Metastatic angiosarcoma of the lung with alveolar hemorrhage
Metastatic angiosarcoma of the lung with alveolar hemorrhage
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DOI：
10.1007/s11604-009-0352-1
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发表时间：
2009-11-01
影响因子：
2.1
通讯作者：
Nakano, Takashi
中科院分区：
文献类型：
--
作者：
Saitoh, Jun-ichi;Sakurai, Hideyuki;Nakano, Takashi
本文报告一例肺转移性血管肉瘤合并肺泡出血的病例。一名76岁妇女被诊断为IIb期宫颈癌。放射治疗后癌症消失了。五年后，由于右髋关节周围剧烈疼痛，她再次入院。X线片显示右侧股骨颈骨折。胸部CT和X线片上，双侧肺野周围可见边缘不清的斑点状或网状阴影。病变位于胸膜下，可见磨玻璃样阴影和小叶间壁增厚等间质阴影。这些病变在1-2周的病程中迅速加重。她在短期住院(2个月)后死于病理性骨折。尸检发现肿瘤转移至骨、肺、心脏等器官，主要为血源性转移。未发现子宫颈癌复发。肿瘤细胞呈多形性或卵圆形，散在分布或呈生长形成的小集合体。免疫组织化学染色CD31、CD34、因子阳性，诊断为上皮样血管肉瘤。肺部的主要表现是肿瘤栓塞术后的肺泡内出血。
A case of metastatic angiosarcoma of the lung with alveolar hemorrhage was experienced. A 76-year-old woman was diagnosed as stage IIb uterine cervical cancer. The cancer disappeared after radiotherapy. Five years later, she was readmitted because of severe pain around the right hip joint. Fracture of the neck of the right femur was found on roentgenogram. On chest CT and roentgenogram, spotted or restiform shadows with uncertain margins were found in the peripheral regions of the bilateral lung field. The lesions reached just underneath the pleura, and interstitial shadows such as ground-glass-like shadows and thickening of the interlobular walls were also found. These lesions were rapidly aggravated in the course of 1-2 weeks. She died after a short period of hospitalization (2 months) with pathological fracture. In autopsy, metastases of the tumor were found to bones, lungs, heart, and other organs that mainly occurred hematogenously. No recurrence of the uterine cervical cancer was detected. Tumor cells were polymorphic or ovoid, and occurred scattered individually or showed growth-forming small aggregates. By immunohistochemical staining, CD31, CD34 and Factor VIII were found to be positive, and the tumor was diagnosed as epithelioid angiosarcoma. The main findings in the lungs were intraalveolar hemorrhage consequent to tumor embolization.