未診断肺腫瘤として外科切除を施行した肺過誤腫症例の検討  [in Japanese] Clinical Characteristics of Pulmonry Hamartoma Resected Surgically as Undiagnosed Pulmonary Nodule  [in Japanese]

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Author(s)

    • 篠原 伸二 SHINOHARA Shinji
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 中川 誠 NAKAGAWA Makoto
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 宗 知子 SO Tomoko
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 田中 文啓 TANAKA Fumihiro
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 花桐 武志 HANAGIRI Takeshi
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 桒田 泰治 KUWATA Taiji
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 竹中 賢 TAKENAKA Masaru
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 岡 壮一 OKA Soichi
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 近石 泰弘 CHIKAISHI Yasuhiro
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 永田 好香 NAGATA Yoshika
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 下川 秀彦 SHIMOKAWA Hidehiko
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health
    • 重松 義紀 SHIGEMATSU Yoshiaki
    • 産業医科大学 医学部 第2外科 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health

Abstract

肺過誤腫は, 肺良性腫瘍の中でもっとも頻度の高い良性腫瘍である. 当科において2000年から2009年の間に外科切除を施行した肺過誤腫の9例について臨床病理学的に検討した. 性別は, 男性1例, 女性8例であった. 年齢は, 42歳から77歳に分布し, 平均59歳であった. CTにおいて石灰化を認めた症例は1例のみであった. 気管支鏡下肺生検は5例に行われ, いずれの症例も術前確定診断は得られなかった. <sup>18</sup>F-fluorodeoxy glucose (FDG)-positron emission tomography検査は6例に施行され, 1例に軽度のFDGの集積を認め, 5例においては集積を認めなかった. 術式は管状葉切除1例, 区域切除1例, 葉切除2例, 部分切除3例, 核出術2例であった. 全例において, 術後合併症はなく, 再発も認めていない. 術前に気管支鏡下肺生検で診断できないことが多く, 典型的な過誤腫の特徴を備えていない場合は, 肺癌, 転移性肺腫瘍などの悪性腫瘍との鑑別が重要となり, 診断・治療を兼ねて, 外科切除を行うことが必要となる.

Pulmonary hamartoma is the most common tumor in benign lung neoplasm. We reviewed the clinical characteristics of 9 patients who had undergone surgical resection for pulmonary hamartoma between 2000 and 2009. There were 1 male and 8 female patients. The age of the patients ranged from 42 to 77 years old (mean 59). Calcification was not observed by computed tomography scan except in 1 patient. Although transbronchial lung biopsy (TBLB) was performed in 5 patients, no definitive diagnosis was obtained. Six patients underwent <sup>18</sup>F- fluorodeoxyglucose (FDG) - positron emission tomography, and none of them showed any accumulation of FDG except for 1 patient. Concerning the operative procedures, a sleeve lobectomy was performed in 1 patient, a segmentectomy in 1, a lobectomy in 2, a partial resection of the lung in 3, and a nucleation in 2 patients. The postoperative courses were uneventful, and no findings of recurrence were observed in any of the patients after surgery. As a preoperative diagnosis of pulmonary hamartoma is often difficult in TBLB, it is necessary to perform surgical resection in the differential diagnosis of lung cancer or metastatic lung tumor, unless there are typical findings of pulmonary hamartoma in clinical imaging.

Journal

  • Journal of UOEH

    Journal of UOEH 34(1), 41-46, 2012

    The University of Occupational and Environmental Health, Japan

Codes

  • NII Article ID (NAID)
    110009418874
  • NII NACSIS-CAT ID (NCID)
    AN0009832X
  • Text Lang
    JPN
  • ISSN
    0387-821X
  • NDL Article ID
    023561556
  • NDL Call No.
    Z19-1000
  • Data Source
    NDL  NII-ELS  J-STAGE 
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