Wang Xiaojing, Liu Haifeng, Zhai Dongjie, Qin Yanan, Fan Chuifeng, Zhang Di
Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, Shenyang, 110001, People's Republic of China.
Onco Targets Ther. 2022 Jan 6;15:13-19. doi: 10.2147/OTT.S344086. eCollection 2022.
Multiple primary lung cancer (MPLC) is considered relatively rare. This report presents an unusual case of multiple pulmonary nodules in a 74-year-old man who presented with three independent synchronous tumors in the right upper lobe. The tumors were diagnosed as peripheral squamous cell carcinoma (SCC), adenocarcinoma, and pulmonary mixed squamous cell and glandular papilloma (mixed papilloma). Mixed papilloma is an extremely rare, benign pulmonary tumor with a typical papillary appearance, showing squamous and glandular epithelial differentiation. The histological and immunohistochemical features of each tumor were analyzed. In addition, molecular pathological examination for epidermal growth factor receptor (EGFR) showed no mutation in two primary cancers. Mixed papilloma showed no BRAF V600E mutation or HPV infection. The present case report provides a clinicopathological understanding of an instance in which three tumors of different pathological types are present in the same lung lobe. Furthermore, it provides a literature review regarding multiple lung nodules, focusing on the clinicopathological diagnosis, clinical treatment, and prognostic assessment of these nodules. This is the first case report of mixed papilloma arising in MPLC.
多原发性肺癌（MPLC）被认为相对罕见。本报告介绍了一名74岁男性的罕见多肺结节病例，该患者右上叶出现了三个独立的同步肿瘤。这些肿瘤被诊断为外周型鳞状细胞癌（SCC）、腺癌以及肺混合性鳞状细胞和腺性乳头状瘤（混合性乳头状瘤）。混合性乳头状瘤是一种极其罕见的良性肺肿瘤，具有典型的乳头状外观，表现出鳞状和腺上皮分化。对每个肿瘤的组织学和免疫组化特征进行了分析。此外，对表皮生长因子受体（EGFR）的分子病理学检查显示，两种原发性癌症均无突变。混合性乳头状瘤未显示BRAF V600E突变或人乳头瘤病毒（HPV）感染。本病例报告提供了对同一肺叶中出现三种不同病理类型肿瘤情况的临床病理认识。此外，它还提供了关于多个肺结节的文献综述，重点关注这些结节的临床病理诊断、临床治疗和预后评估。这是首例关于MPLC中出现混合性乳头状瘤的病例报告。
