Imanishi Jungo, Yazawa Yasuo, Meguro Shiori, Shimizu Michio
Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama Prefecture, Japan.
BMJ Case Rep. 2014 Feb 11;2014:bcr2013203357. doi: 10.1136/bcr-2013-203357.
We report the case of a 78-year-old man with multiple bone tumours and three round, smooth nodules in the right lung. He was referred to our hospital because of the left femoral neck pathological fracture. The histological characteristics of the femoral tumour corresponded to clear cell carcinoma, and bone and lung lesions were regarded as metastatic from an unknown primary site, since there was no clinical evidence of renal carcinoma. His general conditions gradually declined, and he died 2 months after the operation. At autopsy, no neoplasia lesion was found in the kidneys. Although clear cell components were histologically dominant in the affected organs such as the lungs, bones and liver, neoplastic tubular structures also existed. Immunohistochemically, atypical cells were positive for napsin-A. The final diagnosis was adenocarcinoma of the lung origin with prominent clear cell features.
我们报告了一例78岁男性患者，其患有多发性骨肿瘤，右肺有三个圆形、边界光滑的结节。他因左股骨颈病理性骨折转诊至我院。股骨肿瘤的组织学特征符合透明细胞癌，由于没有肾癌的临床证据，骨和肺病变被认为是来自未知原发部位的转移瘤。他的一般状况逐渐恶化，术后2个月死亡。尸检时，未在肾脏发现肿瘤病变。虽然在肺、骨和肝等受累器官中组织学上以透明细胞成分占主导，但也存在肿瘤性管状结构。免疫组化显示，非典型细胞 napsin-A 呈阳性。最终诊断为具有显著透明细胞特征的肺源性腺癌。
