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低级别胎儿肺腺癌伴 TP53 突变 1 例报告。

A case report of low grade fetal lung adenocarcinoma with TP53 mutation.

机构信息

Department of Surgery, Yanbian University, Yanji, Jilin, China,Department of Thoracic Surgery Medicine, Affiliated Hospital of Yanbian University, Yanji, Jilin, China.

出版信息

Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000029047.

DOI:10.1097/MD.0000000000029047
PMID:35356917
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10684199/
Abstract

RATIONALE

Fetal lung adenocarcinoma (FLAC) is a rare malignant tumor that occurs in the alveolar epithelium. FLAC, as a distinct entity, is a malignancy with a very low incidence, accounting for less than 0.5% of all lung tumors, with a high rate of misdiagnosis due to its rarity, lack of typical presentation and imaging signs. According to histopathological differences, FLAC is further divided into 2 types: low-grade FLAC and high-grade FLAC. In the article, we report a young woman who was diagnosed with low-grade fetal-type lung adenocarcinoma.

PATIENT CONCERNS

An 18-year-old female patient was admitted due to cough and chest distress.

DIAGNOSIS

The final pathological examination confirmed that the lesion was a low-grade fetal lung adenocarcinoma.

INTERVENTIONS

The patient underwent thoracoscopic left lower lobectomy and regional lymph node dissection.

OUTCOMES

The postoperative course was stable, and no recurrence was observed 1 year after operation.

LESSONS

To the best of our knowledge, there are no previous case reports of low-grade fetal-type adenocarcinoma, TP53 gene mutation, and the significance of its mutation is not extensively studies. FLAC, although extremely rare, is considered in the differential diagnosis of lung cancer. In addition, biopsy, histopathology, and specific immunohistochemical staining of larger tissue specimens are helpful for accurate diagnosis of FLAC.

摘要

背景

胎儿型肺腺癌(FLAC)是一种罕见的肺上皮恶性肿瘤。FLAC 作为一种独特的实体瘤,其发病率非常低,不到所有肺部肿瘤的 0.5%,由于其罕见性、缺乏典型表现和影像学特征,误诊率很高。根据组织病理学差异,FLAC 进一步分为 2 型:低级别 FLAC 和高级别 FLAC。本文报道了 1 例年轻女性低级别胎儿型肺腺癌患者。

患者关注

18 岁女性患者因咳嗽和胸闷入院。

诊断

最终的病理检查证实病变为低级别胎儿肺腺癌。

干预

患者接受了胸腔镜下左肺下叶切除术和区域淋巴结清扫术。

结果

术后过程稳定,术后 1 年无复发。

教训

据我们所知,此前尚无低级别胎儿型肺腺癌、TP53 基因突变以及其突变意义的报道。FLAC 虽然极其罕见,但在肺癌的鉴别诊断中应予以考虑。此外,活检、组织病理学和更大组织标本的特定免疫组织化学染色有助于准确诊断 FLAC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b09/10684199/2c021e59d38e/medi-101-e29047-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b09/10684199/4960217c968c/medi-101-e29047-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b09/10684199/2c021e59d38e/medi-101-e29047-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b09/10684199/4960217c968c/medi-101-e29047-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b09/10684199/2c021e59d38e/medi-101-e29047-g002.jpg

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本文引用的文献

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Thorac Cancer. 2021 Oct;12(20):2789-2795. doi: 10.1111/1759-7714.14126. Epub 2021 Aug 31.
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Morphologic, Immunohistochemical, and Genetic Differences Between High-grade and Low-grade Fetal Adenocarcinomas of the Lung.肺高、低级别胎儿性腺癌的形态学、免疫组织化学和遗传学差异。
Am J Surg Pathol. 2021 Nov 1;45(11):1464-1475. doi: 10.1097/PAS.0000000000001744.
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Well-differentiated fetal adenocarcinoma of the lung: positron emission tomography features and diagnostic difficulties in frozen section analysis-a case report.
肺高分化胎儿型腺癌:正电子发射断层扫描特征及冰冻切片分析中的诊断难点——病例报告
Surg Case Rep. 2020 Jun 29;6(1):152. doi: 10.1186/s40792-020-00910-0.
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Classical biphasic pulmonary blastoma in a young woman: case report and review of literature.一名年轻女性的经典双相性肺母细胞瘤:病例报告及文献复习
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Lung Cancer (Auckl). 2018 Aug 23;9:57-63. doi: 10.2147/LCTT.S137410. eCollection 2018.
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Differences between low and high grade fetal adenocarcinoma of the lung: a clinicopathological and molecular study.肺低级别与高级别胎儿型腺癌的差异:一项临床病理及分子研究
J Thorac Dis. 2017 Jul;9(7):2071-2078. doi: 10.21037/jtd.2017.07.14.
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Histopathology. 2015 Dec;67(6):806-16. doi: 10.1111/his.12711. Epub 2015 Jun 5.
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