Moniodis A, Racila E, Divo M
Department of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Clinics Building PBB 311, 75 Francis Street, Boston, Massachusetts, USA.
Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts, USA.
Transplant Proc. 2015 Apr;47(3):852-4. doi: 10.1016/j.transproceed.2015.01.019.
Lung transplantation confers an increased risk of lung cancer, especially for single lung transplant recipients, due to both the epidemiologic risk factors associated with the patient population and the posttransplantation immunosuppression required. We report what we believe to be the first case of combined small cell lung carcinoma identified in the native lung of a single lung transplant recipient. Combined small cell lung cancer is an increasingly recognized subtype of small cell carcinoma, and its possible presence is an important consideration in the interpretation of fine-needle aspiration biopsies. In our case, initial fine-needle aspiration suggested squamous cell carcinoma, and it was only after lobectomy that the diagnosis of small cell carcinoma was made. The case highlights the increased risk of malignancy in lung transplant recipients and suggests a role for adaptation of lung cancer screening guidelines to address this high-risk population.
肺移植会增加患肺癌的风险，尤其是对于单肺移植受者，这是由于与该患者群体相关的流行病学风险因素以及移植后所需的免疫抑制。我们报告了我们认为是首例在单肺移植受者的原生肺中发现的合并小细胞肺癌病例。合并小细胞肺癌是一种越来越被认可的小细胞癌亚型，其可能存在是细针穿刺活检结果解读中的一个重要考虑因素。在我们的病例中，最初的细针穿刺提示为鳞状细胞癌，直到肺叶切除术后才确诊为小细胞癌。该病例凸显了肺移植受者发生恶性肿瘤的风险增加，并提示调整肺癌筛查指南以应对这一高危人群的必要性。
