Department of Pulmonary and Critical Care Medicine, Affliated Hospital of Zunyi Medical University, Zunyi Guizhou 563000, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Apr 28;47(4):529-534. doi: 10.11817/j.issn.1672-7347.2022.210603.
The clinical data for a patient with primary lung adenocarcinoma complicated with pulmonary hamartoma, who admitted to Zunyi Medical University Hospital in September 2020, was retrospectively analyzed. The 62-years-old male visited outpatient service because of dysphagia in March 2015, and the pulmonary nodules were found. In September 2020, the computed tomography indicated the enlarged nodule in the lower lobe of left lung with lobulation, and there was ground glass nodule in the upper lobe of left lung. After thoracoscopic wedge surgery, the primary pulmonary adenocarcinoma in the upper lobe of left lung and pulmonary hamartoma in the lower lobe of left lung were confirmed by pathology. Whole exon sequencing revealed that kinesin family member 20B () gene was not expressed in lung adenocarcinoma, but was expressed in pulmonary hamartoma. The clinical manifestations of lung adenocarcinoma complicated with pulmonary hamartoma was not typical, which could locate in the same side and different sides of the lung. The imaging manifestations of the 2 kinds of tumors were diverse and can not be completely distinguished. The pathological examination after surgery is the gold standard, and the possibility of malignant transformation of pulmonary hamartoma should be warned.
回顾性分析了 2020 年 9 月遵义医科大学附属医院收治的 1 例原发性肺腺癌合并肺错构瘤患者的临床资料。该患者为 62 岁男性，因吞咽困难于 2015 年 3 月就诊于门诊，发现肺部结节。2020 年 9 月，胸部 CT 提示左肺下叶结节增大，呈分叶状，左肺上叶有磨玻璃结节。行胸腔镜楔形手术后，病理证实左肺上叶原发性肺腺癌和左肺下叶肺错构瘤。全外显子测序显示，肺腺癌中驱动蛋白家族成员 20B（）基因不表达，但在肺错构瘤中表达。肺腺癌合并肺错构瘤的临床表现不典型，可位于同侧或不同侧肺部。两种肿瘤的影像学表现多样，不能完全区分。术后病理检查是金标准，并应警惕肺错构瘤恶变的可能。
