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肺部原发性鳞状细胞癌的无症状结肠转移,粪便潜血试验呈阳性。

Asymptomatic colonic metastases from primary squamous cell carcinoma of the lung with a positive fecal occult blood test.

作者信息

Hirasaki Shoji, Suzuki Seiyuu, Umemura Shigeki, Kamei Haruhito, Okuda Masato, Kudo Kenichiro

机构信息

Department of Internal Medicine, Sumitomo Besshi Hospital, 3-1 Ohji-cho, Niihama, Japan.

出版信息

World J Gastroenterol. 2008 Sep 21;14(35):5481-3. doi: 10.3748/wjg.14.5481.

Abstract

We describe a 74-year-old man with a colonic metastatic squamous cell carcinoma (SCC) from the lung. His chest X-ray revealed an abnormal shadow in the right upper lobe. Computed tomography (CT) of the chest demonstrated a large lung tumor in the right upper lobe obstructing the right upper bronchus. Bronchoscopy revealed an easy-bleeding tumor in the right upper bronchus that was diagnosed as poorly differentiated squamous cell lung carcinoma. He underwent colonoscopy because he had a positive fecal occult blood test. Colonoscopy revealed a large protruding lesion with central ulceration in the descending colon. Histological examination of the biopsy specimen obtained from the colonic lesion revealed SCC. The lesion was diagnosed as metastatic colonic SCC. He had no abdominal symptoms. He underwent chemotherapy with an infusion of cisplatin 130 mg i.v. day 1, and docetaxel hydrate 100 mg i.v. day 1, repeated every 4 wk, followed by 4 courses of chemotherapy. The primary lesion shrank by less than 10% and was judged to be "Partial Response" (PR) after 3 courses of treatment. The patient still lived 23 wk after the diagnosis of metastatic colonic SCC. Colonic metastasis of primary SCC of the lung is rare.

摘要

我们描述了一名74岁男性,患有来自肺部的结肠转移性鳞状细胞癌(SCC)。他的胸部X线显示右上叶有异常阴影。胸部计算机断层扫描(CT)显示右上叶有一个大的肺部肿瘤,阻塞了右上支气管。支气管镜检查发现右上支气管有一个易出血的肿瘤,诊断为低分化鳞状细胞肺癌。由于他的粪便潜血试验呈阳性,因此接受了结肠镜检查。结肠镜检查发现降结肠有一个大的突出病变,中央有溃疡。从结肠病变获取的活检标本的组织学检查显示为SCC。该病变被诊断为转移性结肠SCC。他没有腹部症状。他接受了化疗,静脉输注顺铂130 mg第1天,多西他赛水合物100 mg第1天,每4周重复一次,共进行4个疗程的化疗。3个疗程的治疗后,原发灶缩小不到10%,被判定为“部分缓解”(PR)。该患者在诊断为转移性结肠SCC后仍存活23周。肺原发性SCC的结肠转移很少见。

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