Kawasaki Hidenori, Ishikawa Kiyoshi, Kuniyoshi Masayuki, Ohta Morio, Kawabata Tsutomu, Hirayasu Tsuneo
Division of Thoracic Surgery, National Okinawa Hospital, 3-20-14 Ganeko, Ginowan, Okinawa 901-2214, Japan.
Jpn J Thorac Cardiovasc Surg. 2004 Jan;52(1):21-5. doi: 10.1007/s11748-004-0056-5.
A 73-year-old female was referred to our hospital in June 2000 for the evaluation of an abnormal shadow in the left upper lobe of her lung and two other shadows in the left lower lobe. A computed tomography examination revealed an ill-defined tumor with ground glass opacity in the left upper division segment, suggesting a primary lung adenocarcinoma, and two well-defined nodules in the left lower lobe, suggesting metastatic carcinomas. A transbronchial lung biopsy of the tumor in the upper division segment confirmed the presence of an adenocarcinoma but failed to provide a histological diagnosis for the nodules in the lower lobe. A partial resection of the left lower lobe using video-assisted thoracoscopy revealed granulomatous tissue with no signs of malignancy. A curative resection of the adenocarcinoma in the left upper division segment was therefore performed. Histologically, the resected specimens obtained from the left lower lobe were diagnosed as cryptococcomas. The patient was diagnosed as having a stage IA lung adenocarcinoma and two cryptococcomas. The patient is presently well and has not experienced any recurrences or relapse for 3 years since the resection.
2000年6月，一名73岁女性因左肺上叶异常阴影及左肺下叶另外两个阴影被转诊至我院。计算机断层扫描检查显示，左上叶前段有一个边界不清、伴有磨玻璃影的肿瘤，提示原发性肺腺癌，左肺下叶有两个边界清晰的结节，提示转移性癌。对上叶前段肿瘤进行经支气管肺活检，证实为腺癌，但未能对下叶结节做出组织学诊断。使用电视辅助胸腔镜对左肺下叶进行部分切除，结果显示为肉芽肿组织，未见恶性迹象。因此，对左上叶前段的腺癌进行了根治性切除。组织学检查显示，取自左肺下叶的切除标本被诊断为隐球菌病。该患者被诊断为IA期肺腺癌和两处隐球菌病。患者目前情况良好，自切除术后3年未出现任何复发或病情进展。
