Tsuda T, Matsunobe S, Matsumoto K, Nemoto T, Terada Y, Shimizu Y
Respiratory Center, Shiga Health Insurance Hospital, Otsu, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Nov;40(11):2066-9.
A 70-year-old woman with leiomyosarcoma, followed up for 5 years as tuberculoma, is described. The tumor, in the left lower lobe, had enlarged from 1.5 x 1.5 cm to 3.4 x 3.4 cm in 5 years, and doubling time was calculated to be 540 days. Another tumor (1.8 x 1.8 cm) was also recognized in the right lower lobe at the later time. Since not only a benign tumor but metastatic disease was suspected, thoracotomy was performed, and the intraoperative pathologic diagnosis was leiomyosarcoma. However, only partial lung resection was performed because of the low growth rate of the tumor, the patient's advanced age, limited lymphatic metastasis and favorable prognosis with only partial resection. DNA analysis of the tumor based on flow cytometry showed a diploid pattern, and this was thought to account for the long doubling time of the tumor. The postoperative course was satisfactory without any signs of recurrence at the operation site.
本文描述了一名70岁患有平滑肌肉瘤的女性患者，该患者被误诊为结核瘤并随访了5年。肿瘤位于左下叶，5年内从1.5×1.5厘米增大至3.4×3.4厘米，计算得出倍增时间为540天。之后在右下叶又发现了另一个肿瘤（1.8×1.8厘米）。由于怀疑不仅是良性肿瘤而且可能是转移性疾病，遂进行了开胸手术，术中病理诊断为平滑肌肉瘤。然而，鉴于肿瘤生长速度缓慢、患者高龄、淋巴转移局限以及仅行部分切除预后良好，仅进行了部分肺切除。基于流式细胞术的肿瘤DNA分析显示为二倍体模式，这被认为是肿瘤倍增时间长的原因。术后病程顺利，手术部位无任何复发迹象。
