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頁籤選單縮合
題名 | Breast Metastasis from Pulmonary Adenocarcinoma=肺腺癌轉移至乳房 |
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作者 | 王鼎堯; 陳秉聰; 陳苡揚; 李錦輝; 官鋒澤; 黃慈恩; 李冠德; 陳志丞; 呂長賢; | 書刊名 | 臺灣癌症醫學雜誌 |
卷期 | 29:3 2013.09[民102.09] |
頁次 | 頁141-149 |
分類號 | 415.468 |
關鍵詞 | 肺腺癌; 乳房轉移; 免疫組織化學染色; 鑑別診斷; Metastatic lung adenocarcinoma; Breast metastasis; Immnunohistochemical staining; Differential diagnosis; |
語文 | 英文(English) |
中文摘要 | 一名 52 歲的台灣女性罹患轉移性肺腺癌患者,在接受酪胺酸激酶抑制劑(tyrosine kinase inhibitors, TKI)治療六個月後,發現右側乳房出現持續變大的硬塊。該乳房硬塊經 切片病理檢查顯示為侵襲性癌,而免疫組織化學(immunohistochemistry, IHC)染色結果 顯示:甲狀腺轉錄因子-1(thyroid transcription factor-1, TTF-1),細胞角蛋白 7(Cytokeratin 7, CK7),napsin A(Nap-A),雌激素受體(estrogen receptor, ER)為陽性反應;黃體素受 體(progesterone receptor , PR)和 HER2/neu 則為陰性。單從組織學上來分別腫瘤是肺腺癌轉移至乳房或是次發性的乳癌相當的困難,IHC 標記常被利用來分辨腫瘤的原發部位。 不論是乳癌具有 TTF-1 和 Nap-A 的表現或是乳房以外的癌症轉移至乳房,兩種情形在臨 床上都相當的罕見。我們回顧過去的文獻中相關於這兩種罕見的情況,並以此病例探討 IHC 標記在分辨轉移性肺腺癌和原發性乳癌的角色。根據臨床表現及免疫組織化學染色 的結果,我們診斷此病例為肺腺癌之乳房轉移,並依此提出了下一步的治療計劃。 |
英文摘要 | A 52-year-old Taiwanese woman presented with a progressively enlarged right breast mass after 6 months of tyrosine kinase inhibitor (TKI) treatment for metastatic lung adenocarcinoma. A core needle biopsy of the breast lesion revealed invasive carcinoma with positive immunohistochemical (IHC) staining for thyroid transcription factor-1 (TTF-1), cytokeratin 7 (CK7), napsin A (Nap-A), estrogen receptor (ER), and a negative result for progesterone receptor (PR) and HER2/neu. It is difficult to distinguish the histology between metastatic lung adenocarcinoma and metachronous breast cancer. However, IHC markers can help to differentiate the site of origin. A primary breast cancer with expression of TTF-1 and Nap-A is uncommon, and metastasis to the breast is a rare clinical manifestation. We reviewed the literature for both of these rare conditions, and discussed the utility of IHC markers to distinguish lung metastasis from primary breast cancer in this case. We ultimately diagnosed that this female patient had lung adenocarcinoma with breast metastasis, and a further treatment plan was devised. |
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