis than does atypical carcinoid.
我们描述了两例胸腺非典型类癌。一例为82岁女性，主诉干咳和背痛；另一例为64岁无症状女性。两例患者的胸部计算机断层扫描均显示前纵隔有一个大肿块。前一例还发现有骨和肝的多发转移。对其肿瘤进行组织学检查发现，肿瘤细胞呈巢状、小梁状或假菊形团排列，有丝分裂数量增加、核异型性及坏死存在。此外，免疫组化显示细胞神经元特异性烯醇化酶、突触素和嗜铬粒蛋白A染色阳性。前一例患者以卡铂和依托泊苷组成的联合化疗作为初始化疗，后一例作为辅助化疗。前一例患者获得了短期部分缓解。将非典型类癌与其他胸腺肿瘤区分开来很重要，因为包括胸腺瘤在内的此类肿瘤的预后比非典型类癌要好得多。
