Xu Jieyu, Wang Jinjing, Li Chengfang, Yao Jin, Liu Puyu, Yang Xiaorong
Department of Clinical Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Transl Cancer Res. 2022 Mar;11(3):591-596. doi: 10.21037/tcr-22-166.
Multiple primary lung cancer (MPLC) is a rare type of tumor, and it is necessary to differentiate it from a metastatic tumor. The type of adenocarcinoma with adenoid cystic carcinoma (ACC) is extremely rare and has not yet been reported in the literature. The initial clinical symptoms of double primary lung cancer may be nonspecific; hence, the diagnosis is often missed or incorrect.
In this case presentation, we report the case of a 67-year-old female who had experienced persistent cough and expectoration for 8 days. Chest computed tomography (CT) revealed 2 nodules in the patient's lung. Radiographic findings could not distinguish between the 2 nodules and between primary and metastatic lesions. Thus, the patient underwent bronchoscopic biopsy and percutaneous lung puncture. We could not determine the type of the two tumors in hematoxylin and eosin (H&E) staining sections, and we subsequently performed specific immunohistochemical (IHC) staining. Combined with morphological and IHC results, we concluded that this was a case of MPLC, consisting of adenocarcinoma and ACC. The patient received symptomatic treatment because of the metastases.
This report reports a rare combination of MPLC and shows that a definitive diagnosis of double primary lung cancer can be based on tissue biopsy and IHC techniques.
多原发性肺癌(MPLC)是一种罕见的肿瘤类型,有必要将其与转移性肿瘤区分开来。腺癌合并腺样囊性癌(ACC)的类型极为罕见,文献中尚未见报道。双原发性肺癌的初始临床症状可能不具有特异性;因此,诊断常常被漏诊或误诊。
在本病例报告中,我们报道了一名67岁女性患者,她持续咳嗽、咳痰8天。胸部计算机断层扫描(CT)显示患者肺部有2个结节。影像学检查结果无法区分这2个结节以及原发性和转移性病变。因此,患者接受了支气管镜活检和经皮肺穿刺。在苏木精-伊红(H&E)染色切片中,我们无法确定这两种肿瘤的类型,随后进行了特异性免疫组织化学(IHC)染色。结合形态学和IHC结果,我们得出结论,这是一例由腺癌和ACC组成的MPLC病例。由于发生了转移,患者接受了对症治疗。
本报告报道了一种罕见的MPLC组合,并表明双原发性肺癌的明确诊断可以基于组织活检和IHC技术得出。