폐와 흉강에 발생하는 종양의 병리학적 검사에 대한 고찰

소개글

저널클럽에서 발표했던 자료입니다.
폐와 흉강의 다양한 종양을 진단할 때 병리학적 검사 (조직검사, 세포검사, 동결절편검사) 등이
어떻게 이루어져야 하며, 그 효과는 어떤지 정리한 논문입니다.
내과나 흉부외과 같은 임상의학이나, 병리학, 임상병리사 선생님들
모두에게 유용할 것으로 생각됩니다.

목차

1. Introduction

2. General Considerations in making Pathological Diagnoses

3. Diagnosis and Staging of Tumors within the Lung/Pleura
- Section 1: Lung Lesions
- Section 2: the Mediastinum
- Section 3: the Pleura and Pleural Cavity
- Section 4: Extra-thoracic Metastatic Lung Carcinoma

4. Conclusions and Future Perspectives

본문내용

Malignant diseases of the lungs and pleura are common causes of morbidity and mortality.
For determining the appropriate treatment strategies, pathologist should provide an accurate tissue-based histological or cytology diagnosis with confirmation of the clinical stage.
A variety of techniques are available to sample the main anatomical sites (lungs, mediastinum, pleural cavity and distant organs)
But each method has technical and sensitivity/specificity considerations and limitations.
In this review
Diagnostic modalities available with discussion of their limitations
commonly encountered questions raised at multidisciplinary team meetings from the perspective of a practising pathologist

<중 략>

Section 4: Extra-thoracic Metastatic Lung Carcinoma
Metastasis sites of Lung carcinoma
: Lung, Pleura, Brain, Bone, Adrenals, Liver, LNs
CT or MRI + PET-CT : 93% Sensitivity and 90% Specificity
Supraclavicular LNs
N2/3 stage suggested by Imaging (ex. PET- CT)
+ Sono-guided FNA or core biopsy : Positive in 45%
Liver
CT or Sono-guided PCNA : Safe & Effective
Adrenal gland
Problematic in differentiating metastasis and non-functioning adrenal adenomas
MRI + Image-guided FNA for ≥3cm mass
100% sensitivity and specificity & Low complication rate
Technical limitation and the risk of obtaining a tissue

참고 자료

T.D. Andrews & W.A.H. Wallace
Diagnosis and Staging of Lung and Pleural Malignancy an Overview of Tissue Sampling Techniques and the Implications for Pathological Assessment
Clinical Oncology
Volume 21, Issue 6 , Pages 451-463, August 2009