Pulmonary Carcinosarcoma Presenting with Hypertrophic Pulmonary Osteoarthropathy

以增生性肺骨關節病變表現的肺癌肉瘤－個案報告

許以霖(I-Lin Hsu) ； 馮瑤(Yaou Fong) ； 曾慶誠(Ching-Cherng Tzeng)

《胸腔醫學》 19卷1期 (2004/02) Pp. 25-31

摘要

肺部癌肉瘤是罕見的腫瘤，並且同時包含了表皮和間葉細胞分化的惡化細胞，它以組織和免疫組織生化病理報告來診斷。由於不完整的切片，所以極少於術前就有正確的診斷。即使大多數可以手術切除，癌肉瘤的預後仍非常差。
肺骨關節病變是包含了因對稱及增生性的骨膜炎而導致長骨和關節疼痛和腫脹的臨床症狀，有時也會伴隨杵狀指的發生。放射線的證據包括了骨膜增生和核醫骨掃瞄下?旁的增加吸收。肺部癌肉瘤最常見的症狀是咳嗽和咳血，以肺骨關節病變來表現文獻上僅在一九九一年有過一例。我們提出這個非常罕見的個案及回顧文獻來討論。

並列摘要

Pulmonary carcinosarcoma is a rare malignant tumor which exhibits both epithelial and mesenchymal elements, and is identified by its histological and immunohistochemical characteristics. Pulmonary carcinosarcomas are rarely diagnosed preoperatively because of incomplete biopsies, and although most are respectable, they have a poor prognosis. Hypertrophic pulmonary osteoarthropathy is a clinical syndrome consisting of joint and long bone pain and swelling from symmetric and proliferating distal bone periostitis. Clubbing of the fingers and toes may also be noted. Radiographically, periosteal thickening and increases in pericortical 99Tcm-MDP uptake in bone scans may be seen. Pulmonary carcinosarcomas usually present with cough and hemoptysis. A relationship between pulmonary carcinosarcoma and hypertrophic pulmonary osteoarthropathy has been described only once before, in 1991. A rare case of pulmonary carcinosarcoma presenting with hypertrophic pulmonary osteoarthropathy is reported and discussed, herein with reference to the literature.

並列關鍵字

carcinosarcoma ； hypertrophic pulmonary osteoarthropathy