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首页> 外文期刊>The Internet Journal of Pulmonary Medicine >Image in Medicine: Squamous Cell Granulomas in Completely Regressed Stage IIIB Lung Cancer after Chemoradiation Therapy
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Image in Medicine: Squamous Cell Granulomas in Completely Regressed Stage IIIB Lung Cancer after Chemoradiation Therapy

机译：医学影像：化学放疗后完全退行的IIIB期肺癌的鳞状细胞肉芽肿

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A stage IIIB squamous cell carcinoma of the lung was treated with neoadjuvant chemoradiation therapy before pneumonectomy. The postsurgical specimen showed complete pathologic response with no viable tumor identified. However, extensive squamous cell granulomas were present in the previous tumor bed. Squamous cell granulomas can cause diagnostic difficulty, and have only been previously described in treated head and neck squamous carcinomas in the literature. Case Report A 52-year-old man presented with cough. CT scan revealed a right bronchial lesion, diagnosed as squamous cell carcinoma on biopsy. Exploratory thoracotomy revealed invasion into the pulmonary vein and a positive level 7 lymph node, leading to stage IIIB (T4, N2, M0). The patient underwent chemoradiation therapy with cisplatin, etoposide and 60 Gy of mediastinal radiation, followed by right pneumonectomy. Post-operative pathology revealed complete response (ypT0, N0) without residual tumor. However, numerous squamous cell granulomas were seen in the previous tumor bed, some within arterial walls suggesting previous lymphatic invasion (Fig. 1, 100x), and some within hilar lymph nodes with prominent asteroid bodies (Fig. 2, 100x; inset, 400x).
机译：在肺切除术之前，用新辅助化学放疗治疗了肺部IIIB期鳞状细胞癌。术后标本显示出完整的病理反应，未发现可生存的肿瘤。然而，在先前的肿瘤床中存在广泛的鳞状细胞肉芽肿。鳞状细胞肉芽肿可引起诊断困难，并且先前仅在文献中描述过已治疗的头颈部鳞状癌。病例报告一名52岁男子咳嗽。 CT扫描显示右支气管病变，经活检诊断为鳞状细胞癌。探查性开胸手术发现其侵入肺静脉并出现7级阳性淋巴结，从而进入IIIB期（T4，N2，M0）。该患者接受了顺铂，依托泊苷和60 Gy的纵隔放疗的化学放疗，然后进行了右肺切除术。术后病理显示完全缓解（ypT0，N0），无残留肿瘤。然而，在先前的肿瘤床中发现了许多鳞状细胞肉芽肿，有些在动脉壁内提示先前的淋巴管浸润（图1，100x），而在一些肺门淋巴结内，有明显的小行星体（图2，100x;插图，400x）。 ）。

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