- 期刊
Proper Diagnostic Differentiation of Atypical Adenomatous Hyperplasia and Pulmonary Adenocarcinoma
異形腺瘤性增生與肺腺癌的迷思
摘要
異形腺瘤性增生（atypical adenomatous hyperplasia，簡稱AAH）為肺腺癌的癌前病變。真正的AAH在電腦斷層影像中多呈現小於5 mm的毛玻璃狀病灶。如使用小的肺切片檢體診斷出AAH時，需懷疑是否能代表肺病灶的全部性質。我們提出4個病例，其肺結節皆大於5 mm，經電腦斷層導引切片初步診斷為AAH，其中3個個案接受手術切除，最終診斷為具有表皮細胞生長因子接受器（epidermal growthfactor receptor）基因突變的肺腺癌。在只有小切片檢體可供病理診斷或影像高度懷疑為肺惡性腫瘤時，仔細鑑別AAH或肺腺癌是非常重要的。
並列摘要
Atypical adenomatous hyperplasia (AAH) is a precursor of lung adenocarcinoma. Pure AAH lesions often manifest as ground glass opacities on computed tomography (CT) scans, and are usually less than 5 mm in diameter. The histological diagnosis of AAH is often made with small biopsies, which raises doubts about the true nature of the whole lung lesion. We reported 4 patients presenting with a solitary pulmonary nodule greater than 5 mm in diameter and with an initial diagnosis of AAH based on CT-guided lung biopsies. Three of the patients who later received surgical resection or lung re-biopsy were ultimately diagnosed as having pulmonary adenocarcinoma. Further gene analyses revealed that all 3 patients with adenocarcinoma harbored epidermal growth factor receptor (EGFR) mutations. Differentiation between AAH and adenocarcinoma is clinically important, particularly with small biopsy specimens or when radiological images highlight the possibility of a more advanced disease status.
延伸閱讀
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