肺肉瘤样癌11例临床病理观察  

Sarcomatoid carcinoma of the lung: a clinicopathologic observation of 11 cases

作　　者：郭坚[1] 文国英[1] 张根娣[1] 陆平[1] 

机构地区：[1]上海建工医院病理科,上海200083

出　　处：《诊断病理学杂志》2001年第6期337-339,T097,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的　观察肺肉瘤样癌 (SC)的临床病理特征。方法　对 11例肺SC的临床病理特征、免疫表型及影响预后的因素进行探索评价。结果　男性 10例 ,女性 1例 ,平均年龄 5 6 2岁 ,7例有吸咽史。病变部位以上叶为多。组织学检查分为单相性SC(4例 ) ,由欠分化的肉瘤样梭形细胞与数量不定的巨细胞组成 ;双相性SC(7例 ) ,由癌和类似于单相性SC的肉瘤样成分组成 ,腺癌 5例 ,腺鳞癌和巨细胞癌各 1例 ,其中 3例癌与肉瘤分界清。 5例淋巴结转移。 11例均行免疫组化检查 ,10例肉瘤样间质的上皮标记呈阳性。随访 8例 ,结果表明 ,手术范围小 ,周围型SC ,双相性SC及淋巴结受累者预后明显差。结论　肺肉瘤样癌为高度恶性的上皮性肿瘤 。Objective To study the clinicopathologic features of sarcomatoid carcinoma (SC) of the lung. Methods Clinical data, immunophenotypes and the prognosis-related factors were evaluated in 11 cases of lung SC. Results Ten cases were male and one was female. Seven of them were smokers. Majority of the lesions was located in the upper lobe of the lung. The tumor was divided into two histologic subtypes, monophasic (4 cases) and bi-phasic (7 cases). Monophasic SCs were composed of poorly differentiated sarcoma-like spindle cells. Bi-phasic SCs were mixed with a variable proportion of carcinoma and sarcomatoid elements similar to the monophasic tumor. The epitheloid elements included adenocarcinoma (5 cases), adenosquamous cell carcinoma (one case) and giant cell carcinoma (one case). A sharp demarcation between carcinoma and sarcoma was found in 3 cases. Metastasis of the tumor into lymph nodes was noticed in 5 cases. Immunohistochemically, epithelial markers in sarcomatoid areas were identified in 10 cases. Follow-up information was obtained in 8 cases and showed that the prognosis was related to the modes of lobectomy, peripheral location of the tumors, biphasic differentiation and involvement of lymph nodes. Conclusions Lung SC is a high-grade malignant epithelial tumor. Histologic subtype is an important factor to influence the prognosis of the patients.

关 键 词：肺肉瘤样癌 临床病理 预后 SC 罕见肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]