書誌事項
- タイトル別名
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- A Neuroendocrine Carcinoma from a Difficult-to-detect Primary Site Presenting as Neck and Mediastinal Lymphadenopathy
- 症例から学ぶ 頸部リンパ節転移,縦隔リンパ節転移を初発症状とし,原発巣の同定が困難であったneuroendocrine carcinomaの1例
- ショウレイ カラ マナブ ケイブ リンパセツ テンイ,ジュウカク リンパセツ テンイ オ ショハツ ショウジョウ ト シ,ゲンパツ ソウ ノ ドウテイ ガ コンナン デ アッタ neuroendocrine carcinoma ノ 1レイ
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An 83-year-old man presented with supraclavicular and mediastinal lymph nodes swelling and elevated serum levels of neuron-specific enolase (NSE), pro-gastrin-releasing peptide (pro-GRP), and cytokeratin fragment (CYFRA). He underwent supraclavicular lymph node dissection. The pathological diagnosis was metastatic lymph node neuroendocrine carcinoma. The initial diagnosis was small cell lung carcinoma c-TxN3M0 III B with an unknown primary site, because fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) had revealed increased uptake in the neck and mediastinal lymphadenopathy, but no significant intrapulmonary uptake. However, computed tomography (CT) of the chest had detected a lesion, which was assumed to be a vessel, in the right lower lung. The patient underwent radiotherapy, and CT of the chest 1 month later revealed a partial response of the lymph nodes. However, at the same time, disease recurred in the skin adjacent to the site of supraclavicular lymph node dissection, and the lesion in the right lower lung enlarged. We suspected that this intrapulmonary lesion was the primary site. Metastasis to cervical and mediastinal lymph nodes from an unknown primary carcinoma is rare, and the primary site should be determined so that appropriate treatment can be performed. If the primary site cannot be determined with the initial examination, regular follow-up examinations with CT, magnetic resonance imaging, and FDG-PET should be performed.<br>
収録刊行物
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- 日本医科大学医学会雑誌
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日本医科大学医学会雑誌 8 (2), 162-167, 2012
日本医科大学医学会
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詳細情報 詳細情報について
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- CRID
- 1390282680207165568
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- NII論文ID
- 130004471488
- 40019304859
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- NII書誌ID
- AA1200910X
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- ISSN
- 18802877
- 13498975
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- NDL書誌ID
- 023741167
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- NDL
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