- 期刊
A Very Rare Case of Combined Pleomorphic Carcinoma and Small Cell Lung Carcinoma: A Case Report
多型性細胞與小細胞混合肺癌：一個病例報告
摘要
肺癌是癌症死亡的最大主因。多型性細胞癌是一種分化不良的非小細胞癌、混有至少十分之一以上的惡性梭狀細胞和／或巨型細胞。它是一種罕見腫瘤、發生率僅占所有肺腫瘤的0.1～0.3%。混合多型性細胞與小細胞肺癌更為罕見、且比單純小細胞肺癌有更差的預後。一位七十六歲抽菸男性主訴胸痛而且胸部放射線圖像顯示左胸有多葉性腫塊。胸腔電腦斷層發現左下肺有9.7×8.7 cm大小的軟組織腫塊。胸腔手術病理分析顯示是混合多型性細胞與小細胞癌、含有梭形細胞（85%）、鱗狀扁平細胞（10%）與小細胞癌（5%）。病患於兩個月後因敗血症與多器官衰竭而死亡。病患因身體狀況不佳未給予化學藥物治療。吾人於此報告此一罕見與預後不佳的混合多種型態細胞與小細胞肺癌病例。因其具侵犯性佳且不易正確診斷，因此值得注意。
並列摘要
Lung cancer is the most common cause of cancer mortality worldwide. Pleomorphic carcinoma, defined as a poorly differentiated, non-small cell carcinoma, admixed with at least 10% malignant spindle cells and/or giant cells, is a rare tumor with an incidence rate of 0.1-0.3% of all lung tumors. Combined small cell lung carcinoma (SCLC) is also an unusual tumor with a poor prognosis than pure SCLC. A 76-year-old male, a smoker, complained of chest pain and chest X-ray revealed a large lobulated mass in the left lower lung field. Chest computed tomography mainly revealed a 9.7 x 8.7 cm soft tissue mass in the left lower lung. The pathological result of a sample retrieved by thoracotomy revealed combined pleomorphic carcinoma and small cell carcinoma, composed of spindle cell carcinoma (85%), squamous cell carcinoma (10%) and small cell carcinoma (5%). Two months later, the patient died of septic shock with multiple-organ failure without receiving chemotherapy, due to the poor performance status. We reported a relatively rare case of combined pleomorphic carcinoma and SCLC with a poor prognosis. Due to its aggressive behavior and the difficulty of reaching an accurate diagnosis, physicians should be aware of this kind of combined lung cancer, though it is rare.
延伸閱讀
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