Boukhiar S, Tiffet O, Bayle-Bleuez S, Picot T, Yvorel V, Forest F
Centre Hospitalier Universitaire de Saint Étienne, Hôpital Nord. Laboratoire d'Anatomie et Cytologie Pathologiques, avenue Albert-Raimond, 42055 Saint Étienne cedex 2, France.
Centre Hospitalier Universitaire de Saint-Étienne, Hôpital Nord, Service de Chirurgie Thoracique, avenue Albert-Raimond, 42055 Saint-Étienne cedex 2, France.
Rev Mal Respir. 2021 Nov;38(9):942-945. doi: 10.1016/j.rmr.2021.09.001. Epub 2021 Sep 24.
The presence of multiple synchronous lung tumors is not a rare event. Distinguishing intra-pulmonary metastases from multiple synchronous lung adenocarcinoma is a challenge for pathologists and physicians. We present observation of a patient with three lung tumors corresponding to three adenocarcinomas for which molecular analysis had a significant impact on tumor staging.
Three suspect lesions were discovered in a 61-year-old patient, a smoker, in each lobe of the right lung. Right pneumonectomy with lymph node dissection was performed. Pathological examination showed that each tumor was in fact an adenocarcinoma. In order to more precisely indicate tumor staging, molecular analysis was performed with next generation sequencing showing a different point mutation in a driver gene on each tumor. The final diagnosis is that the three tumors are distinct synchronous tumors, which must be staged separately.
In modern-day practice of thoracic oncology and of surgical pathology, molecular biology represents a complement for tumor staging in the event of multiple lung tumors.
肺部出现多个同步肿瘤并非罕见情况。区分肺内转移瘤与多个同步性肺腺癌对病理学家和医生来说是一项挑战。我们报告了一例患有三个肺部肿瘤的患者，这三个肿瘤均为腺癌，分子分析对肿瘤分期产生了重大影响。
在一名61岁的吸烟患者右肺的每个肺叶中发现了三个可疑病变。进行了右肺切除术及淋巴结清扫术。病理检查显示每个肿瘤实际上都是腺癌。为了更精确地确定肿瘤分期，采用下一代测序进行分子分析，结果显示每个肿瘤的驱动基因存在不同的点突变。最终诊断为这三个肿瘤是不同的同步肿瘤，必须分别进行分期。
在现代胸科肿瘤学和外科病理学实践中，分子生物学是多个肺部肿瘤情况下肿瘤分期的一种补充手段。
