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中华肺部疾病杂志(电子版) ›› 2024, Vol. 17 ›› Issue (01) : 165 -167. doi: 10.3877/cma.j.issn.1674-6902.2024.01.038

病例报告

肺尤文肉瘤并发免疫相关性肾炎救治成功一例
王霞1, 张雯1,(), 廖菲1, 高上兰1   
  1. 1. 400037 重庆,陆军(第三)军医大学第二附属医院呼吸内科
  • 收稿日期:2024-01-13 出版日期:2024-02-25
  • 通信作者: 张雯

One case of successful treatment of Ewing′s sarcoma of lung complicated with immune­related nephritis

Xia Wang, Wen Zhang(), Fei Liao   

  • Received:2024-01-13 Published:2024-02-25
  • Corresponding author: Wen Zhang
引用本文:

王霞, 张雯, 廖菲, 高上兰. 肺尤文肉瘤并发免疫相关性肾炎救治成功一例[J]. 中华肺部疾病杂志(电子版), 2024, 17(01): 165-167.

Xia Wang, Wen Zhang, Fei Liao. One case of successful treatment of Ewing′s sarcoma of lung complicated with immune­related nephritis[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(01): 165-167.

尤文肉瘤又称神经外胚层肿瘤(primitive neuroectodermal tumor, PNET),多发生于骨盆或长骨,胸壁尤文肉瘤(称为Askin-Rosai瘤)和肺尤文肉瘤十分罕见。尤文肉瘤形态学和免疫组化结果多与小细胞肺癌(small cell lung cancer, SCLC)相似,因此常被误诊。明确诊断后往往治疗效果不佳,预后差。本文报道了1例青年男性的肺尤文肉瘤患者,最初被误诊为SCLC;再次活检通过第二代测序(next general sequence, NGS)检出EWSR1-FLI1融合,从而确立PNET的诊断。患者在化疗联合免疫治疗过程中出现了免疫相关性肾炎,救治过程,报道如下。

图1 患者肺癌CT影像图。注:A:肺部CT肺窗左上肺类圆形肿块影、可见浅分叶及毛刺;B:肺部CT平扫纵隔窗左上肺类圆形软组织肿块影、密度较均匀;C:肺部CT增强动脉期纵隔窗左上肺肿块中度不均匀强化;D:肺部CT肺窗治疗后左上肺肿块明显缩小
图2 患者组织病理图及免疫组化。注:小圆细胞弥漫分布,瘤细胞大小一致,呈圆形或多角形,胞浆少,细胞核呈圆形或卵圆形,大小比较一致,核深染,染色质均匀。A:CD99+;B:SYN+;C:FLI-1+;D:HE×10;E:HE×10-2;F:HE×20;G:NKX2.2+;H:SYN+
1
熊 震,阳光辉,史海广,等. 胸腔原发骨外尤文肉瘤二例[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(1): 121-123.
2
Antonescu C.Round cell sarcomas beyond ewing: Emerging entities[J]. Histopathology, 2014, 64(1): 26-37.
3
Fletcher CDM, Bridge JA, Hogendoorn PCW, et al. WHO classification of tumours of soft tissue and bone[J]. Geneva: World Health Organization.
4
Buffoni I, Nuri H, Pome G, et al. Pediatric extraskeletal Ewing sarcoma originating in the Heart: A case report and review of the literature[J]. J Pediatr Hematol Oncol, 2021, 3(4): 147-151.
5
Ma Z, Brimo F, Zeizafoun N. Primary Ewing′s sarcoma/primitive neuroectodermal tumor (ES/PNET) of the penis: a report of an extraordinarily unusual site and a literature review of extraskeletal Ewing′s sarcoma[J]. Int J Surg Pathol, 2013, 21(1):63-67.
6
He Y, Sun N, Zhang W, et al. Ewing sarcoma/primitiveneuro-ectodermal tumor of the urogenital system in children: A retrospective observational Case series[J]. J Pediatr Urol, 2019, 15(5): 556.e1-556.
7
Zhang J, Dong A, Cui Y, et al. FDG PET/CT in a case of primary pulmonary Ewing sarcoma[J]. Clin Nucl Med, 2019, 44(8): 666-668.
8
Lee SY, Lim S, Cho DH. Personalized genomic analysis based on circulating tumor cells of extra-skeletal Ewing sarcoma of the uterus: A case report of a 16-year-old Korean female[J]. Exp Ther Med, 2018, 16(2): 1343-1349.
9
Salama H, Abu-Hilal LH, Idkedek M, et al. Primary extraskeletal intradural Ewing sarcoma with acute hemorrhage: a case report and review of the literature[J]. J Med Case Rep, 2024, 18(1): 144.
10
Mankin HJ, Hornicek FJ, Temple HT, et al. Malignant tumors of the pelvis: an outcome study[J]. Clin Orthop Relat Res, 2004, (425): 212-217.
11
Zheng C, Zhou Y, Luo Y, et al. Case report: Primary Ewing sarcoma of the penis with multiple metastases[J]. Front Pediatr, 2021, 8: 591257.
12
Caner O, Taner A, Altan Y, et al. Primary Ewing′s sarcoma of the paranasal sinus with intracranial and intraorbital extension[J]. Eur J Radiology Extra, 2005, 55: 47-50.
13
Firas N, Moustafa A, Ousama A, et al. Ewing′s Sarcoma of the maxillary sinus[J]. Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2015, 16: 177-180.
14
Raney RB, Asmar L, Newton WA Jr, et al. Ewing′s sarcoma of soft tissues in childhood: a report from the Intergroup Rhabdomyosarcoma Study, 1972 to 1991[J]. J Clin Oncol1997, 15(2): 574-582.
15
Le Deley MC, Paulussen M, Lewis I, et al. Cyclophosphamide compared with ifosfamide in consolidation treatment of standard-risk Ewing sarcoma: Results of the randomized noninferiority Euro-EWING99-R1 trial[J]. J Clin Oncol, 2014, 32: 2440-2448.
16
Kathryn I, Pontius MD, Bruce A, et al. Extraskeletal Ewing′s sarcoma arising in the Nasal Fossa: Light-and electron-microscopic observations[J]. Am J Clin Pathol, 1981, 75(3): 410-415.
17
Davide L, Davide M, Luca O, et al. Primary Ewing′s sarcoma of the sinonasal tract in adults: A challenging disease[J]. Head & Neck, 2017, 39(3): E45-E50.
18
Uzuki T, Yasumatsu R, Nakashima T, et al. Primary Ewing′s sarcoma of the sinonasal tract: A case report[J]. Case Rep Oncol, 2017, 10(1): 91-97.
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