Hokka Daisuke, Yoshikawa Koichi, Morimoto Masato, Hashimoto Shotaro, Kamimura Ryosuke, Tai Kentaro, Hoshida Yoshihiko
Department of Thoracic Surgery, Sumitomo Hospital, Osaka, Japan.
Kyobu Geka. 2012 Mar;65(3):255-7.
We report 2 cases of lung cancer incidentally detected following pneumothorax. Case 1:A 40-year-old man complaining of dyspnea was admitted with right pneumothorax. Chest computed tomography (CT) after chest drainage showed a cavitary nodule with pleural indentations in the right lower lobe. It was indicated at surgery that pneumothorax was caused by perforation of the tumor into the pleural cavity. Right lower lobectomy was performed because the pathological diagnosis of the nodule was a large cell carcinoma. The final histopathological diagnosis was stage II A (pT2aN1M0). The patient died of recurrence 14 months after surgery. Case 2:A 47-year-old man who admitted with right pneumothorax was found to have a nodule with pleural indentations closely a bulla at the apex of the right lung by chest CT after chest drainage. Pneumothorax was indicated to be caused by rupture of the bulla at surgery. Right upper lobectomy was performed because the pathological diagnosis of the nodule was a squamous carcinoma. The final histopathological diagnosis was stage I A (pT1bN0M0). The patient is alive at 2 years after the operation without recurrence. Lung cancer detected following pneumothorax which was caused by perforation of the tumor is generally considered to have poor prognosis. Whereas, prognosis of lung cancer incidentally detected following pneumothorax depends on its staging.
我们报告了2例气胸后偶然发现的肺癌病例。病例1：一名40岁男性因呼吸困难入院，诊断为右侧气胸。胸腔闭式引流术后胸部计算机断层扫描（CT）显示右下叶有一个伴有胸膜凹陷的空洞性结节。手术显示气胸是由肿瘤穿破进入胸膜腔所致。由于结节的病理诊断为大细胞癌，遂行右下叶切除术。最终组织病理学诊断为ⅡA期（pT2aN1M0）。患者术后14个月死于复发。病例2：一名47岁男性因右侧气胸入院，胸腔闭式引流术后胸部CT发现右肺尖部有一个伴有胸膜凹陷的结节，紧邻一个肺大疱。手术显示气胸是由肺大疱破裂所致。由于结节的病理诊断为鳞状细胞癌，遂行右上叶切除术。最终组织病理学诊断为ⅠA期（pT1bN0M0）。患者术后2年存活，无复发。因肿瘤穿破导致气胸后发现的肺癌通常预后较差。然而，气胸后偶然发现的肺癌的预后取决于其分期。
