肺转移性肿瘤65例临床病理分析  

Clinical and Pathological Analysis of 65 Cases of Lung Metastatic Tumors

作　　者：赵丹[1] 曲杨[1] 张海青[1] 周立娟[1] 苏丹[1] 张丽丽[1] 

机构地区：[1]首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所病理科,101149

出　　处：《结核病与胸部肿瘤》2016年第2期100-104,共5页Tuberculosis and Thoracic Tumor

摘　　要：目的探讨肺转移性肿瘤的病理类型、临床病理特征及鉴别诊断方法。方法回顾性分析65例肺转移性肿瘤的临床病理资料，观察组织形态，采用免疫组化方法进行鉴别诊断。结果65例中男性30例（46．2％），女性35例（53．8％），年龄16～74岁，平均年龄54．1岁。CT示多发结节型38例（585％）、单发结节型27例（41．5％）。其中17例为转移性乳腺癌（26．2％），14例为转移性结直肠癌（21．5％），转移性透明细胞性肾细胞癌（1213％），其余为转移性骨肉瘤、胸腺瘤、恶性黑色素瘤、尿路上皮癌、平滑肌肉瘤等。转移性乳腺癌需与肺腺癌鉴别，前者ER、PR（＋），TTF-1（-），对鉴别诊断有意义；转移性结直肠癌需与肠型肺腺癌鉴别，前者CK20、CDX2（＋），CK7、TTF-1（-），对鉴别诊断有意义：转移性透明细胞性肾细胞癌需与具有透明细胞形态的肺腺癌、肺透明细胞性鳞状细胞癌、肺透明细胞癌（肺大细胞癌亚型）、肺透明细胞瘤（“糖瘤”）鉴别，转移性透明细胞性肾细胞癌vimentin和CK（＋），TTF-1（-）。结论肺转移性肿瘤的诊断需结合临床资料、病理形态及免疫组化表达特点综合判断。Objective To explore the pathologic types, clinicopathological characteristics and differential diagnosis of lung metastatic tumors. Methods The data of clinicopathological features were reviewed of the 65 cases, diagnosed and distinguished by pathomorphology and immunohistochemistIy. Results The cases included 30 males and 35 females.The age of patients ranged from 16 years to 74 years （ median age=54.05 years） . The CT manifestations included： 27 solitary nodules and 38 multiple nodules. The primary tumor firstly located in breast （ 17/65, 26.2%）, followed by colorectal cancer （14/65, 21.5%）, clear cell renal cell carcinoma （8/65, 12.3%）, osteosarcoma, thymoma, malignant melanoma, urothelial carcinoma, leiomyosarcoma, Differential diagnosis of metastatic breast cancer is lung adenocarcinoma, immunohistochemical staining of metastatic breast cancer showed positive for ER, PR, and negative for TTF-1; Differential diagnosis of metastatic colorectal cancer is enteric lung adenocarcinoma, immunohistochemical staining of metastatic colorectal cancer showed positive for CK20, CDX2, and negative for CK7, TTF-1; Differential diagnosis of metastatic colorectal cancer is lung adenocarcinoma with clear cell, lung clear cell squamous cancer, lung clear cell cancer, lung clear cell tumor （ ＂sugar＂ tumor）, immunohistochemical staining of metastatic colorectal cancer showed positive for Vim, CK-L, and negative for TTF-1. Conclusion Its diagnosis depends on comprehensive analysis of clinical data, histopathology and immunohistochemistry.

关 键 词：肺 转移性肿瘤 临床病理 免疫组化 

分 类 号：R734.2[医药卫生—肿瘤]