肺梗死樣梭形細胞癌一例并文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

江亞 ^1,2 , 楊舉倫 ¹ , 徐文漭 ¹ , 楊麗琳 ¹ , 龍世溢 ¹ ,  王媛媛 ¹

1. ;
2. ;

Corresponding?author：

王媛媛, Email: wyy131328@126.com

Keywords：

肺梗死樣梭形細胞癌; 病理; 程序性死亡蛋白配體1; 肉瘤樣癌; 免疫治療

DOI：

10.7507/1671-6205.202105023

Video：

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目的探討肺梗死樣梭形細胞癌（ISCCL）的臨床病理特征、診斷及鑒別診斷。方法分析2020年10月會診的1例ISCCL患者的臨床信息、病理組織形態以及免疫組織化學染色結果，并復習相關文獻。結果患者為49歲男性。胸部CT示右肺下葉結節，于外院行右肺下葉腫塊切除術。右肺下葉腫塊術后病檢結果顯示大片梗死樣區域，其間可見短梭形異型細胞，圍繞血管生長，部分區域膠原纖維增生，核分裂象少見；免疫組織化學結果顯示腫瘤細胞表達廣譜細胞角蛋白、上皮膜抗原、波形蛋白。病理診斷為ISCCL，行肺葉切除術輔以紫杉醇聯合卡鉑進行化學治療，但效果不佳，患者拒絕進一步治療，于術后8個月因肺癌多發骨轉移死亡。結論 ISCCL是一種罕見的侵襲性惡性腫瘤，形態學特征與多種肺良惡性病變容易混淆，極易誤診、漏診，需綜合分析相鑒別。

Citation： 江亞, 楊舉倫, 徐文漭, 楊麗琳, 龍世溢, 王媛媛. 肺梗死樣梭形細胞癌一例并文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(11): 813-816. doi: 10.7507/1671-6205.202105023 Copy

1.	Davis MP, Eagan RT, Weiland LH, et al. Carcinosarcoma of the lung: Mayo Clinic experience and response to chemotherapy. Mayo Clin Proc, 1984, 59(9): 598-603.
2.	李媛, 謝惠康, 武春燕. WHO胸部腫瘤分類(第5版)中肺腫瘤部分解讀. 中國癌癥雜志, 2021, 31(7): 7.
3.	Rossi G, Nosseir S, Jocollé G et al. Infarct-Like spindle cell carcinoma of the lung: clinicopathologic, immunohistochemical, and molecular analysis of 4 cases. Int J Surg Pathol, 2020, 28(6): 616-623.
4.	Lawther RE, Graham AN, McCluggage WG, et al. Pulmonary infarct cytologically mimicking adenocarcinoma of the lung. Ann Thorac Surg, 2002, 73(6): 1964-1965.
5.	Chang YL, Lee YC, Shih JY, et al. Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma. Lung Cancer, 2001, 34(1): 91-97.
6.	Colby TV. Malignancies in the lung and pleura mimicking benign processes. Semin Diagn Pathol, 1995, 12(1): 30-44.
7.	Lantuejoul S, Colby TV, Ferretti GR, et al. Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing. Eur Respir J, 2004, 24(3): 502-505.
8.	Rajdev K, Siddiqui AH, Ibrahim U, et al. Sarcomatoid carcinoma of the lung presenting as localized bronchiectasis: a case report and review of literature. Respir Med Case Rep, 2018, 24: 143-146.
9.	Zhang Y, Li B, Shi H, et al. Sarcomatoid carcinoma of the lung mimics aspergilloma on 1?F-FDG PET/CT. Hell J Nucl Med, 2015, 18(3): 268-270.
10.	Antic T, Kapur U, Vigneswaran WT, et al. Inflammatory sarcomatoid carcinoma: a case report and discussion of a malignant tumor with benign appearance. Arch Pathol Lab Med, 2005, 129(10): 1334-1337.
11.	賈練, 劉春濤, 唐永江, 等. 肺血栓栓塞癥并發大量胸腔積液誤診一例. 中國呼吸與危重監護雜志, 2016, 15(2): 186-188.
12.	Yousem SA. The surgical pathology of pulmonary infarcts: diagnostic confusion with granulomatous disease, vasculitis, and neoplasia. Mod Pathol, 2009, 22(5): 679-685.
13.	于正倫, 張林. 肺肉瘤樣癌10例臨床分析. 中國呼吸與危重監護雜志, 2014, 13(5): 517-518.
14.	Romano A, Grassia M, Rossetti AR, et al. Sarcomatoid Carcinoma of the lung: A rare case of three small intestinal intussusceptions and literature review. Int J Surg Case Rep, 2015, 13: 48-50.
15.	Schrock AB, Li SD, Frampton GM, et al. Pulmonary sarcomatoid carcinomas commonly harbor either potentially targetable genomic alterations or high tumor mutational burden as observed by comprehensive genomic profiling. J Thorac Oncol, 2017, 12(6): 932-942.
16.	Salati M, Baldessari C, Calabrese F, et al. Nivolumab-induced impressive response of refractory pulmonary sarcomatoid carcinoma with brain metastasis. Case Rep Oncol, 2018, 11(3): 615-621.

1. Davis MP, Eagan RT, Weiland LH, et al. Carcinosarcoma of the lung: Mayo Clinic experience and response to chemotherapy. Mayo Clin Proc, 1984, 59(9): 598-603.
2. 李媛, 謝惠康, 武春燕. WHO胸部腫瘤分類(第5版)中肺腫瘤部分解讀. 中國癌癥雜志, 2021, 31(7): 7.
3. Rossi G, Nosseir S, Jocollé G et al. Infarct-Like spindle cell carcinoma of the lung: clinicopathologic, immunohistochemical, and molecular analysis of 4 cases. Int J Surg Pathol, 2020, 28(6): 616-623.
4. Lawther RE, Graham AN, McCluggage WG, et al. Pulmonary infarct cytologically mimicking adenocarcinoma of the lung. Ann Thorac Surg, 2002, 73(6): 1964-1965.
5. Chang YL, Lee YC, Shih JY, et al. Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma. Lung Cancer, 2001, 34(1): 91-97.
6. Colby TV. Malignancies in the lung and pleura mimicking benign processes. Semin Diagn Pathol, 1995, 12(1): 30-44.
7. Lantuejoul S, Colby TV, Ferretti GR, et al. Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing. Eur Respir J, 2004, 24(3): 502-505.
8. Rajdev K, Siddiqui AH, Ibrahim U, et al. Sarcomatoid carcinoma of the lung presenting as localized bronchiectasis: a case report and review of literature. Respir Med Case Rep, 2018, 24: 143-146.
9. Zhang Y, Li B, Shi H, et al. Sarcomatoid carcinoma of the lung mimics aspergilloma on 1?F-FDG PET/CT. Hell J Nucl Med, 2015, 18(3): 268-270.
10. Antic T, Kapur U, Vigneswaran WT, et al. Inflammatory sarcomatoid carcinoma: a case report and discussion of a malignant tumor with benign appearance. Arch Pathol Lab Med, 2005, 129(10): 1334-1337.
11. 賈練, 劉春濤, 唐永江, 等. 肺血栓栓塞癥并發大量胸腔積液誤診一例. 中國呼吸與危重監護雜志, 2016, 15(2): 186-188.
12. Yousem SA. The surgical pathology of pulmonary infarcts: diagnostic confusion with granulomatous disease, vasculitis, and neoplasia. Mod Pathol, 2009, 22(5): 679-685.
13. 于正倫, 張林. 肺肉瘤樣癌10例臨床分析. 中國呼吸與危重監護雜志, 2014, 13(5): 517-518.
14. Romano A, Grassia M, Rossetti AR, et al. Sarcomatoid Carcinoma of the lung: A rare case of three small intestinal intussusceptions and literature review. Int J Surg Case Rep, 2015, 13: 48-50.
15. Schrock AB, Li SD, Frampton GM, et al. Pulmonary sarcomatoid carcinomas commonly harbor either potentially targetable genomic alterations or high tumor mutational burden as observed by comprehensive genomic profiling. J Thorac Oncol, 2017, 12(6): 932-942.
16. Salati M, Baldessari C, Calabrese F, et al. Nivolumab-induced impressive response of refractory pulmonary sarcomatoid carcinoma with brain metastasis. Case Rep Oncol, 2018, 11(3): 615-621.

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