Kozu Yoshiki, Maniwa Tomohiro, Ohde Yasuhisa, Nakajima Takashi
Division of Thoracic Surgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:625-8. doi: 10.5761/atcs.cr.13-00029. Epub 2013 Aug 30.
Mixed squamous cell and glandular papilloma (mixed papilloma) of the lung is exceedingly rare, with only 18 cases reported in the literature. Herein, we report a case of mixed papilloma and its associated immunohistochemical and positron emission tomographic (PET) findings. A 60-year-old Japanese male with a smoking history of 40 pack-years presented with a smooth-edged pulmonary lesion in the right S5 segment on computed tomography (CT). F18-fluorodeoxyglucose (FDG) PET revealed abnormally increased FDG uptake in the mass (maximum standardized uptake value, 3.4). We performed right middle lobectomy and combined partial resection of the S8 segment. The 1.8-cm tumor that filled the enlarged lumen of the B5b was histologically diagnosed as mixed papilloma. Immunohistochemically, the pseudostratified columnar epithelium was positive for cytokeratin (CK) 5/6 and CK7. p40 positivity was predominant in the basal and squamous cells. Thyroid transcription factor-1 and carcinoembryonic antigen were negative on immunostaining. Malignant features were absent. The postoperative course has been uneventful for 3 months after the surgery. No recurrences were reported after the surgical resection of the mixed papilloma. Therefore, surgical resection may be considered the mainstay of curative treatment.
肺混合性鳞状细胞和腺性乳头状瘤(混合性乳头状瘤)极为罕见,文献中仅报道过18例。在此,我们报告1例混合性乳头状瘤及其相关的免疫组化和正电子发射断层扫描(PET)结果。一名有40包年吸烟史的60岁日本男性,计算机断层扫描(CT)显示其右肺S5段有一个边缘光滑的肺部病变。F18氟脱氧葡萄糖(FDG)PET显示肿块内FDG摄取异常增加(最大标准化摄取值为3.4)。我们进行了右肺中叶切除术并联合S8段部分切除术。填充B5b扩大管腔的1.8厘米肿瘤经组织学诊断为混合性乳头状瘤。免疫组化显示,假复层柱状上皮细胞角蛋白(CK)5/6和CK7呈阳性。p40在基底细胞和鳞状细胞中呈主要阳性。甲状腺转录因子-1和癌胚抗原免疫染色均为阴性。未发现恶性特征。术后3个月病情平稳。混合性乳头状瘤手术切除后未报告复发情况。因此,手术切除可被视为根治性治疗的主要手段。