Kaneko Tsukasa, Honda Takayuki, Fukushima Mana, Haniuda Masayuki, Komatsu Hikotaro, Kodama Tetsuro
National Chuushin Matsumoto Hospital, Matsumoto, Japan.
Pathol Int. 2002 Oct;52(10):643-7. doi: 10.1046/j.1440-1827.2002.01393.x.
A variant of large cell carcinoma showing a rhabdoid phenotype, which is rare among primary lung cancers, is presented. A 59-year-old man was admitted to hospital for an operation. Computed tomography scans showed a mass with a smooth border, invading the thoracic wall. A right upper lobe lobectomy was carried out with resection of a part of the thoracic wall. Pathological examination showed that the tumor was mostly composed of cells with prominent eosinophilic cytoplasmic globules and giant cells, which did not adhere to each other. Cytologically, the tumor cells contained nuclei with a reticular chromatin pattern and one to two prominent nucleoli, and hyaline-like and reticular inclusion bodies, which were immunohistochemically positive for vimentin, but not for alpha-smooth muscle actin, myoglobin or pan-actin. Radiological and laboratory examinations did not detect the presence of the tumor in other organs, indicating that the primary lesion was not situated elsewhere. Metastasis to the right adrenal gland was observed 1 year and 4 months after the operation; however, the patient has been free of the disease 3 years and 11 months after the second operation of an adrenalectomy. This case showed a relatively good prognosis, which is rare among rhabdoid tumors of various organs that generally have poor prognoses with rapid, fatal progression.
本文报告了一例原发性肺癌中罕见的具有横纹肌样表型的大细胞癌变体。一名59岁男性因手术入院。计算机断层扫描显示一个边界光滑的肿块,侵犯胸壁。行右上叶肺叶切除术并切除部分胸壁。病理检查显示肿瘤主要由具有突出嗜酸性细胞质小球和巨细胞的细胞组成,这些细胞彼此不粘连。细胞学检查显示,肿瘤细胞含有具有网状染色质模式的细胞核和一到两个突出的核仁,以及透明样和网状包涵体,免疫组化显示波形蛋白呈阳性,但α-平滑肌肌动蛋白、肌红蛋白或泛肌动蛋白呈阴性。影像学和实验室检查未在其他器官检测到肿瘤存在,表明原发灶不在其他部位。术后1年4个月观察到右肾上腺转移;然而,在第二次肾上腺切除术后3年11个月,患者病情缓解。该病例显示出相对较好的预后,这在各种器官的横纹肌样肿瘤中较为罕见,这些肿瘤通常预后较差,进展迅速且致命。