Tsushima Yukio, Suzuki Kenji, Watanabe Shun-ichi, Kusumoto Masahiko, Tsuta Koji, Matsuno Yoshihiro, Asamura Hisao
Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Chuo-ku, Japan.
Ann Thorac Surg. 2006 Oct;82(4):1508-10. doi: 10.1016/j.athoracsur.2006.01.100.
It is difficult to distinguish multiple primary lung cancers from pulmonary metastasis. We experienced a case of surgically resected lung tumors that showed multiple ground-glass opacities on thoracic computed tomographic scan. There were eight nonsolid and two part-solid ground-glass opacities in the bilateral lungs. Surgical resection was performed because all tumors had a ground-glass opacity appearance on computed tomographic scan, which is compatible with a finding of primary lung adenocarcinoma. The postoperative pathologic diagnoses were two cases of invasive adenocarcinoma, six cases of bronchioloalveolar carcinoma, and eight cases of atypical adenomatous hyperplasia. The patient remains alive without any evidence of recurrence 40 months after surgery. A ground-glass opacity appearance on computed tomographic scan could be interpreted as supportive evidence for multiple primary lung adenocarcinoma rather than pulmonary metastases.
区分多发性原发性肺癌与肺转移瘤很困难。我们遇到一例经手术切除的肺肿瘤病例,胸部计算机断层扫描显示有多个磨玻璃影。双侧肺内有8个纯磨玻璃影和2个部分实性磨玻璃影。由于所有肿瘤在计算机断层扫描上均表现为磨玻璃影,符合原发性肺腺癌的表现,因此进行了手术切除。术后病理诊断为2例浸润性腺癌、6例细支气管肺泡癌和8例非典型腺瘤样增生。患者术后40个月仍存活,无任何复发迹象。计算机断层扫描上的磨玻璃影表现可被视为支持多发性原发性肺腺癌而非肺转移瘤的证据。