Ghigna M R, Dorfmuller P, Crutu A, Fadel E, de Montpréville V Thomas
Pathology Department, Marie Lannelongue Hospital, 133 Avenue de la Resistance, Le Plessis Robinson, 92350, France.
Thoracic and Vascular Surgery Department, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France.
Endocr Pathol. 2016 Dec;27(4):332-337. doi: 10.1007/s12022-016-9422-y.
Though most paragangliomas arise as sporadic tumors, the recent advantages in the genetic screening revealed that about 30 % of paragangliomas are linked to hereditary mutations, such as those involving SDH genes. A 22-year-old woman carrying a left main bronchus tumor underwent surgery in our institution. Her past medical history included a GIST without KIT or PDGFRA mutation. The histological examination revealed a nested proliferation of medium-sized cells expressing neuroendocrine markers (chromogranin A and synaptophysin). The neoplastic cells failed to express SDHB gene product. These findings led us to the final diagnosis of bronchial paraganglioma in the setting of Carney-Stratakis syndrome. Bronchial paragangliomas are exceedingly rare tumors with polymorphous clinical presentation, and usually benign clinical course. Though most paragangliomas are sporadic, some tumors are associated with specific hereditary disease, especially those occurring in young patients or in combination with other neoplasms.
尽管大多数副神经节瘤是散发性肿瘤,但基因筛查方面的最新进展表明,约30%的副神经节瘤与遗传性突变有关,例如那些涉及SDH基因的突变。一名患有左主支气管肿瘤的22岁女性在我们机构接受了手术。她的既往病史包括一个无KIT或PDGFRA突变的胃肠道间质瘤。组织学检查显示,表达神经内分泌标志物(嗜铬粒蛋白A和突触素)的中等大小细胞呈巢状增生。肿瘤细胞未能表达SDHB基因产物。这些发现使我们最终诊断为卡尼-斯特拉塔基斯综合征背景下的支气管副神经节瘤。支气管副神经节瘤是极其罕见的肿瘤,临床表现多样,通常临床病程良性。尽管大多数副神经节瘤是散发性的,但一些肿瘤与特定的遗传性疾病有关,尤其是那些发生在年轻患者或与其他肿瘤同时出现的情况。