「胎児肺型肺腺癌」外科切除 6 症例の臨床病理学的検討

概要

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This is a report of six patients with pulmonary adenocarcinoma of the fetal lung type characterized by clear cytoplasm with much glycogen and no sarcomatous features, unlike pulmonary blastoma. Five were males with a history of heavy smoking. All lesions were located in the periphery of the right lung, and most of them appeared as coin-like shadows on chest X-ray films. Preoperative cytological examinations often showed malignancy, but the histological type was misdiagnosed in most cases. Lobectomy was performed in five patients and pneumonectomy in one. Five tumors were stage I, and one was stage IIIA. Two patients died of tumor recurrence and one of pneumonia three are alive without recurrence. Interestingly, in the patients with tumor recurrence, there were histological features of an admixture with fetal lung type adenocarcinoma and other histological types, such as the usual type of adenocarcinoma or small cell carcinoma. These results suggest that radical operation should be performed in ptatients with pulmonary adenocarcinoma of the fetal lung type, taking clinicopathological features into account, although the "pure" fetal lung type has a good prognosis.
特定非営利活動法人日本呼吸器外科学会の論文