肺巨细胞癌6例临床病理分析

Giant cell carcinoma of the lung: a clinicopathologic analysis of 6 cases

目的 探讨肺巨细胞癌 (GCC)的临床及病理特点。方法 利用HE染色及免疫组化方法对 6例GCC的组织形态进行观察 ,对其临床特点及随访材料进行分析。结果 患者均为男性 ,平均年龄 6 3 8岁。临床表现为胸痛、咳嗽、血痰。右肺 4例 ,左肺 2例。 3例肿瘤位于周边 ,3例近肺门。肿瘤直径 3～ 9cm ,平均 6 8cm。GCC的主要组织学特征是大量肿瘤性巨细胞的存在。巨细胞体积较大 ,形态各异 ,胞质丰富 ,单核或多核伴明显异型。排列疏松 ,部分区域似多形性肉瘤 ,可见巨细胞形成的腺管样结构。 2例有明显的中性粒细胞浸润。巨细胞对上皮性标记呈阳性表达。尤其是CK18,同时也高比例地表达Vim。随访 3例 ,均死亡 ,平均存活 13 3个月。结论 肺巨细胞癌具有临床及组织形态特点 ,与腺癌密切相关 。

Objective To study the clinicopathologic features of giant cell carcinoma (GCC)of the lung Methods Hemotoxylin eosin and immunohistochemical stains were used to observe the histopathologic changes of GCC,and their clinical features and follow up information were also analyzed Results The patients comprised 6 men with average ages of 63 8 years The clinical manifestations included thoracic pain,cough and hemostutum The lesions were on the right lung in 4 patients and left lung in 2 patients The tumors were located on peripheral areas in 3 cases and central areas in 3 cases The diameters of the lesions ranged from 3 to 9?cm (mean 6 8?cm) A large amount of giant cells was the prominent histologic features of GCC The giant cells had a large volume and abundant cytoplasm containing single or multiple atypical nuclei with prominent and large nucleoli The loose arrangement of giant cells and pleomorphic sarcoma like appearance may be seen in local areas The atypical tubular like structures formed by giant cells may be also found There was obvious infiltration of neutrophilic leucocytes within 2 tumors Immunohistochemical study showed the giant cells reacted with epithelial markers(especially CK18 and Vim) at a high rate Follow up information was obtained in 3 patients All of the patients died with an average survival time of 13 3 months Conclusions GCC of the lung has its special clinical and histopathologic features and is closely related to adenocarcinoma of the lung The prognosis of GCC is poorer than that of the aderocarcinoma and squamous cell carcinoma of the lung.