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[伴恶性肿瘤的转移性肺钙化的临床病理特征]

[Clinicopathological features of metastatic pulmonary calcinosis with malignant neoplasm].

作者信息

Nambu Y, Iwata T, Oida K, Kohri Y, Taguchi Y, Tomii K, Mino M, Yunoki Y, Ichijima K, Kobashi Y

机构信息

Department of Respiratory Medicine, Tenri Hospital, Nara, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Aug;29(8):963-70.

PMID:1753531
Abstract

Metastatic pulmonary calcinosis is a rare complication seen in malignancies accompanied by hypercalcemia, or chronic renal failure. We reviewed the clinicopathological findings of 8 cases of metastatic pulmonary calcinosis accompanied malignancy revealed at autopsy. The underlying diseases were malignant lymphoma in 3 cases (adult T cell lymphoma in 2 cases), multiple myeloma in 2, lung cancer in 2, and acute myelocytic leukemia in 1, all cases were complicated by hypercalcemia and renal failure. Chest X-ray revealed almost normal findings in 2 cases, bilateral diffuse infiltrates in 4, bilateral infiltrates in the apex in 1, and right atelectasis in 1. Bone scintigraphy was performed in 4 cases, and revealed warm pulmonary uptake in 1 patient with multiple myeloma and 1 with lung cancer, but normal findings in the 2 other cases. Histopathological examination revealed diffuse alveolar septal edema and fibrosis due to calcium deposition, which were considered to be the cause of respiratory failure. Metastatic pulmonary calcinosis is a rare but a serious complication in malignancies accompanied by hypercalcemia and renal failure, and bone scintigraphy seems to be a useful method for its diagnosis.

摘要

转移性肺钙化是一种在伴有高钙血症或慢性肾衰竭的恶性肿瘤中罕见的并发症。我们回顾了8例尸检时发现的伴有恶性肿瘤的转移性肺钙化的临床病理结果。基础疾病为恶性淋巴瘤3例(成人T细胞淋巴瘤2例)、多发性骨髓瘤2例、肺癌2例、急性髓细胞白血病1例,所有病例均合并高钙血症和肾衰竭。胸部X线检查显示2例基本正常,4例双侧弥漫性浸润,1例双侧尖段浸润,1例右肺不张。4例行骨闪烁显像,1例多发性骨髓瘤患者和1例肺癌患者显示肺部摄取增加,另2例结果正常。组织病理学检查显示由于钙沉积导致弥漫性肺泡间隔水肿和纤维化,这被认为是呼吸衰竭的原因。转移性肺钙化在伴有高钙血症和肾衰竭的恶性肿瘤中虽罕见但严重,骨闪烁显像似乎是其诊断的一种有用方法。

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