Tamiya Motohiro, Yamane Hiroyuki, Terada Haruko, Matsuno Osamu, Yamamoto Suguru
Respiratory Department, NHO Osakaminami Medical Center.
Nihon Kokyuki Gakkai Zasshi. 2008 Nov;46(11):904-8.
A 62-year-old man with pain in his hip joints and back was admitted to our hospital. His chest radiograph and CT showed a huge mass extending from the left upper pericardium to the left hilum, but no pleural effusion or other lesions. A contrast-enhanced abdominal CT showed multiple metastases to bones and both kidneys. Bronchoscopy revealed obstruction of the left B3 by a visible tumor. The biopsy specimens of the initial immunohistochemical staining were slightly positive for calretinin. However, we diagnosed the condition as sarcomatoid carcinoma of the lung on the basis of the clinical evaluation. Although radiotherapy was administered, his condition rapidly deteriorated and he died due to progression of the disease. Autopsy revealed extensive invasion, suggesting mesothelioma. Therefore, immunohistochemical staining was performed; the findings revealed sarcomatoid malignant mesothelioma. In conclusion, we encountered a rare case of sarcomatoid malignant mesothelioma (stage IV).
一名62岁男性因髋关节和背部疼痛入住我院。其胸部X线片和CT显示一个巨大肿块,从左上心包延伸至左肺门,但无胸腔积液或其他病变。腹部增强CT显示骨骼和双肾多发转移。支气管镜检查显示左B3被一个可见肿瘤阻塞。初始免疫组化染色的活检标本钙视网膜蛋白呈弱阳性。然而,根据临床评估,我们将该病例诊断为肺肉瘤样癌。尽管给予了放疗,但其病情迅速恶化,最终因疾病进展死亡。尸检显示广泛浸润,提示为间皮瘤。因此,进行了免疫组化染色;结果显示为肉瘤样恶性间皮瘤。总之,我们遇到了一例罕见的肉瘤样恶性间皮瘤(IV期)病例。