背景:原发性肺腺泡细胞癌非常罕见。在这里,我们报告了一名年轻的女性患者,该患者患有最大的原发性肺腺泡细胞癌,并伴有严重的纵隔偏离,这是以前从未报道过的。我们还回顾了先前报道的20例接受肺叶切除术的原发性肺腺泡细胞癌的数据和特征。
方法:我院收治1例27岁女性患者,反复咳嗽、咯血10年以上。胸部计算机断层扫描(CT)显示右肺门有巨大的占位病变。经过全面详细的术前检查,然后,患者进行了根治性右肺切除术和纵隔淋巴结清扫。肿瘤大小约8.6×4.5×4.4cm。病理结果提示右肺原发性腺泡细胞癌。肿瘤免疫组化显示AE1/AE3(+),Ki-67(2%+),CK7(+),波形蛋白(+),CK19(+),α1-ACT(+),AB-PAS(+),S-100(-),TTF-1(-)。患者在手术后不到2周就出院了。到目前为止,病人已经随访了2年,未观察到肿瘤复发或转移的证据。
结论:此例肺原发腺泡细胞癌是有史以来最大的一例,也是首例接受右肺根治性切除术治疗的病例。此外,该患者同时患有非常罕见的严重纵隔偏离。手术治疗后,随访2年,患者恢复顺利,病情稳定,无复发和转移.该病例与报道的病例一起表明原发性肺腺泡细胞癌的恶性程度较低。手术治疗的预后和治疗效果比较满意。
BACKGROUND: Primary lung acinic cell carcinoma is very rare. Here we report a young female patient who suffered the largest primary lung acinic cell carcinoma with severe mediastinal deviation which has never been reported before. We also reviewed data and features of 20 previously reported cases of primary lung acinic cell carcinoma who underwent lobectomy.
METHODS: A 27-year-old female patient presented with recurrent coughing and hemoptysis for more than 10 years came to our hospital. A chest computed tomography (CT) showed a giant space-occupying lesion in the hilum of right lung. After a thorough and detailed preoperative examination, the patient then was performed a radical right pneumonectomy with mediastinal lymph node dissection. The size of the tumor was about 8.6 × 4.5 × 4.4 cm. The pathological results demonstrated a primary acinic cell carcinoma of right lung. The immunohistochemistry of the tumor showed AE1/AE3 (+), Ki-67 (2% +), CK7 (+), Vimentin (+), CK19 (+), α1-ACT (+), AB-PAS (+), S-100 (-), TTF-1 (-). The patient was discharged less than 2 weeks after the operation. So far, the patient has been followed-up for 2 years, and no evidence of tumor recurrence or metastasis was observed.
CONCLUSIONS: The primary acinic cell carcinoma of lung in this case is the biggest one ever reported and also the first case treated with radical right pneumonectomy. In addition, the patient had a very rare condition of severe mediastinal deviation at the same time. After surgical treatment, the patient recovered uneventfully and had stable disease without recurrence and metastasis after 2 years of follow-up. This case together with the reported case indicate that primary acinic cell carcinoma of lung is of low malignancy, the prognosis and therapy effect of surgical treatment are relatively satisfactory.