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硬化性肺细胞瘤:伴胸膜转移的典型类癌的宿主——披着羊皮的狼。

Sclerosing Pneumocytoma: A Host for a Typical Carcinoid With Pleural Metastasis-A Wolf in Sheep`s Clothing.

机构信息

Division of Thoracic Surgery, Department of General Surgery, Stadtspital Triemli Zuerich, Zurich, Switzerland.

Division of Thoracic Surgery, Department of General Surgery, Stadtspital Triemli Zuerich, Zurich, Switzerland.

出版信息

Chest. 2021 Jan;159(1):e1-e5. doi: 10.1016/j.chest.2020.06.047.

Abstract

Sclerosing pneumocytoma (SP) is a rare primary lung tumor. Typical carcinoids (TCs) count for 2% of lung malignancies. A description of a combined neoplasm of SP with a nodal and pleural metastasized TC has, to our knowledge, never been published. A 57-year-old actively smoking woman received a diagnosis of a lesion in the left lower lobe via a screening CT scan for rheumatoid arthritis. A fluorodeoxyglucose-PET scan confirmed a 21 × 26 × 16 mm (standardized uptake maximum value, 3.0), well-circumscribed round lesion with calcification, which was thought to be most probably benign. No mediastinal lymph node enlargement or fluorodeoxyglucose uptake was detected. The results of routine laboratory tests, respiratory function tests, and physical examination were unremarkable. In diagnostic thoracoscopy pleural, diaphragmatic, and pericardial lesions were discovered and biopsied in addition to a wedge resection. After diagnosis of a pleural metastasized TC mixed with SP, radical resection and systemic lymph node dissection were performed. The patient is in remission after 36 months of follow-up.

摘要

硬化性细支气管肺泡细胞瘤(SP)是一种罕见的原发性肺肿瘤。典型类癌(TCs)占肺部恶性肿瘤的 2%。据我们所知,从未有过将 SP 与淋巴结和胸膜转移 TC 合并的肿瘤的描述。一位 57 岁的活跃吸烟者,因类风湿关节炎筛查 CT 扫描而被诊断为左肺下叶病变。氟脱氧葡萄糖-PET 扫描证实存在一个 21×26×16mm(标准化摄取值最大值 3.0)的边界清楚的圆形钙化病变,最有可能是良性的。未发现纵隔淋巴结肿大或氟脱氧葡萄糖摄取。常规实验室检查、呼吸功能检查和体检结果均无异常。在诊断性胸腔镜检查中,除楔形切除外,还发现了胸膜、膈肌和心包病变并进行了活检。诊断为胸膜转移 TC 合并 SP 后,进行了根治性切除和全身淋巴结清扫。患者在 36 个月的随访后处于缓解期。

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