肺野に孤立性陰影を認めた悪性胸膜中皮腫の1例  [in Japanese] Malignant pleural mesothelioma showing a solitary shadow in the lung field-A case report-  [in Japanese]

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Author(s)

    • 宮内 栄作 MIYAUCHI Eisaku
    • 癌研究会有明病院呼吸器内科 Department of Respiratory Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research
    • 工藤 慶太 KUDO Keita
    • 癌研究会有明病院呼吸器内科 Department of Respiratory Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research
    • 星 利良 HOSHI Rira
    • 癌研究会有明病院細胞診断部 Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
    • 古田 則行 FURUTA Noriyuki
    • 癌研究会有明病院細胞診断部 Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
    • 平井 康夫 HIRAI Yasuo
    • 癌研究会有明病院細胞診断部 Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
    • 元井 紀子 MOTOI Noriko
    • 癌研究会有明病院細胞診断部|癌研究会癌研究所病理部 Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research|Department of Pathology, Cancer Institute, Japanese Foundation for Cancer Research
    • 石川 雄一 ISHIKAWA Yuichi
    • 癌研究会有明病院細胞診断部|癌研究会癌研究所病理部 Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research|Department of Pathology, Cancer Institute, Japanese Foundation for Cancer Research
    • 宝来 威 HORAI Takeshi
    • 癌研究会有明病院呼吸器内科|癌研究会有明病院細胞診断部 Department of Respiratory Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research|Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research

Abstract

<b>背景</b> : 悪性胸膜中皮腫の細胞診は, ほとんどが胸水が対象になっている. 胸部 CT で肺野に腫瘤陰影を認め肺腫瘍が疑われたが, 経気管支的穿刺吸引細胞診を行い腫瘍細胞が得られた悪性胸膜中皮腫を経験した. 経気管支的穿刺吸引細胞診で腫瘍細胞が得られる悪性胸膜中皮腫はまれである.<br><b>症例</b> : 50 歳代, 女性. 検診での胸部 X 線写真で異常陰影を指摘され, 胸部 CT で右中葉領域に腫瘤が認められた. 経気管支的穿刺吸引細胞診では, 小型の異型細胞で構成される細胞集塊が認められたが, 核の大きさが小さく, 異型性に乏しいため悪性細胞と判定できなかった. 確定診断のための胸腔鏡下肺部分切除による組織診および免疫染色にて, 上皮型悪性胸膜中皮腫と診断された.<br><b>結論</b> : 肺に腫瘤を形成した悪性胸膜中皮腫症例において, 経気管支的穿刺吸引細胞診で悪性細胞が採取された. 細胞診に際して臨床情報を十分に把握し診断をする必要がある.

<b><i>Background</i></b> : Malignant pleural mesothelioma is usually diagnosed by pleural effusion cytology, but finding atypical cells by transbronchial aspiration cytology in malignant pleural mesothelioma is rare.<br><b><i>Case</i></b> : A woman in her 50s seen for an abnormal chest X-ray shadow was found in chest computed tomography (CT) to have a right middle lung lobe mass. Atypical cells in sheets observed in transbronchial aspiration cytology smears could not be diagnosed as malignant cells because nuclei were small and less atypical. The tumor was finally diagnosed as malignant pleural mesothelioma by histological and immunohistochemical staining of specimens obtained through video-assisted thoracic surgery (VATS) lung resection.<br><b><i>Conclusion</i></b> : In this case of malignant pleural mesothelioma, the tumor was located in the lung and atypical cells were obtained by transbronchial aspiration cytology, underscoring the importance of cytological diagnosis made together with clinical information.

Journal

  • The Journal of the Japanese Society of Clinical Cytology

    The Journal of the Japanese Society of Clinical Cytology 50(2), 115-119, 2011

    The Japanese Society of Clinical Cytology

Codes

  • NII Article ID (NAID)
    130004513098
  • Text Lang
    JPN
  • ISSN
    0387-1193
  • Data Source
    J-STAGE 
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