Katsuragi N, Shiraishi Y, Kita H, Hashizume M, Miyasaka Y, Tanaka S
Section of Chest Surgery, Fukujuji Hospital, Kiyose, Japan.
Kyobu Geka. 2007 Jul;60(7):529-32.
Lung cancer among people in their twenties is rare and accounts for only 0.1-0.4% of all cases. We describe a case of squamous cell carcinoma of the lung in a 21-year-old man. The otherwise healthy patient presented with a 1 month history of cough. Chest radiography showed a well-defined round mass 5 cm in size in the right lower lobe. Computed tomography also showed a 3 cm hilar lymph node. Bronchoscopy revealed a white polypoid mass obstructing the right basal bronchus. Transbronchial biopsy revealed poorly differentiated squamous cell carcinoma of the lung. Clinical diagnosis was T2N1M0, stage IIB lung cancer. Right lower lobectomy with mediastinal lymph node dissection was performed. Lymph node metastases were proven histologically in the pretracheal, subcarinal, hilar, and intrapulmonary regions. Pathological diagnosis was T2N2M0, stage IIIA lung cancer. Endobronchial and mediastinal lymph node metastases were found 2 months after surgery. He received 3 rounds of chemotherapy with cisplatin and docetaxel and irradiation to the right hilum and mediastinum at a total dose of 60 Gy in 30 fractions. He is alive 6 months after surgery.
二十多岁人群中的肺癌较为罕见,仅占所有病例的0.1 - 0.4%。我们报告一例21岁男性肺鳞状细胞癌病例。这位原本健康的患者有1个月的咳嗽病史。胸部X线显示右下叶有一个边界清晰、大小为5厘米的圆形肿块。计算机断层扫描还显示一个3厘米的肺门淋巴结。支气管镜检查发现一个白色息肉样肿块阻塞右基底支气管。经支气管活检显示为低分化肺鳞状细胞癌。临床诊断为T2N1M0,IIB期肺癌。进行了右下叶切除术及纵隔淋巴结清扫术。组织学证实气管前、隆突下、肺门及肺内区域有淋巴结转移。病理诊断为T2N2M0,IIIA期肺癌。术后2个月发现支气管内及纵隔淋巴结转移。他接受了3个周期的顺铂和多西他赛化疗,并对右肺门和纵隔进行了放疗,总剂量60 Gy,分30次照射。术后6个月他仍存活。