Togashi Ken-ichi, Hirahara Hiroyuki, Sugawara Masaaki, Oguma Fumiaki
Division of Thoracic Surgery, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan.
Jpn J Thorac Cardiovasc Surg. 2003 Dec;51(12):692-5. doi: 10.1007/s11748-003-0014-7.
A 72-year-old male referred for surgical treatment underwent chest computed tomography to further investigate a well defined mass with a maximal diameter of 3.2 cm at the left S10. There was no pathological diagnosis established by either bronchoscopic biopsy specimens or computed tomography-guided percutaneous needle biopsy. The lower lobe and mediastinal lymph nodes were excised (complete resection). The 6.5-cm encapsulated grayish mass showed extensive areas of hemorrhage and necrosis on cut surface. Results from histological and immunohistochemical study yielded a definitive diagnosis of malignant schwannoma. Primary malignant schwannomas of the lung are extremely rare and the prognosis is poor in most cases. Our patient is currently well without recurrence more than 2 years after complete resection. Complete surgical resection is the best therapeutic option for primary malignant schwannoma of the lung.
一名因手术治疗前来就诊的72岁男性接受了胸部计算机断层扫描,以进一步检查左肺S10区一个边界清晰、最大直径为3.2厘米的肿块。支气管镜活检标本或计算机断层扫描引导下经皮穿刺活检均未确立病理诊断。切除了下叶及纵隔淋巴结(完整切除)。这个6.5厘米的包膜完整的灰白色肿块在切面上显示出广泛的出血和坏死区域。组织学和免疫组织化学研究结果明确诊断为恶性神经鞘瘤。原发性肺恶性神经鞘瘤极为罕见,大多数病例预后不良。我们的患者在完全切除术后2年多目前情况良好,无复发。完整的手术切除是原发性肺恶性神经鞘瘤的最佳治疗选择。