摘要目的:对骨转移性伴破骨样巨细胞反应的梭形细胞肺癌进行诊断分析，旨在提高临床病理医师对该病特殊形态的认识，避免误诊、漏诊。方法:回顾性分析2020年我院收治的1例骨转移性伴破骨样巨细胞反应的梭形细胞肺癌的临床资料，经过病理组织学及免疫表型观察进行诊断，并复习相关文献进行分析。结果:骨转移性肺癌与肺原发腺癌组织像不同，光学显微镜下呈现骨转移性肺癌中伴破骨样巨细胞反应的梭形细胞癌形态，经免疫组织化学证实和详细询问患者病史，最终确诊为肺腺癌骨转移。结论:骨转移性肺癌临床较常见，但转移性癌出现伴破骨样巨细胞反应的梭形细胞肺癌临床非常少见。临床病理诊断容易误诊为富巨细胞肉瘤，确诊要依靠免疫组织化学染色及详细询问患者病史。

abstractsObjective:To diagnostic analysis of spindle cell lung cancer with bone metastasis and osteoclastic giant cell response, in order to improve clinicopathological understanding of the special morphology of this disease and avoid misdiagnosis and missed diagnosis.Methods:A retrospective analysis was conducted on the clinical data of a special form of spindle cell lung cancer with bone metastasis and osteoclast like giant cell response in our hospital in 2020. Diagnosis was made by histopathological and immunophenotype observation, and the relevant literatures were reviewed for analysis.Results:The morphology of bone metastatic lung cancer was different from that of primary lung adenocarcinoma. Spindle cell carcinoma with osteoclast like giant cell response appeared in bone metastatic lung cancer, which was confirmed to be adenocarcinoma with lung metastasis by immunohistochemistry and detailed inquiry of the patient medical history.Conclusions:Bone metastatic lung cancer is more common in clinical practice, but spindle cell lung cancer with osteoclast like giant cell response in metastatic cancer is very rare. Clinical pathological diagnosis is easily misdiagnosed as rich giant cell sarcoma, and diagnosis relies on immunohistochemical staining and detailed inquiry of the patient′s medical history.