Okutani Daisuke, Yamane Masaomi, Toyooka Shinichi, Oto Takahiro, Aoe Motoi, Sano Yoshifumi, Date Hiroshi
Department of Surgery, National Hospital Organization Minami-Okayama Medical Center, Okayama 701-0304, Japan.
Acta Med Okayama. 2008 Feb;62(1):55-8. doi: 10.18926/AMO/30991.
Dry pleural dissemination in non-small cell lung cancer, defined as solid pleural metastasis of lung cancer without pleural effusion, is a condition occurring in T4 lung cancer. Positron emission tomography (PET) has been reported to be useful for the diagnosis and staging of lung cancer. It has been reported that positive findings on PET scans of indeterminate pleural abnormalities at computed tomography (CT) are sensitive to malignancy. We encountered two cases of dry small pleural dissemination of adenocarcinoma of the lung preoperatively detected by PET/CT. A 75-year-old man and a 66-year-old man underwent CT scan, which demonstrated solitary tumor in the lung, an enlarged mediastinal lymph node, and a small pleural nodule less than 10 mm in size, all of which were positive findings on the fluorine 18 fluorodeoxyglucose (FDG) PET portion of an integrated PET/CT. Both patients underwent thoracoscopic biopsy of the dry pleural nodule revealing dissemination of adenocarcinoma of the lung (T4). Whereas histological thoracoscopic diagnosis remains mandatory before planning treatment, our cases may suggest that PET/CT will be useful as a screening modality for dry pleural dissemination of lung cancer.
非小细胞肺癌中的干性胸膜播散，定义为无胸腔积液的肺癌实性胸膜转移，是T4期肺癌中出现的一种情况。正电子发射断层扫描（PET）已被报道对肺癌的诊断和分期有用。据报道，计算机断层扫描（CT）上不确定的胸膜异常在PET扫描中的阳性结果对恶性肿瘤敏感。我们遇到了两例术前通过PET/CT检测到的肺腺癌干性小胸膜播散病例。一名75岁男性和一名66岁男性接受了CT扫描，显示肺部有孤立性肿瘤、纵隔淋巴结肿大以及一个小于10毫米的小胸膜结节，所有这些在PET/CT一体化检查的氟-18氟脱氧葡萄糖（FDG）PET部分均为阳性结果。两名患者均接受了干性胸膜结节的胸腔镜活检，结果显示为肺腺癌播散（T4）。虽然在制定治疗方案前组织学胸腔镜诊断仍然是必需的，但我们的病例可能提示PET/CT将作为肺癌干性胸膜播散的筛查方式有用。
