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纸质出版:2012
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许森林,段光杰,申丽丽,阎晓初.肺透明细胞类癌1例报告及文献复习[J].陆军军医大学学报(原第三军医大学学报),2012,34(12):1230-1233.
Xu Senlin,Duan Guangjie,Shen Lili,Yan Xiaochu.Pulmonary clear cell carcinoid tumor: a case report and review of the literature[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(12):1230-1233.
目的 探讨肺透明细胞类癌的临床病理特征、诊断与鉴别诊断要点、治疗及预后。 方法 对来自本院胸外科的1例肺透明细胞类癌青年男性患者的手术标本切片,进行组织形态学观察和免疫组织化学检测,并结合文献进行临床病理分析。 结果 患者因体检发现右下肺包块2年入院,切除标本见肿瘤位于右下肺边缘,为一边界清楚、质地中等的灰白色类圆形结节。镜下观察见均匀一致的肿瘤细胞呈片状或巢团状排列,细胞体积较大,细胞质透明,核圆居中。免疫组化显示肿瘤细胞CD56、Syn、CgA均为强阳性,CK、TTF-1阳性,Ki-67阳性细胞数<1%,S-100蛋白灶性阳性,Vimentin间质血管阳性,而HMB45、SMA、GFAP、Actin均为阴性。病理诊断:肺透明细胞类癌。行肺叶切除术后至今(6年)未见复发转移。 结论 肺透明细胞类癌是一种非常罕见的低度恶性肿瘤,仔细的大体检查、广泛取材和正确的免疫组化标记是诊断的关键;准确的病理组织学分型对治疗和预后评估有重要意义。
Objective To report a case of pulmonary clear cell carcinoid tumor
and to discuss its clinical and pathological features
key points of diagnosis
treatment and prognosis. Methods The pathological and immunohistochemical data of a young male patient with pulmonary clear cell carcinoid tumor admitted in Southwest Hospital was collect
and the literature was reviewed. Results The gross of tumor showed a medium-size and round ashen tubercle with a clear boundary. The microscopy observation showed uniform large tumor cells with transparent cytoplasm and round nuclei in the center
and the tumor cells showed a dispersed or nested arrangement. The immunohistochemical staining showed that CgA
Syn and CD56 were strongly positive and CK and TTF-1 were positive in tumor cells
but SMA
HMB45
GFAP and actin were all negative. The number of Ki-67-positive cells was less than 1%. S-100 protein was focally positive
and vimentin was positive in interstitial blood vessels. No recurrence or metastasis was observed for 6 years after the surgical resection of the pulmonary tumor. Conclusion Pulmonary clear cell carcinoid tumor is a rare form of low malignant potential tumors. Careful gross examination
wide-range sampling and correct immunohistochemical staining are critical for appropriate diagnosis
and both of the treatment and prognosis evaluation are dependent on the histopathological types of carcinoid carcinoma.
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