The diagnosis of pulmonary blastoma

By | March 28, 2012

Pulmonary blastoma (pulmonary blastoma) is common with adult biphasic differentiation of lung cancer. Primitive epithelial component that contains the same time, leaves with the original Q matrix components, may be associated with multifocal osteosarcoma, chondrosarcoma or rhabdomyosarcoma with sarcoma. More common in adults, over 80% of patients have a long history of smoking.
The diagnosis of pulmonary blastoma (1) Clinical cases: pulmonary blastoma nearly half of the patients may be asymptomatic, individual patients for up to 6 years duration. Common symptoms are cough, chest pain, bloody sputum, oxygen, weight loss, fever and pleural effusion. Preoperative bronchoscopy and fine needle aspiration diagnosis rate of 1 / 3. Treatment is surgical excision, supplemented by chemotherapy. Poor prognosis. Prognosis was associated with clinical stage.
The diagnosis of pulmonary blastoma (2) pathological features: section swelling, soft, white, fish-like, if hemorrhage and necrosis, pale red, pale yellow, cystic change may occur. Microscope: biphasic tumor differentiation, with the original epithelial mesenchymal components and original. The original formation of branching tubular epithelial components, there is no cilia, similar to the fetal lung tubules. Duct covered single or columnar epithelium; cytoplasm translucent; nucleus or nucleation of small deeply stained. On the nuclei and (or) Nucleation of glycogen vacuoles, morphologically similar to endometrial glands. But the ingredients can be in solid epithelial cord, color ribbon, epithelial nests or small inflorescences were shaped basal cell-like groups like glands, and a small amount of liquid found in the gland. Sang occasionally or even seen the body structure.
Pulmonary blastoma another part of the embryo or primitive mesenchymal tissue. By the small round, oval or spindle cells, stromal teach fluid change. Mesenchymal tissue in the original, showing focal differentiation and maturation of rhabdomyosarcoma, osteosarcoma or chondrosarcoma, and liposarcoma, the other main component of fibrosarcoma.
Pulmonary blastoma occurred in slightly more than the right lung left lung, upper lobe more than the lower lobe. Divided into the hilar type and peripheral type, which is more common. Large tumor volume, the average diameter of more than 5cm; without capsule. If it occurs in the peripheral lung, was isolated mass; if occurred in the hilar and tracheal polypoid protrusions.
The diagnosis of pulmonary blastoma (3) immunohistochemistry: pulmonary blastoma immunohistochemical expression colorful. Of epithelial (eg, CK, CEA), epithelial gland showed diffuse positive tube; primitive mesenchymal cells less CK. The surfactant protein A Park Sang is very glandular epithelium and form of body cells. Su Ming tablets addicted to A (CgA) and 64% of NSE positive in the glands, mulberry and even 72% of the body; vimentin, muscle specific actin (MS-actin) and the binding protein of mesenchymal fine. Such as tumor differentiation to striated muscle and cartilage, can be expressed myoglobin and S-100.
The diagnosis of pulmonary blastoma (4) electron microscopy: differentiation of tumor tissue also showed biphasic characteristics.
The diagnosis of pulmonary blastoma (5) diagnosis of pulmonary blastoma under: adults smoked; in lung cancer; microscope with a typical biphasic differentiation.

Leave a Reply

Your email address will not be published. Required fields are marked *