PDF(Pubmed)
Abstract：
One year following bladder cancer surgery, a 65-year-old man had computed tomography (CT) that revealed bilateral pulmonary nodules. Pulmonary wedge resections were performed after the nodules were found to grow in follow-up. Unusually, we found that these two lesions were not homologous, nor were they metastases from prior bladder cancer, and therefore, synchronous double primary lung cancer (sDPLC) was diagnosed. The immunohistochemical findings excluded the possibility of bladder cancer metastasis, but could not determine whether they were from the same source. Next generation sequencing (NGS) supported the diagnosis sDPLC because they amply demonstrated the two sources\' distinct origins. Finally, after discussion with pathologists, this patient was diagnosed as small cell lung carcinoma (SCLC) and received postoperative EP chemotherapy. We also documented a few rather uncommon alterations that might serve as a foundation for further investigation. This case suggests that in addition to immunohistochemical, NGS is also helpful to clarify the etiology and refine the pathological classification of tumors, which has guiding significance for the establishment of precise diagnosis and optimal treatment.
摘要：
膀胱癌手术后一年，一名65岁的男性接受了计算机断层扫描(CT),显示双侧肺结节.在随访中发现结节生长后，进行了肺楔形切除术。通常情况下，我们发现这两个病变不是同源的，它们也不是以前膀胱癌的转移，因此,诊断为同步双原发性肺癌（sDPLC）。免疫组化结果排除了膀胱癌转移的可能性，但无法确定它们是否来自同一来源。下一代测序（NGS）支持诊断sDPLC，因为它们充分证明了两种来源的不同起源。最后,在与病理学家讨论后，该患者被诊断为小细胞肺癌（SCLC），并接受了术后EP化疗。我们还记录了一些相当罕见的改动，这些改动可能是进一步调查的基础。这种情况表明，除了免疫组织化学，NGS还有助于明确肿瘤的病因和细化病理分类,对建立精准诊断和优化治疗具有指导意义。
