Takanashi Yusuke, Tajima Shogo, Tsukui Masaru, Shinmura Kazuya, Hayakawa Takamitsu, Takahashi Tsuyoshi, Neyatani Hiroshi, Funai Kazuhito
Department of Thoracic Surgery, Fujieda Municipal General Hospital , Fujieda.
Department of Pathology, Fujieda Municipal General Hospital.
Rare Tumors. 2016 Dec 7;8(4):6580. doi: 10.4081/rt.2016.6580. eCollection 2016 Nov 17.
An extremely rare case of non-mucinous lepidic-predominant invasive adenocarcinoma (LPA) showing extensive aerogenous spread with a is reported. A 73-year-old woman was referred to our hospital because of an infiltrative shadow on chest xray. Chest computed tomography revealed extensive ground glass opacities in the right lower lobe, which was accompanied by infiltrative shadow with a Invasive mucinous adenocarcinoma was presumed, and a partial resection of the right lower lobe was done. Histopathological examination revealed lepidic growth-predominant invasive adenocarcinoma with Clara type tumor cells, and there were innumerable aerogenous metastases also consisting of Clara cells. Because Alcian Blue and periodic acid-Schiff staining disclosed no mucus, the tumor was diagnosed as a non-mucinous LPA. The patient showed a poor response to 5 courses of pemetrexed, and she died one year after the diagnosis due to cancer progression. Nonmucinous LPA showed a rare presentation characterized by extensive aerogenous spread followed by a poor prognosis.
报道了一例极其罕见的非黏液性鳞屑状为主型浸润性腺癌（LPA），其表现为广泛的气源性播散。一名73岁女性因胸部X线出现浸润性阴影而转诊至我院。胸部计算机断层扫描显示右下叶有广泛的磨玻璃影，并伴有浸润性阴影。初步诊断为浸润性黏液腺癌，遂行右下叶部分切除术。组织病理学检查显示为以鳞屑状生长为主的浸润性腺癌，伴有克拉拉细胞型肿瘤细胞，且存在无数同样由克拉拉细胞组成的气源性转移灶。由于阿尔辛蓝和过碘酸希夫染色未显示黏液，该肿瘤被诊断为非黏液性LPA。该患者对5个周期的培美曲塞治疗反应不佳，诊断后1年因癌症进展死亡。非黏液性LPA表现出一种罕见的特征，即广泛的气源性播散且预后不良。
