Kung I T, Lui I O, Loke S L, Khin M A, Mok C K, Lam W K, So S Y
Am J Surg Pathol. 1985 Jun;9(6):391-400. doi: 10.1097/00000478-198506000-00001.
A total of 49 consecutive specimens of lung cancer were collected prospectively at surgical resection or autopsy from 40 men and nine women, aged 40-74 years. Of the 49 tumors, the gross appearance of 22 fitted the description of a scar cancer, i.e., a tumor with pleural puckering and central pigmentation. Nineteen of the "scar cancers" were peripheral (17 adenocarcinomas and two squamous cell carcinomas); three were central (one squamous cell carcinoma and two adenocarcinomas). In the 19 peripheral "scar cancers," elastic stains demonstrated the presence of collapsed, unfibrosed lung tissue at the center with traction of the overlying pleura toward it. Elsewhere in the tumor, the elastic framework was either destroyed or expanded by tumor filling the alveolar spaces. None of the "scar cancers" had a significant desmoplastic reaction that might otherwise explain the scarred appearance. It appeared that local atelectasis was solely responsible for the pleural puckering and central pigmentation. On the other hand, atelectatic lung tissue was not seen in the 27 cancers that did not have the appearance of a scar cancer. Tuberculosis was found in 10 of the 49 lung specimens. In only one specimen was the tuberculous lesion anatomically associated with the tumor. There was no evidence of pulmonary infarct in any of the specimens. The term "scar cancer" was considered inappropriate as there was no preformed fibrous tissue. The scarred appearance was thought to be the result of localized pulmonary atelectasis owing to small airways obstruction by tumor. Association with tuberculosis was considered incidental.
前瞻性收集了40名男性和9名女性年龄在40 - 74岁之间，经手术切除或尸检获得的49例连续肺癌标本。在这49个肿瘤中，22个肿瘤的大体外观符合瘢痕癌的描述，即伴有胸膜皱缩和中央色素沉着的肿瘤。19个“瘢痕癌”为周围型（17个腺癌和2个鳞癌）；3个为中央型（1个鳞癌和2个腺癌）。在19个周围型“瘢痕癌”中，弹性染色显示肿瘤中央存在塌陷、未纤维化的肺组织，其上覆胸膜向其牵拉。在肿瘤的其他部位，弹性结构要么被肿瘤破坏，要么因肿瘤填充肺泡腔而扩张。没有一个“瘢痕癌”有明显的促纤维增生反应，否则可能解释其瘢痕样外观。似乎局部肺不张是胸膜皱缩和中央色素沉着的唯一原因。另一方面，在27个没有瘢痕癌外观的癌症中未见到肺不张的肺组织。49例肺标本中有10例发现结核。仅在1个标本中结核病变与肿瘤在解剖学上相关。所有标本中均无肺梗死的证据。由于不存在预先形成的纤维组织，“瘢痕癌”这一术语被认为不合适。瘢痕样外观被认为是肿瘤阻塞小气道导致局部肺不张的结果。与结核的关联被认为是偶然的。
