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緩除な発育を示し, 陰影濃度の変化を契機に発見された肺腺癌の1例


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Title: 緩除な発育を示し, 陰影濃度の変化を契機に発見された肺腺癌の1例
Other Titles: A slowly progressive adenocarcinoma of the lung detected by change of density of the shadow
Authors: 仲宗根, 朝紀 / 綾部, 公懿
Authors (alternative): Nakasone, Tomonori / Ayabe, Hiroyoshi
Issue Date: 20-Apr-2000
Publisher: 日本肺癌学会
Citation: 肺癌 = Japanese Journal of Lung Cancer, 40(2), p.143-147; 2000
Abstract: 症例は74歳, 女性.主訴は胸部X線上異常陰影.1993年胸部X線上, 右中肺野に約1.5cmの境界不明瞭な淡い円形陰影を認めた.胸部CT写真では右S^2に長円形の低濃度陰影を認めたが, 炎症性病変として経過観察していた.1999年胸部CTにて, 陰影内部に充実性の高吸収域が出現してきた.炎症性病変に肺癌の合併を考慮しCTガイドした肺生検を施行, Class IIIで肺癌が疑われた.1999年3月18日右上葉切除術兼縦隔リンパ節郭清を施行した.摘出標本では, CT上の低濃度部分に相当する約1.5cmの腫瘍内に0.4×0.4cmの充実性の部分を認め, この部分がCT上の充実性高吸収域部分に相当した.組織所見では充実性部分が中分化乳頭腺癌で周囲の低濃度部分が高分化乳頭腺癌であった.p-T1N1M0でstage IIAであった.本症例はfollow upしていた陰影全体が腺癌であり, 6年間の緩除な経過を示した腺癌であった. / Background : There have been very few reports describing slowly progressive adenocarcinomas. We here present the case with a review of the literature. Case : A 1.5cm ill-defined faint round shadow was pointed out in the right middle lung field on a chest X-ray film of a 74-year-old woman in 1993. Chest CT scan revealed a low density oval shadow in right S^2. The shadow was followed up as an inflammatory disease. Chest CT scan in January 1999 revealed a solid high density area in the low density shadow. The high density area was thought to be lung cancer associated with inflammatory disease. CT-guided percutaneous lung biopsy revealed malignant findings. Right upper lobectomy was performed with mediastinal lymph npde dissection(R2a). Microscopically the solid high density area on the chest CT was moderately differentiated papillary adenocarcinoma, but the circumferential low density area was well differentiated papillary adenocarcinoma. Metastasis to mediastinal lymph mode #11 was recognized. The pathological staging was T1N1M0, stage IIA. Conclusion : Our case was a slow progressive adenocarcinoma of the lung with a 6-year clinical history detected by the change of density of the shadow on chest CT.
Keywords: Slow growing / Adenocarcinoma of the lung / Density of shadow
URI: http://hdl.handle.net/10069/20254
ISSN: 03869628
Relational Links: http://ci.nii.ac.jp/naid/110003111515/
Rights: 日本肺癌学会 / 本文データは学協会の許諾に基づきCiNiiから複製したものである
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/20254

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