多発性肺硬化性血管腫の1例 [in Japanese] MULTIPLE SCLEROSING HEMANGIOMA OF THE LUNG : REPORT OF A CASE [in Japanese]
Access this Article
Search this Article
症例は22歳の女性で,単純X線写真像上,左S<sup>4</sup>に大小不同の結節影の集簇を指摘され, CTにて境界明瞭な充実性病変と周囲の小結節群が確認された.造影MRI上,主病変部は良好に造影され, dynamic studyでも徐々に濃染されたが,病変と連絡する血管影は認められなかった.経気管支肺生検(TBLB)ではII型肺胞上皮増殖と基底膜の肥厚が見られ,硬化性血管腫や過誤腫,肉芽腫が疑われたが,確定診断はえられなかった.肺部分切除術を施行し,摘出標本にて白色調,大小不同の結節群を認めた.病理組織学的に,大きな結節内には海綿状血管腫様成分,充実性胞巣,線維化,石灰化が存在し,硬化性血管腫と診断した.一方,小結節群は境界不明瞭なものが多く,総て充実性で,血液貯留部はみられなかった.
A 22-year-old woman had multiple nodular shadows in the left S<sup>4</sup> of the lung on chest X-ray examination. There wre innumerable lesions on chest CT and the main nodules were well-demarcated and solid. On chest MRI, the main nodules were well enhanced and, on the dynamic study, gradually enhanced but no connection between vessels and nodules was seen on MRA. By transbronchial lung biopsy, the proliferation of type II alveolar cell and thickening of the basement membrane were found. Pulmonary sclerosing hemangioma, hamartoma or granuloma was suspected. But we had difficulty in diagnosis. Partial resection of the lung was performed and, in the exised lung, various sizes of white nodules existed. Histopathologically, the main nodules were composed of cavernous hemangioma like portion, solid cellular, fibrosis, calcification and we diagnosed them as sclerosing hemangioma. On the other hand, small nodules were all solid, not demarcated well and had no blood pooling.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 58(6), 1226-1229, 1997-06-25
Japan Surgical Association