胸水細胞診に苦慮した微小肺腺癌の１例

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  • A Case of Minute Peripheral Lung Adenocarcinoma With Difficult Pleural Cytology

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Background. Type A and type B adenocarcinomas in Noguchi's classification have good prognoses and there have been no reports of malignant effusion with these types. Case. Left lung nodule was detected in a 42- year-old woman by mass screening. Her chest CT scan showed a ground glass opacity (GGO) in the left S1+2 which was 4 mm in size. Preoperative examinations revealed no malignant lesions in any other organs. Immediately before surgery, we performed CT-guided marking of the tumor. Left upper division segmentectomy was performed. On that occasion, slight pleural effusion was recognized and was diagnosed as class V. The primary tumor proved to be well differentiated, localized bronchioloalveolar carcinoma which was classified as type A of Noguchi's classification. Postoperative adjuvant chemotherapy was done. The patient has been well without any symptoms for 21 months after surgery. The cause of the pleural effusion in this case is doubtful. The malignancy of the pleural effusion specimen was thought to be positive because of epithelial immunocytochemical staining. Conclusion. Data contradictory to clinico-pathological findings must be evaluated again by other methods, e. g. immunological methods, and finally the data should be interpreted as an integrated whole including information from the clinical course.

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  • 肺癌

    肺癌 43 (1), 35-39, 2003

    特定非営利活動法人 日本肺癌学会

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