Pseudomezoteliomatozni karcinom pluća

  • Jelena Milivoje Vukovic Clinic for Pulmology Military Medical Academy, Belgrade, Serbia
  • Goran Plavec Clinic for Pulmology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Slobodan Aćimović Clinic for Pulmology, Military Medical Academy, Belgrade, Serbia
  • Milena Jović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Marko Stojsavljević Clinic for Pulmology, Military Medical Academy, Belgrade, Serbia
  • Jovana Trimčev Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Sanja Nikolajević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Vesna Skuletić Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia; †Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Olivera Lončarević Clinic for Pulmology Military Medical Academy, Belgrade, Serbia
  • Vladan Živković Clinic for Pulmology Military Medical Academy, Belgrade, Serbia
  • Lidija Zolotarevska Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Snežana Cerović Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP150811138V
Ključne reči: lung neoplasms||, ||pluća, neoplazme, adenocarcinoma||, ||adenokarcinom, diagnosis||, ||dijagnoza, diagnosis differentiall||, ||diferencijalna, mesothelioma, malignant||, ||mesoteliom, maligni, prognosis||, ||prognoza, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Pseudomezoteliomatozni karcinom pluća je poseban, redak entitet koji se karakteriše obimnim pleuralnim rastom i manjim zahvatanjem plućnog parenhima. Klinički, radiološki, makroskopski, pa i histološki ovaj tumor može biti pogrešno dijagnostikovan kao maligni mezoteliom pleure. Prikaz bolesnika. U radu je prikazan bolesnik, star 64 godine, bivši pušač. Zbog tegoba u vidu suvog kašlja, osećaja nelagodnosti i bolova u desnoj polovini grudnog koša, malaksalosti, otežanog disanja, pojačanog znojenja, povišene telesne temperature i do 39,6°C lečen je kombinovanom antibiotskom terapijom (makrolidima, cefalosporinima i penicilinom) bez poboljšanja. Na radiografiji grudnog koša uočena je senka pleuralnog izliva do visine prednjeg okrajka trećeg rebra sa desne strane. Multislajsni skener (MSCT) grudnog koša pokazao je izrazito zadebljalu pleuru apikalno i posteriorno uz gornji desni režanj, uz postojanje masivnog pleuralnog izliva. U gornjem desnom režnju opisana je subpleuralna kondenzacija parenhima promera oko 30 mm. Citološkom analizom pleuralnog izliva viđene su maligne ćelije za koje nije bilo moguće odrediti da li se radi o metastazi adenokarcinoma ili malignom mezoteliomu pleure. Histohemijskom i imunohistohemijskom analizom uzorka plućne maramice utvrđeno je postojanje pseudomezoteliomatoznog adenokarcinoma pluća. Zaključak. Pseudomezoteliomatozni karcinom pluća može da predstavlja dijagnostički problem. Njegova dijagnoza bazira se na prepoznavanju patohistoloških karakteristika koje omogućavaju njegovo razlikovanje od epitelne varijante malignog mezotelioma pleure.

 

Biografija autora

Jelena Milivoje Vukovic, Clinic for Pulmology Military Medical Academy, Belgrade, Serbia
Clinic for Pulmology

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Objavljeno
2017/03/14
Broj časopisa
Vol. 73 Br. 12 (2016)
Rubrika
Prikaz bolesnika