肺叶切除术及辅助化疗后,原发病灶肺鳞状细胞癌向转移淋巴结病灶小细胞肺癌组织学转变1例

IF 0.3 Q4 ONCOLOGY
Xinran O Zhao, Ye Qin, Di Zhang, Yang Han, Guang-Ping Wu, Huanyu Zhao
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引用次数: 0

摘要

肺癌是全球癌症死亡的主要原因。肺鳞状细胞癌向小细胞肺癌(SCLC)的组织学转变越来越多,其发病机制尚不清楚,治疗具有挑战性。病例介绍:一名62岁男性患者,在原发性肺叶切除术和辅助化疗后的3年内,组织学从原发病变转变为转移性复发病变。患者初发病及复发时有咳嗽症状。左上叶根段原发病灶诊断为无基因突变(包括EGFR、ALK、BRAF V600E等)的肺鳞状细胞癌,4L组纵隔肿大淋巴结复发病灶诊断为SCLC。到目前为止,患者在第一次手术后存活了近4年。讨论:手术切除是早期肺癌患者的主要治疗方法。淋巴结转移是早期患者的一大威胁。近年来,关于肺癌组织学转化的机制和病例的研究报道越来越多。在本例中,在肺叶切除术和辅助化疗后,组织学从原发病灶的鳞状细胞癌转变为转移性淋巴结病变的小细胞肺癌。然而,没有基因突变。这是一份非常不寻常的报告。结论:通过临床症状、影像学特征、实验室检查、基因检测、组织病理学特征和免疫组化检查,分析了1例由原发病灶组织学转变为淋巴转移的肺癌患者。这有助于了解肺癌组织转化和转移进展的发病机制,优化治疗措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Histologic transformation from lung squamous cell carcinoma in primary lesion to small cell lung cancer in metastatic lymph node lesion following lobectomy and adjuvant chemotherapy: a case report
Introduction: Lung cancer is the leading cause of cancer death worldwide. Histologic transformation from lung squamous cell carcinoma to small cell lung cancer (SCLC) has become more and more, and its treatment is challenging because of unknown pathogenesis. Presentation of Case: A 62-year-old male patient presented with histologic transformation from primary lesion to metastatic recurrence lesion within 3 years following primary lobectomy and adjuvant chemotherapy. The patient had the symptom of cough at the time of initial illness and recurrence. The primary lesion at the root segment of left superior lobe was diagnosed as lung squamous cell carcinoma without gene mutation (including EGFR, ALK, BRAF V600E, etc.), and recurrence lesion at the swollen lymph nodes in mediastinum (4L group) was diagnosed as SCLC. Up to now, the patient was alive for nearly 4 years after first surgery. Discussion: Surgical resection is the main treatment for lung cancer patient in early stage. Lymph node metastasis is a big threat for the patients in early stage. Recently, the research reports focused on the mechanism and cases of histologic transformation of lung cancer have become more and more. In this case, histologic transformation from squamous cell carcinoma in primary focus to SCLC in metastatic lymph node lesion following lobectomy and adjuvant chemotherapy. However, there was no gene mutation. This is a very unusual report. Conclusion: We analyzed a lung cancer patient with histologic transformation from primary focus to lymphatic metastasis by clinical symptoms, radiologic features, laboratory tests, gene detection, histopathologic characteristics, and immunohistochemical testing. It is helpful to understand the pathogenesis of histologic transformation and metastatic progression for optimizing treatment measures to lung cancer.
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