肺浸润性腺癌伴纵隔淋巴结转移性NUT中线癌1例报告及文献复习  

Invasive adenocarcinoma of lung complicated with metastatic NUT midline carcinoma of mediastinal lymph node:A case report and literature review

作　　者：王晓明[1] 王雪野[2] WANG Xiaoming;WANG Xueye(Department of Pathology,People’s Hospital,Jilin Province,Changchun 130021,China;Drug Chinical Trial Institution,People’s Hospital,Jilin Province,Changchun 130021,China)

机构地区：[1]吉林省人民医院病理科,吉林长春130021 [2]吉林省人民医院药物临床试验机构,吉林长春130021

出　　处：《吉林大学学报（医学版）》2024年第3期825-830,共6页Journal of Jilin University：Medicine Edition

基　　金：吉林省卫健委继续医学教育项目(20220104002)。

摘　　要：目的:分析1例肺浸润性腺癌伴纵隔淋巴结转移性睾丸核蛋白(NUT)中线癌患者的病理诊断过程,为该病的临床诊断提供依据。方法:收集1例肺浸润性腺癌伴纵隔淋巴结转移性NUT中线癌患者的临床资料,术中送检肺肿物行冰冻快速病理诊断以判断病变性质,术后另送纵隔肿瘤行慢病理检测,肺及纵隔肿物均行常规病理检查和免疫组织化学染色,结合相关文献分析该病的病理诊断过程,并进行病理鉴别。结果:患者,男性,59岁,于外院行CT检查见前纵隔软组织密度影和右肺下叶磨玻璃样结节影,均考虑肿瘤性病变。术中肺肿物快速病理诊断考虑肺浸润性腺癌,术后经免疫组织化学染色证实为肺原发性浸润性腺癌。术后另送纵隔肿物,经免疫组织化学染色、院外会诊及基因检测最终证实为淋巴结转移性NUT中线癌。结论:NUT中线癌是罕见的低分化鳞状细胞癌,常发生于中线部位,可伴发其他器官肿瘤并发生淋巴结转移,其确诊需要结合组织学形态、影像学资料和基因检测结果。Objective:To discuss the pathological diagnostic process of one case of invasive adenocarcinoma of lung complicated with metastatic nuclear protein of testis(NUT) midline carcinoma of mediastinal lymph node,and to provide the basis for the clinical diagnosis of this disease.Methods:The clinical materials of one patient with invasive adenocarcinoma of lung complicated with metastatic NUT midline carcinoma of mediastinal lymph node were collected.Intraoperative frozen section pathological diagnosis of the lung tumor was performed to determine the nature of the lesion,and postoperative mediastinal tumor was sent for slow pathological examination.Both lung and mediastinal tumors underwent routine pathological examination and immunohistochemical staining,the pathological diagnostic process was analyzed combined with the relevant literatures,and the pathological differentiation was performed.Results:The patient,a 59-year-old man,underwent a CT scan at an external hospital,which revealed a soft tissue density shadow in the anterior mediastinum and a ground-glass nodule in the lower lobe of the right lung,both were considered to be neoplastic lesions.The intraoperative rapid pathological diagnosis of the lung tumor suggested pulmonary invasive adenocarcinoma,and the postoperative immunohistochemical staining results confirmed it as primary pulmonary invasive adenocarcinoma.The postoperative mediastinal tumor was confirmed as lymph node metastatic NUT midline carcinoma through immunohistochemical staining,external consultation,and genetic testing.Conclusion:NUT midline carcinoma is a rare poorly differentiated squamous cell carcinoma that often occurs in the midline structures and may involve other organs and lymph node metastasis;its diagnosis requires a combination of histological morphology,imaging data,and genetic testing results.

关 键 词：肺浸润性腺肿瘤 胸腺肿瘤 睾丸核蛋白中线癌 免疫组织化学染色 

分 类 号：R734.2[医药卫生—肿瘤]