転移性肺腫瘍の流注気管支にみられた菌球型アスペルギルス症の 1 例  [in Japanese] A Case of Bronchial Aspergilloma with Metastatic Lung Cancer  [in Japanese]

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Abstract

症例は74歳女性。8年前に直腸癌の手術を受け, 外来にて経過観察中にCEA値の上昇と胸部異常陰影を認め, 精査の目的にて入院した。胸部X線では, 左S^3bに胸膜嵌入を伴った腫瘤陰影があり, 気管支鏡検査にて左上区枝の入口部をほぼ閉塞する形で黄色の柔らかな半球状のわずかな膨隆を認めた。病理組織学的には, 壊死組織にまじって, 有節性Y字状を呈する菌糸が多数認められ, 培養でもaspergillusが確認された。また経気管支的肺生検(TBLB)による腫瘤の病理組織は, ラクトフェリン染色陰性の高分化型腺癌で, 直腸癌の転移と考えられた。本症例は転移性肺腫瘍で抗癌剤使用中の患者で, 転移巣の流注気管支内腔にアスペルギローマが形成された1例であった。今後, 気管支鏡検査法の普及と抗癌剤などの使用の増加につれてこのような症例が増加してくるものと思われ, 症例の集積により菌球の形成過程の機序が解明されることを期待して, これを報告した。

A case of bronchial aspergilloma with metastatic lung cancer in a 74-year-old woman is reported. She had undergone resection for rectal cancer 8 years previously. Her CEA value increased and an abnormal shadow on chest X-ray film was pointed out and she was admitted to our hospital for further examination. Chest X-ray film showed a tumor shadow with pleural indentation in left S^3b. Bronchofiberscopy revealed a soft yellow polypoid lesion occluding the orifice of the left upper division bronchus. Histologic examination of the polypoid lesion revealed a lot of interwoven segmentated Y-shaped mycelial filaments, and aspergillus was detected by culture. The histology of the tumor specimen obtained by TBLB showed well-differentiated adenocarcinoma with negative lactoferrin staining. Accordingly, the tumor was thought to be metastasis from the rectal cancer. It is considered that the bronchial aspergilloma of this case appeared against the background of metastatic lung cancer. In future, a bronchofiberscopy becomes even more common and effective anti-cancer therapy becomes more widespread, cases such as this may increase.

Journal

  • The Journal of the Japan Society for Respiratory Endoscopy

    The Journal of the Japan Society for Respiratory Endoscopy 11(4), 382-386, 1989

    The Japan Society for Respiratory Endoscopy

Cited by:  3

Codes

  • NII Article ID (NAID)
    110004086412
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0287-2137
  • Data Source
    CJPref  NII-ELS  J-STAGE 
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