以异常阴道出血为首发症状的肺腺癌子宫内膜转移一例并文献复习

doi:10.12280/gjfckx.20230725

摘要/Abstract

摘要：

原发性支气管肺癌简称肺癌，是世界各国发病率和死亡率较高的恶性肿瘤之一。近年来，女性肺癌发病率升高且多为肺腺癌。因肺癌早期症状隐匿，发现时常伴有转移。报道1例肺腺癌子宫内膜转移病例，该患者因异常阴道出血就诊，诊刮术后病理提示腺癌。结合免疫组织化学检查和影像学检查，排除其他部位肿瘤来源可能后，确诊为肺腺癌转移至子宫内膜。肺癌转移至子宫内膜极其罕见，极可能被漏诊、误诊。回顾性分析该病例资料并复习相关文献，以期提高临床对肺腺癌子宫内膜转移的警惕。

关键词: 肺腺癌, 子宫内膜肿瘤, 肿瘤转移, 诊断, 免疫组织化学, 病例报告

Abstract:

Primary bronchial lung cancer, commonly known as lung cancer, is one of the malignant tumors with high morbidity and mortality in the world. In recent years, the incidence of lung cancer in women has increased, and most of them are lung adenocarcinoma. Because the early symptoms of lung cancer are occult, it is often detected when metastasis has already occurred. We report a case of endometrial metastasis of lung adenocarcinoma. The patient presented with abnormal vaginal bleeding, and the pathology after curettage indicated adenocarcinoma. After immunohistochemical examination and imaging examination were combined to exclude the possibility of tumor origin in other sites, the diagnosis was confirmed as lung adenocarcinoma metastasis to the endometrium. Metastasis of lung cancer to the endometrium is extremely rare and is likely to be missed or misdiagnosed. In this paper, the data of a case of endometrial metastasis of lung adenocarcinoma were retrospectively analyzed and the relevant literatures were reviewed in order to enhance the clinical vigilance of endometrial metastasis of lung adenocarcinoma.

Key words: Adenocarcinoma of lung, Endometrial neoplasms, Neoplasm metastasis, Diagnosis, Immunohistochemistry, Case reports

陈彦熹, 刘卉, 蒋鹏程. 以异常阴道出血为首发症状的肺腺癌子宫内膜转移一例并文献复习[J]. 国际妇产科学杂志, 2024, 51(1): 74-77.

CHEN Yan-xi, LIU Hui, JIANG Peng-cheng. Endometrial Metastasis of Lung Adenocarcinoma with Abnormal Vaginal Bleeding as the First Symptom: A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2024, 51(1): 74-77.

图/表 3

图1 门诊诊断性刮宫后组织病理图（HE染色×100）注：标尺=200 μm。

图2 2021年5月31日肺癌免疫组织化学检查图（TTF-1染色×100）注：标尺=200 μm。

图3 肺部及子宫部分PET/CT图注：A为右肺上叶尖段见一软组织密度肿块，内见空洞，边缘可见浅分叶及段毛刺影，约3.0 cm×2.6 cm；伴糖代谢异常增高，SUVmax=14.14。B为子宫稍增大，腔内见片状不规则糖代谢异常增高灶，SUVmax=11.26，CT未见明显异常密度影；双侧附件区未见明显异常密度影和糖代谢异常增高灶。

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