肺母细胞瘤1例及文献复习
Pulmonary Blastoma: A Case Report and Literature Review
DOI: 10.12677/acm.2025.15113102, PDF,   
作者: 王 鑫：西安医学院研究生工作部，陕西 西安；李文生*：陕西省人民医院病理科，陕西 西安
关键词: 肺母细胞瘤；肺癌；肺原发肿瘤；病理诊断；Pulmonary Blastoma； Lung Cancer； Primary Pulmonary Tumor； Pathological Diagnosis
摘要: 肺母细胞瘤是一种罕见肿瘤，本文报道1例发生在成人的肺母细胞瘤；患者，男，59岁，发现右肺上叶占位性病变，就诊于我院，行CT平扫示：右肺上叶尖段见实性结节影。手术完整切除肿物送病理检查。镜下见：由低级别的胎儿型腺癌和原始间充质成分构成，伴异源性成分(软骨肉瘤)，胎儿型腺癌特点是假复层柱状细胞组成，似子宫内膜样癌，核小、均匀、圆形至椭圆形胞浆透明至轻度嗜酸性，具有核下空泡。间质成分为致密的原始卵圆型细胞，具有高的核/浆比，散布在纤维或黏液样背景之中。免疫组化染色：间质成分表达Vimentin、胎儿型腺癌成分表达CK。病理诊断：肺母细胞瘤，伴异源性成分(软骨肉瘤)。肺母细胞瘤罕见，需要提高对此病的病理形态特征认识，避免误诊、漏诊。
Abstract: Pulmonary blastoma is an extremely rare neoplasm. We present one case occurring in an adult. A 59-year-old man was found to have a space-occupying lesion in the right upper lobe and was admitted to our hospital. Contrast-enhanced CT showed a solid nodule in the apical segment of the right upper lobe. The tumor was completely resected and submitted for pathological examination. Microscopically, the lesion was composed of low-grade fetal adenocarcinoma and primitive mesenchymal components accompanied by heterologous elements (chondrosarcoma). The fetal adenocarcinoma consisted of pseudostratified columnar cells resembling endometrioid carcinoma; the nuclei were small and uniform, round to oval, with clear to lightly eosinophilic cytoplasm and subnuclear vacuoles. The mesenchymal component was formed by dense primitive ovoid cells with a high nuclear-to-cytoplasmic ratio, scattered in a fibrous or myxoid background. Immunohistochemistry showed that the mesenchymal component was positive for vimentin, whereas the fetal adenocarcinoma component was positive for CK. Pathological diagnosis: pulmonary blastoma with heterologous component (chondrosarcoma). Because pulmonary blastoma is rare, greater awareness of its pathological morphology is required to avoid misdiagnosis and missed diagnosis.
文章引用：王鑫, 李文生. 肺母细胞瘤1例及文献复习[J]. 临床医学进展, 2025, 15(11): 330-334. https://doi.org/10.12677/acm.2025.15113102

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