Kakemizu N, Nishikawa M, Ikeda H, Okubo T, Osawa H, Yoshida T, Kitamura H
First Department of Internal Medicine, Yokohama City University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Apr;35(4):432-6.
A 59-year-old woman was referred to our clinic because a solitary mass shadow (2.5 cm in diameter was seen in the left lower lung field on a chest roentgenogram. Transbronchial biopsy via a fiberoptic bronchoscope did not yield a definitive diagnosis. Examination of a specimen obtained by CT-guided percutaneous needle biopsy revealed that the tumor consisted of small cells proliferating in a solid, tubular, pseudoglandular, and follicular pattern, which suggested the diagnosis of carcinoid. A left lower lobectomy was performed, and several hilar and mediastinal lymph nodes were also removed. The tumor cells did not show pleomorphism of nuclei, mitotic activity, or necrosis. Grimelius and immunohistochemical stains for chromogranin. A, neuron-specific-enorase, synaptophysin, and serotonin were positive. These findings confirmed the diagnosis of carcinoid CT-guided percutaneous needle biopsy can be useful for the diagnosis of peripheral carcinoid and other peripheral lung tumors.
一名59岁女性因胸部X线片显示左下肺野有一个孤立的肿块阴影（直径2.5厘米）而被转诊至我院。经纤维支气管镜进行的经支气管活检未能得出明确诊断。对CT引导下经皮针吸活检获取的标本进行检查发现，肿瘤由呈实性、管状、假腺管状和滤泡状增殖的小细胞组成，提示类癌诊断。遂行左下肺叶切除术，并切除了多个肺门和纵隔淋巴结。肿瘤细胞未显示核异型性、有丝分裂活性或坏死。嗜银染色以及嗜铬粒蛋白A、神经元特异性烯醇化酶、突触素和血清素的免疫组化染色均为阳性。这些发现证实了类癌的诊断。CT引导下经皮针吸活检对于周围型类癌及其他周围型肺肿瘤的诊断可能有用。
