PDF(Pubmed)
Abstract：
Most lung carcinomas are subtyped by their morphologies; however, immunohistochemistry is usually performed when it is difficult to determine. The most reliable antibodies for distinguishing lung adenocarcinoma from squamous cell carcinoma are thyroid transcription factor-1 (TTF-1) and p40 (ΔNp63). In general, these markers are mutually exclusive in their expression of lung primary carcinoma; however, a few cases of non-small cell lung carcinoma (NSCLC) with coexpression of both markers have been reported. Examining a tissue microarray of 229 squamous cell carcinomas and 346 adenocarcinomas, we found one case of NSCLC with coexpression of TTF-1 and p40. Herein, we present a 71-year-old man, who had a mass lesion in the left lung apex. A transbronchial lung biopsy was performed, revealing NSCLC. He underwent left upper segmentectomy and lymph node dissection. Macroscopically, the mass showed a white-to-tan solid tumor on the cut surface. Microscopically, the tumor was composed of polygonal tumor cells which had round and vesicular nuclei with prominent nucleoli. They had an abundant amount of cytoplasm, which was slightly eosinophilic or amphophilic. Multinucleated cells with atypical nuclear features were observed to be scattered in some areas. Multifocal necrosis and hemorrhage were also noted. Distinct squamous features and obvious glandular features were absent. Immunohistochemically, the most tumor cells were coexpressed positive for both TTF-1 and p40. In our study, NSCLC with TTF-1 and p40 coexpression is rare; therefore, it is necessary to obtain further data and examine similar cases to establish more precise definitions and clinicopathological features.
摘要：
大多数肺癌是根据其形态分型的；然而，免疫组织化学通常在难以确定时进行。用于区分肺腺癌和鳞状细胞癌的最可靠的抗体是甲状腺转录因子-1(TTF-1)和p40(ΔNp63)。总的来说,这些标志物在肺癌中的表达是相互排斥的;然而,有报道称,少数非小细胞肺癌(NSCLC)同时存在两种标志物的共表达.检查229个鳞状细胞癌和346个腺癌的组织微阵列，我们发现1例TTF-1和p40共表达的NSCLC。在这里，我们介绍一个71岁的老人,左肺尖部有肿块病变。进行了经支气管肺活检，揭示NSCLC。他接受了左上段切除术和淋巴结清扫术。宏观上,肿块显示切面为白色至棕褐色的实体瘤。微观上,肿瘤由多角形肿瘤细胞组成，有圆形和泡状核，核仁突出。它们有大量的细胞质，轻度嗜酸性或两性。观察到具有非典型核特征的多核细胞散布在某些区域。还注意到多灶性坏死和出血。不存在明显的鳞状特征和明显的腺状特征。免疫组织化学，大多数肿瘤细胞对TTF-1和p40共表达阳性。在我们的研究中,与TTF-1和p40共表达的NSCLC是罕见的;因此，有必要获得更多数据并检查类似病例,以建立更精确的定义和临床病理特征.
