肺腺癌眼球转移1例并文献复习  

The Eye Metastasis of Lung Adenocarcinoma:a Case Report and Literature Review

作　　者：杨江辉[1] 于燕 李博文[1] 雒文英 李勇[1] 高国强 尹洪芳[1] YANG Jiang-hui;YU Yan;LI Bo-wen;LUO Wen-ying;LI Yong;GAO Guo-qiang;YIN Hong-fang(Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院病理科清华大学临床医学院

出　　处：《标记免疫分析与临床》2019年第9期1508-1511,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的通过分析1例肺腺癌眼部转移病例,探讨肺腺癌眼球转移的临床和病理特征。方法回顾性分析1例肺腺癌眼球转移病例的临床表现、病理特征及免疫组化表型,并进行文献复习。结果患者男性,51岁,以右眼渐进性视力下降6月为主诉入院。镜下可见(眼球)视神经盘处中度异型腺体呈浸润性生长,并产黏液伴坏死形成,累及视网膜、脉络膜及巩膜,未侵透巩膜,压迫视神经,但未见明确侵犯;视神经断端及周围软组织未见癌浸润。免疫组化染色结果:AE1/AE3(+)、CK7(+)、TTF-1(+)、Napsin A(+)、CDX-2(-)、HMB45(-)、CK20(-)、Vimentin(-)、Ki67(80%+)。综上:腺癌,中分化,结合临床考虑肺脏来源。结论对于以眼部症状首发,有肺癌家族史和胸片提示肺部结节的患者,还应进一步完善相关检查,以缩短疾病的诊断周期,及早进行对症治疗。Objective To investigate the clinical and pathological features of ocular metastasis of lung adenocarcinoma.Methods The clinical manifestations,pathological features and immunohistochemical phenotype of 1 case of eyeball metastasis of lung adenocarcinoma were retrospectively analyzed,and the relevant literatures were reviewed.Results A 51-year-old male patient was admitted to the hospital with a complaint of progressive vision loss in the right eye for 6 months.Microscopically,medium heterotype glands in the optic nerve disc showed invasive growth and mucous production accompanied by necrosis,involving the retina,choroid and sclera,without penetrating the sclera and optically pressing the optic nerve,but no clear invasion was observed.No carcinoma infiltration was found at the broken end of optic nerve and surrounding soft tissue.Immunohistochemical staining results showed as follows:AE1/AE3(+),CK7(+),TTF-1(+),Napsin A(+),CDX-2(-),HMB45(-),CK20(-),Vimentin(-),Ki67(80%+).Conclusion For patients who start with eye symptoms,also have a family history of lung cancer and chest radiography suggesting pulmonary nodules,more relevant examinations should be conducted to shorten the diagnosis cycle of the disease,and symptomatic treatment should be carried out as early as possible.

关 键 词：肺腺癌 眼部转移 免疫组织化学 病理诊断 

分 类 号：R73[医药卫生—肿瘤]