肺浸润性黏液腺癌1例报告及文献复习  

Invasive mucinous adenocarcinoma of lung:A case report and literature review

作　　者：赵敏 金鑫[2] 邸鑫[1] 田畅 刘伽莹 丛珊[1] 王珂[1] ZHAO Min;JIN Xin;DI Xin;TIAN Chang;LIU Jiaying;CONG Shan;WANG Ke(Department of Respiratory and Critical Care Medicine,Second Hospital,Jilin University,Changchun 130041,China;Department of Oncology and Hematology,Second Hospital,Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院呼吸与危重症医学科,吉林长春130041 [2]吉林大学第二医院肿瘤血液科,吉林长春130041

出　　处：《吉林大学学报（医学版）》2020年第3期634-638,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(20180101103JC);吉林省科技厅科技发展计划项目资助课题(20190303162SF,20191102012YY)。

摘　　要：目的:探讨肺浸润性黏液腺癌(IMAs)患者的临床特征、诊断方法和治疗过程,提高临床医生对IMAs的认识。方法:收集1例IMAs患者的一般资料、影像学表现和治疗方案,并进行相关文献复习。结果:患者,女性,42岁,因咳嗽和咳痰入院,CT检查显示双肺斑片状影,因疑似双肺肺炎行抗感染治疗后症状未见好转,经支气管镜肺活检术(TBLB)及胸水脱落细胞检测结果均为炎性表现,后经皮穿刺活检病理回报为IMAs。基因检测结果为KRAS外显子2点突变。行紫杉醇加卡铂并联合应用血管靶向药物贝伐珠单抗化疗后,患者临床症状明显改善,肺部影像学表现明显改变。结论:IMAs是一种特殊病理类型的肺腺癌(ADCs),该类患者影像学表现多样,基因表达特殊,治疗原则与其他类型ADCs不同。Objective:To investigate the clinical characteristics and diagnosis and treatment process of a patient with invasive mucinous adenocarcinoma(IMAs)of lung,and to improve the clinician’s understanding of IMAs.Methods:The general materials,imaging manifestations and treatment plan of a patient with IMAs were collected,and the related literature review was conducted.Results:A 42-year-old female patient was admitted to hospital due to cough and expectoration,the CT examination results showed the bilateral lung patchy shadows,the patient was suspected of having pneumonia.After anti-infective treatment,the patient’s symptoms did not improve.The pathological findings of transbronchial lung biopsy(TBLB)and the examination of exfoliated cells of pleural fluid all showed inflammation,and the pathological result of percutaneous biopsy was IMAs.The result of gene detection was 2-point mutation in exon of KRAS.After chemotherapy with paclitaxel plus carboplatin combined with bevacizumab,the symptoms of the patients were improved significantly,and the changes of imaging manifestations were obvious.Conclusion:IMAs is a special pathological type of lung adenocarcinomas(ADCs)with various imaging manifestations and specific gene expression.The treatment principles are different from those of the other types of ADCs.

关 键 词：肺浸润性黏液腺癌 肺腺癌 基因突变 影像学表现 

分 类 号：R563.9[医药卫生—呼吸系统]