胸腺脂肪腫の1手術例  [in Japanese] A RESEXTED CASE OF THYMOLIPOMA  [in Japanese]

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Abstract

24歳男性の胸腺脂肪腫手術例を経験した. 11歳および20歳時,胸部X線上心肥大を指摘されたが,無症状のため放置した.その後,職域検診で縦隔異常陰影を指摘され入院した. CT上,前縦隔の腫瘤は境界明瞭で脂肪の吸収値を示し, MRIでT1T2強調画像ともに高信号を呈し,画像上胸腺脂肪腫あるいは胸腺腫が疑われた. 1993年7月に胸骨正中切開で手術が施行された.肥大した胸腺の右葉下部に胸腺被膜に被われた黄色の腫瘤が認められた.腫瘤は境界明瞭で柔らかく,周囲への浸潤を認めず,縦隔リンパ節腫大も無かった.拡大胸腺摘出術が施行された.腫瘍は20×7.5×3.5cm,重量200gで,割面では粗大分葉状を呈していた.組織学的には,大部分成熟脂肪細胞よりなり,脂肪組織間に島状に多くの胸腺組織が散見されたため,胸腺脂肪腫と診断された.術後経過良好にて14病日に退院し,術後1年10カ月経過した現在,再発の兆候を認めず,社会復帰している.

We experimented a resected case of thymolipoma in an asymptomatic 24-year-old man. The patient has been pointed out a widning of the mediastinum by routine chest roentgenography when he was 11 and 20 years old, and had been diagnosed as cardiac hypertrophy. In 1993, a chest roentgenogram revealed a mass-like shadow at the mediastium, and he was admitted to the hospital with a suspected mediastinal tumor. The mass of the right anteroinferior mediastinum which was clearly shown by chest CT scan and MRI was diagnosed as mediastinal lipoma, thymoma, or thymolipoma. On July, 1993, median sternotomy was performed. The tumor, 20×7.5×3.5cm in diameter and 200g in weight, was removed together with both lobes of the thymus and mediastinal adipose tisse (extended thymectomy). Histological examination confirmed that it was thymolipoma consisting of lipomatous and thymus tissue. The postoperative course was very satisfactory and he was diwcharged as cured on 14th postoperative day. There has been no sign of reccurrence, as of 22 months after the surgery.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 57(2), 343-347, 1996-02-25

    Japan Surgical Association

References:  17

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008519002
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
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