自然生长十年的细支气管肺泡细胞癌一例并文献复习

目的 提高对细支气管肺泡细胞癌(BAC)临床及影像学特点的认识.方法 分析2009年7月收治的1例BAC患者的临床资料及诊治经过,并结合相关文献进行复习.截至2010年6月,以bronchioloalveolar carcinoma、ground glass opacity、high resolution computed tomography为检索词,在PubMed检索系统进行检索,在万方数据库以细支气管肺泡细胞癌、磨玻璃影为检索词进行检索.结果 患者男,76岁,常规体检时胸部CT示左肺上叶小片状高密度影,但无特殊临床表现.随访10年,至2009年复查胸部CT示左肺上叶病灶密度稍有增加.考虑恶性肿瘤不能除外,在全身麻醉下行左上肺叶切除术加纵隔淋巴结清扫术,术后病理报告:左上肺BAC.在PubMed检索系统检索到35篇文献.共报道664例磨玻璃影表现的BAC,其中4篇为综述,24篇为回顾性分析,7篇为个案报道;在万方数据库检索到1篇回顾性分析,报道24例以磨玻璃影为表现的BAC.结论 影像学表现为磨玻璃影的BAC,其临床表现缺乏特异性,仅胸部CT表现为小片状高密度影.对于此类患者应定期随访,如提示恶变的可能,应及时进行手术治疗.

Report of a case of bronchioloalveolar carcinoma with natural growth for 10 years and review of the literature

Objective To better understand the clinical and imaging characteristics of bronchioloalveolar carcinoma(BAC).Methods A case diagnosed with BAC with a natural history for 10 years was reported and the related literature was reviewed. We searched literatures in PubMed with “bronchioloalveolar carcinoma”,“ground glass opacity”,“ high resolution computed tomography” as the search term,in WANFANG MED ONLINE with “bronchioloalveolar carcinoma”,“ ground glass opacity” as the search term by June 2010.Results The clinical and imaging characteristics of BAC were variable.A case of BAC in a 76 year old asymptomatic man was reported.He presented with a small ‘ flake like' density shadow in the left upper lobe which gradually increased in density over a 10 year follow-up.Subsequent upper lobectomy and mediastinal node dissection confirmed BAC.We received 35 literatures reported 664 cases of ground-glass performance BAC,including reviews of 4,retrospective analysis of 24,reported case of 7 in PubMed. We received a retrospective analysis reported 24 cases in WANFANG MED ONLINE.Conclusions Patients presenting with ground glass opacities on chest CT with no specific clinical manifestations should alert the clinicians to the possibility of BAC.Regular follow-up with CT scans is needed and surgical resection should be considered if BAC is suspected.