肺原发性肝样腺癌临床病理特征研究

doi:10.3969/j.issn.1000-8535.2019.03.016

广州医药 ›› 2019, Vol. 50 ›› Issue (3): 61-65.DOI: 10.3969/j.issn.1000-8535.2019.03.016

肺原发性肝样腺癌临床病理特征研究

王小拍¹, 刘寿生², 杨耀湘¹, 李秀博¹, 杨静¹, 杜洪¹

1 广州市第一人民医院病理科,华南理工大学附属第二医院 (广州 510180)
2 中山大学肿瘤防治中心综合科、华南肿瘤学国家重点实验室、肿瘤医学协同创新中心 (广州 510060)

收稿日期:2018-12-02 出版日期:2019-05-20 发布日期:2021-12-17
通讯作者: 杜洪,E-mail: dhyx123456@126.com

Clinicopathologic characteristics of primary hepatoid adenocarcinoma of the lung

WANG Xiaopai¹, LIU Shousheng², YANG Yaoxiang¹, LI Xiubo¹, YANG Jing¹, DU Hong¹

1 Department of Pathology, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou 510180, China
2 Department of General Medicine, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China

Received:2018-12-02 Online:2019-05-20 Published:2021-12-17

摘要/Abstract

摘要： 目的分析肺肝样腺癌(HAL)的临床病理特征、诊断、免疫表型、基因检测及治疗预后等。方法对1例HAL临床及影像学、组织学形态、免疫组化及基因检测结果等进行观察,并结合相关文献综合分析。结果患者为48岁吸烟男性,镜下肿瘤具有肝细胞样和腺样分化特征,血清AFP升高。免疫组化: Hepatocyte,AFP, Arginase-1均阳性,ARMS-PCR法均未检测到EGFR,ALK/ROS1,KRAS及BRAF突变。结合相关文献分析: HAL常见于有吸烟史的男性,血清AFP值升高也是该肿瘤的一个特点。肿物多见于肺上叶,体积较大,易发生淋巴结和远处转移,预后相对较差。结论 HAL非常少见,易误诊,其诊断需结合形态学特点、临床病理特征及免疫组化结果等。

关键词: 肝样腺癌, 免疫组织化学, ARMS, 临床病理特征

Abstract: Objective To explore the clinicopathologic characteristics, diagnosis, immunophenotype, gene detection and prognosis of primary hepatoid adenocarcinoma of the lung (HAL). Methods A case of hepatoid adenocarcinoma of the lung was analyzed with clinical manifestations, histology, immunohistochemical staining and gene detection, and relevant literatures were reviewed. Results The patient was a 48-years-old man with smoking history. Microscopically, the tumor has the characteristics of hepatocellular carcinoma and adenoid differentiation, also serum AFP was elevated. The immunohistochemical results showed that Hepatocyte, AFP and Arginase-1were positive. No mutations were detected for EGFR, ALK/ROS1, KRAS and BRAF by ARMS-PCR. Combining with literature analysis, HAL is common in males and most patients with this tumor are smokers. Serum AFP in very high levels has been a distinguishing feature of this tumor. HAL usually presents as a large bulky solitary mass in the upper lobe. Lymph nodes and distant metastases are prone to occur. Therefore, the prognosis is very poor. Conclusion HAL is a rare malignant tumor and easy to be misdiagnosed. The diagnosis of primary hepatoid adenocarcinoma of the lung should be combined with morphological features, clinicopathological features and immunohistochemical findings.

Key words: Hepatoid adenocarcinoma, Immunohistochemistry, ARMS, Clinicopathologic features

王小拍, 刘寿生, 杨耀湘, 李秀博, 杨静, 杜洪. 肺原发性肝样腺癌临床病理特征研究[J]. 广州医药, 2019, 50(3): 61-65.

WANG Xiaopai, LIU Shousheng, YANG Yaoxiang, LI Xiubo, YANG Jing, DU Hong. Clinicopathologic characteristics of primary hepatoid adenocarcinoma of the lung[J]. Guangzhou Medical Journal, 2019, 50(3): 61-65.

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肺原发性肝样腺癌临床病理特征研究

Clinicopathologic characteristics of primary hepatoid adenocarcinoma of the lung

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