孤立性腫りゅう陰影を呈しCTガイド下経皮肺生検で術前診断した肺末梢カルチノイドの1例  [in Japanese] Peripheral Carcinoid Tumor of the Lung Presenting as a Solitary Mass Shadow on a Chest Roentgenogram and Diagnosed by CT-Guided Percutaneous Needle Biopsy.  [in Japanese]

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Abstract

症例は59歳, 女性. 健診にて左下肺野に直径2.5cmの孤立性腫瘤陰影を指摘され来院. 気管支鏡検査では確定診断には至らなかった. CTガイド下経皮肺生検にて確実に腫瘍部分から組織を得ることができ, 肺カルチノイドと診断した. 手術適応と考え, 左肺下葉切除術および肺門・縦隔リンパ節郭清術を施行した. 病理組織学的には核異型性はほとんどなく, 核分裂像・壊死像もみられなかった. Grimelius 染色陽性, さらに chromogranin A, NSE, synaptophysin, serotonin 陽性であり, 定型的カルチノイドに一致する所見であった. 肺野末梢に孤立性腫瘤陰影を呈する末梢型肺カルチノイドの術前診断に, CTガイド下経皮肺生検は有用である.

A 59-year-old woman was referred to our clinic because a solitary mass shadow (2.5cm in diameter was seen in the left lower lung field on a chest roentgenogram. Transbronchial biopsy via a fiberoptic bronchoscope did not yield a definitive diagnosis. Examination of a specimen obtained by CT-guided percutaneous needle biopsy revealed that the tumor consisted of small cells proliferating in a solid, tubular, pseudoglandular, and follicular pattern, which suggested the diagnosis of carcinoid. A left lower lobectomy was performed, and several hilar and mediastinal lymph nodes were also removed. The tumor cells did not show pleomorphism of nuclei, mitotic activity, or necrosis. Grimelius and immunohistochemical stains for chromogranin. A, neuron-specific-enorase, synaptophysin, and serotonin were positive. These findings confirmed the diagrosis of carcinoid. CT-guided percutaneous needle biopsy can be useful for the diagnosis of peripheral carcinoid and other peripheral lung tumors.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 35(4), 432-436, 1997

    The Japanese Respiratory Society

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