Matsushima Hidekazu, Oda Toshimi, Hasejima Nobuchika, Kou Eitetsu, Kadoyama Chikabumi, Takezawa Shinji
Department of Internal Medicine, Saitama Red Cross Hospital.
Nihon Kokyuki Gakkai Zasshi. 2007 Jul;45(7):556-9.
A 63-year-old man was admitted to our hospital for evaluation of an abnormal chest X-ray film finding. He was asymptomatic. The chest HRCT showed a ground-glass attenuation with multiloculated cystic change in the left lower lobe. There were no cystic lesions in the other lung fields except a ground-glass attenuation in the left lower lobe. The pathological examination of trans-bronchial lung biopsy specimen revealed adenocarcinoma. Therefore, primary lung cancer was diagnosed, and he underwent left lower lobectomy and mediastinal lymph node resection. Macroscopic examination of the resected lung specimen revealed multiloculated cystic lesions associated with a poorly demarcated white-gray tumor. The histological examination showed that papillary adenocarcinoma proliferated along the alveolar walls and that the walls of the multiloculated cystic lesions were composed of cancer cells. We speculated that adenocarcinoma cells extended along the alveolar walls and destroyed the alveoli without disrupting the overall lung architecture, resulting in enlarged multiloculated cystic lesions.
一名63岁男性因胸部X线片异常发现入院评估。他没有症状。胸部高分辨率CT显示左下叶有磨玻璃样密度影伴多房囊性改变。除左下叶有磨玻璃样密度影外，其他肺野未见囊性病变。经支气管肺活检标本的病理检查显示为腺癌。因此，诊断为原发性肺癌，他接受了左下叶切除术和纵隔淋巴结切除术。切除的肺标本宏观检查显示多房囊性病变伴有边界不清的灰白色肿瘤。组织学检查显示乳头状腺癌沿肺泡壁增殖，多房囊性病变的壁由癌细胞组成。我们推测腺癌细胞沿肺泡壁延伸并破坏肺泡，而不破坏整个肺结构，导致多房囊性病变扩大。
