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肺腺癌与抗中性粒细胞胞质抗体相关性血管炎的先后关系:一例报告。

Lung adenocarcinoma and sequential antineutrophil cytoplasmic antibody-associated vasculitis: a case report.

机构信息

Department of Respiratory, The Sixth Medical Center of PLA General Hospital, Beijing, China.

Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

J Int Med Res. 2021 Feb;49(2):300060521993319. doi: 10.1177/0300060521993319.

Abstract

The relationship between antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and lung cancer remains unclear. A 66-year-old man presented with pulmonary nodules. Histological examination of a specimen from computed tomography-guided percutaneous transthoracic biopsy revealed adenocarcinoma. The patient was treated using cryoablation and systemic chemotherapy. Sixteen months later, the patient presented with fever, nasal inflammation, recurrent lung lesions, elevated serum creatinine levels, and high levels of ANCA. Histological examination of a specimen from ultrasound-guided percutaneous renal biopsy revealed pauci-immune necrotizing crescentic glomerulonephritis. The patient responded to treatment, but granulomatosis with polyangiitis recurred and he later died. This case highlights the possibility of sequential AAV with lung cancer. Although this is relatively rare, further research is needed to better understand the association or pathophysiological link between lung cancer and AAV.

摘要

抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)与肺癌之间的关系尚不清楚。一名 66 岁男性因肺部结节就诊。胸部 CT 引导经皮穿刺活检标本的组织学检查显示为腺癌。患者接受了冷冻消融和全身化疗。16 个月后,患者出现发热、鼻炎症、复发性肺部病变、血清肌酐水平升高和 ANCA 水平升高。超声引导经皮肾活检标本的组织学检查显示为少免疫性坏死性新月体肾小球肾炎。患者对治疗有反应,但肉芽肿性多血管炎复发,随后死亡。本例提示可能存在肺癌伴发 AAV 的情况。尽管这种情况相对较少见,但需要进一步研究以更好地了解肺癌与 AAV 之间的关联或病理生理学联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded4/7897826/08f6bb2ec9b0/10.1177_0300060521993319-fig1.jpg

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