Daga H, Isobe T, Ishikawa N, Ochiai M, Fujitaka K, Yamasaki M, Oguri T, Yokozaki M, Ishioka S, Yamakido M
Second Department of Internal Medicine, Hiroshima University Faculty of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2001 Jan;39(1):35-9.
Routine chest radiography demonstrated abnormal opacities in the right lower lung field of a 54-year-old man with idiopathic interstitial pneumonia. A high-resolution chest CT scan showed diffuse air-space consolidation in the right lower lung with replacement of a honeycomb area. The diagnosis was adenocarcinoma, and a right lower lobectomy was performed. Histopathologic examination showed moderately differentiated adenocarcinoma and the pathological stage was T3 N0 M0 (Stage IIB). About 1 year later, the cancer recurred with diffuse air-space consolidation in the whole of the right lung and the left middle and lower lung, which resulted in the patient's death. It was difficult to discriminate between an acute change for the worse of idiopathic interstitial pneumonia and a recurrence of lung cancer on the basis of the CT findings in this patient. It is important to elucidate the CT features of lung cancer associated with idiopathic interstitial pneumonia.
常规胸部X线检查显示,一名54岁特发性间质性肺炎男性患者右下肺野出现异常阴影。高分辨率胸部CT扫描显示右下肺弥漫性气腔实变,并有蜂窝状区域被替代。诊断为腺癌,遂行右下肺叶切除术。组织病理学检查显示为中分化腺癌,病理分期为T3 N0 M0(IIB期)。约1年后,癌症复发,整个右肺以及左肺中下部出现弥漫性气腔实变,导致患者死亡。根据该患者的CT表现,很难区分特发性间质性肺炎的急性恶化与肺癌复发。阐明与特发性间质性肺炎相关的肺癌的CT特征非常重要。