- 期刊
Small Cell Carcinoma Involving the Esophagus and Stomach: Report of a Case
侵犯食道及胃之小細胞癌：一病例報告
摘要
一位七十歲男性病人因上腹痛、體重減輕、胃口不佳及間歇性鮮黑便，歷經一個月後就診。住院後一系列檢查發現一腫瘤侵犯食道下端及胃上部合併遠處頸部淋巴結轉移，內視鏡下作病理切片檢查證實為小細胞癌。因腫瘤持續出血伴有阻塞現象。於是病人接受緩解性手術治療，術後身體狀況持續惡化而無法接受化學治療，於住院兩個月後死亡。總括而言，食道及胃小細胞癌為少見之惡性腫瘤。其臨床症狀及內視鏡或上消化道系列攝影的表現與其他的食道及胃腫瘤相當類似，所以要確立診斷須靠組織病理學檢查；在光學顯微鏡下呈現成群細小圓形癌細胞伴有濃染的細胞核及稀少的細胞質，核分裂亦常見。在電子顯微鏡下；有些可在細胞質內發現神經分泌顆粒。同時特殊的免疫組織化學染色對診斷亦有相當大的幫助。關於其細胞起源，一般認為乃源自一種全能性基源細胞；具有高度分化性而容易轉變成其他的鱗狀細胞、腺癌細胞或神經分泌細胞。用在肺小細胞癌之化學治療亦常被使用在食道及胃小細胞癌上；但是一旦診斷確立時，多已見淋巴結及其他器官之轉移，所以預後極差。
並列摘要
A 70-year-old man experienced dull epigastralgia, body weight loss, poor appetite and intermittent melena for one month. Serial work-up showed a tumor occupying the distal esophagus, cardia, fundus, and upper body of the stomach with distant neck lymphadenopathy. Endoscopic biopsy revealed a small cell carcinoma which was confirmed by immunohistochemical stain. The patient underwent palliative surgery. Chemotherapy was precluded by the patient's deteriorating general condition. He died two months after admission. Small cell carcinoma involving the esophagus and stomach is unusual. This neoplasm shows an aggresive nature with rapid distant metastasis, similar to pulmonary small cell carcinoma and may be treated with chemotherapy.