Gleason Tyler, Haas Michael, Le Brian H
Department of Medicine, Reading Hospital, West Reading, PA 19611, USA.
Department of Radiology and Radiation Oncology, Reading Hospital, West Reading, PA 19611, USA.
Case Rep Radiol. 2017;2017:8135957. doi: 10.1155/2017/8135957. Epub 2017 Sep 17.
A 76-year-old female with coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus type II, and 40 pack-year smoking history presented with a four-day history of cough, productive of green-yellow sputum. Chest X-ray revealed opacification of the left upper lung field, and computed tomography (CT) of the chest showed a large cavitary lesion invading the T2-T3 vertebral bodies, extending into the epidural space, giving rise to mild cord compression. Biopsy of the lesion revealed a poorly differentiated neoplasm composed of distinct epithelial and mesenchymal components, consistent with carcinosarcoma. A metastatic workup was negative. Primary lung carcinosarcoma is a rare tumour that can demonstrate an especially aggressive clinical course; diagnosis is often nuanced by limited sampling at initial presentation, especially in a setting of advanced disease and debility that precludes consideration for upfront resection or more extensive, invasive sampling.
一名76岁女性，有冠状动脉疾病、慢性阻塞性肺疾病、II型糖尿病，并有40年包年吸烟史，出现咳嗽、咳黄绿色痰4天的症状。胸部X线显示左上肺野模糊，胸部计算机断层扫描（CT）显示一个大的空洞性病变侵犯T2 - T3椎体，延伸至硬膜外间隙，导致轻度脊髓受压。病变活检显示为一种低分化肿瘤，由不同的上皮和间充质成分组成，符合癌肉瘤。转移检查结果为阴性。原发性肺癌肉瘤是一种罕见肿瘤，可表现出特别侵袭性的临床病程；诊断常常因初次就诊时取样有限而难以明确，尤其是在晚期疾病和身体虚弱的情况下，无法考虑进行 upfront 切除或更广泛、侵入性更强的取样。
