Zaizen Yoshiaki, Tokito Takaaki, Masuda Ken, Azuma Koichi, Naito Yoshiki, Tsuneyoshi Shingo, Sakazaki Yuki, Matsuo Norikazu, Ishii Hidenobu, Yamada Kazuhiko, Akiba Jun, Hoshino Tomoaki
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan.
Department of Diagnostic Pathology, Kurume University School of Medicine, Japan.
Intern Med. 2018 Dec 1;57(23):3419-3422. doi: 10.2169/internalmedicine.1200-18. Epub 2018 Jul 6.
There have been few reports on the accuracy of the diagnosis of small-cell carcinoma based on a cytological examination of malignant pleural effusion, so whether or not such a diagnosis is possible using this approach alone remains unclear. We herein report a 76-year-old Japanese man in whom small-cell carcinoma was diagnosed cytopathologically from pleural effusion and squamous cell carcinoma was diagnosed histopathologically from a transbronchial biopsy. Tumor shrinkage was achieved by treatment with docetaxel, but the efficacy of carboplatin plus etoposide was inadequate. If small-cell carcinoma is detected on the basis of pleural fluid cytopathology alone, it is extremely important to perform a histopathological examination to rule out the possibility of other malignancies.
关于基于恶性胸腔积液的细胞学检查诊断小细胞癌的准确性的报道较少，因此仅用这种方法能否做出诊断仍不明确。我们在此报告一名76岁的日本男性，其通过胸腔积液的细胞病理学诊断为小细胞癌，通过经支气管活检的组织病理学诊断为鳞状细胞癌。多西他赛治疗实现了肿瘤缩小，但卡铂加依托泊苷的疗效不佳。如果仅基于胸水细胞病理学检测到小细胞癌，进行组织病理学检查以排除其他恶性肿瘤的可能性极其重要。
