Watanabe Tatsuaki, Sado Tetsu, Notsuda Hirotsugu, Eba Shunsuke, Watanabe Yui, Suzuki Takaya, Noda Masafumi, Sakurada Akira, Hoshikawa Yasushi, Endo Chiaki, Okada Yoshinori, Kondo Takashi
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Kyobu Geka. 2011 Dec;64(13):1176-9.
We report a case of coexistence of sarcoidosis and thymic carcinoid. A 57-year-old man was pointed out the anterior mediastinal tumor when his generator of pacemaker was exchanged. The tumor was diagnosed as atypical carcinoid by percutaneous needle biopsy. Chest computed tomography (CT) revealed the mediastinal and right hilar lymphadenopathy. Preoperative transbronchial aspiration cytology revealed no malignancy and extirpation of the anterior mediastinal tumor was carried out together with left diagraphmatic nerve and pericardium. The histopathological examination of the pretracheal lymph node was sarcoidosis. Postoperative radiation was performed because the thymic carcinoid invaded the pericardium. The right hilar lymph node was enlarged after the radiation. Five months later, follow-up chest CT showed reduction of the right lymph node. He has been alive without recurrence of the thymic carcinoid for 3 years. Simultaneous occurrence of sarcoidosis and thymic carcinoid is extremely rare. Assessment of mediastinal lymph node is difficult either preoperatively and postoperatively. Histological confirmation of the lymph node and careful follow-up are necessary.
我们报告一例结节病与胸腺类癌并存的病例。一名57岁男性在更换起搏器发生器时被发现前纵隔肿瘤。经皮针吸活检将该肿瘤诊断为非典型类癌。胸部计算机断层扫描(CT)显示纵隔和右肺门淋巴结肿大。术前经支气管针吸细胞学检查未发现恶性肿瘤,遂连同左膈神经和心包一起切除前纵隔肿瘤。气管前淋巴结的组织病理学检查为结节病。由于胸腺类癌侵犯心包,术后进行了放疗。放疗后右肺门淋巴结肿大。五个月后,胸部CT随访显示右淋巴结缩小。他已存活3年,胸腺类癌未复发。结节病与胸腺类癌同时发生极为罕见。术前和术后评估纵隔淋巴结都很困难。对淋巴结进行组织学确认并仔细随访是必要的。