AKCİĞERİN PLEOMORFİK KARSİNOMU (OLGU SUNUMU)

Öz

Akciğerin pleomorfik karsinomu nadir görülen bir malign epitelyal tümördür. Erken evrede saptanıp rezeke edilmezse kötü prognozlu akciğer kanseri tipidir. 68 yaşında erkek olgu nefes darlığı, hemoptizi ve öksürük yakınmaları ile başvurdu. Posteroanterior akciğer grafisinde sağ hilusa süperpoze düzensiz sınırlı homojen dansite, bilgisayarlı toraks tomografisinde sağ hiler bölgede sağ pulmoner arter ve vene invaze kitle saptandı. Bronkoskopide sağ ana bronş girişinde lümeni tama yakın tıkayan vejetan tümöral lezyon görüldü. Bu bölgeden alınan biyopsi materyalinin histopatolojik ve immünhistokimyasal incelemesi pleomorfik karsinom olarak rapor edildi. Pleomorfik karsinom akciğerin nadir görülen ve kötü prognoza sahip bir tümörüdür, akciğerde kitle yapan etyolojik nedenler arasında akılda tutulmalıdır. Olgu, nadir görülmesi nedeniyle literatür eşliğinde sunuldu.

Anahtar Kelimeler

• Pleomorfik karsinom, akciğer

PLEOMORPHIC CARCINOMA OF THE LUNG (CASE REPORT)

Abstract

Pleomorphic carcinoma of the lung is a rare malignant tumour and is type of lung cancer with a poor prognosis when the tumor is not resected in early stages. A 68 years old man applied with complaints of cough, hemoptysis and breathlessness . There was irregular homogenius lesion in right hilus on posterior-anterior chest radiography and a mass lesion located in right hiler region with invasion of right pulmonary artery and vein on thorax computed tomography. In bronchoscopy, vegetan tumoral lesion that obstructs the lumen of right main bronchus was seen. Pleomorphic carcinoma was reported in histopathological and immunohistochemical examination of biopsy that was taken from this region. Pleomorphic carcinoma is a rarely seen tumor with a poor prognosis and should be thought in etiology of pulmonary masses. The case is presented with the review of literature as a rare entity.

Keywords

• Pleomorphic carcinoma, lung

Kaynakça

1. 1. Fishback NF, Travis WD, Moran C, et al. Pleomorphic (spindle/giant cell)) carcinoma of the lung. A clinicopathologic correlation of 78 cases. Cancer 1994; 73: 2936-45.
2. 2. Rossi G, Cavazza A, Sturm N, et al. Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements; A clinicopathologic and immunohistochemical study of 75 cases. Am J Surg Pathol 2003; 27: 311-24.
3. 3. Chang YL, Lee YC, Shih JY, Wu CT. Pulmonary pleomorphic (spindle) cell carcinoma: Peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma. Lung Cancer 2001; 34: 91-7.
4. 4. Raveglia F, Mezzetti M, Panigalli T, Furia S, Giuliani L, Conforti S, Meda S. Persanal experience in surgical management of pulmonary pleomorphic carcinoma. Ann Thorac Surg.2004 Nov;78(5):1742-47.
5. 5. Nappi O, Glasner SD, Swanson PE, Wick MR. Biphasic and monophasic sarcomatoid carcinomatoid carcinomas of the lung.A reappraisel of ‘carcinomas’ and ‘spindlecell carcinomas’. Am J Clin Pathol 1994; 102: 331-40.
6. 6. Nakajima M, Kasai T, Hashimoto H, Iwata Y, Manabe H. Sarcomatoid carcinoma of the lung: a clinicopathologic study of 37 cases. Cancer 1999; 86: 608-16.
7. 7. Kim TS, Hen J, Lee KS, et al. CT findings of surgically resected pleomorphic carcinoma of the lung in 30 patients. AJR 2005; 185: 120-5.
8. 8. Mehmet K, Levent Y, O¤uz A, O¤uz U, Bedri K. Akci¤erin sarkomatoid karsinomlar›: Üç olgu sunumu Türk Patoloji Dergisi 2008; 24 (1): 64-7.

9. 9. Bae HM, Min HS, Lee SH, Kim DW, Chung DH, Lee JS, Kim YW, Heo DS. Palliative chemotheraphy for pulmonary pleomorphic carcinoma. Lung Cancer 2007; 58 (1): 112-15.
10. 10. Kakegawa S, Kawashima O, Sugano M, Nagashima T, Morishita Y. Pleomorphic lung cancer; a clinicopathologic study. Kyobu Geka 2006; 59 (2): 110-3.