Suemitsu Ryuichi, Takeo Sadanori, Yamaguchi Masafumi, Hamatake Motoharu
Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
Ann Thorac Cardiovasc Surg. 2011;17(2):182-4. doi: 10.5761/atcs.cr.08.01373.
A 63-year-old male with lung cancer underwent a left upper lobectomy and mediastinal lymph node dissection through a median sternotomy. Postoperatively, he received 4 cycles of adjuvant chemotherapy with cisplatin and gemcitabin. Chest computed-tomography (CT) scan after the adjuvant chemotherapy showed a large cystic mass originating from the tracheal bifurcation. Fiberoptic bronchoscopy (FOB) revealed chylomediastinum during the aspiration biopsy of the mass. The chylous effusion was first removed by aspiration under FOB, though 2 weeks later the patient returned with a fever, and the CT lead us to suspect mediastinitis. After performing primary surgery for the removal of chylomediastinum, there was no recurrence thus we concluded that it was the better method.
一名63岁的肺癌男性患者通过正中胸骨切开术接受了左上叶切除术和纵隔淋巴结清扫术。术后，他接受了4个周期的顺铂和吉西他滨辅助化疗。辅助化疗后的胸部计算机断层扫描（CT）显示一个起源于气管分叉的巨大囊性肿块。纤维支气管镜检查（FOB）在肿块穿刺活检期间发现乳糜纵隔。乳糜性积液首先在FOB引导下通过抽吸清除，尽管2周后患者因发热复诊，CT检查使我们怀疑有纵隔炎。在进行了切除乳糜纵隔的初次手术后，未出现复发，因此我们得出结论，这是更好的方法。
