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一名年轻男性的巨大囊性肺细胞瘤:具有临床放射学和组织病理学特征的罕见诊断难题

Giant Cystic Pneumocytoma in a Young Male: Rare Diagnostic Conundrum with Clinicoradiological and Histopathological Features.

作者信息

Singhal Manphool, Yadav Nishita, Subramanian Pavithra, Singh Harkant, Bal Amanjit, Sharma Arun

机构信息

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Cardiovascular & Thoracic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Radiol Imaging. 2024 Aug 26;35(1):192-195. doi: 10.1055/s-0044-1789244. eCollection 2025 Jan.

DOI:10.1055/s-0044-1789244
PMID:39697513
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11651875/
Abstract

Pulmonary sclerosing pneumocytoma is a rare benign neoplasm typically seen in middle-aged women. The exact preoperative diagnosis is quite challenging considering its nonspecific clinical and radiologic features along with complex histology. Moreover, obtaining an exact histopathological diagnosis can be difficult especially with the small biopsy specimens. Most patients are generally asymptomatic with incidental detection of peripheral, homogenous, solitary pulmonary nodule. It is essential to differentiate it from other mimickers including malignant lesions as limited surgical resection is curative in these cases without adjuvant therapy. We present a rare giant cystic variant of pneumocytoma, in a young male, which was initially mimicking inflammatory myofibroblastic tumor even on preoperative histology.

摘要

肺硬化性细胞瘤是一种罕见的良性肿瘤,多见于中年女性。鉴于其非特异性的临床和影像学特征以及复杂的组织学表现,术前准确诊断颇具挑战性。此外,尤其是对于小活检标本,获得准确的组织病理学诊断可能很困难。大多数患者通常无症状,多通过偶然发现外周均匀的孤立性肺结节。将其与包括恶性病变在内的其他类似疾病相鉴别至关重要,因为在这些病例中,有限的手术切除即可治愈,无需辅助治疗。我们报告了一例罕见的男性青年肺硬化性细胞瘤巨大囊性变体病例,即使在术前组织学检查中,该病例最初也被误诊为炎性肌纤维母细胞瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9259/11651875/9c98221cfbe8/10-1055-s-0044-1789244-i2443562-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9259/11651875/4eff8b88de10/10-1055-s-0044-1789244-i2443562-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9259/11651875/65e949aeb841/10-1055-s-0044-1789244-i2443562-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9259/11651875/9c98221cfbe8/10-1055-s-0044-1789244-i2443562-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9259/11651875/4eff8b88de10/10-1055-s-0044-1789244-i2443562-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9259/11651875/65e949aeb841/10-1055-s-0044-1789244-i2443562-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9259/11651875/9c98221cfbe8/10-1055-s-0044-1789244-i2443562-3.jpg

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本文引用的文献

1
Pulmonary sclerosing pneumocytoma.肺硬化性肺泡细胞瘤
Asian J Surg. 2023 Aug;46(8):3362-3363. doi: 10.1016/j.asjsur.2023.03.083. Epub 2023 Mar 27.
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Analysis of the value of enhanced CT combined with texture analysis in the differential diagnosis of pulmonary sclerosing pneumocytoma and atypical peripheral lung cancer: a feasibility study.增强 CT 联合纹理分析在鉴别诊断硬化性肺细胞瘤和不典型周围型肺癌中的价值分析:一项可行性研究。
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Huge Pulmonary Sclerosing Pneumocytoma with Endobronchial Invasion: A Case Report with a Literature Review.
巨大肺硬化性肺细胞瘤伴支气管内侵犯:一例报告并文献复习
J Chest Surg. 2021 Dec 5;54(6):528-531. doi: 10.5090/jcs.21.016.
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Correlation Between Pulmonary Sclerosing Pneumocytoma Features and MSCT Imaging Manifestations in 34 Patients: Implications for Precision Medicine.34例肺硬化性肺细胞瘤特征与MSCT影像表现的相关性:对精准医学的启示
Front Med (Lausanne). 2021 Mar 18;8:650996. doi: 10.3389/fmed.2021.650996. eCollection 2021.
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Pulmonary sclerosing pneumocytoma: Cytomorphology and immunoprofile.肺硬化性血管瘤:细胞形态学和免疫表型。
Cancer Cytopathol. 2020 Jun;128(6):414-423. doi: 10.1002/cncy.22251. Epub 2020 Feb 5.
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Large pulmonary sclerosing pneumocytoma with massive necrosis and vascular invasion: a case report.伴有大片坏死及血管侵犯的巨大肺硬化性细胞瘤:一例报告
Oxf Med Case Reports. 2019 Jul 1;2019(7). doi: 10.1093/omcr/omz066.
7
F-FDG PET/CT imaging: A supplementary understanding of pulmonary sclerosing pneumocytoma.18F-FDG PET/CT 显像:对肺硬化性血管瘤的补充认识。
Thorac Cancer. 2019 Jul;10(7):1552-1560. doi: 10.1111/1759-7714.13100. Epub 2019 May 27.
8
Pulmonary sclerosing pneumocytoma remains a diagnostic challenge using frozen sections: a clinicopathological analysis of 59 cases.肺硬化性血管瘤使用冰冻切片诊断仍然具有挑战性:59 例临床病理分析。
Histopathology. 2018 Feb;72(3):500-508. doi: 10.1111/his.13391. Epub 2017 Nov 28.
9
Bone metastasis in pulmonary sclerosing hemangioma.肺硬化性血管瘤中的骨转移
Korean J Intern Med. 2015 Nov;30(6):928-30. doi: 10.3904/kjim.2015.30.6.928. Epub 2015 Oct 30.
10
The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification.2015 年世界卫生组织肺肿瘤分类:自 2004 年分类以来遗传、临床和放射学进展的影响。
J Thorac Oncol. 2015 Sep;10(9):1243-1260. doi: 10.1097/JTO.0000000000000630.