原发性肺黏液表皮样癌1例报告并文献复习

目的 提高对原发性肺黏液表皮样癌的认识.方法 结合1例原发性黏液表皮样癌患者的临床资料,搜集13篇国内文献的199例患者的临床资料以及复习国内外相关文献,分析、归纳该病的临床表现、影像学特点、病理学特征、诊断及鉴别诊断、治疗及预后.结果 原发性肺黏液表皮样癌的临床症状为咳嗽、咳痰、胸闷、胸痛,但症状缺乏特异性.胸片常显示出肺不张或肺炎,CT主要表现为光滑分叶状或息肉状肿块伴远端支气管黏液嵌塞和肺不张.病理学检查主要特征是可见不同比例的黏液分泌细胞、鳞状表皮样细胞以及中间型细胞组成,未见角化.治疗首选手术,放、化疗治疗效果目前没有得到肯定.预后相较于传统的非小细胞肺癌更好.结论 原发性肺黏液表皮样癌罕见,容易误诊,应充分认识该病的有关特点,提高疗效,改善预后.

Primary mucoepidermoid carcinoma of lung: one case report and literature review

Objective To improve the understanding of primary mucoepidermoid carcinoma of lung.Methods Based on the clinical data of one patient with primary mucoepidermoid carcinoma,we collected the clinical data of 199 cases from 13 articles in China and reviewed the related domestic and foreign literatures.The etiology,clinical manifestations,radiological features,pathological characteristics,diagnosis,differential diagnosis,treatment and prognosis were analyzed and summarized.Results The etiology of primary mucoepidermoid carcinoma of lung was not clear,and the clinical symptoms of the disease included cough,expectoration,chest tightness and chest pain.However,these symptoms were unspecific.It was shown as atelectasis or pneumonia in chest X-ray.It was demonstrated as smooth and lobulated mass or polypoid mass with distal bronchial mucoid impaction and distal atelectasis.It was characterized by pathology as varying proportions of mucus-secreting,squamous (epidermoid) and intermediate cells,without keratinization.The primary choice of treatment for the disease was surgery,and the effects of radiotherapy and chemotherapy were not confirmed yet.The prognosis was better than the ordinary non-small cell lung cancer.Conclusions Primary mucoepidermoid carcinoma of lung is rare and easy to be misdiagnosed.It is necessary to further study the characteristics of the disease so as to improve curative effect and prognosis.