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題名 | Primary Pulmonary Lymphoepithelioma-like Carcinoma--Experience with Five Cases at MacKay Memorial Hospital=原發性類淋巴上皮細胞肺癌--五個馬偕醫院案例經驗 |
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作者 | 鍾心珮; 彭明仁; 張惟鈞; 陳培然; 吳健樑; 林榮祿; | 書刊名 | 胸腔醫學 |
卷期 | 30:3 2015.06[民104.06] |
頁次 | 頁171-177 |
分類號 | 415.468 |
關鍵詞 | 原發性類淋巴上皮細胞肺癌; EB病毒; Lymphoepithelioma-like carcinoma; Epstein-Barr virus; |
語文 | 英文(English) |
中文摘要 | 原發性類淋巴上皮細胞肺癌屬於一種非常罕見的非小細胞肺癌,且大部分發生在南亞地區。Begin 在1987 年首次發表這種疾病,原發性類淋巴上皮細胞肺癌與鼻咽癌有相似的病理特徵,且在亞洲地區是和EB 病毒的感染相關。 從1991 年1 月至2013 年 12 月期間,馬偕醫院總共診斷 5 個原發性類淋巴上皮細胞肺癌的個案。其中3 名個案沒有症狀為影像學上的意外發現,其中4 名為非吸菸者,沒有個案診斷時為晚期肺癌(2 名個案是IA 期、2 名為IIA 期、1 名為IIIA 期)。典型的電腦斷層影像為單個大小不一、靠近中央的腫瘤;而典型的病理表現為層狀生長的腫瘤細胞,外圍環繞淋巴漿細胞,其中4 名個案的病理檢體的EB 病毒染色呈陽性反應。5 名個案皆對於多種治療效果良好,在追蹤10 到93 個月後無惡化。 原發性類淋巴上皮細胞肺癌大部分發生在無症狀、較年輕的非吸菸者,且無性別相關性。這個疾病和EB 病毒有關聯性,且與分化不全型鼻咽癌在臨床上和生物特性上相類似。案例皆診斷於早期、可手術切除,且對於化學或放射治療反應良好。 |
英文摘要 | Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non small-cell lung cancer (NSCLC) and is mostly reported in Southeast Asia. It was first reported by Begin in 1987; it has pathological features similar to nasopharyngeal carcinoma and was associated with Epstein-Barr virus infections in Asia. We reported 5 cases of primary pulmonary LELC from Jan 1991 to Dec 2013, 3 of them were incidentally found as asymptomatic tumors or nodules on chest radiographs. Four patients were non-smokers and none of them was diagnosed as having advanced disease (2 stage IA, 2 stage IIA, 1 stage IIIA, respectively). The typical CT radiographs show single, centrally located tumors of various sizes. The typical pathologic features revealed sheet growth of tumor cells surrounded by lymphoplasmacytic cells; 4 of the specimens were positive for EBV stain. The 5 patients responded well to multi-modality treatment without progression during a follow-up of 10 to 93 months. Primary pulmonary LELC often affects asymptomatic and younger non-smokers without gender predilection. Patients diagnosed with early, resectable disease respond well to chemotherapy or radiotherapy. |
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