论文部分内容阅读
目的探讨以骨髓浸润为首发表现的胸腺神经内分泌癌临床表现及病理特征。方法回顾性分析1例以骨髓浸润为首发表现的胸腺神经内分泌癌患者临床资料及诊治经过。结果男性患者骨髓象示原始幼稚细胞占83%,骨髓活检倾向胸腺神经内分泌癌骨髓侵犯,胸部增强CT见前纵隔巨大软组织肿块影,免疫组化考虑为小细胞型胸腺神经内分泌癌。患者经过3次住院EP方案(依托泊苷+顺铂)化疗顺利。复查骨髓象粒细胞系明显增生,复查胸部CT见前纵隔巨大软组织肿块影,约3.2cm×2.8cm,较化疗前明显缩小。患者转胸外科行手术治疗,术后病理示(前纵隔)小细胞恶性肿瘤,结合病史符合小细胞型胸腺神经内分泌癌。结论胸腺神经内分泌癌以肿瘤转移为首发症状罕见,无特异性,诊断需依赖组织病理学检查。
Objective To investigate the clinical manifestations and pathological features of thymic neuroendocrine carcinoma with bone marrow infiltration as the first manifestation. Methods A retrospective analysis of 1 case of bone marrow infiltration as the first manifestation of thymic neuroendocrine cancer in patients with clinical data and diagnosis and treatment after. Results The bone marrow of the male patients showed 83% of naive cells, bone marrow biopsy tended to have bone marrow invasion of thymic neuroendocrine carcinoma, chest enhanced CT showed anterior mediastinal massive soft tissue mass, and immunohistochemistry was considered as small cell type thymus neuroendocrine carcinoma. Patients after 3 hospitalized EP regimen (etoposide + cisplatin) chemotherapy smoothly. Review bone marrow granulosa cell line significantly hyperplasia, chest CT review of the anterior mediastinal huge soft tissue mass, about 3.2cm × 2.8cm, significantly reduced compared with before chemotherapy. Surgery in patients with thoracic surgery, postoperative pathology (anterior mediastinum) of small cell malignancies, combined with history of small cell thymic neuroendocrine cancer. Conclusions Thymic neuroendocrine carcinoma is rare with tumor metastasis as its first symptom, so its diagnosis depends on histopathology.