肺腺癌转移至胸膜孤立性纤维性肿瘤临床病理观察  

Metastasis of lung cancer to pleura solitary fibrous tumor: a clinicopathological analysis

作　　者：张继新[1] 崔力方[1] 周全[1] 高颖[1] 郭洋[1] 昌红[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院病理科,北京100038

出　　处：《诊断病理学杂志》2014年第3期145-148,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肺腺癌转移至胸膜孤立性纤维性肿瘤的临床病理特征。方法报道1例肺腺癌转移到胸膜孤立性纤维性肿瘤的临床及影像学资料,行HE及免疫组化染色,分析其临床病理特征,并复习相关文献。结果患者男性,63岁。体检发现右肺上叶占位1周。胸部CT示右肺上叶后段空洞并多发纵隔淋巴结肿大,右肺下叶后基底段类圆形结节影。镜下右肺上叶后段病变为典型的肺腺癌,右肺下叶病变为胸膜孤立性纤维性肿瘤肺腺癌转移。右肺上叶肺腺癌细胞及右肺下叶混合性肿瘤中的肺腺癌成分具有相同的免疫表型,CK7、CK8/18、TTF-1、Napsin-A和CEA(+);右肺下叶混合性肿瘤中的梭形肿瘤细胞vimentin、CD34、bcl-2和CD99(+)。结论肿瘤转移至肿瘤十分罕见,肺腺癌转移至胸膜孤立性纤维性肿瘤尚未见报道,临床需要提高认识,识别这类罕见肿瘤,并根据不同成分制定合理的治疗方案。Purpose To explore the clinicopathologic characteristics of the metastasis of lung cancer to pleura solitary fibrous tumor. Methods One case of lung cancer with metastasis of pleura solitary fibrous tumor was analyzed with the literatures reviewed. Immunohistochemical staining was performed. Results A 63-year-old man was occasionally found to have a pulmonary nodule in the right lung in chest roentgenogram during a routine medical checkup. CT scan of the chest revealed an irregular cavity of upper lobe of the fight lung. The microscopic examination revealed adenocarcinoma in the upper lobe of fight lung, while the nodule of the lower lobe showed a solitary fibrous tumor including a moderately differentiated lung adenocarcinoma at the middle. Immunophenotyping showed that the tumor cells of the upper lobe were positive for CK7, CK8/18, TTF-1, napsin A, and CEA. In the right upper lobe, the spindle tumor cells expressed vimentin, CD34, CD99 and Bcl-2 protein. Areas of adenocarcinoma expressed TTF-1, CEA, and napsin A. Conclusion TTM is a rare clinical finding, its diagnosis should be combined with clinical and radiologic data, pathological features and immunohistochemical findings.

关 键 词：肺腺癌 肿瘤转移至肿瘤 孤立性纤维性肿瘤 免疫组化 

分 类 号：R734.2[医药卫生—肿瘤]