National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Thorac Cancer. 2020 Dec;11(12):3596-3598. doi: 10.1111/1759-7714.13692. Epub 2020 Oct 16.
Here, we present a case of a distal-type bronchiolar adenoma (BA) of the lung. BAs are benign lung tumors characterized by nodular proliferation of bilayered bronchiolar-type epithelium with a continuous layer of basal cells. This patient underwent S3 segmentectomy following detection by computed tomography (CT) scan of a gradually enlarging ground-glass nodule (GGO) over a five month period. Nodule morphology and immunophenotype were consistent with those of distal-type BA of the lung. An epidermal growth factor receptor (EGFR) exon 21 p.L858R missense mutation was identified which, to the best of our knowledge, is the first case to be reported of a common gene mutation associated with non-small cell lung cancer (NSCLC) being found in a BA lesion. Following surgery, the patient remains relapse-free. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Pathological assessment of a lung nodule confirmed a papillary tumor with a double-layered cell structure, less than typical cytoplasm, and a mixture of ciliated columnar and globular cells, consistent with a distal-type bronchiolar adenoma. WHAT THIS STUDY ADDS: This is the first report of an EGFR exon 21 p.L858R mutation in a bronchiolar adenoma.
在这里，我们报告了一例肺部远端型细支气管腺瘤（BA）。BA 是一种良性肺肿瘤，其特征为双层细支气管型上皮细胞结节状增生，具有连续的基底细胞层。该患者在 CT 扫描发现逐渐增大的磨玻璃结节（GGO）五个月后接受了 S3 段切除术。结节形态和免疫表型与肺部远端型 BA 一致。检测到表皮生长因子受体（EGFR）外显子 21 p.L858R 错义突变，据我们所知，这是首例在 BA 病变中发现与非小细胞肺癌（NSCLC）相关的常见基因突变的病例。手术后，患者无复发。
对肺结节的病理评估证实为具有双层细胞结构的乳头状肿瘤，细胞浆不典型，纤毛柱状和球形细胞混合存在，符合远端型细支气管腺瘤。
这是首例在细支气管腺瘤中发现 EGFR 外显子 21 p.L858R 突变的病例。
