肺硬化性血管しゅの臨床病理学的検討 [in Japanese] A Clinico-pathological Study of Sclerosing Hemangioma of the Lung [in Japanese]
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我々の施設において昭和48年以来9年間に切除した肺腫瘍は263例で, うち良性腫瘍は16例(6%)である. 良性腫瘍のうち, 肺硬化性血管腫は5例あり, それらにつき臨床病理学的に検討した. 症例は全例女性で, 30才代2例, 60才代3例に認められ, 全例無症状であつた. X線像としては本腫瘍に特徴的な所見が認められるが, X線上の診断は疑診の域を出ないし, 確定診断をつける意味からも外科的に処置を加える必要がある. その際には肺良性腫瘍の手術の原則として肺機能温存が心がけられた方法がとられるべきである. 又2例に電顕にて検討を加えたが, 本腫瘍の増殖細胞はII型肺胞上皮細胞由来を考えられ, 本腫瘍の本態は肺実質構成成分の量的異常あるいは分化過程の異常により腫瘍を形成した, 肺末梢発生の過誤腫を考えさせるものであつた.
A clinico-pathological study was done on 5 cases with sclerosing hemangioma of the lung who were operated between 1973 and 1981. The number of cases with sclerosing hemangioma represented 1.9% of a total of 263 patients with resected lung neoplasms admitted to our hospital. Although the age range varied from 34 to 68 years, most of the patients were seen in their thirties and sixties. All cases were female and had no symptoms. Roentgenographically, shadows of tumors were round, sharply circumscribed and located predominantly in the periphery of the lung field and the subpleural region. Grossly, the lesions were round masses with sharply circumscribed borders and distinct pseudocapsules in all cases. Microscopic findings were consistent with typical sclerosing hemangioma of the lung described by Liebow and Hubbell. The ultrastructural features of the predominant cells were considered to be those of pneumocyte. Proliferation of immature endothelial cells and pericytes was not identfied. Findings of pre-existing inflammation were not obtained clinically and histologically. We conclude that sclerosing hemangioma of the lung is not of endothelial orgin but of epithelial orgin, and this tumor might be hamartoma of peripheral lung tissue rather than postinflammatory tumor.
- Japanese Journal of National Medical Services
Japanese Journal of National Medical Services 36(12), 1212-1216, 1982
Japanese Society of National Medical Services