支气管转移癌的内镜下表现和病理诊断

The fiberoptic bronchoscopy characteristics and pathological diagnosis of endotracheal-endobronchial metastases cancer

摘要:

目的 探讨气管支气管转移癌（EEM）的纤维支气管镜下特点及病理诊断，提高临床医师对EEM的认识及诊断水平。方法 回顾性研究该院收治的经支气管镜、组织病理学及免疫组织化学检查确诊的10例EEM的临床资料，包括原发肿瘤的来源、临床、影像及纤维支气管镜下特点，探讨EEM诊断方法。结果 EEM从确诊原发肿瘤至确诊EEM的时间为1～15年，其临床、影像表现均与原发性支气管肺癌相似，其支气管镜下的表现呈多样性，随原发肿瘤的不同而不同，但其又有不同于原发性中央型支气管肺癌的镜下特点。10例有4例是通过常规病理诊断的，其他6例都是进一步通过免疫组织化学检查而确诊的。结论 EEM的确诊有赖于支气管镜检查和组织病理及免疫组织化学检查。

Abstract:

【Objective】 To investigate the endotracheal-endobronchial metastases (EEM) under fiberoptic bronchoscopy characteristics and pathological diagnosis, and to improve the understanding, diagnosis of the EEM. 【Methods】 Retrospective and follow-up analyses were conducted for 10 cases of bronchoscopically, histopathologically and immunohistologically confirmed EEM. The original tumor, clinical characteristics, imaging and the characteristics of fiberoptic bronchoscopy were examined. 【Results】 The time span between diagnosis of the primary lesion and EEM was 1~15 years. The clinical symptoms and imaging features of EEM was similar to the primary bronchogenic carcinoma. The presentations of EEM under the fiberoptic bronchoscopy were polymorphic, and differed with the primary tumor. 4 of the 10 cases were diagnosed by routine pathological, the other 6 cases were confirmed by further immunohistochemical examination. 【Conclusion】 The diagnosis of EEM depends on the fiberoptic bronchoscopy , histopathology and the immunohistology.