Zhang Jie, Deng Hui, Wu Chong Chong, Wang Zhaoyu, Zhao Dahai, Wei Bo, Zhang Jing Yuan, Tong Xinjie, Gao Jie, Pan Lei, Xue Xin Ying
Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University.
Department of Radiology, General Hospital of PLA, Beijing.
Medicine (Baltimore). 2019 Apr;98(14):e15031. doi: 10.1097/MD.0000000000015031.
Thin-wall cystic lung cancer is becoming of increasing interest in the study of pulmonary medicine. Consequently, more and more different images and pathologic manifestations have been found. The purpose of this article is to find pathologic characteristics and try to explain the formation mechanism of thin-walled cystic lung cancer.Sixty-five patients with this special lung cancer were analyzed retrospectively based on the review of medical records, radiologic findings, and pathologic changes.We found 3 pathologic types: adenocarcinoma, squamous cell carcinoma, and lymphoma. There were 60 cases of adenocarcinoma, 4 cases were squamous cell carcinoma, and only 1 lymphoma. Tumor cells, pulmonary vessels, fibrous tissues, and residual bronchi are the pathologic basis of different image findings.Thin-walled cystic lung cancers are mostly adenocarcinoma, but other pathologic types can also appear, such as squamous cell carcinoma and lymphoma. We can see that a large amount of fibrous tissues were generated by tumors around the bronchus, resulting in airway stenosis and degeneration. Tumor cells also can invade the bronchial wall and cause structural damage. All these lesions are similar to 1-way valves which can cause gas accumulation in the tumor area and result in thin-walled cystic lung cancer.
薄壁囊性肺癌在肺部医学研究中越来越受到关注。因此，人们发现了越来越多不同的影像学表现和病理表现。本文旨在找出薄壁囊性肺癌的病理特征，并尝试解释其形成机制。通过回顾病历、影像学检查结果和病理变化，对65例患有这种特殊肺癌的患者进行了回顾性分析。我们发现了3种病理类型：腺癌、鳞状细胞癌和淋巴瘤。其中腺癌60例，鳞状细胞癌4例，淋巴瘤仅1例。肿瘤细胞、肺血管、纤维组织和残留支气管是不同影像学表现的病理基础。薄壁囊性肺癌大多为腺癌，但也可出现其他病理类型，如鳞状细胞癌和淋巴瘤。我们可以看到，肿瘤在支气管周围产生大量纤维组织，导致气道狭窄和变性。肿瘤细胞也可侵犯支气管壁并造成结构破坏。所有这些病变类似于单向阀，可导致肿瘤区域气体积聚，从而形成薄壁囊性肺癌。
