罕见的低分化肺腺癌伴胃十二指肠多发转移1例报道  

Rare low-differentiated pulmonary adenocarcinoma with multiple metastasis to the stomach and duodenum:one case report

作　　者：李许明 朱敏婕 何雅军 舒建昌 LI Xuming;ZHU Minjie;HE Yajun;SHU Jianchang(Department of Gastroenterology,Guangzhou Red Cross Hospital(Guangzhou Red Cross Hospital of Jinan University),Guangzhou 510000,China)

机构地区：[1]广州市红十字会医院消化内科,广东广州510000

出　　处：《胃肠病学和肝病学杂志》2025年第2期310-312,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：肺腺癌伴胃十二指肠多发转移非常罕见,由于其发生率低,缺乏特异性临床症状及影像学表现,临床上极易忽略,本病例报道了1例低分化肺腺癌伴胃十二指肠转移的诊治过程以引起临床医师对其重视。患者为长期吸烟老年男性,因右上肺结节住院,肋后肿物及胃十二指肠肿物活检示低分化腺癌,免疫组织化学染色结果提示原发性肺腺癌可能性大,患者持续黑便,经积极内科保守治疗及血管介入栓塞治疗后仍未见明显改善,经多学科会诊考虑为肺腺癌伴胃十二指肠转移并出血,已无手术指征,经积极内科保守治疗无效死亡。对于胃肠道多处转移合并消化道出血的患者,治疗棘手,目前尚无疗效确切的治疗方案,应当遵循个体化、多学科联合协助诊疗原则。Pulmonary adenocarcinoma with multiple gastric and duodenal metastasis is very rare.Due to its low incidence,lack of specific clinical symptoms and imaging manifestations,it is easily overlooked in clinical practice.This case report described the diagnosis and treatment process of a case of poorly differentiated pulmonary adenocarcinoma with gastric and duodenal metastasis to draw the attention of clinicians.The patient was an elderly male smoker who was hospitalized for a right upper lung nodule.Biopsy of the posterior rib mass and gastric and duodenal mass showed poorly differentiated adenocarcinoma.Immunohistochemical staining results suggested a high possibility of primary pulmonary adenocarcinoma.The patient had persistent melena and did not show significant improvement after active conservative treatment and vascular interventional embolization.After multidisciplinary consultation,he was considered to have pulmonary adenocarcinoma with gastric and duodenal metastasis and bleeding.He had no surgical indication and died of ineffective conservative treatment.For patients with multiple gastrointestinal metastasis and gastrointestinal bleeding,the treatment is difficult and there is no definite effective treatment plan.The principle of individualized and multidisciplinary collaborative diagnosis and treatment should be followed.

关 键 词：原发性肺癌 胃肠道转移 十二指肠恶性肿瘤 消化道出血 

分 类 号：R57[医药卫生—消化系统]