先天性肺囊肿性病变60例临床病理观察

Clinicopathologic features of congenital cystic lung lesions of sixty cases

目的探讨先天性肺囊肿性病变临床病理特点以及与肺癌的关系。方法对60例外科手术切除先天性肺囊肿性病变进行临床病理学分析,并进行文献复习。结果支气管源性肺囊肿49例(81.7%);先天性囊性腺瘤样畸形5例(8.3%),其中1例伴发粘液性原位腺癌(国际肺癌研究协会/美国胸科学会/欧洲呼吸学会国际多学科肺腺癌分类2011年版,简称新版),1例伴发鳞癌;肺隔离症6例(10.0%)。结论支气管源性囊肿是先天性肺囊肿性病变最常见的囊肿类型,先天性囊性腺瘤样畸形(CCAM)最少见。CCAMⅠ型常伴有粘液细胞化生,粘液细胞增生可能属于浸润性粘液腺癌(新版分类,过去的粘液型细支气管肺泡癌)癌前病变。

Objective To study the clinicopathologic features and correlation with lung cancer in congenital cystic lung lesions. Methods The clinical and pathologic features were analyzed in 60 cases with congenital cystic lung lesions.All cases were resection specimens. Results Including 49 cases of bronchogenic cysts,5 cases of congenital cystic adenomatoid malformation （CCAM）, 6 cases of bronchopulmonary sequestration.One case of CCAM was associated with mucinous adenocarcinoma in situ （LASLC/ATS/ERS 2011）,another case of CCAM was associated with squmous cell carcinoma. Conclusion Bron- chogenic cysts were more often morphologie entity of congenital cystic lung lesions. CCAM is a rare entity,type I of CCAM often occurs mucinous cell, mucinous cell hyperplasia possibly represents a premalignant lesion of invasive mucinous adenocarcinoma （formerly mucinous bronchioloalveolar carcinoma）.