Hepatoid Adenocarcinoma Of The Lung: A Case Report

摘要

A case of a 71-year-old man with dyspnea attacks, weight loss and astheno-adynamia syndrome is presented. A 7.7 x 6.4 cm well-delineated tumor is found intraoperatively in the superior lobe of the left lung towards the posterior mediastinum. The tumor cells resemble hepatocytes histologically and show expression for alpha-fetoprotein. Diagnosis primary hepatoid lung adenocarcinoma is made. Pericellular basal membrane-like material is found on electron microscopy. A clinico-morphological discussion regarding the biological behavior and prognosis of this rare tumor is presented. Introduction Hepatoid adenocarcinoma is a morphological diagnosis of a tumor that “has histological characteristics of liver tissue and produces alpha-fetoprotein (AFP)” introduced by Ishikura et al. in 1985 (1). These tumors affect organs developing from the primitive foregut (2,3,4,5). Hepatoid lung adenocarcinomas (HLA) are extremely rare. Only 10 cases of such localization have been described in literature (6,7,16). Due to the rarity of the tumor the last is not familiar to the surgical pathologists and any new case contributes to clarification of its complete clinico-morphological description, biological behavior and prognosis. We present a case of primary lung carcinoma with morphological, immunohistochemical and ultrastructural characteristics of hepatoid adenocarcinoma. Case Report A 71-year-old man presented with a nine-month history of dyspnea, weight loss and astheno-adynamia syndrome. The CT scan revealed a 7.7 x 6.4 cm tumor formation in the superior lobe of the left lung without communication with the aorta (figure 1). During the operation a well-delineated lobulated tumor mass that did not invade the adjacent lung tissue was found posteriorly in the superior lobe of the left lung bordering the vertebral column. The tumor showed expansive growth and had pseudocapsule. It was firm and gray-whitish in color. The trachea was displaced to the opposite side and forward.