Multifoci of atypical adenomatous hyperplasia with multiple adenocarcinomas of the lung.
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Plain chest x-ray examination of a 61-year-old man revealed two distinct shadows in the rigth upper lung field. Sputum cytologic examination showed a large cluster of neoplastic cells which was then diagnosed as goblet cell carcinoma. The two lesions were examined separately by aspiration needle cytology. In one of the lesions clusters of atypical hyperchromatic cells with a high N/C ratio and lacy cytoplasm were detected along with necrosis, and poorly differentiated adenocarcinoma was diagnosed. The second lesion was characterized by sheets of polygonal cells and was interpreted as well differentiated adenocarcinoma. A right upper lobectomy specimen revealed three distinct discontinuous nodular lesions, each of which consisted of histologically different adenocarcinomas: goblet cell type in S<SUP>2</SUP><SUB>b</SUB> and papillary and poorly differentiated adenocarcimas in S<SUP>2</SUP><SUB>a</SUB>. Moreover, multifoci of AAH and alveolar hyperplasia were scattered in the remaining lung parenchyma. Immunoexpression of CEA, EMA and p 53 were stronger in all three neoplastic lesions than in the AAH lesions. Image analysis with CAS-200 revealed an aneuploidy pattern in all the neoplastic lesions while three of the 10 AAH lesions had the same pattern. The remaining seven AAH lesions showed a diploidy pattern. It was therefore thought that the lesions which morphologically resembled AAH might have actually included some of the neoplastically transformed lesions as well.
- 特定非営利活動法人 日本臨床細胞学会の論文
特定非営利活動法人 日本臨床細胞学会 | 論文
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