摘要
目的:探讨成人型肺母细胞瘤临床特点、病理特征、诊断和治疗。方法:回顾性分析1990年8月～2006年4月期间15例成人型肺母细胞瘤的临床和病理资料。结果:全组均行手术治疗,其中肺叶切除9例,双叶切除2例,肺段切除1例,肺叶切除及支气管成形1例,肺叶切除及血管成形术1例,全肺切除1例。术前诊断为肺癌11例;良性肿瘤2例,间叶源性恶性肿瘤1例和肺母细胞瘤1例。免疫组化示6例CK(+)、EMA(+),5例Vim(+),1例S100(+)。结论:成人型肺母细胞瘤是一种少见的含有类似于分化好的胎儿腺癌的原始上皮成分和原始间叶成分的双向性肿瘤,该病临床症状无特征性,术前确诊极为困难,应结合临床表现和形态学及免疫组化标记综合考虑。本病应首选手术治疗,彻底切除是手术的关键。治疗以肺叶切除加纵隔淋巴结清扫术为主,本病恶性度高,易复发和转移,预后不佳。
Objective： To study the clinical and histopathologic characteristics of pulmonary blastoma （PB） and to discuss the diagnostic criteria and the corresponding therapies. Methods： Data from 15 cases of PB seen in our hospital between 1990 and 2006 were reviewed. Results： All patients underwent surgery. Nine patients received lobectomy, 2 patients had bilateral lobectomy, 1 patient underwent Iobectomy and bronchus figuration, 1 patient received segment resection, 1 patient had Iobectomy and angioplasty, and 1 patient had resection of the whole lung. Before surgery, 11 cases were diagnosed as lung cancer, 2 cases were suspected of being benign lung tumor, 1 case was suspected as obus intermedius malignant tumor and only 1 case was accurately diagnosed as PB. Immunohistochemistry showed that CK and EMA were positive in 6 cases, Vim was positive in 5 cases, and S100 was positive in 1 case. Conclusion： As a highly malignant tumor with poor prognosis, PB has a high rate of recurrence and metastasis. PB contains primitive epithelial components and mesenchymal stroma, making the tumor appear similar to well-differentiated fetal adenocarcinoma. Preoperative diagnosis of PB is very difficult. Clinical manifestations, morphological characteristics and immunohistochemical presentation provide important information. The main treatment for PB is surgery consisting of Iobectomy and dissection of diaphragm lymph nodes. Thorough resection is paramount.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2008年第12期661-663,共3页
Chinese Journal of Clinical Oncology
基金
河北省普通高等学校强势特色学科肿瘤学建设基金资助(编号:2005-52)
关键词
成人型
肺母细胞瘤
诊断
治疗
Pulmonary blastoma
Adult-type
Diagnosis
Therapy
