Banfi L, Corbella G, Guzzini F, Ceppi M
II Divisione di Medicina, Ospedale di Saronno.
Clin Ter. 1993 May;142(5):433-8.
Sarcomatous degeneration is the most dreaded complication of Paget's disease of bone: this case report offers an opportunity for underlining the difficulties of differential diagnosis in a case of pulmonary metastatization in the presence of osteitis deformans. Immunohistochemical assay applied to the cytology of pulmonary needle-aspiration and surgical biopsy targeted to the suspected neoplastic lesion allowed correct diagnosis. This case confirms the very poor prognosis of this kind of neoplasm: the rapidity of the fatal outcome was not significantly influenced even by the most aggressive polychemotherapy. This poor prognosis appears to be related to a more aggressive growth of the neoplasm and to the reduced immunologic resistance of the elderly.
本病例报告为强调在畸形性骨炎存在的情况下,肺转移病例的鉴别诊断困难提供了一个机会。应用于肺针吸细胞学检查和针对疑似肿瘤病变的手术活检的免疫组织化学检测得以做出正确诊断。本病例证实了这类肿瘤的预后极差:即使采用最积极的多药化疗,致命结局的快速性也未受到显著影响。这种不良预后似乎与肿瘤更具侵袭性的生长以及老年人免疫抵抗力降低有关。