Goto Taichiro, Maeshima Arafumi, Akanabe Kumi, Hamaguchi Reo, Wakaki Misa, Oyamada Yoshitaka, Kato Ryoichi
Department of General Thoracic Surgery, National Hospital Organization Tokyo Medical Center, Japan.
Ann Thorac Cardiovasc Surg. 2011;17(2):174-7. doi: 10.5761/atcs.cr.09.01516.
Pleomorphic adenoma usually occurs in the salivary glands but rarely in the trachea or bronchi. A 71-year-old man had abnormal shadows on a chest X-ray. Chest CT revealed one tumor in the right basal segment of the lung and another, in the left main bronchus. Bronchoscopic biopsy of the right tumor revealed well-differentiated squamous cell carcinoma. Right lower lobectomy and lymph node dissection were performed (pT2N0M0, stage IB). At the orifice of the left main bronchus, bronchoscopy identified a polypoid lesion nearly obstructing the airway. The lesion was resected with hot snare ablation. The histological examination revealed a mixture of epithelial and myxoid mesenchymal elements, characterized by ductal structures, squamous metaplasia, and cartilage tissue. The diagnosis was bronchial pleomorphic adenoma coexisting with squamous cell carcinoma of the lung.
多形性腺瘤通常发生于涎腺，但很少见于气管或支气管。一名71岁男性胸部X线检查发现异常阴影。胸部CT显示右肺基底段有一个肿瘤，左主支气管也有一个肿瘤。对右侧肿瘤进行支气管镜活检，结果显示为高分化鳞状细胞癌。遂行右下肺叶切除术及淋巴结清扫术（pT2N0M0，ⅠB期）。在左主支气管开口处，支气管镜检查发现一个息肉样病变，几乎阻塞气道。用圈套热切除术切除该病变。组织学检查显示上皮和黏液样间充质成分混合，其特征为导管结构、鳞状化生和软骨组织。诊断为支气管多形性腺瘤合并肺鳞状细胞癌。
