Seki H, Tsuneta Y, Matsuki K, Nishiura Y, Takahashi W, Kato H, Kawai T
Department of Internal Medicine, Konan Hospital, Sapporo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Feb;30(2):363-7.
A 67-year-old male was admitted for detailed investigation of an abnormal chest roentgenogram showing a tumor shadow about 3 cm in diameter in the left S1+2. The shadow was surrounded by minute granular and striate shadows. Small cell carcinoma of the lung was diagnosed and chemotherapy was commenced, but without effect. Hypercalcemia and superior vena caval syndrome followed. Autopsy indicated highly specific calcinosis present in the left upper lobe peripheral to the primary disease. This calcinosis was observed subepithelially in bronchi and bronchioles, in the tunica intima of the veins, and in the alveolar septa. It could not be detected in the tumor or arterial or lymphatic systems. The calcinosis had been present prior to the development of hypercalcemia, and the density of the calcinosis was greatest close to the tumor, gradually decreasing with increased distance from the tumor. The calcinosis appeared to have been caused by some substance, and to have been accelerated by venous congestion, resulting in its unique distribution.
一名67岁男性因胸部X线片异常入院接受详细检查,X线片显示左肺上叶S1+2区域有一个直径约3 cm的肿瘤阴影。该阴影被微小的颗粒状和条纹状阴影环绕。诊断为肺小细胞癌并开始化疗,但无效。随后出现高钙血症和上腔静脉综合征。尸检显示在原发性疾病周围的左上叶存在高度特异性的钙质沉着。在支气管和细支气管的上皮下、静脉内膜以及肺泡间隔中观察到了这种钙质沉着。在肿瘤、动脉或淋巴系统中未检测到。钙质沉着在高钙血症发生之前就已存在,且钙质沉着的密度在靠近肿瘤处最大,随着与肿瘤距离的增加而逐渐降低。这种钙质沉着似乎是由某种物质引起的,并因静脉淤血而加速,从而导致其独特的分布。