肝細胞癌切除後の肺門リンパ節転移の1例 RESECTED LYMPH NODES METASTASIS TO THE HILUS OF THE LUNG AFTER OPERATION FOR A HEPATOCELLULAR CARCINOMA : A CASE REPORT

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肝細胞癌切除後の肺門リンパ節転移巣を切除し,良好な経過を得た症例を経験したので報告する.症例は63歳男性.平成5年10月,肝S7の肝細胞癌に肝後区域切除を施行し,約2年後S8の残肝再発と右肺上葉の肺転移に対し肝部分切除と肺部分切除を施行した.平成8年8月の胸部CTにて約2cmの肺門リンパ節腫大を認め, 3カ月後には腫瘤は約3cmに増大した.肺門リンパ節転移と診断し,平成9年1月よりミトキサントロンによる化学療法を施行し経過観察した. 5月の胸部CTで腫瘤は約4cmと増大したが,画像上で新たな他病変はなく手術適応と考えた.血管造影で大血管への浸潤はなく, 6月25日右開胸下右肺上葉切除とリンパ節郭清を行い術後15日目に退院した.術後約1年経過した現在,外来にて厳重に経過観察をしているが血液検査および画像診断で再発の徴候はない.

This paper presents successfully recected case of lymph nodes metastasis to the hilus of the lung after resection for a hepatocellular carcinoma in a 63-year-old man. The patient had undergone a posterior segmen-tectomy for a hepatocellular carcinoma in the S7 in October 1993, and then a partial hepatectomy and a partial excision of the lung for metastases to the remnant liver and right upper lobe of the lung 2 years after the initial operation. In August, 1996, a chest CT scan revealed lymph node swelling at the hilum of the lung about 2cm in size which became larger to about 3cm in size 3 months later. It was diagnosed as hilar lymph node metastasis Chemotherapy with mitoxantoron was started in January, 1997, and his clinical course was observed. Chest CT scan in May visualized the enlarged tumor to about 4cm in size but no other lesions. The patient was though to be candidate for operation. Angiography also revealed no invasions into the aorta. On June 25, an excision of the right upper lobe of lung with lymph nodes dissection was performed under a right thoracotomy. The patient was discharged from the hospital 15 days after the operation, and is strictly fol-lowed on an ambulant basis. There have been no signs of recurrence on blood examination and imaging methods as of one year after the operation.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 60(9), 2338-2343, 1999-09-25

    Japan Surgical Association

参考文献:  8件中 1-8件 を表示

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各種コード

  • NII論文ID(NAID)
    10008496754
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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