Mucinous Bronchioloalveolar Carcinoma: A Case Report and Literature Review for Immunohistochemical Evaluation and Prognosis

黏液型細支氣管肺泡癌－病例報告與免疫組織化學染色的評估及預後之文獻回顧

陳崇裕(Chung-Yu Chen) ； 張逸良(Yih-Leong Chang) ； 陳冠宇(Kuan-Yu Chen) ； 李元麒(Yung-Chie Lee) ； 楊泮池(Pan-Chyr Yang)

《胸腔醫學》 22卷2期 (2007/04) Pp. 98-105

https://doi.org/10.29806/TM.200704.0004

摘要

黏液型細支氣管肺泡癌是肺線癌中一種少見的組織型態。不同的臨床症狀、放射線表現與不同類型細支氣管肺泡癌的病理發現都和病人的存活率有密切的關係。黏液型細支氣管肺泡癌在組織型態上與其他肺部原發的黏液型腫瘤和轉移的黏液型腺癌極為相似。目前常用的免疫組織化學染色法中，Thyroid Transcription Factor (TTF-1)，Cytokeration(CK)7和CK20可以用來幫助區別原發性肺腺癌或轉移性腺癌。所以經由免疫組織化學的研究來對肺腺癌加以分類，可以幫助我們建立診斷及預後的推測。我們報告一個68歲的女性黏液型細支氣管肺泡癌患者，一開始是在胸部X片上右下肺葉的地方發現一個塊狀的陰影。她順利地接受了右下肺葉切除術與淋巴腺切除，在我們的門診追蹤至今並沒有發現腫瘤復發的情形。我們回顧了有關黏液型細支氣管肺泡癌免疫組織化學染色的研究與預後相關之文獻報告。

關鍵字

細支氣管肺泡癌 ； 免疫組織化學染色 ； 甲狀腺轉錄因子1 ； 細胞角質蛋白

並列摘要

Mucinous bronchioloalveolar carcinoma (BAC) is an uncommon histologic type of lung adenocarcinoma. The various clinical, radiographic and pathologic findings of different subtypes of BAC are correlated with survival. The mucinous type of BAC histologically mimics other primary mucin-producing adenocarcinomas of the lung and metastatic mucinous adenocarcinomas. Commonly-used immunohistochemical markers, such as thyroid transcription factor-1 (TTF-1), cytokeratin (CK) 7 and CK20 are helpful in distinguishing between primary pulmonary adenocarcinoma and metastatic adenocarcinoma. Therefore, subclassification of lung adenocarcinoma by immunohistochemical evaluation will probably help in establishing diagnoses and predicting survival. We report a 68-year-old female patient with mucinous BAC that initially manifested as a focal opacity in the right lower lobe on chest radiography. Right lower lobe lobectomy and lymph node dissection were performed. The post-operation course was smooth, and she has been followed at our clinic without recurrence, as of this writing. The literature concerning immunohistochemical studies and prognosis are reviewed.

並列關鍵字

bronchioloalveolar carcinoma ； immunohistochemistry ； cytokeratins ； thyroid transcription factor