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弥漫性肺浸润:腺癌的一种表现形式。

Diffuse pulmonary infiltrates: A guise of adenocarcinoma.

作者信息

Ismail Mourad, Sekhon Raminderjit

机构信息

Department of Medicine, New York Medical College at Saint Joseph's Regional Medical Center, 703 Main St, Paterson, NJ 07503, USA.

出版信息

Respir Med Case Rep. 2017 Aug 6;22:150-153. doi: 10.1016/j.rmcr.2017.08.003. eCollection 2017.

Abstract

Small and non-small cell lung cancer present in a variety of radiologic and clinical patterns, and have been linked to smoking. Primary adenocarcinoma of the lung has been increasingly recognized in females and nonsmokers, often presenting a diagnostic challenge. In the absence of smoking history, these radiographic patterns may be initially misdiagnosed as an infectious or inflammatory condition, often delaying the diagnosis of malignancy. We report two cases of female patients with relatively short or no smoking history presenting with diffuse pulmonary infiltrates not typically seen in primary lung cancer, which created a diagnostic challenge, ultimately diagnosed as primary lung adenocarcinoma. Each case had different subtype patterns of adenocarcinoma. The first case described adenocarcinoma of mostly acinar pattern; while the second case was noted to have adenocarcinoma of micropapillary pattern. Given lung adenocarcinoma's nonspecific presentation, which may mimic infectious and diffuse interstitial lung disease, the above cases highlight the importance of entertaining lung adenocarcinoma as part of the differential diagnosis of such presentations.

摘要

小细胞肺癌和非小细胞肺癌呈现出多种放射学和临床特征,且都与吸烟有关。原发性肺腺癌在女性和非吸烟者中越来越常见,常常带来诊断挑战。在没有吸烟史的情况下,这些影像学表现最初可能被误诊为感染性或炎症性疾病,常常延误恶性肿瘤的诊断。我们报告两例女性患者,她们吸烟史较短或无吸烟史,表现为原发性肺癌中不常见的弥漫性肺浸润,这带来了诊断挑战,最终被诊断为原发性肺腺癌。每例腺癌都有不同的亚型模式。第一例描述的主要是腺泡型腺癌;而第二例则是微乳头型腺癌。鉴于肺腺癌的表现不具特异性,可能类似感染性疾病和弥漫性间质性肺病,上述病例凸显了将肺腺癌纳入此类表现的鉴别诊断的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc29/5552382/44dae7bd07bc/gr1.jpg

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