肺转移性肿瘤113例临床病理学观察  

Clinical and pathological analysis of 113 cases of lung metastatic tumors

作　　者：张建波 宋魏 王媛媛 孙淼淼 

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院)病理科,450008

出　　处：《心肺血管病杂志》2017年第12期979-982,987,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨肺转移性肿瘤的临床病理学特点、诊断及鉴别诊断。方法:回顾性分析2010年至2016年间,113例肺转移性肿瘤患者的临床资料,观察病理形态学特点,En Vision法进行免疫组织化学检测。结果:113例中男性48例(42.5%),女性65例(57.5%),年龄9~77岁,平均年龄55岁。胸部CT示,肺内多发结节61例(54%)、单发性结节52例(46%)。原发瘤为乳腺癌31例(27.4%),结直肠癌23例(20.4%),透明细胞性肾细胞癌15例(13.3%),宫颈鳞癌13例(11.5%),卵巢高级别浆液性癌9例(8%),甲状腺癌7例(6.2%),其余15例为尿路上皮癌、胸腺癌,骨肉瘤、恶性黑色素瘤、平滑肌瘤、平滑肌肉瘤、腺泡状软组织肉瘤。肺转移性肿瘤多表现原发肿瘤的病理形态学特征,免疫表型与原发肿瘤一致。结论:肺是其他器官肿瘤较常见的转移部位,多表现原发肿瘤的形态学特征,有时易误诊为原发肺肿瘤。结合临床病史、病理学形态及免疫表型特征有助于肺原发与转移性肿瘤的诊断及鉴别诊断。Objective： To investigate the clinicopathological characteristics and differential diagnosis of lung metastatic tumors. Methods： The data of clinicopathological features were reviewed of the 113 cases,microscopic pathologic examinations and immunohistochemistry（ En Vision method） were performed. Results： The cases included 48 males and 65 females. ranging from 9 to 77 years old（ average 55 years）. The CT manifestations included： 52 solitary nodules and 61 multiple nodules. The primary tumor firstly located in breast（ 27.4%）,followed by colorectal cancer（ 20. 4%）,clear cell renal cell carcinoma（ 13. 3%）,squamous cell carcinoma of cervix（ 11. 5%）,high-grade ovarian serous carcinoma（ 8. 0%）,thyroid cancer（ 6. 2%）,The rest of the15 cases were urothelial carcinoma,thymic carcinoma,osteosarcoma,malignant melanoma,liomyoma,leiomyosarcoma and alveolar soft part sarcoma. Morphologic characteristics and immunohistochemical features of metastatic tumors were consistent with the primary tumors. Conclusion： Metastases to the lung are more common and show pathologic features of primary tumors. It is usually presumed to be a primary lung tumor. Histopathologic features and clinical history in conjunction with the immunohistochemical result should be considered in differentiating a secondary mass from a primary lung tumor.

关 键 词：肺部疾病 转移性肿瘤 临床病理 免疫组化 

分 类 号：R56[医药卫生—呼吸系统]