Primary Lymphoepithelioma-Like Carcinoma of the Lung Associated With Hypertrophic Osteoarthropathy: A Case Report

肺原發淋巴上皮瘤樣癌合併肥大性骨關節病變之一病例報告

王傳生(Chuan-Sheng Wang) ； 蔡坤寶(Kun-Bow Tsai) ； 蔡忠榮(Jong-Rung Tsai) ； 許超群(Chau-Chyun Sheu) ； 洪仁宇(Jen-Yu Hung) ； 許德宏(Te-Hung Hsu) ； 黃明賢(Ming-Shyan Huang)

《胸腔醫學》 18卷5期 (2003/10) Pp. 455-460

https://doi.org/10.29806/TM.200310.0011

摘要

肺原發淋巴上皮瘤樣癌是一個EB病毒相關的未分化癌，它占肺癌的極少部分，只有一些病例曾見諸於文獻。在此我們報告一位42歲男性病患主訴雙側膝部，肘部及腕部紅腫疼痛合併手指及腳指杵狀變形而住進我們醫院治療。胸部X光及胸部電腦斷層掃瞄發現在右上肺部中有一顆軟組織腫瘤，關節及長骨的X光和99mTc MDP骨骼掃描攝影顯示肥大性骨關節病變。他接受肺原發病變區域的外科切除手術，根據組織特徵及原位染交EBER-1陽性訊號，確定診斷為肺淋巴上皮瘤樣癌。在手術之後，他繼之接受輔助性化學藥物及放射治療，九個月後的追蹤檢查顯示這位病人並無關節症狀，而且沒有復發或轉移的證據。

關鍵字

肺原發淋巴上皮瘤樣癌 ； 肥大性骨關節病變

並列摘要

Lymphoepithelioma-like carcinoma of the lung, an Epstein-Barr virus (EBV) –associated undifferentiated carcinoma, is a rare entity of pulmonary malignancy, and only a few cases have been reported in the literature. Herein, we report a 42-year-old man who was admitted to our hospital with the chief complaint of symmetrical pain, swelling, and hyperemia of the knees, elbows, and wrists, associated with clubbing of the toes and fingers. The chest roentgenogram and computed tomography (CT) of the thorax revealed a soft tissue mass in the upper lobe of the right lung. Radiographs of the joints and long bones and a 99mTc MDP whole body bone scan revealed hypertrophic osteoarthropathy. The patient underwent surgical resection of the primary pulmonary lesion. From the histological characteristics and positive signals for EBV-encoded RNA-1(EBER-1) found by in situ hybridization, the diagnosis of lymphoepithelioma-like carcinoma of the lung was made. After the operation, he received adjuvant chemotherapy and radiotherapy. A follow-up examination nine months later showed the patient to be free of joint symptoms and without evidence of relapse or metastasis.

並列關鍵字

Primary lymphoepithelioma-like carcinoma of the lung ； LELC ； hypertrophic osteoarthropathy ； HOA