Brambilla E, Moro D, Veale D, Brichon P Y, Stoebner P, Paramelle B, Brambilla C
Department of Pathology, CHRU de Grenoble, France.
Hum Pathol. 1992 Sep;23(9):993-1003. doi: 10.1016/0046-8177(92)90260-a.
On review of 115 poorly or undifferentiated lung cancers from 671 lung tumors resected over a 7-year period, we have found 38 cases of basaloid carcinoma. The cardinal histopathologic features distinguishing this tumor from other non-small cell lung cancers are a lobular growth pattern of small cells with moderately hyperchromatic nuclei, with no prominent nucleoli, and with scant cytoplasm, a high mitotic rate, and peripheral palisading. Basaloid carcinoma was present in a pure form in 19 cases and the other 19 tumors were of a mixed, but prominent, basaloid type associated with squamous cell carcinoma, large cell carcinoma, or adenocarcinoma. The immunophenotype of basaloid cancers was close to that of basal bronchial epithelial cells, with a low level of expression of low molecular weight cytokeratins. Staining for neuroendocrine markers was infrequent and inconsistent. Ultrastructural study showed an absence of neurosecretory granules and the presence of some squamous and/or glandular differentiation. This morphologic and immunologic phenotype suggests that basaloid carcinoma is derived from a pluripotent reserve cell or a basal bronchial epithelial stem cell. This unique histologic form of lung tumor has a poor prognosis, with a median survival rate of 22 months for stage I and II disease. This justifies classification of basaloid carcinoma as a distinct form of lung cancer, separate from small cell lung carcinoma.
在对7年期间切除的671例肺肿瘤中的115例低分化或未分化肺癌进行回顾时，我们发现了38例基底样癌。将这种肿瘤与其他非小细胞肺癌区分开来的主要组织病理学特征是：小细胞呈小叶状生长模式，细胞核中度深染，无明显核仁，胞质稀少，有丝分裂率高，以及周边栅栏状排列。基底样癌以纯形式存在的有19例，另外19例肿瘤为混合性但以基底样为主的类型，与鳞状细胞癌、大细胞癌或腺癌相关。基底样癌的免疫表型与支气管基底上皮细胞接近，低分子量细胞角蛋白表达水平较低。神经内分泌标志物染色少见且不一致。超微结构研究显示无神经分泌颗粒，存在一些鳞状和/或腺性分化。这种形态学和免疫表型表明基底样癌起源于多能储备细胞或支气管基底上皮干细胞。这种独特的肺肿瘤组织学形式预后较差，I期和II期疾病的中位生存率为22个月。这证明将基底样癌归类为与小细胞肺癌不同的一种独特的肺癌形式是合理 的。
