Kolibu Reagen Irwan, Bakhtiar Arief
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Int J Surg Case Rep. 2022 May;94:107103. doi: 10.1016/j.ijscr.2022.107103. Epub 2022 Apr 20.
Pulmonary spindle cell carcinoma is a type of variant sarcomatoid carcinoma, which is a very rare case.
A 53-year-old male presented with weakness, 95% oxygen saturation with nasal cannula 3 L/min, asymmetric chest movement, and problem in the right lung (dull to percussion, and low vesicular auscultation). X-ray and CT-Scan supported hemothorax and lung malignancies in the right lung. The patient had a chest drain inserted which confirmed the hemothorax and was transferred to the operating room for emergency thoracotomy to stop the bleeding. Bleeding was still massive so re-thoracotomy and lobectomy were performed. The lung tissue was examined for anatomical pathology, and the results showed spindle cell carcinoma. The patient was given pemetrexed and carboplatin chemotherapy. The patient refused to continue therapy and died 3 months after the first chemotherapy.
Immunohistochemistry markers are the parameter for diagnosis of pulmonary spindle cell carcinoma that is highly positive for pan-cytokeratin, vimentin, and Ki67. The treatment is similar to other NSCLC, depending on the staging, and may include surgical resection, chemotherapy, and radiotherapy.
Pulmonary spindle cell carcinoma is very rare and has a poor prognosis, especially in the presence of hemothorax.
肺梭形细胞癌是一种变异型肉瘤样癌，极为罕见。
一名53岁男性，表现为虚弱，经鼻导管吸氧3升/分钟时血氧饱和度为95%，胸部运动不对称，右肺有问题（叩诊浊音，听诊肺泡音减弱）。X线和CT扫描支持右侧血胸和肺部恶性肿瘤。患者插入胸腔引流管，证实为血胸，随后被转至手术室进行紧急开胸手术止血。出血仍很严重，因此进行了再次开胸手术和肺叶切除术。对肺组织进行解剖病理学检查，结果显示为梭形细胞癌。患者接受培美曲塞和卡铂化疗。患者拒绝继续治疗，首次化疗3个月后死亡。
免疫组织化学标志物是诊断肺梭形细胞癌的参数，对全细胞角蛋白、波形蛋白和Ki67呈高度阳性。治疗方法与其他非小细胞肺癌相似，取决于分期，可能包括手术切除、化疗和放疗。
肺梭形细胞癌非常罕见，预后较差，尤其是合并血胸时。
