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[肺多形性癌;1例报告]

[Pulmonary pleomorphic carcinoma; report of a case].

作者信息

Usami N, Fukui T, Ito S, Sato N, Uchiyama M, Taniguchi T, Yoshioka H, Yokoi K

机构信息

Division of General Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Kyobu Geka. 2005 Oct;58(11):1013-6.

Abstract

We report a case of a 64-year-old man with pleomorphic carcinoma of the lung and thymic cyst. He was admitted to our hospital because of an abnormal shadow observed on chest X-ray. Computed tomography (CT) showed a mass lesion located in the right upper lobe and a non-invasive anterior mediastinal tumor adjacent to the left brachiocepharic vein. On enhanced CT, the lung mass showed central low-attenuation areas with a substantial enhancement in the periphery. Preoperative transbronchial blushing cytology of the mass revealed adenocarcinoma. With a diagnosis of primary lung cancer (cT3N0M0) and mediastinal tumor, an operation was performed through a median sternotomy. The mediastinal tumor was excised and a right upper lobectomy and were also accomplished, because the lung tumor did not show adhesion or pleural invasion. Histopathologic examination of the resected specimen revealed that the lung tumor composed of a mixture of spindle and giant cell features and contained a component of adenocarcinoma and squamous cell carcinoma. This finding yielded a pathological diagnosis of pleomorphic carcinoma (pT2N0M0). The mediastinal tumor was diagnosed as thymic cyst. The postoperative course was uneventful, and he is currently well 6 months after surgery.

摘要

我们报告一例64岁男性患有肺多形性癌和胸腺囊肿。他因胸部X线检查发现异常阴影而入住我院。计算机断层扫描(CT)显示右肺上叶有一个肿块病变,以及一个与左头臂静脉相邻的非侵袭性前纵隔肿瘤。增强CT显示肺部肿块中央为低密度区,周边有明显强化。术前对肿块进行经支气管刷检细胞学检查显示为腺癌。诊断为原发性肺癌(cT3N0M0)和纵隔肿瘤后,通过正中胸骨切开术进行了手术。由于肺部肿瘤未显示粘连或胸膜侵犯,切除了纵隔肿瘤并完成了右上叶切除术。对切除标本的组织病理学检查显示,肺部肿瘤由梭形细胞和巨细胞特征混合组成,包含腺癌和鳞状细胞癌成分。这一发现得出多形性癌的病理诊断(pT2N0M0)。纵隔肿瘤诊断为胸腺囊肿。术后过程顺利,他目前术后6个月情况良好。

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