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肺淋巴上皮瘤样癌:一例报告并重点介绍 CT 表现。

Pulmonary lymphoepithelioma-like carcinoma: A case report with emphasis on computed tomography findings.

机构信息

Department of Radiology, Pidu District People's Hospital.

Department of Radiology, Shenzhen Children's Hospital, Shantou University Medical College.

出版信息

Medicine (Baltimore). 2021 Feb 5;100(5):e24453. doi: 10.1097/MD.0000000000024453.

Abstract

RATIONALE

Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare type of primary malignant lung tumor characterized by Epstein-Barr virus infection, with, to the authors' knowledge, a total of only 500 reported cases during the past 30 years worldwide. Histologically, PLELC is similar to undifferentiated nasopharyngeal carcinoma and poorly differentiated squamous cell carcinoma. However, although PLELC accounts for <1% of all lung cancers, it has a better prognosis and is usually detected in non-smokers and individuals of Asian ancestry.

PATIENT CONCERNS

The patient presented with chest distress of no apparent cause, dizziness, headaches, and a feeling of disequilibrium without remission, as well as a pulmonary nodule incidentally detected on contrast-enhanced computed tomography (CT).

DIAGNOSIS

PLELC was confirmed histopathologically rather than on preoperative CT; nevertheless, CT findings still contributed to the diagnosis.

INTERVENTIONS

The patient underwent thoracoscopic wedge resection of the affected lung.

OUTCOMES

The patient recovered after the lung nodule was completely removed, and was discharged. No evidence of recurrence or metastasis was found at the latest follow-up appointment 2 months after the operation.

LESSONS

PLELC is a rare bronchogenic carcinoma associated with lymphatic tissue with a favorable prognosis in most cases. With nonspecific clinical symptoms, specific radiological findings may facilitate an early diagnosis in some cases, followed by timely surgical intervention.

摘要

背景

肺淋巴上皮瘤样癌(PLELC)是一种罕见的原发性肺恶性肿瘤,其特征为 EBV 感染,据作者所知,在过去 30 年中,全球范围内总共仅有 500 例报告病例。组织学上,PLELC 类似于未分化型鼻咽癌和低分化鳞状细胞癌。然而,尽管 PLELC 占所有肺癌的比例不到 1%,但其预后较好,通常发生在不吸烟和亚裔人群中。

病例介绍

患者无明显原因出现胸闷,伴有头晕、头痛和不平衡感,且无法缓解,胸部增强 CT 偶然发现肺部结节。

诊断

组织病理学证实为 PLELC,而非术前 CT;然而,CT 表现仍有助于诊断。

治疗

患者接受了胸腔镜楔形切除术。

结果

患者在完全切除肺部结节后康复,已出院。在术后 2 个月的最新随访中,未发现复发或转移的迹象。

教训

PLELC 是一种罕见的支气管源性癌,与淋巴组织相关,大多数情况下预后良好。由于临床症状无特异性,特定的影像学表现可能有助于某些病例的早期诊断,从而及时进行手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d03/7870249/15666109c959/medi-100-e24453-g001.jpg

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