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原发性支气管内涎腺上皮-肌上皮癌的支气管镜治疗:一例报告

Bronchoscopic management of a primary endobronchial salivary epithelial-myoepithelial carcinoma: A case report.

作者信息

Patterson Dalton T, Halverson Quinn, Williams Sarah, Bishop Justin A, Ochoa Cristhiaan D, Styrvoky Kim

机构信息

Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, 75239, USA.

Division of Pulmonary and Critical Care, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, 75239, USA.

出版信息

Respir Med Case Rep. 2020 May 7;30:101083. doi: 10.1016/j.rmcr.2020.101083. eCollection 2020.

Abstract

Here, we discussed a 55 y/o African man who recently immigrated from Nigeria to the United States and who presented to Parkland Memorial Hospital with a productive, intermittent cough of one year duration. The cough was associated with shortness of breath and chest pain. Cough was not associated with voice hoarseness, hemoptysis, melanoptysis, and wheezing. He had a computed tomography (CT) scan of the chest that showed a 1.9 cm mass in the right main stem bronchus with ipsilateral right lower lobe consolidation and bronchiectasis. The patient was seen by pulmonology who recommended bronchoscopy for diagnosis and possible intervention. Bronchoscopy showed a 90% obstructing mass in the proximal right mainstem bronchus and bronchus intermedius. The mass was large and endobronchial, circumferential, exophytic, and polypoid. The decision was made to undergo bronchoscopic tumor ablation using electrocautery snare, argon plasma coagulation (APC), suction, and forceps. The tumor was successful ablated. Microscopic examination revealed eosinophilic ducts tightly coupled with a surrounding layer of clear cell myoepithelial cells and the diagnosis of epithelial-myoepithelial carcinoma (EMC) of the lung was made. The patient was discharged from the hospital with scheduled outpatient visits for monitoring of the carcinoma by pulmonology and thoracic surgery. Unfortunately, he was lost to follow up.

摘要

在此,我们讨论了一名55岁的非洲男性,他最近从尼日利亚移民到美国,因持续性、间歇性咳嗽一年就诊于帕克兰纪念医院。咳嗽伴有呼吸急促和胸痛。咳嗽与声音嘶哑、咯血、黑痰和喘息无关。他进行了胸部计算机断层扫描(CT),显示右主支气管有一个1.9厘米的肿块,同侧右下叶实变和支气管扩张。呼吸科医生对该患者进行了诊治,建议进行支气管镜检查以明确诊断并可能进行干预。支气管镜检查显示右主支气管近端和中间支气管有一个阻塞性肿块,阻塞率为90%。肿块较大,位于支气管内,呈环形、外生性和息肉样。决定使用电凝圈套器、氩等离子体凝固(APC)、吸引器和活检钳进行支气管镜肿瘤消融。肿瘤成功消融。显微镜检查显示嗜酸性导管与周围一层透明细胞肌上皮细胞紧密相连,诊断为肺上皮-肌上皮癌(EMC)。患者出院,安排了门诊随访,由呼吸科和胸外科监测癌症情况。不幸的是,他失访了。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7977/7232110/9737da28905f/gr1.jpg

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