Yang Mingguang, Yang Yanli, Chen Jing, Stella Giulia M, Um Sang-Won, Tandon Yasmeen K, Liu Heng
Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Medical Imaging Department, Chongqing University Central Hospital, Chongqing, China.
Transl Lung Cancer Res. 2021 Sep;10(9):3840-3849. doi: 10.21037/tlcr-21-654.
Signet ring cell carcinoma (SRCC) is a subtype of adenocarcinoma with characteristics of strong invasion and a poor prognosis. While it can occur in various organs, including the stomach, colon, esophagus, bladder, prostate, pancreas, and breast, primary lung SRCC is rare, and most SRCC found there are from gastrointestinal metastasis. Reports on primary lung SRCC are few and the aim of this study is to describe the imaging, histopathological, and immunohistochemical characteristics of a case of primary lung SRCC in our hospital. A 68-year-old female with no smoking history was admitted with recurrent cough, chest pain, and dyspnea of 2 months duration. Computed tomographic (CT) chest showed multiple solids nodules of different sizes and mass in the left upper lobe, lower lobe, and subpleural region. Multiple enlarged lymph nodes were seen in the mediastinum and left hilum. The aim of this paper is to improve the understanding of this tumor. A literature review identified 15 cases of primary lung SRCC with available CT imaging. Except for two patients with multiple ground glass nodules and multiple small nodules, the rest were solid, and ranged in size from 1.0 to 8 cm. Only one patient had a cavity in the solid lesion. Immunohistochemical stains for thyroid transcription factor-1 (TTF-1) (13/13) and CK7 (12/12) showed positive reaction in all cases evaluated, and napsin A (3/4) were also positive, while all cases including CK20 (12/12) and CDX2 (6/6) were negative.
印戒细胞癌（SRCC）是腺癌的一种亚型，具有侵袭性强和预后差的特点。虽然它可发生于包括胃、结肠、食管、膀胱、前列腺、胰腺和乳腺在内的多种器官，但原发性肺SRCC罕见，且多数发生于肺部的SRCC为胃肠道转移所致。关于原发性肺SRCC的报道较少，本研究旨在描述我院1例原发性肺SRCC的影像学、组织病理学和免疫组化特征。一名68岁无吸烟史女性因反复咳嗽、胸痛和呼吸困难2个月入院。胸部计算机断层扫描（CT）显示左上叶、下叶及胸膜下区域有多个大小不等的实性结节及肿块。纵隔和左肺门可见多个肿大淋巴结。本文旨在提高对该肿瘤的认识。文献回顾确定了15例有CT影像资料的原发性肺SRCC病例。除2例有多发性磨玻璃结节和多个小结节外，其余均为实性，大小为1.0至8 cm。仅1例实性病变内有空洞。甲状腺转录因子-1（TTF-1）（13/13）和细胞角蛋白7（CK7）（12/12）的免疫组化染色在所有评估病例中均呈阳性反应， napsin A（3/4）也呈阳性，而包括细胞角蛋白20（CK20）（12/12）和尾型同源盒转录因子2（CDX2）（6/6）在内的所有病例均为阴性。
