van der Hoef M, Capaul R, Krayenbühl P, Steurer-Stey C, Schulthess G
Departement für Radiologie und Departement für Innere Medizin, Universitätsspital Zürich.
Praxis (Bern 1994). 2003 Jun 4;92(23):1087-91. doi: 10.1024/0369-8394.92.23.1087.
After his girl friend had been diagnosed with active pulmonary tuberculosis, a 45-year old male was referred to rule out transmission of this disease. The chest x-ray showed no signs of tuberculosis, however a small retrosternal lung nodule was found on the lateral film. Three months later, the nodule showed an increase in size and a CT of the chest was performed: No nodule could be found in the expected retrosternal location, but incidentally a small nodule in the right upper lobe was identified. This nodule could retrospectively be identified on the previous chest X-rays, its size had been increasing. After surgical removal, the lesion was diagnosed to be an adenocarcinoma T1, N0, M0. Careful follow-up of small intrapulmonary nodules detected on chest X-rays is highly advisable, especially in smokers of middle and older age bronchial carcinoma and therefore a straight forward approach with excision of the nodule should be considered. Nodules have to be surgically removed if an increase in size can be noted.
一名45岁男性在其女友被诊断为活动性肺结核后前来就诊，以排除该疾病的传播。胸部X光片未显示肺结核迹象，但在侧位片上发现一个胸骨后小肺结节。三个月后，该结节尺寸增大，遂进行胸部CT检查：在预期的胸骨后位置未发现结节，但偶然发现右上叶有一个小结节。这个结节在之前的胸部X光片上也能追溯到，其尺寸一直在增大。手术切除后，病变被诊断为腺癌T1、N0、M0。对于胸部X光片上检测到的肺内小结节，尤其是中老年吸烟者，强烈建议进行仔细的随访，因此应考虑直接切除结节的方法。如果结节尺寸增大，则必须进行手术切除。
