Jeonbuk National University, Jeonju, Korea.
Int J Surg Pathol. 2020 Sep;28(6):658-662. doi: 10.1177/1066896920908330. Epub 2020 Feb 25.
Mixed squamous and glandular papilloma (mixed papilloma) of the lung has been reported in fewer than 25 cases in the English literature. Although it is known as a benign tumor, malignant transformation has been reported. Papillary cystic carcinoma is characterized by papillary and cystic growth patterns and has been reported as a subtype of adenocarcinoma, mainly in the salivary glands, breast, and pancreas. In this article, we report a case of adenocarcinoma-papillary cystic pattern arising from mixed papilloma of the lung in a 76-year-old male patient. Chest computed tomography scan revealed an endobronchial mass growing at the right medial segmental bronchus. Middle lobe lobectomy was performed, revealing a 4.9 × 1.9 cm-sized mass that protruded into the bronchus. Microscopically, the tumor showed numerous cysts lined by micropapillary projections. The tumor cells had round and vesicular nuclei with prominent nucleoli, and mitosis was frequent. A limited portion of the tumor consisted of benign mixed papilloma. The tumor showed diffuse immunoreactivity for thyroid transcription factor-1 and strong expression of p16. We investigated the mutational status of cancer-related genes using targeted next-generation sequencing and identified a genetic alteration in the gene. This is the first case report of papillary cystic carcinoma arising in mixed papilloma of the lung.
肺混合性鳞状和腺样乳头状瘤（混合性乳头状瘤）在英文文献中报道的病例少于 25 例。尽管它被认为是一种良性肿瘤，但也有恶性转化的报道。乳头状囊腺癌的特征是乳头状和囊状生长模式，已被报道为腺癌的一个亚型，主要发生在唾液腺、乳腺和胰腺。本文报道了一例 76 岁男性患者肺混合性乳头状瘤发生的腺鳞癌-乳头状囊状型。胸部计算机断层扫描显示右内侧段支气管生长的支气管内肿块。行中叶肺切除术，显示 4.9×1.9cm 大小的肿块向支气管突出。显微镜下，肿瘤显示许多由微乳头状突起排列的囊肿。肿瘤细胞具有圆形和泡状核，核仁明显，有丝分裂频繁。肿瘤的有限部分由良性混合性乳头状瘤组成。肿瘤弥漫性表达甲状腺转录因子-1，p16 表达强烈。我们使用靶向下一代测序研究了与癌症相关基因的突变状态，并在 基因中发现了一个遗传改变。这是首例肺混合性乳头状瘤发生的乳头状囊腺癌的报道。
