Ohtaki Yoichi, Ishii Genichiro, Hasegawa Tadashi, Nagai Kanji
Division of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
Interact Cardiovasc Thorac Surg. 2011 Aug;13(2):220-2. doi: 10.1510/icvts.2010.262204. Epub 2011 Mar 9.
Adult onset neuroblastoma arising in the mediastinum, except posterior mediastinum is extremely rare. We report a case of surgically resected neuroblastoma in the superior mediastinum. A 64-year-old male was admitted to a local hospital, after an abnormal shadow had been detected on a chest radiogram on a routine medical checkup. Computed tomography (CT) examination revealed the tumor located in the superior mediastinum. Preoperatively, we suspected malignant lymphoma or lymph node metastasis from an unknown primary site. We resected the mediastinal tumor for both definitive diagnosis and local treatment. The tumor was composed of sheets of small round cells positive for CD56, NSE, chromogranin A, and vimentin, but negative for AE1/3, CK5/6, CK7, CD3, CD20, CD79a, c-kit, S-100, SMA and CD99. N-myc gene amplification was also confirmed and supported diagnosis of neuroblastoma. Chest CT seven months after surgery revealed multiple recurrences in lymph nodes.
成人纵隔(后纵隔除外)发生的神经母细胞瘤极为罕见。我们报告一例手术切除的上纵隔神经母细胞瘤病例。一名64岁男性因常规体检胸部X线片发现异常阴影入住当地医院。计算机断层扫描(CT)检查显示肿瘤位于上纵隔。术前,我们怀疑是恶性淋巴瘤或不明原发部位的淋巴结转移。我们切除纵隔肿瘤以明确诊断并进行局部治疗。肿瘤由成片的小圆形细胞组成,这些细胞CD56、神经元特异性烯醇化酶(NSE)、嗜铬粒蛋白A和波形蛋白呈阳性,但细胞角蛋白AE1/3、细胞角蛋白5/6、细胞角蛋白7、CD3、CD20、CD79a、原癌基因c-kit、S-100、平滑肌肌动蛋白(SMA)和CD99呈阴性。同时也证实了N-myc基因扩增,支持神经母细胞瘤的诊断。术后七个月的胸部CT显示淋巴结多处复发。