Miura H, Taira O, Hiraguri S, Hagiwara M, Kato H
Department of Thoracic Surgery, Hachioji Medical Center of Tokyo Medical College, 1163 Tate-Machi, Hachioji, Tokyo 193-0944, Japan.
Ann Thorac Cardiovasc Surg. 1998 Jun;4(3):154-8.
The characteristics and outcomes of resected adenocarcinoma with cavity formation were studied in 7 cases, which were 14.9% of all 47 resected adenocarcinomas in the past three years. Tumor size was less than 3 cm in diameter in 3 cases, 3 to 5 cm in 2 and more than 5 cm in 2. Cavities were multiple in 4 cases and single in 3. Cavities were divided into 4 types pathologically. 1. Central necrosis type: central ischemia was suspected. This type was observed in 2 cases that died due to cancer. 2. Cancer cell lining type: the inner wall of the cavity was lined by viable cancer cells without necrosis. The cause of this type may be detachment of the central portion of a papillary growth tumor without necrosis. One of three patients died from cancer. The others are alive without recurrence. 3. Bronchial expansion type: the inner wall was composed of cancer cells and bronchus. This may be caused by ectatic change of peripheral bronchi following tumor invasion to more central bronchi. One of this type of case died due to myocardial infarction. 4. Alveolar expansion type: the inner wall was composed of cancer cells and alveoli. Detachment of destroyed alveoli or invasion along the wall of cavities of a honeycomb lung was suspected as a possible cause. One of this type of case is alive. Cavity formation can occur in adenocarcinoma even when the tumor is small. However there were few inflammatory related findings in adenocarcinoma with cavity formation. The outcome of the central necrosis type was especially poor, suggesting rapid tumor growth.
对7例有空洞形成的切除性腺癌的特征及转归进行了研究，这7例占过去三年中47例切除性腺癌的14.9%。肿瘤直径小于3 cm者3例，3至5 cm者2例，大于5 cm者2例。空洞4例为多发，3例为单发。空洞在病理上分为4型。1. 中央坏死型：怀疑有中央缺血。此型见于2例因癌死亡的病例。2. 癌细胞衬里型：空洞内壁衬有存活的癌细胞，无坏死。此型的原因可能是乳头状生长肿瘤的中央部分无坏死而脱落。3例患者中有1例死于癌症。其他患者存活且无复发。3. 支气管扩张型：内壁由癌细胞和支气管组成。这可能是肿瘤侵犯至更中央的支气管后外周支气管扩张改变所致。此型中有1例因心肌梗死死亡。4. 肺泡扩张型：内壁由癌细胞和肺泡组成。怀疑其原因可能是破坏的肺泡脱落或沿蜂窝肺空洞壁浸润。此型中有1例存活。即使肿瘤较小，腺癌也可出现空洞形成。然而，有空洞形成的腺癌中炎症相关表现较少。中央坏死型的转归尤其差，提示肿瘤生长迅速。
