Mizushina Yoshiko, Bando Masashi, Hosono Tatsuya, Ohno Shoji, Sohara Yasunori, Hironaka Mitsugu, Yukihiko Sugiyama
Division of Pulmonary Medicine, Jichi Medical University.
Nihon Kokyuki Gakkai Zasshi. 2008 May;46(5):379-84.
A 44-year-old woman who had undergone hystero-oophorectomy for uterine sarcoma presented to our hospital with palindromic pneumothorax and her chest CT revealed multiple cystic lesions. After admission video-assisted thoracoscopic surgery (VATS) showed the pulmonary lesions to be primarily leiomyoma, however, further examination revealed that her uterine sarcoma resected in 2000 exhibited not only mitosis but also venous invasion. We therefore considered her lung tumors as metastases from uterine leiomyosarcoma. Cases of secondary spontaneous pneumothorax (SSP) due to pulmonary metastases are rare and almost half are from mesenchymal tumors. Thin-wall cavities and cysts are formed by a check-valve mechanism in the process of pulmonary metastases formation. When multiple thin-wall cavities and cysts are found in the lung, pulmonary metastases should be considered as one of the causes, and pathological specimens obtained in past illness should be re-examined in detail.
一名因子宫肉瘤接受子宫卵巢切除术的44岁女性因复发性气胸入住我院，胸部CT显示有多个囊性病变。入院后，电视辅助胸腔镜手术（VATS）显示肺部病变主要为平滑肌瘤，然而，进一步检查发现她在2000年切除的子宫肉瘤不仅有核分裂象，还伴有静脉浸润。因此，我们认为她的肺部肿瘤是子宫平滑肌肉瘤转移所致。因肺转移导致的继发性自发性气胸（SSP）病例罕见，其中近一半来自间叶组织肿瘤。在肺转移形成过程中，通过单向活瓣机制形成薄壁空洞和囊肿。当肺部发现多个薄壁空洞和囊肿时，应考虑肺转移是病因之一，应对既往疾病的病理标本进行详细复查。
