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| 名称： | |
| 描述： | |
- 食管癌肺部转移？
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| 姓 名： | ××× | 性别： | 男 | 年龄： | 65 |
| 标本名称： | 送检楔形切除肺组织一块及一段食管 | ||||
| 简要病史： | CT示左肺占位，食管占位（间质瘤？）。 | ||||
| 肉眼检查： | 食管一段，粘膜面见一隆起，粘膜灰白灰红光滑，粘膜下见一肿物，切面积：4.5×2厘米，灰白淡黄色，侵达外膜。肺组织切面见一肿物，灰白灰黑色，质硬，与周围界不清。 | ||||
请教：两者图像相似，只是食管细胞较之肺部更小，食管旁淋巴结有转移，如何诊断？食管小细胞癌左肺转移？？还是不典型类癌？？（以下为食管肿物）
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xianyuanqq82 离线
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| 以下是引用谈东风在2010-4-28 23:56:00的发言：
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It is a very good case presentation. I agree with all differential diagnosis discussed.
My impression is High-grade Neuroendocrine Carcinoma.
Morphologically and immunohistochemically, it is difficult to tell the primary site (lung or esophagus), since the above IHC stains have no differential power (non-pulmonary neuroendocrine carcinoma can be positive for TTF-1). 1) Surfactant stain may offer some help. 2) radiological images are important: any hilar adenopathy of the lung? any direct relationship/invasion of these two masses. 3) as described, there were esophageal lymph node metastasis, may suggest an esphageal primary, if 1) and 2) are supportive.
