Liu H C, Hsu W H, Huang M H
Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 2000 May;63(5):424-8.
Tracheal bronchus, directly arising from the abnormal tracheal wall, is a rare congenital anomaly of the airway. Lung cancer developing in a tracheal bronchus is even more rare. A 68-year-old man had a mass shadow over the right upper lung on chest radiography. Bronchoscopy revealed an abnormally displaced bronchus stemming from the right side of the tracheal wall, 2 cm above the carina. Arising from this tracheal bronchus was a tumor, a biopsy of which showed squamous cell carcinoma. During surgery, a bronchus arising from the right lateral wall of the trachea and supplying the apical segment of the right upper lobe was found. There was a tumor occluding the lumen of the tracheal bronchus, causing distal obstructive pneumonitis. The patient underwent right upper lobectomy with closure of the tracheal bronchus and radical lymph node dissection. The subsequent pathologic examination of the specimen revealed squamous cell carcinoma with surrounding pneumonitis. Bronchogenic cancers developing in a tracheal bronchus are rarely reported in the English language literature. Surgical resection appears to be the treatment of choice.
气管支气管直接起源于异常的气管壁,是一种罕见的气道先天性异常。发生在气管支气管的肺癌更为罕见。一名68岁男性胸部X线检查显示右上肺有肿块阴影。支气管镜检查发现气管壁右侧距隆突上方2 cm处有一支气管移位异常。该气管支气管上长出一个肿瘤,活检显示为鳞状细胞癌。手术中发现一根起源于气管右侧壁并供应右上叶尖段的支气管。有一个肿瘤阻塞了气管支气管的管腔,导致远端阻塞性肺炎。患者接受了右上叶切除术,同时封闭气管支气管并进行根治性淋巴结清扫。随后对标本的病理检查显示为鳞状细胞癌伴周围肺炎。英语文献中很少报道发生在气管支气管的支气管源性癌。手术切除似乎是首选的治疗方法。