Torii Yoko, Susumu Sasano, Obara Tetsuya
"Department of Respirology, Tokyo Metropolitan Tama Cancer Detection Center.
Nihon Kokyuki Gakkai Zasshi. 2006 Nov;44(11):844-7.
A 69-year-old man presented with bloody sputum. Chest X-ray showed a trabecular shadow in the right upper lung field. Chest CT showed a bronchial cast shadow in the right B3a, extending along the bronchial bifurcations to the periphery. Impaction of the bronchus was suspected. Sputum cytology was class IIIb. Though bronchoscopic examination did not reveal a tumor or obstruction at the orifice of the right B3a, squamous cell carcinoma was diagnosed by biopsy. Right upper lobectomy was performed. Pathologically, the tumor was diagnosed as moderately differentiated squamous cell carcinoma, measuring 25 x 20 x 10mm in size. The tumor showed intrabronchial branching growth into the peripheral site of the right B3a and neither mucoid nor inflammatory granulation tissue was present. Impaction of the bronchus was made up by the squamous cell carcinoma itself. Lung cancer originating in subsegmental or sub-subsegmental bronchi, showed bronchial cast appearance due to intrabronchial growth is very rare.
一名69岁男性因咯血就诊。胸部X线显示右上肺野有条索状阴影。胸部CT显示右B3a区有支气管铸型阴影，沿支气管分支向周边延伸。怀疑有支气管堵塞。痰细胞学检查为IIIb级。尽管支气管镜检查未发现右B3a开口处有肿瘤或阻塞，但活检诊断为鳞状细胞癌。行右上叶切除术。病理检查显示，肿瘤为中分化鳞状细胞癌，大小为25×20×10mm。肿瘤呈支气管内分支状生长至右B3a周边部位，未见黏液样或炎性肉芽组织。支气管堵塞由鳞状细胞癌本身构成。起源于亚段或亚亚段支气管的肺癌，因支气管内生长而表现为支气管铸型外观的情况非常罕见。
