Umemori Y, Kotani K, Makihara S
Department of Thoracic Surgery, Sanyo National Chest Hospital, Ube, Japan.
Kyobu Geka. 2002 Mar;55(3):264-6.
A 66-year-old man who underwent an extirpation of thymoma in stage I on September 16 1997 was followed in the outpatient clinic. In October 1998, a chest CT scan revealed a 2.0 x 1.0 cm faint frosted glass like shadow in the right S9. On September 13 1999, the patient was admitted to the hospital for close examination. Two times of transbronchial lung biopsy could not offer any clear diagnosis because the lesion was present so as to encircle the central segment of the B9 gronchus. A segmental resection (S9 + 10) under thoracotomy was performed. Intraoperative frozen section diagnosis was bronchioloalveolar carcinoma (type A according to Noguchi's classification), and a resection of the remnant lower lobe and mediastinal lymph nodes dissection (ND 2 a) were added. With expected increase in frequency of detecting early pulmonary cancer's through CT, clinical cases for which we are obliged to diagnosed the disease by segmental resection may increase, if the lesion develops in the vicinity of the hilum of lung like this case.
一名66岁男性,于1997年9月16日接受了I期胸腺瘤切除手术,术后在门诊随访。1998年10月,胸部CT扫描显示右肺下叶背段(S9)有一个2.0×1.0 cm的淡薄磨砂玻璃样阴影。1999年9月13日,患者因需进一步检查入院。两次经支气管肺活检均未能明确诊断,因为病变环绕右肺下叶背段支气管中心部。遂行开胸肺段切除(S9 + 10)。术中冰冻切片诊断为细支气管肺泡癌(根据Noguchi分类为A型),并加做了余肺下叶切除及纵隔淋巴结清扫(ND 2 a)。鉴于通过CT检测早期肺癌的频率预计会增加,如果病变像本例这样发生在肺门附近,那么我们不得不通过肺段切除来诊断疾病的临床病例可能会增加。