Primary signet ring cell adenocarcinomas of the lung: a clinicopathological study of 15 cases
Primary signet ring cell adenocarcinomas of the lung: a clinicopathological study of 15 cases
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DOI：
10.1046/j.1365-2559.2001.01224.x
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发表时间：
2001-10-01
期刊：
影响因子：
6.4
通讯作者：
Suster, S
中科院分区：
文献类型：
--
作者：
Castro, CY;Moran, CA;Suster, S
目的：描述15例原发性印戒细胞腺癌的临床病理特征，并强调认识到不是所有具有印戒细胞特征的腺癌都代表转移性腺癌的重要性。方法和结果：我们分析了15例印戒细胞腺癌的临床病理和免疫组织化学特征。男12例，女3例，年龄30~75岁，平均52.5岁。在彻底的临床检查中，没有发现其他地方有原发肿瘤的证据。9名患者接受了切除，其余患者接受了活组织检查。肿瘤最大径18~80 mm。显微镜下看。我们发现了两种不同的生长模式：腺泡型和弥漫型。肿瘤的特征是>；75%的印戒细胞存在。高碘酸席夫和粘液碱染色呈胞内强阳性。免疫组织化学TTF-1(6/6)和CEA(9/9)均呈强阳性反应。6例肿瘤中3例同时表达细胞角蛋白7。所有肿瘤(6/6)均为阴性表达。11例患者获得随访资料，6例患者在确诊后1年内死亡，5例患者在确诊后3~36个月内存活。结论：这些病例突出了一种不寻常的组织学生长模式，可能被误认为是来自隐匿性原发癌的转移。对这种类型的肺癌的认识对于正确的治疗是很重要的。
Aims: We describe the clinicopathological characteristics of 15 cases of primary signet ring cell adenocarcinoma of the lung and highlight the importance of recognizing that not all adenocarcinomas with signet ring cell features represent metastatic adenocarcinomas.Methods and results: We evaluated the clinicopathological and immunohistochemical features of 15 cases of signet ring cell adenocarcinoma of the lung. The patients were 12 men and three women, age 30-75 years (mean 52.5 years). No evidence of a primary tumour elsewhere could be found on thorough clinical examination. Nine patients underwent resection and the remainder were biopsied. The tumours ranged from 18 to 80 mm in greatest dimension. Microscopically. two distinct patterns of growth were recognized: acinar and diffuse. The tumours were characterized by the presence of >75% signet ring cells. Periodic acid-Schiff and mucicarmine showed strong intracellular positive staining. Immunohistochemical stains for TTF-1 (6/6) and CEA (9/9) showed strong positive reaction in all cases evaluated. Three out of six cases were also positive for cytokeratin 7. All the tumours (6/6) were negative for cytokeratin 20, ER, PR and GCDFP-15. Follow-up information was obtained in 11 patients; six patients died within 1 year and five patients were alive from 3 to 36 months after initial diagnosis.Conclusion: These cases highlight an unusual histological growth pattern of primary lung adenocarcinoma that may be mistaken for a metastasis from an occult primary. The recognition of this pattern of lung tumours is important for proper treatment.