肺腺癌治癒切除13年後に脳転移と肺転移を認め切除しえた1例 [in Japanese] A CASE OF SOLITARY BRAIN AND SOLITARY LUNG METASTASES OCCURRED 13 YEARS AFTER AN OPERATION FOR ADENOCARCINOMA OF THE LUNG [in Japanese]
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肺癌術後10年以上を経ての再発は比較的稀である,今回,術後13年後に孤立性脳転移と孤立性肺転移が指摘され,切除しえた1例を経験したので報告する.症例は74歳,1983年1月前医で肺腺癌により右下葉切除術(R<SUB>2</SUB>)施行.p-T<SUB>1</SUB>N<SUB>0</SUB>M<SUB>0</SUB>,IA期,絶対的治癒切除であった.1996年11月意識消失および痙攣発作で当院入院.孤立性脳転移と孤立性肺転移が指摘され,共に外科的に切除しえた.病理所見から共に肺線癌転移病変と診断された. 原発および脳・肺転移切除標本での増殖細胞核抗原(PCNA) とsialyl-LewisX糖鎖抗原(sLe<SUP>x</SUP>)の発現についての免疫組織学的検討では,全標本で強陽性の結果がえられた.PCNA,sLe<SUP>x</SUP>陽性の場合には,術後長期にわたってのフォローの必要性が考えられた.
We have experienced a rare case of solitary brain and solitary lung metastases occurred 13 years after our operation that resulted in curative resection for a stage I lung cancer (adenocarcinona). A 74-year-old woman was admitted to the hospital because of attacks of unconsciousness and convulsions. Thirteen years prior to this admission, she had undergone a right lower lobectomy due to adenocarcinoma. T1N0M0, stage IA. A solitary brain tumor shadow was detected on a brain CT and brain MRI. and a solitary lung nodular shadow was showed in the right lung field on a chest CT. Both brain and lung tumors were resected and both were diagnosed histologically as metastasis of the lung cancer. Immunohistochemical expression of PCNA and sialyl-Lewis X antigen (sLex) were examined for three operative specimens that were primary lung cancer, brain metasitasis, and lung metastasis. For all three specimens, the expressions of both PCNA and sLex were highly positive. The patient with lung cancer that is highly expressive of PCNA and sLex would require a long-term follow up after operation for the primary lesion.
- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 60(12), 3317-3324, 1999-12-25
Japan Surgical Association