Shiono S, Masaoka T, Sato T, Yanagawa N
Division of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
Kyobu Geka. 2006 May;59(5):426-9.
A 75-year-old man admitted to our hospital due to an abnormal X-ray shadow detected during an annual health check-up. Chest computed tomography (CT) revealed 3.0 cm solid nodules with chest wall invasion in the left lung. We could not get a definitive diagnosis by transbronchial lung biopsy or CT-guided needle biopsy. Positron emission tomography (PET)-CT revealed positive findings in the tumor, aortopulmonary window lymph node and splenic flexure. Under a diagnosis of suspected lung cancer, thoracotomy was performed. As intraoperative diagnosis revealed a moderately differentiated squamous cell carcinoma, the patient underwent a left upper lobectomy, mediastinal lymph node dissection, and combined chest wall resection. Pathological stage was T3N2M0, stage IIIA. Ten days after surgery, the patient suffered from ileus and emergent surgery was performed. Subsequent pathological examination revealed lung cancer metastasis in the small intestine.
一名75岁男性因年度健康检查时发现X线阴影异常而入住我院。胸部计算机断层扫描（CT）显示左肺有一个3.0厘米的实性结节并侵犯胸壁。经支气管肺活检或CT引导下针吸活检均未能明确诊断。正电子发射断层扫描（PET）-CT显示肿瘤、主动脉肺动脉窗淋巴结和脾曲有阳性发现。在疑似肺癌的诊断下，进行了开胸手术。术中诊断为中分化鳞状细胞癌，患者接受了左上肺叶切除、纵隔淋巴结清扫和胸壁联合切除。病理分期为T3N2M0，ⅢA期。术后10天，患者发生肠梗阻，进行了急诊手术。随后的病理检查显示小肠有肺癌转移。
