Yamada Hideki, Kondo Satoshi, Kamiya Junichi, Nagino Masato, Miyachi Masahiko, Kanai Michio, Hayata Atsushi, Washizu Junji, Nimura Yuji
Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
Surg Today. 2006;36(2):187-9. doi: 10.1007/s00595-005-3110-8.
A 53-year-old man who had the habit of consuming fish bones was referred to our clinic because of a suspected malignant abdominal wall tumor. Computed tomography (CT) showed a mass (10 x 5 cm) in continuity with the transverse abdominal muscle, containing a small calcification. A laparotomy was performed with a preoperative diagnosis of an inflammatory mass due to fish bone penetration from the sigmoid colon. A fish bone, measuring 2.3 cm in length, was detected within the tumor by specimen radiography. The pathological findings demonstrated actinomycotic colonies. We herein present the first case of a CT demonstration showing a fish bone in an abdominal mass which was pathologically confirmed to be actinomycosis. Evidence of the presence of a foreign body is valuable for diagnosing inflammatory nodules such as actinomycosis and differentiation from malignancies.
一名有食用鱼骨习惯的53岁男性因疑似腹壁恶性肿瘤被转诊至我院。计算机断层扫描(CT)显示一个与腹横肌相连的肿块(10×5厘米),内有小钙化灶。术前诊断为鱼骨从乙状结肠穿透导致的炎性肿块,遂行剖腹手术。通过标本X线摄影在肿瘤内检测到一根长2.3厘米的鱼骨。病理检查发现放线菌菌落。我们在此报告首例CT显示腹部肿块中有鱼骨且经病理证实为放线菌病的病例。异物存在的证据对于诊断放线菌病等炎性结节以及与恶性肿瘤相鉴别具有重要价值。