Kishimoto T, Yamaguchi K
Department of Clinical Investigation, Kure Kyosai Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jul;28(7):1028-32.
A 76 year-old male with simultaneous double cancer (lung and stomach cancer) was reported. The patient was followed up for pleural plaque on chest X-ray from 1986. The diagnosis of stomach cancer was decided by biopsy and lung cancer by operation at the same time in 1989. The histology of these two tumors were different (stomach: well differentiated tubular adenocarcinoma, lung: moderately differentiated papillary adenocarcinoma) and the stomach cancer was early stage and lung cancer was stage IIIa. He had a definite history of asbestos exposure in Japanese naval shipyard. Pleural plaque with calcification was found on chest X-ray and numerous asbestos bodies were detected in the resected lung tissue. Almost all asbestos fibers examined by an X-ray analyzer with scanning microscopy were chrysotile or tremolite. Furthermore, he was a heavy smoker (B.I., 1650). These tumors developed after 59 years of the first asbestos exposure. Asbestos exposure and smoking are considered to be important pathogenesis factors related to these two tumors.
报告了一名患有同时性双癌（肺癌和胃癌）的76岁男性。该患者自1986年起因胸部X光片上的胸膜斑接受随访。1989年，通过活检确诊为胃癌，同时通过手术确诊为肺癌。这两种肿瘤的组织学类型不同（胃：高分化管状腺癌，肺：中分化乳头状腺癌），胃癌为早期，肺癌为Ⅲa期。他有明确的在日本海军造船厂接触石棉的病史。胸部X光片上发现有钙化的胸膜斑，在切除的肺组织中检测到大量石棉小体。通过扫描显微镜用X射线分析仪检查的几乎所有石棉纤维均为温石棉或透闪石。此外，他是重度吸烟者（吸烟指数，1650）。这些肿瘤在首次接触石棉59年后发生。石棉接触和吸烟被认为是与这两种肿瘤相关的重要发病因素。
