Department of General Thoracic Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
World J Surg Oncol. 2012 Jan 21;10:16. doi: 10.1186/1477-7819-10-16.
Cases of pulmonary artery masses have only rarely been reported, and the optimal type of the diagnosis and treatment is controversial.
An 81-year-old woman was found to have an abnormal shadow on chest X-ray film. Computed tomography showed an irregularly bordered tumor centered in the hilar region extending from segment 6 to the middle lobe of the right lung. Pulmonary angiography showed complete occlusion of the trunk at the periphery proximal to the bifurcation of the posterior ascending branch. Based on bronchoscopic biopsy of the tumor, an adenocarcinoma was diagnosed. Middle and lower lobectomy was performed. Histopathologically, the adenocarcinoma had invaded the tunica intima of the pulmonary artery and also replaced the endothelium in the same region. Although a large thrombus was found at the vessel invasion site of the adenocarcinoma in the pulmonary artery, there were no malignant findings in the thrombus itself.
This is the first reported case of radical resection of a lung cancer with invasion along the pulmonary artery wherein a benign thrombus had formed. In general, surgery would be the treatment of choice for a pulmonary artery mass.
肺动脉肿块的病例很少见，其最佳诊断和治疗类型存在争议。
一名 81 岁女性在胸片上发现异常阴影。计算机断层扫描显示以肺门区为中心的不规则边界肿瘤，从第 6 段延伸至右肺中叶。肺动脉造影显示，在后上支分叉近端的外围，主干完全闭塞。根据肿瘤的支气管镜活检，诊断为腺癌。进行了中、下肺叶切除术。组织病理学检查显示，腺癌侵犯肺动脉内膜，并在同一区域取代了内皮细胞。尽管在肺动脉腺癌的血管侵犯部位发现了一个大血栓，但血栓本身没有恶性发现。
这是首例报道的根治性切除侵犯肺动脉的肺癌并形成良性血栓的病例。一般来说，手术是治疗肺动脉肿块的首选方法。
