興味ある画像所見を呈した胸膜発生 Solitary Fibrous Tumor の1例  [in Japanese] A case of solitary fibrous tumor of the pleura  [in Japanese]

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Abstract

症例は59歳, 女性.増大傾向のある胸部異常陰影を指摘され, 当科入院となった.胸部X線にて, 左中肺野外側に末梢に向かって楔状に拡がる陰影を認めた.立位にて陰影はやや足側へ偏位していた.胸腔鏡下に手術を施行した.左肺上葉より細い茎を有してポリープ様に突出する腫瘤を認め, 正常肺部分にてこれを切除した.病理組織学的に腫瘍は紡錘形, 一部多角形の腫瘍細胞からなり, 膠原繊維束を分け入るように散在性に増殖していた.全体的に悪性所見はなかったが, ごく一部に核異型を認めた.免疫組織染色では, CD34, vimentinが陽性で, cytokeratin, calretinin, EMAが陰性であり, 間葉系組織由来のsolitary fibrous tumorと診断した.術前画像所見にて, 体位変換にて移動する陰影をみた場合, 腫瘍の大小にかかわらず, 本症例を念頭において, まずは審査胸腔鏡を行い, 切除を試みることが望ましい.

A 59-year-old female was admitted to our hospital because of an enlarged abnormal shadow on chest roentgenogram. Chest roentgenogram revealed a wedge-shaped abnormal shadow in the left middle field. The mass slightly changed in position with the change in patient's position. A pedunculated tumor arose from the visceral pleura of left upper lobe. The tumor was completely resected through thoracotomy. Histologically, spindle and polymorphic tumor cells were scattered in the collagen fibers. Only a few atypical cells were recognized. An immunohistochemical study was positive for CD34, vimentin and negative for cytokeratin, calretinin and EMA. From these immunohistochemical staining findings and microscopic findings, the tumor was diagnosed as a solitary fibrous tumor. SFT should be kept in mind when preoperative images show a mobile tumor, even when it is a large tumor. Thoracic surgery is well indicated for this type of tumor.

Journal

  • The Journal of the Japanese Association for Chest Surgery

    The Journal of the Japanese Association for Chest Surgery 17(2), 102-106, 2003-03-15

    The Japanese Association for Chest Surgery

References:  10

Cited by:  4

Codes

  • NII Article ID (NAID)
    110001271509
  • NII NACSIS-CAT ID (NCID)
    AN10467885
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09190945
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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