Background: The pathogenesis of a ciliated muconodular papillary tumor (CMPT) of the lung is extremely rare which is difficult to distinguish from other lung lesions and it is easy to cause misdiagnosis and missed diagnosis. By collecting CMPT data, its clinical and pathological features can provide medical treatment ideas for the majority of medical workers and reduce medical errors.
Methods: The clinical data, pathological features, immunophenotype of a typical CMPT patient and related literature were analyzed.
Results: The chest computed tomography (CT) showed there was a mixed density nodule in the right lower lung near the pleura with a diameter of about 9 mm. We performed a wedge resection on the patient. The pathological results showed that the nodule was composed of proliferated ciliated cells, mucous cells, and basal-like cells. The ciliated cells were lined on the surface of papillary structures. The basal-like cells were located in the outer layer, while the mucous cells were located between the two. The cell atypia was not obvious. Immunohistochemistry: epithelial cells CEA (+), CK7 (+), CA125 (+), weakly positive for TTF-1, CK20 (-), Ki67 (1%+), CK5/6 (+), and basal cells P63 (+).
Conclusions: CMPT is a rare pulmonary neoplasm. There is no definite conclusion about its biologic nature, but most experts prefer a benign to a malignant tumor. CMPT can show many malignant tumor signs on imaging and is often mistaken for lung adenocarcinoma. According to its typical histopathological characteristics and immunohistochemical phenotype, it can be differentiated from other pulmonary diseases. Whether gene mutation is the driving factor is still unknown. Surgical resection for the tumor reveals a good prognosis.
【中文题目：典型肺纤毛黏液结节性乳头状肿瘤1例 临床病理分析】 【中文摘要：背景与目的 肺纤毛黏液结节性乳头状肿瘤（ciliated muconodular papillary tumor of the lung, CMPT）的发病极其少见，在临床上与其他肺部病变亦难以区别，易造成误诊、漏诊；通过收集CMPT的资料，分析其临床病理特征，可以为广大医务工作者提供诊治思路，减少医疗差错。方法 回顾性分析1例典型的CMPT患者的临床资料、病理特征、免疫表型并结合相关文献进行探讨。结果 患者胸部计算机断层扫描（computed tomography, CT）提示右下肺近胸膜处可见混合密度结节影，直径约9 mm，肿瘤行肺楔形切除术，镜下见结节由增生的纤毛细胞、黏液细胞及基底样细胞混合组成，以乳头状、腺样结构为主，纤毛细胞衬覆于乳头状结构表面，基底样细胞位于外层，黏液细胞则位于两者之间，各种细胞异型不明显。免疫组化：上皮细胞CEA（+）、CK7（+）、CA125（+）、TTF-1（弱+）、CK20（-）、Ki67（1%+）、CK5/6（+）；基底细胞P63（+）。结论 CMPT是一种新近发现的罕见的肺部肿瘤，关于其良恶性目前尚无定论，但多数学者倾向于良性，其在影像学上可表现出诸多恶性肿瘤征象而常被误认为是肺腺癌，通过其典型的病理组织学特点及免疫组化表型可与其他肺部疾病进行鉴别，基因突变是否是其驱动因素目前尚不得知，该肿瘤行手术切除预后较好。】 【中文关键词：肺肿瘤；肺纤毛黏液结节性乳头状肿瘤；临床病理学；免疫表型】.
Keywords: Ciliated muconodular papillary tumor of the lung; Clinicopathology; Immunophenotype; Lung neoplasms.