気管支内腔へポリポイドに進展した浸潤性胸腺腫の1例  [in Japanese] An Invasive Thymoma with Endobronchial Polypoid Growth  [in Japanese]

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Author(s)

    • 杉山 栄里 Sugiyama Eri
    • 国立がん研究センター東病院呼吸器内科 Division of Thoracic Oncology, National Cancer Center Hospital East
    • 仁保 誠治 Niho Seiji
    • 国立がん研究センター東病院呼吸器内科 Division of Thoracic Oncology, National Cancer Center Hospital East
    • 永井 完治 Nagai Kanji
    • 国立がん研究センター東病院呼吸器外科 Division of Thoracic Surgery, National Cancer Center Hospital East

Abstract

症例.68歳男性.血痰を主訴に,近医を受診した.胸部X線にて異常陰影を指摘され,肺癌を疑い,当院へ紹介受診された.胸部CT上,左上葉S^3縦隔側に48×46mm大の腫瘤を認め,肺門に向かって左B^3内腔をポリポイドに充填する所見を認めた.気管支鏡検査にて,左上区支内腔が隆起性病変により高度狭窄を認めていたため,同部位より生検を施行した.組織学的に,胸腺T細胞および上皮細胞の増殖を認め,胸腺腫と診断した.胸腺腫胸腺全摘,左上葉・心膜合併切除術を施行し,永久標本で最終的に胸腺腫(WHO分類Type B1)の肺浸潤および気管支内進展を確認した.結論.肺に直接浸潤し,気管支内腔をポリポイドに進展する特異な発育を示した,浸潤性胸腺腫の1例を経験した.このような進展形式を呈する浸潤性胸腺腫は稀ながら認められ,鑑別時に考慮する必要がある.

Case. A 68-year-old man presented with hemoptysis. A chest computed tomography (CT) examination performed at a previous hospital showed a mass in the left upper lobe (S^3) with direct invasion to the anterior mediastinum, 48×46mm in size. The patient was referred to our hospital for the evaluation of an abnormal shadow. Tumor markers were negative. A bronchoscopic examination was performed, and a white polypoid lesion in the left superior segment bronchus was discovered. A definitive diagnosis of the biopsy specimen obtained from this tumor revealed a thymoma. A thymothymectomy, a left upper lobectomy and a pericardiectomy were performed. The surgical specimen was found to be a type B1 thymoma, and the tumor had extended not only to the mediastinum, but also to the pulmonary parenchyma with polypoid growth into the bronchial lumen. Conclusion. Cases of invasive thymoma with endobronchial growth are rare, but the possibility of a thymoma should be considered in cases with endobronchial polypoid growth.

Journal

  • The Journal of the Japan Society for Respiratory Endoscopy

    The Journal of the Japan Society for Respiratory Endoscopy 36(2), 183-187, 2014

    The Japan Society for Respiratory Endoscopy

Codes

  • NII Article ID (NAID)
    110009807534
  • Text Lang
    JPN
  • ISSN
    0287-2137
  • Data Source
    NII-ELS  J-STAGE 
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