Yamashita K, Yamamoto M, Nishimura H, Akiyama H, Tsuchiya E, Tanaka S
Department of Chest Surgery, Saitama Cancer Center, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Mar;48(3):194-7. doi: 10.1007/BF03218121.
A 48-year-old man, who underwent a right nephrectomy for renal cell carcinoma 7 years earlier, was found to have hilar lymph node metastasis alone, without lesions, in the pulmonary parenchyma. Chest X-ray and CT findings showed a left hilar mass about 4 x 2.5 cm in diameter. Left bronchial arteriography showed a hypervascular mass lesion in the left hilum. Macroscopic tumor invasion of the pulmonary artery and left main bronchus indicated left pneumonectomy. The resected specimen was found histologically to involve metastatic renal cell carcinoma in the left hilar lymph node about 3 cm in diameter. Tumor metastasis was limited to the lymph node. The metastatic pathway of renal cell carcinoma to the hilar lymph node was considered lymphogenous via either retrograde lymphatic flow from the thoracic duct or through the lymphatics in the inferior pulmonary ligament.
一名48岁男性，7年前因肾细胞癌接受了右肾切除术，现发现仅肺门淋巴结转移，肺实质无病变。胸部X线和CT检查发现左肺门有一直径约4×2.5 cm的肿块。左支气管动脉造影显示左肺门有一血管丰富的肿块病变。肉眼可见肿瘤侵犯肺动脉和左主支气管，提示需行左肺切除术。切除标本经组织学检查发现左肺门淋巴结有直径约3 cm的转移性肾细胞癌。肿瘤转移局限于淋巴结。肾细胞癌转移至肺门淋巴结的途径被认为是通过胸导管逆行淋巴引流或通过肺下韧带的淋巴管经淋巴途径转移。
