Uehara M, Nakajima T, Nakajima S, Watanabe A, Higami T, Inoue N
Department of Second Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Kyobu Geka. 2009 Feb;62(2):89-93; discussion 93-5.
Pleomorphic carcinoma is a rare pulmonary epithelial malignant tumor defined in the World Health Organization classification updated in 1999. We investigated the clinical findings and prognosis associated with this tumor since to our knowledge they have yet to be well-understood. Between 2000 and 2006, in our hospital 387 patients underwent surgical resection for primary nonsmall cell lung carcinoma (NSCLC). Of these, 13 (3.4%) were diagnosed as pleomorphic carcinoma. We compared the clinical and pathological data between the patients with pleomorphic carcinoma (n = 13) and patients with other NSCLC (n = 374). Twelve (92.3%) of our patients were men and 9 (69.2%) were symptomatic. These tumors were located predominantly in an upper lobe and were associated more often with adjacent bullae than were other NSCLC. Surgical resection in 4 of the cases was incomplete due to tumor invasion into mediastinum, aortic arch, pleurae and/or chest wall. None of the diagnoses could be confirmed preoperatively. Thus, invasion of surrounding tissue occurred frequently and early. Although there are no defined management strategies for pleomorphic carcinoma, it is important to make the diagnosis early and perform complete resection if possible.
多形性癌是一种罕见的肺上皮恶性肿瘤，在1999年更新的世界卫生组织分类中有所定义。据我们所知，这种肿瘤的临床发现和预后尚未得到充分了解，因此我们对其进行了调查。2000年至2006年间，我院有387例患者接受了原发性非小细胞肺癌（NSCLC）的手术切除。其中，13例（3.4%）被诊断为多形性癌。我们比较了多形性癌患者（n = 13）和其他NSCLC患者（n = 374）的临床和病理数据。我们的患者中有12例（92.3%）为男性，9例（69.2%）有症状。这些肿瘤主要位于上叶，与其他NSCLC相比，更常与相邻的肺大疱相关。4例患者因肿瘤侵犯纵隔、主动脉弓、胸膜和/或胸壁，手术切除不完全。术前均无法确诊。因此，周围组织的侵犯经常且早期发生。虽然对于多形性癌尚无明确的治疗策略，但早期诊断并尽可能进行完整切除很重要。
