Mount Sinai-Elmhurst Hospital Center, Elmhurst, NY, U.S.A.
Curr Oncol. 2011 Jan;18(1):e35-7. doi: 10.3747/co.v18i1.647.
Renal cell carcinoma comprises 80%-85% of kidney malignancies. For early presentations, nephrectomy provides a high cure rate, but patients usually present at advanced stages, leading to poor outcomes. Even for patients without metastatic spread who undergo nephrectomy, metastatic recurrence is frequent. We report the case of a patient who underwent nephrectomy for stage iii renal cell carcinoma and who presented 20 months later with respiratory symptoms consistent with pneumonia, influenza, or (less likely) congestive heart failure or a cardiac event. Persistent right pleural effusion on serial chest radiographs despite treatment prompted computed tomography evaluation, which revealed lymphangitic carcinomatosis, a very rare form of renal cell carcinoma metastasis to the lung. This preliminary finding was confirmed by right middle lobe tissue biopsy through bronchoscopy and cytopathology examination.
肾细胞癌占肾脏恶性肿瘤的 80%-85%。对于早期表现，肾切除术提供了高治愈率，但患者通常处于晚期，导致预后不良。即使对于没有转移扩散的接受肾切除术的患者，转移复发也很常见。我们报告了一例 iii 期肾细胞癌患者，术后 20 个月出现与肺炎、流感一致的呼吸症状，或（不太可能）充血性心力衰竭或心脏事件。尽管经过治疗，连续的胸部 X 线片仍显示持续的右侧胸腔积液，促使进行计算机断层扫描评估，显示淋巴管癌病，这是一种非常罕见的肾细胞癌肺转移形式。支气管镜检查和细胞学检查通过右中叶组织活检证实了这一初步发现。
