[Clinicopathological and immunohistochemical features of pulmonary blastoma: analysis of 4 cases and review of the literature].
OBJECTIVE
To analyze the clinicopathological and immunohistochemical features of pulmonary blastoma (PB).


METHODS
Four patients with PB, 1 male and 3 females, with the onset age of 2 months approximately 80 years, underwent resection of the tumor and were followed up for 32 months at most. The clinical data were analyzed retrospectively.


RESULTS
Pathology showed that the 4 cases all suffered from epithelial type PB. Under microscope, epithelial cells were atypical, mostly in mitogenic phase, and were lined up as many dense tubes. All of the patients underwent surgical resection and 3 - 5 cycles of chemotherapy and one had radiotherapy following surgery. The survival time was 5 - 32 months. One of the four patients died during follow-up due to metastasis 5 months after operation. The other patients still survived. Immunohistochemistry showed that cytokeratin and thyroid transcription factor-1 were positive, and vimentin, epithelial membrane antigen, and S-100 protein were negative in the tumor tissues; and a part of tumor cell presented positive Cg-A.


CONCLUSIONS
PB is rare and presents different clinical features. It is difficult to determine the diagnosis before operation. The modular structures and expression of neuroendocrine markers are helpful in differentiating epithelial type PB from usual adenocarcinoma in immunohistochemical staining.
Department of Thoracic Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China.
Guo-qing
GQ
Zhang
Xin-zhi
XZ
Fang
Bo-qing
BQ
Wang
Wei
W
Sun
A Dili
AD
Salai
D000328:Adult; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D009687:Nuclear Proteins / Q000032:analysis; D018202:Pulmonary Blastoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors / Q000032:analysis
C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors; D007633:Keratins