CAJ | 학술논문

目的：通过探讨原发性肺滑膜肉瘤的临床症状，病理学及影像学表现，提高对本病的认识。方法总结2例资料完整的原发性肺滑膜肉瘤的临床表现，病理学特征及影像学表现，2例患者均行胸部X线及CT检查，均手术切除肿物及病理学检查。结果临床表现为咳嗽、咳痰或胸痛。病理学检查提示为梭形细胞恶性肿瘤，瘤细胞呈流水状排列，核分裂象易见，免疫组化EMA、Bcl-2、Vimentin等阳性。影像学表现为肺部肿块影，边缘清楚或呈分叶状，病灶密度不均匀，增强扫描呈不均匀强化，可伴纵隔淋巴结肿大及胸腔积液。结论肺的滑膜肉瘤临床表现及影像学表现上无特异性，不易与其他肺或胸膜原发性肉瘤相鉴别，需要结合病理及免疫组化结果进行诊断。
목적：통과탐토원발성폐활막육류적림상증상，병이학급영상학표현，제고대본병적인식。방법총결2례자료완정적원발성폐활막육류적림상표현，병이학특정급영상학표현，2례환자균행흉부X선급CT검사，균수술절제종물급병이학검사。결과림상표현위해수、해담혹흉통。병이학검사제시위사형세포악성종류，류세포정류수상배렬，핵분렬상역견，면역조화EMA、Bcl-2、Vimentin등양성。영상학표현위폐부종괴영，변연청초혹정분협상，병조밀도불균균，증강소묘정불균균강화，가반종격림파결종대급흉강적액。결론폐적활막육류림상표현급영상학표현상무특이성，불역여기타폐혹흉막원발성육류상감별，수요결합병리급면역조화결과진행진단。
Objective To evaluate the clinical manifestations, pathological and imaging characteristics of primary pulmonary synovial sarcoma and to improve the understanding of the disease. Methods Clinical manifestations, pathological and imaging features of two patients with primary pulmonary synovial sarcoma were summarized. All patients underwent chest x-ray examination and CT scanning. All patients were confirmed by surgical pathology. Results Clinical manifestations included cough, expectoration and chest pain. Pathological examination showed sheets of spindle cell carcinoma with common mitotic count. Immunohistochemistry revealed positive for EMA, Bcl-2 and Vimentin. Chest X-ray and CT scan showed a heterogenous mass in lung of lobular shape or with clear margin. Contrast enhanced CT showed heterogeneous enhancement of the mass. Lymphadenopathy and pleural effusion were seen in one patient respectively. Conclusions Primary synovial sarcoma of the lung has no characteristic clinical and imaging manifestations and is difficult to be differentiated from other sarcoma of lung. The diagnosis depends on pathological and immunohistochemistry examination.