Department of Medical Oncology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Baiziting, Nanjing, China.
Department of Thoracic Surgery, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Baiziting, Nanjing, China.
Front Immunol. 2023 May 24;14:1203876. doi: 10.3389/fimmu.2023.1203876. eCollection 2023.
To investigate the clinical features, pathological characteristics, immunophenotype, differential diagnosis and prognosis of pulmonary hepatoid adenocarcinoma using a clinical case and literature report.
We analyzed the clinical presentation, histological pattern and immunohistochemistry of a case of primary hepatoid adenocarcinoma of the lung in April 2022. We also reviewed literature on hepatoid adenocarcinoma of the lung from PubMed database.
The patient was a 65-year-old male with smoking history, who was admitted to hospital with an enlarged axillary lymph node. The mass was round, hard, and grayish-white and grayish-yellow in color. Microscopically, it presented hepatocellular carcinoma-like and adenocarcinoma differentiation features, with abundant blood sinuses visible in the interstitium. Immunohistochemistry showed that the tumor cells were positive for hepatocyte markers, including AFP, TTF-1, CK7 and villin, and negative for CK5/6, CD56, GATA3, CEA and vimentin.
Pulmonary hepatoid adenocarcinoma is a rare epithelial malignancy of primary origin in the lung with poor prognosis. Establishing the diagnosis relies mainly on the detection of hepatocellular structural morphology resembling hepatocellular carcinoma, and on clinicopathological and immunohistochemical testing to exclude diseases such as hepatocellular carcinoma. Combination treatment, mainly surgery, can prolong the survival of early-stage cases of the disease, whereas radiotherapy is mostly used for intermediate and advanced cases. Individualized treatment with molecular-targeted drugs and immunotherapy has shown different therapeutic effects for different patients. Further research is needed to better understand this rare clinical condition for the development and optimization of treatment strategies.
通过临床病例和文献报告，研究肺肝样腺癌的临床特征、病理特征、免疫表型、鉴别诊断和预后。
我们分析了 2022 年 4 月 1 例原发性肺肝样腺癌患者的临床表现、组织学模式和免疫组化。我们还查阅了 PubMed 数据库中肺肝样腺癌的文献。
患者为 65 岁男性，有吸烟史，因腋窝淋巴结肿大就诊。肿块呈圆形，质硬，灰白色和灰黄色。显微镜下，表现出肝细胞癌样和腺癌分化特征，间质可见丰富的血窦。免疫组化显示肿瘤细胞阳性表达肝细胞标志物，包括 AFP、TTF-1、CK7 和 villin，阴性表达 CK5/6、CD56、GATA3、CEA 和 vimentin。
肺肝样腺癌是一种罕见的原发性肺上皮恶性肿瘤，预后差。诊断主要依赖于检测类似于肝细胞癌的肝细胞结构形态，并结合临床病理和免疫组化检测排除肝癌等疾病。以手术为主的联合治疗可以延长早期病例的生存时间，而中晚期病例多采用放疗。针对不同患者的个体化治疗，包括分子靶向药物和免疫治疗，已经显示出不同的治疗效果。需要进一步研究以更好地了解这种罕见的临床情况，从而制定和优化治疗策略。
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