CAJ | 학술논문

目的分析肺透明细胞癌的临床特征、影像学表现及病理诊断要点.方法报告1例经肺活检病理确诊的肺透明细胞癌病例,并结合文献资料对该病的临床特征、影像学表现及病理诊断要点进行分析.结果本例患者为女性,45岁,以反复咳嗽2个月为首发症状,胸部CT示两肺多发结节灶合并肺门及纵隔淋巴结肿大,胸腔镜下肺活检病理确诊为原发性肺透明细胞癌.近20年国内外文献报道肺透明细胞癌病例仅27例,其中男性18例,女性9例,平均年龄(55±11)岁.临床表现主要为咳嗽(16/27)、胸痛(12/27)、咯血(10/27).影像学表现以周围型单发结节或团块影多见(22/27),病灶直径0.5～11 cm.该病罕见,属大细胞癌的变异型；确诊多依赖开胸肺组织病理活检,免疫组织化学染色有助于鉴别.结论肺透明细胞癌的临床表现无特异性；影像学表现以肺部单发结节或团块影多见,亦可为两肺多发和弥漫型；确诊依赖肺组织病理活检,免疫组织化学染色有助于鉴别.
목적 분석폐투명세포암적림상특정、영상학표현급병리진단요점.방법 보고1례경폐활검병리학진적폐투명세포암병례,병결합문헌자료대해병적림상특정、영상학표현급병리진단요점진행분석.결과 본례환자위녀성,45세,이반복해수2개월위수발증상,흉부CT시량폐다발결절조합병폐문급종격림파결종대,흉강경하폐활검병리학진위원발성폐투명세포암.근20년국내외문헌보도폐투명세포암병례부27례,기중남성18례,녀성9례,평균년령(55±11)세.림상표현주요위해수(16/27)、흉통(12/27)、각혈(10/27).영상학표현이주위형단발결절혹단괴영다견(22/27),병조직경0.5～11 cm.해병한견,속대세포암적변이형；학진다의뢰개흉폐조직병리활검,면역조직화학염색유조우감별.결론 폐투명세포암적림상표현무특이성；영상학표현이폐부단발결절혹단괴영다견,역가위량폐다발화미만형；학진의뢰폐조직병리활검,면역조직화학염색유조우감별.
Objective To analyze the clinical,imaging and pathological features of primary lung clear cell carcinoma.Methods A case of primary lung clear cell carcinoma confirmed by video-assisted thoracoscopic lung biopsy was reported and the literatures were reviewed.Results A 45 year-old female was referred to our department with complaints of two months of cough.Chest computed tomography revealed multiple nodular shadows in bilateral lung fields with hilar and mediastinal lymphadenectasis.Video-assisted thoracoscopic lung biopsy confirmed the diagnosis of primary lung clear cell carcinoma.27 cases of primary lung clear cell carcinoma reported in the past 20 years were collected by literature review.Two-thirds of the patients were male,with an average age of (55 ± 11) years old.Patients complained most commonly of cough (16/27),chest pain (12/27) and haemoptysis (10/27).Radiologically,most cases presented as a peripheral lung nodule or mass with irregular margins (22/27).The maximum diameter of pulmonary lesions ranged from 0.5 to 11 cm.Clear cell carcinoma of the lung is a histological variant of large cell carcinoma,which is a rather rare histological type.Open lung biopsy was often needed for diagnosis,and immunostaining was helpful for differentiation.Conclusions Clear cell carcinoma of the lung has no specific clinical presentation.It often presents as a peripheral lung nodule or mass radiologically.The histological type is rare.Open lung biopsy is often needed for diagnosis,and immunostaining is helpful for differentiation.