Wang Meifang, Liu Yuquan, Qian Xin, Li Dan, You Hui, Wei Na, Tang Yijun
Department of Pulmonary and Critical Care Medicine.
Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China.
Medicine (Baltimore). 2019 May;98(20):e15689. doi: 10.1097/MD.0000000000015689.
Pulmonary sarcomatoid carcinomas (PSCs) are rare tumors within the sarcomatoid carcinoma group. Giant cell carcinoma of the lung (GCCL) is a rare type of PSCs that consists entirely of highly pleomorphic tumor giant cells; the prognosis is poor.
A patient presented with a single cyst and was diagnosed with GCCL. The patient was a 59-year-old male who was admitted to the hospital with a cough. A chest computerized tomography (CT) scan showed a single, thin-walled cyst containing air in the left upper lobe of the lung. Bronchoscopy revealed chronic bronchitis. The initial diagnosis was pulmonary infection and the patient was treated with antibiotics. The cyst wall increased in thickness, and the cyst eventually formed a cavity.
Surgery was performed, and a diagnosis of GCCL was established. The stage was pT1bN1M0 (equal to stage IIB).
The patient underwent video-assisted thoracoscopic surgery and 4 cycles of adjuvant chemotherapy consisting of cisplatin and docetaxel. After 9 months, the patient occurred mediastinal lymph node metastasis, and received radiotherapy (60Gy/30F).
His prognosis was good without progression (complete response) based on serial CT scans over 9 months of follow-up evaluations, then the patient occurred mediastinal lymph node metastasis. The patient lived during 30 months of follow-up, after which he was lost to follow-up.
A solitary pulmonary parenchymal cystic lesion usually suggests an infectious disease or congenital abnormality; however, a cystic lesion is occasionally encountered in GCCL.
肺肉瘤样癌(PSC)是肉瘤样癌组中的罕见肿瘤。肺巨细胞癌(GCCL)是PSC的一种罕见类型,完全由高度多形性的肿瘤巨细胞组成;预后较差。
一名患者出现单个囊肿,被诊断为GCCL。患者为59岁男性,因咳嗽入院。胸部计算机断层扫描(CT)显示左肺上叶有一个含气的薄壁单个囊肿。支气管镜检查显示慢性支气管炎。初步诊断为肺部感染,患者接受了抗生素治疗。囊肿壁厚度增加,最终囊肿形成一个空洞。
进行了手术,确诊为GCCL。分期为pT1bN1M0(等同于IIB期)。
患者接受了电视辅助胸腔镜手术以及由顺铂和多西他赛组成的4个周期辅助化疗。9个月后,患者出现纵隔淋巴结转移,并接受了放疗(60Gy/30F)。
根据9个月随访评估期间的系列CT扫描,其预后良好且无进展(完全缓解),之后患者出现纵隔淋巴结转移。患者在30个月的随访期间存活,之后失访。
孤立性肺实质囊性病变通常提示感染性疾病或先天性异常;然而,GCCL中偶尔也会遇到囊性病变。