Protein induced by vitamin K absence or antagonist II (PIVKA-II) producing large cell neuroendocrine carcinoma (LCNEC) of lung with multiple liver metastases: A case report
Protein induced by vitamin K absence or antagonist II (PIVKA-II) producing large cell neuroendocrine carcinoma (LCNEC) of lung with multiple liver metastases: A case report
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DOI：
10.1111/pin.12499
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发表时间：
2017-02-01
影响因子：
2.2
通讯作者：
Ito, Masahiro
中科院分区：
文献类型：
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作者：
Kurohama, Hirokazu;Mihara, Yumi;Ito, Masahiro
一名78岁男性因肺部和肝脏多发肿瘤入院。最初的临床诊断为肝细胞癌 (HCC) 并伴有肺转移，因为缺乏维生素 K 或拮抗剂 II (PIVKA-II) (6,705mAU/mL) 导致血清蛋白升高。然而，对之前的 CT 检查显示，肺肿瘤在检测到肝肿瘤之前 6 个月就已存在。肿瘤进展迅速，患者入院37天后死亡。尸检显示，肺和肝肿瘤均表现出大细胞神经内分泌癌（LCNEC）的组织学特征。免疫组织化学显示肿瘤细胞不仅广泛表达神经内分泌标志物，还广泛表达PIVKA-II。未检测到肝样分化。背景肝脏未显示任何慢性肝病。最终诊断为产生 PIVKA-II 的肺部 LCNEC，并伴有多发性肝转移。除 HCC 之外，产生 PIVKA-II 的肿瘤极为罕见。据我们所知，这是首例 PIVKA-II 产生肺部神经内分泌肿瘤的病例报告。
A 78-year-old man was admitted to our hospital for multiple lung and liver tumors. Initial clinical diagnosis was hepatocellular carcinoma (HCC) with lung metastases because of a high value of serum protein induced by vitamin K absence or antagonist II (PIVKA-II) (6,705mAU/mL). However, a review of a prior CT showed the lung tumor had existed 6 months before liver tumors were detected. The tumors progressed rapidly and the patient died 37 days after admission. Autopsy revealed that both lung and liver tumors exhibited the histology of large cell neuroendocrine carcinoma (LCNEC). Immunohistochemistry revealed that the tumor cells expressed not only neuroendocrine markers but also PIVKA-II diffusely. Hepatoid differentiation was not detected. Background liver did not show any chronic liver disease. The final diagnosis was PIVKA-II producing LCNEC of the lung with multiple liver metastases. PIVKA-II producing tumors other than HCC are extremely rare. To our best knowledge, this is the first case report of PIVKA-II producing neuroendocrine tumors of the lung.