Kim Jong Hee, Woo Jung Han, Lim Chae Young, An Taein, Han Joungho, Chung Myung Jin, Cha Yoon Ki
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Thorac Dis. 2024 Mar 29;16(3):1753-1764. doi: 10.21037/jtd-23-1606. Epub 2024 Mar 8.
SMARCA4-deficient non-small cell lung carcinoma (SD-NSCLC) is a relatively rare tumor, which occurs in 5-10% of NSCLC. Based on World Health Organization thoracic tumor classification system, SMARCA4-deficient undifferentiated tumor (SD-UT) is recognized as a separate entity from SD-NSCLC. Differentiation between SD-NSCLC and SD-UT is often difficult due to shared biological continuum, but often required for choosing appropriate treatment regimen. Therefore, the aim of our study was to identify the clinicopathologic, computed tomography (CT), and positron emission tomography (PET)-CT imaging features of SD-NSCLC.
Nine patients of pathologically confirmed SD-NSCLC were included in our analysis. We reviewed electronic medical records for clinical information, demographic features, CT, and PET-CT imaging features were analyzed.
Smoking history and male predominance are observed in all patients with SD-NSCLC (n=9). On CT, SD-NSCLC appeared as relatively well-defined masses with lobulated contour (n=8) and peripheral location (n=7). Invasion of adjacent pleura or chest wall (n=7) were frequently observed, regardless of small tumor size. Four cases showed lymph node metastases. Among nine patients, three patients showed multiple bone metastases, and one patient showed lung-to-lung metastases.
In patient with SD-NSCLC, there was tendency for male smokers, peripheral location and invasion of adjacent pleural or chest wall invasion regardless of small tumor size, when compared to SD-UT.
SMARCA4缺陷型非小细胞肺癌(SD-NSCLC)是一种相对罕见的肿瘤,占非小细胞肺癌的5%-10%。根据世界卫生组织胸肿瘤分类系统,SMARCA4缺陷型未分化肿瘤(SD-UT)被认为是与SD-NSCLC不同的实体。由于存在共同的生物学连续性,SD-NSCLC与SD-UT的鉴别往往困难,但这对于选择合适的治疗方案通常是必需的。因此,我们研究的目的是确定SD-NSCLC的临床病理、计算机断层扫描(CT)和正电子发射断层扫描(PET)-CT成像特征。
我们纳入了9例经病理证实的SD-NSCLC患者进行分析。我们查阅电子病历以获取临床信息,分析人口统计学特征、CT及PET-CT成像特征。
所有SD-NSCLC患者(n=9)均有吸烟史且以男性为主。CT表现上,SD-NSCLC表现为边界相对清晰的肿块,呈分叶状轮廓(n=8)且位于周边(n=7)。无论肿瘤大小,均常见侵犯相邻胸膜或胸壁(n=7)。4例出现淋巴结转移。9例患者中,3例出现多发骨转移,1例出现肺内转移。
与SD-UT相比,SD-NSCLC患者倾向于男性吸烟者、肿瘤位于周边且无论肿瘤大小均易侵犯相邻胸膜或胸壁。