Nabeshima K, Inoue T, Tanaka Y, Koono M
Second Department of Pathology, Miyazaki Medical College, Japan.
Acta Pathol Jpn. 1992 Nov;42(11):847-51. doi: 10.1111/j.1440-1827.1992.tb01888.x.
A rare autopsy case, in which pleural malignant fibrous histiocytoma (MFH) and peripheral pulmonary adenocarcinoma were present concurrently in the right thorax, is described. Clinically, only a pleural mass was detected because of massive pleural effusion. Since cytologic examination of the effusion showed only adenocarcinoma cells, the pleural mass was considered to be enlarged mediastinal lymph nodes due to metastasis of adenocarcinoma. Histopathologically, the pleural mass showed the features of a common type of MFH, accompanied by metastatic adenocarcinoma cells in the pleural lymphatics. No mixture of MFH and adenocarcinoma cells was present. Immunohistochemically, the MFH lesion showed positive staining for alpha-1-antitrypsin, alpha-1-chymotrypsin, and factor XIIIa, but no reactivity for cytokeratins. The adenocarcinoma lesion showed positive staining for carcinoembryonic antigen (CEA), and contained hyaluronidase-resistant mucin. To our knowledge, this is the second reported case of pleural MFH with pulmonary adenocarcinoma.
本文描述了一例罕见的尸检病例，患者右胸同时存在胸膜恶性纤维组织细胞瘤（MFH）和周围型肺腺癌。临床上，由于大量胸腔积液，仅检测到一个胸膜肿块。由于积液的细胞学检查仅显示腺癌细胞，故该胸膜肿块被认为是腺癌转移所致的纵隔淋巴结肿大。组织病理学检查显示，胸膜肿块具有常见类型MFH的特征，并伴有胸膜淋巴管内的转移腺癌细胞。不存在MFH和腺癌细胞的混合。免疫组化检查显示，MFH病变对α-1-抗胰蛋白酶、α-1-糜蛋白酶和因子XIIIa呈阳性染色，但对细胞角蛋白无反应。腺癌病变对癌胚抗原（CEA）呈阳性染色，并含有抗透明质酸酶的黏液。据我们所知，这是第二例报道的伴有肺腺癌的胸膜MFH病例。
