Takagi Masamichi, Akiba Tadashi
Department of Respiratory Medicine, Jikei University Kashiwa Hospital.
Nihon Kokyuki Gakkai Zasshi. 2007 Feb;45(2):198-201.
A 62-year-old woman, who had received immunosuppressive treatment for myasthenia gravis, was admitted to our hospital for the treatment of a right pulmonary tumor. In October 2003, a chest computed tomography showed a nodule-like lesion in the right lung. Two years later, the lesion was shown to have increased in size, and a right upper lobectomy was performed using video-assisted thoracic surgery. A tumor biopsy showed histological features of bronchioloalveolar carcinoma. It has been reported that malignant tumors occur more frequently in patients with myasthenia gravis with concurrent thymoma. Therefore, such patients need to be followed closely for a long period of time for any possible malignant tumor occurring in different organs. In addition, protection of the bronchial stump may be necessary to prevent a bronchial fistula, because wound healing can be delayed due to immunosuppressive treatment.
一名62岁女性因重症肌无力接受免疫抑制治疗，因右肺肿瘤入院治疗。2003年10月，胸部计算机断层扫描显示右肺有一个结节样病变。两年后，病变显示增大，遂采用电视辅助胸腔镜手术进行了右上叶切除术。肿瘤活检显示为细支气管肺泡癌的组织学特征。据报道，合并胸腺瘤的重症肌无力患者发生恶性肿瘤的频率更高。因此，这类患者需要长期密切随访，以观察不同器官是否可能出现恶性肿瘤。此外，由于免疫抑制治疗可能会延迟伤口愈合，可能需要保护支气管残端以预防支气管瘘。
