Takemasa A, Bando M, Murayama F, Sohara Y, Hironaka M, Sugiyama Y
Department of Pulmonary Medicine, Jichi Medical School, Minamikawachi-machi, Kawachi-gun, Tochigi 329-0498, Japan.
Nihon Kokyuki Gakkai Zasshi. 2001 May;39(5):322-7.
We encountered 12 cases (9 men, 3 women) of intrapulmonary lymph nodes, discovered by chest radiography or chest CT and identified by thoracoscopic lung biopsy (in 10 cases), open lung biopsy (1 case) or lobectomy (1 case). We also studied the literature related to intrapulmonary lymph nodes in Japanese. Many intrapulmonary lymph nodes were found in the lower lung field, few in the upper lung field. All intrapulmonary lymph nodes were spherical and were located under the pleura, but we were not able in some cases to differentiate them from malignancies by the CT scanfindings. We could not diagnose them or rule out malignancy before surgery. Pathological findings revealed that all of them showed anthracosis. Silicotic changes were found in three cases. We consider that thoracoscopy is useful in making a definite diagnosis if peripheral pulmonary lesions cannot be diagnosed. We emphasize that intrapulmonary lymph nodes should be taken into consideration in differential diagnoses of small nodular lesions in the lung.
我们遇到了12例肺内淋巴结病例（9例男性，3例女性），通过胸部X线摄影或胸部CT发现，并通过胸腔镜肺活检（10例）、开胸肺活检（1例）或肺叶切除术（1例）确诊。我们还研究了日语中与肺内淋巴结相关的文献。许多肺内淋巴结位于肺下野，肺上野较少。所有肺内淋巴结均呈球形，位于胸膜下，但在某些情况下，我们无法通过CT扫描结果将它们与恶性肿瘤区分开来。在手术前我们无法诊断它们或排除恶性肿瘤。病理结果显示，所有病例均有炭末沉着症。3例发现硅沉着病改变。我们认为，如果不能诊断周围性肺部病变，胸腔镜检查有助于做出明确诊断。我们强调，在肺内小结节病变的鉴别诊断中应考虑肺内淋巴结。
