Fukuda M, Sasaki Y, Sakamoto M, Noguchi M, Saijo N
Department of Internal Medicine, National Cancer Center Hospital, Tokyo.
Jpn J Clin Oncol. 1990 Jun;20(2):177-81. doi: 10.1093/oxfordjournals.jjco.a039384.
An autopsy case of an 18-year-old boy with adenocarcinoma of the lung is reported. He experienced dyspnea and hemosputum in July 1988. Chest radiographs showed a diffuse bilateral streaky shadow, bilateral pleural effusion and cardiac enlargement. The diagnosis of adenocarcinoma was made by transbronchial biopsy at another hospital. He visited the National Cancer Center Hospital on October 7, 1988. The diagnosis of lung cancer was strongly suggested by positive immunohistochemical staining for pulmonary surfactant apoprotein in biopsy specimens from supraclavicular lymph nodes. Intensive systemic survey demonstrated no other primary site than the lung. The patient was treated with cisplatin, adriamycin and etoposide and his subjective symptoms such as cough and dyspnea significantly improved over the next three months. Tumor shadows in the lung increased steadily, however after February, 1989. A significant lymphangitic spread of the carcinoma and marked obsteoblastic bone metastases were revealed at autopsy.
报告了一例18岁男性肺腺癌的尸检病例。他于1988年7月出现呼吸困难和咯血。胸部X线片显示双侧弥漫性条纹状阴影、双侧胸腔积液和心脏扩大。在另一家医院通过经支气管活检确诊为腺癌。他于1988年10月7日就诊于国立癌症中心医院。锁骨上淋巴结活检标本中肺表面活性物质载脂蛋白免疫组化染色阳性，强烈提示肺癌诊断。全面的全身检查未发现肺部以外的其他原发部位。患者接受了顺铂、阿霉素和依托泊苷治疗，在接下来的三个月里，咳嗽和呼吸困难等主观症状明显改善。然而，1989年2月以后，肺部肿瘤阴影稳步增大。尸检发现癌有明显的淋巴管播散和显著的成骨型骨转移。
