摘要
目的探讨胸腺恶性肿瘤的临床、病理特点以及诊疗思路。方法通过1例胸腺鳞癌患者的临床诊治经过,结合文献分析回顾,探讨胸腺恶性肿瘤的发病特点。结果该例患者以咳嗽、气促为表现,影像学检查提示前纵隔占位合并右侧胸腔积液,手术切除纵隔肿块,并做胸膜结节活检,最初术中冰冻病理切片提示肉芽肿性炎伴坏死及纤维化,考虑纵隔结核不除外,最终石蜡切片病理找到胸腺鳞癌细胞而明确诊断。结论胸腺鳞癌是一种罕见的纵隔肿瘤,治疗上首选手术切除。病理诊断结合免疫组织化学是诊断疾病的金标准,但胸腺肿瘤常有多种病理类型伴发而难以确诊,须结合临床表现、实验室检查和辅助检查,尤其是病理免疫组织化学染色,建立系统的诊疗思路,以免漏诊、误诊。
Objective To investigate the clinical and pathologic features of thymic squamous cell carcinoma and improve diagnosis and treatment. Methods One case of thymic squamous cell carcinoma was reported and related literatures were reviewed to elucidate the features of thymic squamous cell carcinoma. Results The patient presented with cough and shortness of breath.The CT scan revealed a mass in the anterior mediastinum and pleural effusion in the right chest.Surgical resection was performed subsequently and the pathological findings showed granuloma inflammation with necrosis and fibrosis, which indicated a possible diagnosis of mediastinal tuberculosis.Nevertheless, based on the final pathologic results, the diagnosis of thymic squamous cell carcinoma was eventually established. Conclusions Thymic squamous cell carcinoma is a rare mediastinal tumor and surgical resection is recommended.The diagnosis criterion is based on pathological results and immunohistochemical staining.However, it′s hard to make accurate diagnosis because of overlapping histological features between different types.Clinical features, laboratory and auxiliary examination, especially the immunohistochemistry assay should be combined to make accurate diagnosis, in order to avoid misdiagnosis or missed diagnosis.
作者
顾问
韩锋锋
王妍敏
管雯斌
郭雪君
Gu Wen;Han Fengfeng;Wang Yanmin;Guan Wenbin;Guo Xuejun(Department of Respiratory Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China;Department of Pathology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China)
出处
《国际呼吸杂志》
2019年第3期172-177,共6页
International Journal of Respiration
关键词
胸腺鳞癌
结核
胸腔积液
病理诊断
Thymic squamous cell carcinoma
Tuberculosis
Pleural effusion
Pathological diagnosis
