Okabe Hirofumi, Tomita Kazuhiro, Ogasawara Takashi, Iesato Ken, Kominami Satoshi, Ohde Yasuhisa, Toyoda Futoru, Otsuki Yoshiro, Shimizu Shin-ichi, Kobayashi Hiroshi, Nakamura Hidenori
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka, 430-8558, Japan.
Nihon Kokyuki Gakkai Zasshi. 2003 May;41(5):341-6.
A 64-year-old man without respiratory symptoms was introduced to our hospital because of a nodule of 20 mm in diameter found in the left lung in a periodic health examination. The chest radiograph and CT scan showed a well-defined nodule in the middle of the left lung field, and enlarged mediastinal lymph nodes. Lung cancer was suspected, and transbronchial and CT guided biopsies were performed, but did not lead to a definitive diagnosis. Since the patient refused further examinations, we carefully followed up the nodule in the chest radiograph. After a year and a half, the nodule and the lymph nodes became enlarged, and the patient was admitted to the hospital for a surgical biopsy. Video-assisted thoracoscopic surgery followed by thoracotomy was performed for both a biopsy and nodule resection. Histologically, the nodule tissue was rich in amorphous substances positively stained with Congo Red, which was consistent with amyloidosis. No findings of systemic amyloidosis or secondary amyloidosis were demonstrated.
一名64岁无呼吸道症状的男性因在定期健康检查中发现左肺有一个直径20毫米的结节而被转诊至我院。胸部X线片和CT扫描显示左肺野中部有一个边界清晰的结节,纵隔淋巴结肿大。怀疑为肺癌,遂进行了经支气管活检和CT引导下活检,但未能得出明确诊断。由于患者拒绝进一步检查,我们通过胸部X线片对该结节进行了仔细随访。一年半后,结节和淋巴结增大,患者入院接受手术活检。进行了电视辅助胸腔镜手术,随后开胸进行活检和结节切除。组织学检查显示,结节组织富含刚果红阳性染色的无定形物质,符合淀粉样变性。未发现系统性淀粉样变性或继发性淀粉样变性的表现。