一例伴有肿瘤内出血的快速进展型肺梭形细胞癌尸检病例
An Autopsy Case of Rapidly Progressing Spindle Cell Carcinoma of the Lung Accompanied with Intratumor Hemorrhage.
作者信息
Kida Jun-ichiro, Kanaji Nobuhiro, Kishi Sosuke, Imaida Katsumi, Bandoh Shuji
机构信息
Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan.
Department of Pathology and Host-Defense, Onco-Pathology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan.
出版信息
Am J Case Rep. 2015 Nov 12;16:805-10. doi: 10.12659/ajcr.894443.
BACKGROUND
Spindle cell carcinoma (SPCC) of the lung is a subset of sarcomatoid carcinoma. Its clinical features are unclear because of its rarity. Here, we report an autopsy case of SPCC and review CT findings and chemotherapeutic regimens based on previous reports of this disease. To our knowledge, this is the first reported case of pemetrexed used to treat SPCC.
CASE REPORT
A 74-year-old Japanese male presented with dyspnea and contrast-enhanced computed tomography (CT) showed abundant left pleural effusion and a mass in lower lobe of the left lung. By the tumor biopsy, he was diagnosed for SPCC of the lung, cT3N0M1a, stage IV. The tumor was resistant to chemotherapy with carboplatin and pemetrexed, and rapidly progressed. Autopsy revealed abundant hemorrhage within the tumor, which apparently reflects a low-density area in CT.
CONCLUSIONS
Present case and the accumulation of cases indicate that low-density areas in CT and rapid tumor progression may be common SPCC findings.
背景
肺梭形细胞癌（SPCC）是肉瘤样癌的一个亚型。由于其罕见性，其临床特征尚不清楚。在此，我们报告一例SPCC尸检病例，并根据此前关于该疾病的报告回顾其CT表现及化疗方案。据我们所知，这是首例使用培美曲塞治疗SPCC的报道病例。
病例报告
一名74岁日本男性因呼吸困难就诊，增强计算机断层扫描（CT）显示左侧胸腔大量积液及左肺下叶肿块。经肿瘤活检，他被诊断为肺SPCC，cT3N0M1a，IV期。该肿瘤对卡铂和培美曲塞化疗耐药，并迅速进展。尸检显示肿瘤内大量出血，这显然反映在CT上为低密度区。
结论
本病例及病例积累表明，CT上的低密度区和肿瘤快速进展可能是SPCC的常见表现。
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