Sagawa Motoyasu, Sugita Makoto, Hatta Rieko, Ueda Yoshimichi, Maeda Sumiko, Sakuma Tsutomu
Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
Jpn J Thorac Cardiovasc Surg. 2005 Sep;53(9):510-2. doi: 10.1007/s11748-005-0098-3.
We experienced a rare case of lung cancer without hilar/mediastinal nodal involvement or direct invasion to the thoracic wall, but with metastasis to a lymph node in the thoracic wall. A 72-year-old woman with lung cancer was admitted to our hospital for the surgical therapy. She had suffered from right pleuritis in her childhood. During the dissection of the pleural adhesion around the whole lung, one small black lymph node was found in the thoracic wall and resected. Then, right middle and lower lobectomy and systematic nodal dissection were performed. The postoperative pathological examination revealed that nodal involvement was not observed in all samples except in the lymph node in the thoracic wall. In lung cancer patients with broad pleural adhesion, we should pay attention to lymph nodes in the thoracic wall. If we find them, the nodes should be resected for accurate staging.
我们遇到了一例罕见的肺癌病例，该病例无肺门/纵隔淋巴结受累，也未直接侵犯胸壁，但胸壁淋巴结有转移。一名72岁的肺癌女性因手术治疗入住我院。她童年时曾患右侧胸膜炎。在对全肺周围的胸膜粘连进行剥离时，在胸壁发现一个小的黑色淋巴结并予以切除。然后，进行了右中、下叶切除术及系统性淋巴结清扫术。术后病理检查显示，除胸壁淋巴结外，所有样本均未发现淋巴结受累。对于有广泛胸膜粘连的肺癌患者，我们应注意胸壁淋巴结。如果发现这些淋巴结，应予以切除以进行准确分期。
