Tomita Shougo, Takeda Norikazu, Hasumoto Makoto, Kagiyama Nao, Yano Ryouzou, Nakamura Takayuki, Kijima Hirotake, Iwaku Fumiko, Kuraishi Hiroshi, Kikuchi Toshiki, Otsuka Hidehiko, Narushima Michiaki, Suzuki Hajime
Dept. of Respiratory Medicine, Fujigaoka Hospital of Showa University School of Medicine, Fujigaoka 1-30, Aobaku, Yokohama 227-8501.
Nihon Kokyuki Gakkai Zasshi. 2004 Feb;42(2):181-4.
Small cell lung cancer was diagnosed in a 54-year-old man in 1997. He had received 5 cycles of systemic chemotherapy and thoracic irradiation since 1997, and a favorable response had been achieved. In August 2001, pro-GRP was again elevated, and he was readmitted. Bronchoscopic findings revealed a white dendritic endobronchial mass on a cheese-like plug obstructing the left upper bronchus division. Numerous mucor hyphe and cancer cells were detected by transbronchial biopsy, and a fungal culture disclosed mucor. Although no antifungal drug was administered, the bronchial lesion disappeared after removal with biopsy forceps and 2 cycles of systemic anticancer chemotherapy. Endobronchial involvement of mucormycosis is rare and this case is unique because of the peculiar bronchoscopic finding with the endobronchial lesion.
1997年,一名54岁男性被诊断为小细胞肺癌。自1997年以来,他接受了5个周期的全身化疗和胸部放疗,并取得了良好的反应。2001年8月,胃泌素释放肽前体(pro-GRP)再次升高,他再次入院。支气管镜检查发现,在阻塞左肺上叶支气管分支的奶酪样栓子上有一个白色树枝状支气管内肿物。经支气管活检检测到大量毛霉菌丝和癌细胞,真菌培养显示为毛霉菌。尽管未使用抗真菌药物,但在使用活检钳切除病变并进行2个周期的全身抗癌化疗后,支气管病变消失。毛霉菌病的支气管内受累很少见,该病例因其支气管镜下独特的支气管内病变表现而独一无二。