Shen Yu-Yao, Jiang Jing, Zhao Jing, Song Jie
Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, Shandong Province, China.
Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
World J Clin Cases. 2022 Dec 16;10(35):13006-13014. doi: 10.12998/wjcc.v10.i35.13006.
Lung cancer is the leading cause of cancer-related death. Early diagnosis is critical to improving a patient's chance of survival. However, lung cancer associated with cystic airspaces is often misdiagnosed or underdiagnosed due to the absence of clinical symptoms, poor imaging specificity, and high risk of biopsy-related complications.
We report an unusual case of cancer in a 55-year-old man, in which the lesion evolved from a small solitary thin-walled cyst to lung squamous cell carcinoma (SCC) with metastases in both lungs. The SCC manifested as rare clustered cystic lesions, detected on chest computed tomography. There were air-fluid levels, compartments, and bronchial arteries in the cystic lesions. Additionally, there was no clear extrathoracic metastasis. After chemotherapy, the patient achieved a partial response, type I respiratory failure was relieved, and the lung lesions became a clustered thin-walled cyst.
Pulmonary cystic lesions require regular imaging follow-up. Lung SCC should be a diagnostic consideration in cases of thin-walled cysts as well as multiple clustered cystic lesions.
肺癌是癌症相关死亡的主要原因。早期诊断对于提高患者的生存几率至关重要。然而，由于缺乏临床症状、影像学特异性差以及活检相关并发症风险高，与囊性气腔相关的肺癌常被误诊或漏诊。
我们报告了一例55岁男性的罕见癌症病例，其中病变从一个小的孤立薄壁囊肿演变为双肺转移的肺鳞状细胞癌（SCC）。SCC表现为罕见的簇状囊性病变，在胸部计算机断层扫描中被检测到。囊性病变中有气液平面、间隔和支气管动脉。此外，没有明确的胸外转移。化疗后，患者获得部分缓解，I型呼吸衰竭得到缓解，肺部病变变为簇状薄壁囊肿。
肺囊性病变需要定期进行影像学随访。对于薄壁囊肿以及多个簇状囊性病变的病例，应考虑诊断为肺SCC。
