摘要

異形腺瘤性增生(atypical adenomatous hyperplasia,簡稱AAH)為肺腺癌的癌前病變。真正的AAH在電腦斷層影像中多呈現小於5 mm的毛玻璃狀病灶。如使用小的肺切片檢體診斷出AAH時,需懷疑是否能代表肺病灶的全部性質。我們提出4個病例,其肺結節皆大於5 mm,經電腦斷層導引切片初步診斷為AAH,其中3個個案接受手術切除,最終診斷為具有表皮細胞生長因子接受器(epidermal growthfactor receptor)基因突變的肺腺癌。在只有小切片檢體可供病理診斷或影像高度懷疑為肺惡性腫瘤時,仔細鑑別AAH或肺腺癌是非常重要的。
原文英語
頁(從 - 到)224-231
頁數8
期刊胸腔醫學
30
發行號4
出版狀態已發佈 - 八月 1 2015

指紋

Hyperplasia
Biopsy
Lung
Adenocarcinoma
Tomography
Solitary Pulmonary Nodule
Epidermal Growth Factor Receptor
Glass
Adenocarcinoma of lung
Mutation
Genes

引用此文

@article{1632dd2eada64745a9605f2cb23f9c0d,
title = "Proper Diagnostic Differentiation of Atypical Adenomatous Hyperplasia and Pulmonary Adenocarcinoma",
abstract = "Atypical adenomatous hyperplasia (AAH) is a precursor of lung adenocarcinoma. Pure AAH lesions often manifest as ground glass opacities on computed tomography (CT) scans, and are usually less than 5 mm in diameter. The histological diagnosis of AAH is often made with small biopsies, which raises doubts about the true nature of the whole lung lesion. We reported 4 patients presenting with a solitary pulmonary nodule greater than 5 mm in diameter and with an initial diagnosis of AAH based on CT-guided lung biopsies. Three of the patients who later received surgical resection or lung re-biopsy were ultimately diagnosed as having pulmonary adenocarcinoma. Further gene analyses revealed that all 3 patients with adenocarcinoma harbored epidermal growth factor receptor (EGFR) mutations. Differentiation between AAH and adenocarcinoma is clinically important, particularly with small biopsy specimens or when radiological images highlight the possibility of a more advanced disease status.",
keywords = "異形腺瘤性增生, 肺腺癌, 表皮細胞生長因子接受器, atypical adenomatous hyperplasia, pulmonary adenocarcinoma epidermal growth factor receptor",
author = "Lai, {Kevin S.} and Sey-En Lin and Ming-Syong Zeng and Kai-Ling Lee and Shih-Hsin Hsiao and Chi-Li Chung",
year = "2015",
month = "8",
day = "1",
language = "English",
volume = "30",
pages = "224--231",
journal = "胸腔醫學",
issn = "1023-9855",
publisher = "臺灣胸腔暨重症加護醫學會",
number = "4",

}

TY - JOUR

T1 - Proper Diagnostic Differentiation of Atypical Adenomatous Hyperplasia and Pulmonary Adenocarcinoma

AU - Lai, Kevin S.

AU - Lin, Sey-En

AU - Zeng, Ming-Syong

AU - Lee, Kai-Ling

AU - Hsiao, Shih-Hsin

AU - Chung, Chi-Li

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Atypical adenomatous hyperplasia (AAH) is a precursor of lung adenocarcinoma. Pure AAH lesions often manifest as ground glass opacities on computed tomography (CT) scans, and are usually less than 5 mm in diameter. The histological diagnosis of AAH is often made with small biopsies, which raises doubts about the true nature of the whole lung lesion. We reported 4 patients presenting with a solitary pulmonary nodule greater than 5 mm in diameter and with an initial diagnosis of AAH based on CT-guided lung biopsies. Three of the patients who later received surgical resection or lung re-biopsy were ultimately diagnosed as having pulmonary adenocarcinoma. Further gene analyses revealed that all 3 patients with adenocarcinoma harbored epidermal growth factor receptor (EGFR) mutations. Differentiation between AAH and adenocarcinoma is clinically important, particularly with small biopsy specimens or when radiological images highlight the possibility of a more advanced disease status.

AB - Atypical adenomatous hyperplasia (AAH) is a precursor of lung adenocarcinoma. Pure AAH lesions often manifest as ground glass opacities on computed tomography (CT) scans, and are usually less than 5 mm in diameter. The histological diagnosis of AAH is often made with small biopsies, which raises doubts about the true nature of the whole lung lesion. We reported 4 patients presenting with a solitary pulmonary nodule greater than 5 mm in diameter and with an initial diagnosis of AAH based on CT-guided lung biopsies. Three of the patients who later received surgical resection or lung re-biopsy were ultimately diagnosed as having pulmonary adenocarcinoma. Further gene analyses revealed that all 3 patients with adenocarcinoma harbored epidermal growth factor receptor (EGFR) mutations. Differentiation between AAH and adenocarcinoma is clinically important, particularly with small biopsy specimens or when radiological images highlight the possibility of a more advanced disease status.

KW - 異形腺瘤性增生

KW - 肺腺癌

KW - 表皮細胞生長因子接受器

KW - atypical adenomatous hyperplasia

KW - pulmonary adenocarcinoma epidermal growth factor receptor

M3 - Article

VL - 30

SP - 224

EP - 231

JO - 胸腔醫學

JF - 胸腔醫學

SN - 1023-9855

IS - 4

ER -