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1.
Presented herein is a case of combined small cell and squamous cell carcinoma in a polypoid bronchial tumor, showing a histologically unique progression, in a 76-year-old Japanese man. A bronchofiberscopic examination revealed that the bronchus (left B3) was occluded by the polypoid tumor. Biopsies were performed, and the pathological diagnosis was poorly differentiated squamous cell carcinoma. The patient consequently underwent a left upper lung lobectomy. The surgical specimen was described as a 24 x 8 x 8 mm soft tumor, emanating from the bronchial wall (left B3). Histologically, the tumor had two distinct components: (i) nearly the entire tumor was composed of atypical small round cells, with a high nuclear-cytoplasmic ratio, in the lamina propria, under the basement membrane; and (ii) the surface of the tumor was composed of poorly differentiated squamous cell carcinoma that had proliferated primarily above the basement membrane but there was also some proliferation, seen as island-like formations, below the basement membrane. The histological diagnosis was combined small cell and squamous cell carcinoma. It was suspected that poorly differentiated squamous cell carcinoma, generated in the bronchial epithelium, had caused small cell carcinoma resulting from neuroendocrine differentiation during its invasion into the lamina propria.  相似文献   

2.
The first case of mucosal spreading adenocarcinoma at the hilum of the lung is presented. The patient was a 72 year old Japanese male smoker. The carcinoma was located at the right main bronchus with involvement of the apical, posterior and anterior segmental bronchi. The tumor consisted of stratified oval or polygonal cells and signet ring cells spreading along the bronchial mucosa in an in situ fashion with extension down the bronchial gland ducts and acini. Only a small micro-invasive focus not extending beyond the bronchial cartilage was seen. Immunohistochemically, the tumor was positive for lysozyme but negative for lactoferrin and PE-10 indicating that this tumor was possibly showing goblet cell differentiation.  相似文献   

3.
We present a case of a 48 year old man who complained of progressive dyspnoea. Radiograph revealed a large tumor in the left lung. Biopsy was performed and revealed beneath a normal bronchial epithelium polymorph tumor cells admixed with some histiocytes. These tumor cells were strongly pigmented and expressed HMB-45 and protein S-100 immunohistochemically. Malignant melanoma of the bronchus was included in the differential diagnosis. A thoracotomy and left lower lobe resection was performed. Histology revealed an angiomyolipoma. The lung is an uncommon localisation of angiomyolipoma with so far three reported cases. Lipoma, leiomyoma and lymphangioleiomyomatosis have to be included in the differential diagnosis. The peculiarity of this case is the presence of multiple pigmented tumor cells that express HMB-45. This has not been reported yet.  相似文献   

4.
In the lung, acinic cell carcinoma (ACC) is a rare form of tumor. Reported herein is a unique bronchial gland-type tumor diagnosed as well-differentiated ACC that developed in the B9 bronchus of the left lung. Various immunohistochemical and histochemical staining partly satisfied the diagnosis of ACC. Moreover, this tumor contained various sizes of mucous cysts lined by columnar mucous cells, which produced abundant mucin positive for Alcian blue, which is usually present in mucoepidermoid carcinoma. Therefore, the present case is a unique tumor having a broad spectrum of cell differentiation from the terminal duct--acinar unit to the striated duct and excretory duct. This is the first case of unique bronchial gland-type tumor with mixed histological features of ACC and mucoepidermoid carcinoma.  相似文献   

5.
A case of bronchial plasmacytoma occurring in a 57- year-old housewife is reported. She had had the productive cough and the "abnormal shadow" in the right lower lobe for three years before admission. On bronchocopy, a tumor was found in the right main bronchus, large enough to obstruct the air way. The tumor was resected through rigid bronchoscope. Histological impression was "plasmacytoma with local amyloid deposit." M-protein was never detected in the serum or urine. Applying the immunoperoxidase technique for the paraffin section, the plasma cells were found to contain only a single type of immunoglobulin, Ig G-L. The differential diagnosis between plasmacytoma and plasma cell granuloma was made, and plasmacytoma was considered to be one type of extranodal malignant lymphoma.  相似文献   

6.
Two cases with complete bronchial stenosis of the mainstem bronchus secondary to thoracic blunt trauma are presented. One patient had hemoneumothorax on the left side, the other one had bilateral hemothorax. Both were initially treated with drainage by thoracostomy tube with partial resolution of the thoracic bloody pleural collection. Later, the two patients developed complete atelectasis of the lung, one on the left side and the other one in the right; this later case was subject to lung decortication. The fiberopticbronchoscopy showed a complete occlusion of the mainstem bronchus in both patients. A bronchoplasty with sleeve resection of the stenotic segment was performed; the lumen of the bronchus was preserved by an end-to-end suture with separate stitchs of Vycryl 0000. Both cases remain without bronchopulmonary pathology after 4 years of follow-up of bronchoplasty. In cases of blunt thoracic trauma, it is important to consider the possibility of bronchial rupture. The importance of bronchoscopic diagnosis and surgical treatment is stressed.  相似文献   

7.
Primary lung tumors mimicking the salivary gland-type neoplasms are extremely rare. These types of tumors originate from submucosal bronchial glands. Epithelial-myoepithelial carcinoma is an uncommon tumor in this group, and only 7 cases have been reported. It is considered to be a low-grade malignant neoplasm. We report a case of epithelial-myoepithelial carcinoma of bronchial gland origin in a 73-year-old man who presented with coughing and dyspnea. The bronchus of the left lower lobe contained a tumor mass that had a polypoid growth pattern. The tumor also extended into the pulmonary parenchyma, forming a well-circumscribed mass with a pushing margin. The tumor consisted of epithelial and myoepithelial cells. The epithelial cells were positive for cytokeratins and epithelial membrane antigen, while the myoepithelial cells were positive for S100 protein and muscle-specific actin. According to these findings, we diagnosed epithelial-myoepithelial carcinoma. After undergoing pneumonectomy, the patient has been disease free for 34 months.  相似文献   

8.
肺内支气管动脉分布的应用解剖   总被引:1,自引:0,他引:1  
目的:为选择性支气管动脉造影提供解剖学依据。方法:选用40例肺血管灌注标本和8例肺腐蚀铸型标本进行观测。结果:40侧成人肺标本中.共有59支支气管动脉,左肺l~3支.右肺为1-2支。支气管动脉分为3型.左肺2支型最多.右肺1支型最多。肺门支气管动脉平均外径.右肺1支型口径显著大于2支型.左肺各型口径无显著性差别。支气管动脉进入肺门后,一支动脉分布到几个肺叶者:左侧占72.7%,右侧占92.3%.专入某一肺叶者:左侧占27.3%,右侧占7.7%。肺叶支气管动脉和肺段支气管动脉均以2支最常见。结论:对于肺内支气管动脉的去向应引起重视。  相似文献   

9.
Epithelial-myoepithelial tumors of the lung are rare neoplasms whose biological behavior and clinical course still remain to be defined. A case of epithelial-myoepithelial tumor of the lung arising from bronchial mucosa-submucosa and occurring as a polypoid lesion of the upper left bronchus in a 47-year-old man is reported. The tumor did not infiltrate the cartilaginous wall of the bronchus and showed a biphasic histological appearance with a double layering of epithelial and myoepithelial cells. Myoepithelial spindle cells with eosinophilic cytoplasm were also observed. Mitotic figures were very rare and necrosis absent. Immunohistochemical study for epithelial and muscular markers confirmed the presence of a double-cell component in the tumor, namely epithelial and myoepithelial. The patient is alive and well, with no evidence of recurrent or metastatic disease 6 months after surgery. On the basis of the present case and the six previously reported cases, we suggest using the noncommittal term pulmonary epithelial-myoepithelial tumor of unproven malignant potential (PEMTUMP) for this type of neoplasm. In addition, we first introduce p63 as a novel marker for highlighting the myoepithelial cells of the respiratory tract and speculate on the role of these cells in the development of this unusual tumor.  相似文献   

10.
Primary mixed carcinomas of the bronchus are found to occur more frequently than previously reported. Forty-two cases of primary mixed carcinomas of the bronchus were seen at the London Chest Hospital from 1966 to 1969. During this time, 3853 patients were admitted to the hospital and among them 733 had bronchial carcinomas. In 27 instances, the tumour histologically was squamous and adenocarcinomatous in type. Of the other 15; squamous and oat cell characters, and undifferentiated carcinoma of large polygonal cell and adenocarcinomatous characters were present in five instances; adenocarcinoma and oat cell, and undifferentiated carcinoma of large polygonal cell and oat cell characters were present in two instances; and only one had mixed alveolar and oat cell carcinomatous pattern. A study of the pathological changes in these mixed bronchial carcinomas revealed little differences, if any, from a primary bronchial carcinoma.
The histogenesis of these mixed carcinomas remains uncertain. The most plausible view is that they arise by divergent differentiation from the descendants of the original multipotent cancer cells. ACTA PATH. JAP. 22:555–564, 1972.  相似文献   

11.
On review of 115 poorly or undifferentiated lung cancers from 671 lung tumors resected over a 7-year period, we have found 38 cases of basaloid carcinoma. The cardinal histopathologic features distinguishing this tumor from other non-small cell lung cancers are a lobular growth pattern of small cells with moderately hyperchromatic nuclei, with no prominent nucleoli, and with scant cytoplasm, a high mitotic rate, and peripheral palisading. Basaloid carcinoma was present in a pure form in 19 cases and the other 19 tumors were of a mixed, but prominent, basaloid type associated with squamous cell carcinoma, large cell carcinoma, or adenocarcinoma. The immunophenotype of basaloid cancers was close to that of basal bronchial epithelial cells, with a low level of expression of low molecular weight cytokeratins. Staining for neuroendocrine markers was infrequent and inconsistent. Ultrastructural study showed an absence of neurosecretory granules and the presence of some squamous and/or glandular differentiation. This morphologic and immunologic phenotype suggests that basaloid carcinoma is derived from a pluripotent reserve cell or a basal bronchial epithelial stem cell. This unique histologic form of lung tumor has a poor prognosis, with a median survival rate of 22 months for stage I and II disease. This justifies classification of basaloid carcinoma as a distinct form of lung cancer, separate from small cell lung carcinoma.  相似文献   

12.
We have used in situ hybridization for RNA to localize cells containing mRNA for the 92 kd gelatinase in carcinomas of the lung. We used archival material to analyze sections from 12 cases of squamous cell carcinomas of the lung including six stage I and three stage II and from three cases of adenocarcinoma of the lung. Presence of mRNA in the tissue was verified by in situ hybridization for gamma actin. The 92 kd gelatinase mRNA was found in all 12 squamous cell carcinomas tumors and was highly expressed in the tumor cells themselves. In addition, it was found in host stromal cells surrounding the tumor, but not in normal lung fibroblasts. In contrast it was not found in the adenocarcinomas of the lung or in the stroma surrounding these tumors. The mRNA for the 92 kd gelatinase was present in normal pulmonary tissue, bronchial epithelium, basal cell hyperplasia of bronchial epithelium, alveolar macrophages, and focally in bronchial mucous glands. It was not present in normal alveoli, vascular cells, cartilage, or most lymphocytes. We corroborated the presence of the mRNA for the 92 kd gelatinase by ribonuclease protection assay. The levels of mRNA for the 92 kd gelatinase in two specimens of squamous cell carcinoma were 6- to 10-fold greater than in the nonneoplastic tissue and two adenocarcinoma specimens.  相似文献   

13.
A man with high urinary levels of 5-hydroxyindole acetic acid had an oat cell carcinoma of the bronchus. The patient had symptoms of the carcinoid syndrome and at autopsy was found to have evidence of carcinoid heart disease. This report supports the hypothesis that bronchial carcinoids and oat cell carcinomas are derived from argentaffin (Kulchitsky)-type cells of the lung.  相似文献   

14.
目的 探讨呼吸运动对中央气道径线值的影响及其临床意义。方法 2016年3—7月郑州大学第一附属医院放射介入科招募60名健康成人志愿者进行前瞻性研究。其中男32例,女28例,年龄25~54(34.0±9.1)岁。志愿者均行胸部多层螺旋CT(MSCT)检查,于深吸气末、深呼气末分别扫描全肺,薄层图像结合多平面重建技术(MPR),使用特殊纵隔窗(窗宽500 HU,窗位-100 HU) 在吸气末、呼气末时测量中央气道横截面积,计算塌陷指数,测量左主支气管-右主支气管夹角(隆突角,∠C)、右上叶-中间支气管夹角(∠RI)、右中叶-右下叶支气管夹角(∠RMI)及左上叶-左下叶支气管夹角(∠LUI),并观察吸气末、呼气末时中央气道的形态改变。结果 深呼气末,中央气道横截面积均少于吸气末相,差异均有统计学意义(P值均<0.01)。气管塌陷指数为19.7%±8.6%;右主支气管、中间支气管、右上叶支气管、右中叶支气管和右下叶支气管塌陷指数分别为21.4%±9.6%、14.7%±6.2%、15.5%±5.7%、10.1%±3.6%、24.5%±9.1%;左主支气管、左上叶支气管、左下叶支气管塌陷指数分别为24.0%±9.4%、15.1%±5.0%、27.6%±10.7%。左侧中央气道中,各级支气管塌陷指数比较,差异有统计学意义(F=32.696, P<0.05);其中左主支气管、左下叶支气管的塌陷指数较大,与左上叶支气管塌陷指数比较,差异均有统计学意义(P值均<0.05)。右侧中央气道中,各级支气管塌陷指数比较,差异有统计学意义(F=38.154, P<0.05);其中右主支气管、右下叶支气管的塌陷指数较大,分别与右上叶支气管、中间支气管、右中叶支气管塌陷指数比较,差异均有统计学意义(P值均<0.05)。呼气末与吸气末时比较,∠C增大,∠RI、∠RMI、∠LUI均减小,差异均有统计学意义(P值均<0.01),其中∠LUI吸气-呼气差值最大。深吸气末时,中央气道的轴位横断面多为类圆形或卵圆形。深呼气末时,气管85%(51/60)、左主支气管70%(42/60)、右主支气管82%(49/60)呈后膜变平或轻度前弓形态。叶支气管断面形态改变不明显。结论 MSCT为观察和测量中央气道径线的有效手段,根据不同呼吸时相的气管及各级支气管的横截面积和夹角变化程度不同,有利于指导临床选择合适型号的气道支架,也有助于探讨和研发更具有生理适应性的气道支架。  相似文献   

15.
The authors report a case of primary bronchial malignant melanoma, occurring in a 34-year-old woman presenting with persistent cough. At bronchoscopic examination, a polypoid mass was found to occlude the left mainstem bronchus. Biopsies showed a malignant epithelioid tumor resembling an atypical carcinoid. Histochemistry, electron microscopic study, and immunohistochemistry confirmed the diagnosis of melanoma. Physical examination and additional clinical history to exclude other possible primary sites were negative. The patient underwent thoracotomy with left pneumonectomy. Nineteen months after resection she was found to have a histologically similar tumor involving her left adrenal gland. Review of the literature shows that melanoma of the lower respiratory tract has been reported only in adults and has a tendency to present as a central polypoid growth that may be responsive to surgical resection.  相似文献   

16.
Glycodelin (Gd), which is localized in cells of bronchial epithelium, type II pneumocytes and alveolar macrophages in rats and humans, plays an important role in the pulmonary immune response in asthmatic inflammation. In this study, sections of paraffin-embedded tumor adjacent lung tissue and sections of adenocarcinoma of the lung, squamous cell carcinoma of the lung and metastases of colonic adenocarcinoma were investigated for the distribution and expression of Gd using a polyclonal anti-Gd antibody. Glycodelin protein is located in the cytoplasm of bronchial epithelial cells, pneumocytes and alveolar macrophages. Furthermore, Gd is expressed in adenocarcinoma and squamous cell carcinoma of the lung as well as in lung metastases of colonic adenocarcinoma. Densitometric analyses showed a significantly increased expression of glycodelin protein in cancer tissue compared to tumor adjacent lung tissue. The Gd protein level was 1.7–2.6-fold increased in lung carcinoma compared to tumor adjacent lung tissue. The Gd protein level did not differ from each other between the investigated types of cancer tissue. Because these data validate the recent findings of Gd mRNA expression, it may be concluded that glycodelin plays an important role in the pathogenesis of lung cancer and lung metastases.  相似文献   

17.
18.
To contribute to the phylogenetic evaluation of the river dolphin, the morphology of the tracheobronchial tree of the Ganges river dolphin was analyzed according to Nakakuki's fundamental bronchial tree model of mammals. In the right lung, the bronchial tree consists of the tracheal bronchus, five lateral series bronchi, three dorsal series bronchi and one ventral series bronchus. In the left lung, it consists of five lateral series bronchi, four dorsal series bronchi and one ventral series bronchus. In the Ganges river dolphin, the tracheal bronchus corresponds to type III of Nakakuki's nomenclature. This characteristic is of especial interest in light of the fact that the Ganges river dolphin has a forestomach as do Artiodactyla.  相似文献   

19.
20.
Salivary gland-type carcinomas of the lung are rare but well-known tumors. Among them, acinic cell carcinoma (ACC) is extremely rare and its cytological features have not been reported. We present a case of bronchial ACC and describe its cytological characteristics. The tumor occurred in a 58-yr-old man as a 15-mm polypoid lesion at the right middle lobar bronchus and filled its lumen. Transbronchial brush cytology and a biopsy failed to collect tumor cells but transbronchial fine-needle aspiration (FNA) cytology was successful. The smear obtained was richly cellular and a large number of thick-layered or monolayered sheet-like tumor cell clusters and dissociated tumor cells were observed. Cribriform globular spaces were common and a lobulated acinar structure was found focally. The tumor cells had a fine granular large polygonal cytoplasm and rather uniform round or ovoid nuclei. The nuclei were situated eccentrically or centrally and the nuclear/cytoplasmic ratio was consistently low. These cytological features were essentially similar to those of ACC of the head and neck region. The patient underwent a lobectomy and the tumor was resected completely. Transbronchial FNA cytology was useful for diagnosing bronchial ACC and differentiating it from other conventional and salivary gland type carcinomas.  相似文献   

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