Sclerosing pneumocytoma with report of one case bizarre nuclei combined with invasive adenocarcinoma and adenocarcinoma in situ
WU Jing-peng
GUO Jia
CHEN Huang
ZHONG Ding-rong
Abstract：Objective: To explore the clinical pathological features, diagnosis, and treatment strategies of pulmonary sclerosing alveolar cell adenoma (PSP) with bizarre nuclei combined with invasive lung adenocarcinoma and adenocarcinoma in situ. Methods: Clinical data of one case of PSP combined with invasive lung adenocarcinoma and adenocarcinoma in situ were collected, and the histopathological features were summarized. Immunohistochemical staining and molecular testing were performed to analyze the clinical pathological characteristics, and relevant literature was reviewed. Results: The patient was a 51-year-old female without a smoking history, who was found to have an irregular mass shadow in the lower lobe of the left lung during a physical examination. Pathological examination showed that the tumor consisted of solid areas, sclerotic areas, and hemangioma-like regions, with bizarre nuclear tumor giant cells surrounding the hemorrhagic areas, exhibiting significant nuclear atypia. Immunohistochemical and molecular testing results showed that both the PSP area and the invasive lung adenocarcinoma area exhibited AKT1 mutations, while the invasive lung adenocarcinoma area had an additional mTOR mutation. The independent adenocarcinoma in situ area showed a SLX4 mutation. After surgery, the patient did not receive radiotherapy or chemotherapy. Follow-up for 9 months showed that the patient was in good condition with no recurrence or metastasis. Conclusion: PSP with bizarre nuclei combined with invasive lung adenocarcinoma and adenocarcinoma in situ is a rare pulmonary tumor. Accurate diagnosis depends on detailed pathological examination and molecular testing.
Keywords：Pulmonary Sclerosing Alveolar Cell AdenomaInvasive Lung AdenocarcinomaAdenocarcinoma in SituBizarre NucleiGene Mutation
Publication Date：2025-03-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 339-341,308 )