Watanabe Noriyuki, Iwazawa Takashi, Nagai Kennichi, Miyake Masakazu, Hata Taishi, Kawanishi Kenshu, Fujita Junya, Akagi Kenzo, Dono Keizo, Nishioka Kiyonori, Adachi Shiro, Kitada Masashi
Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan.
Kyobu Geka. 2012 Apr;65(4):341-3.
A 73-year-old woman who had underwent right lower lobectomy for adenocarcinoma of the lung( S10,pT1aN0M0, stage I A) 5 years before, visited our hospital with back pain. Whole body computed tomography (CT) revealed the enlargement of the abodominal lymph nodes surrounding the celiac artery,which was positive for fluorodeoxyglucose-positron emission tomography( FDG-PET). Open biopsy of the lymph node was performed and histopathological diagnosis was metastases of adenocarcinoma.Additional immunohistological examination showed positive findings for cytokeratin( CK) 7 and thyroid transcription factor( TTF)-1, but negative for CK20, suggesting the lesion to be metastases of lung cancer. Abdominal lymph node should be kept in mind in patients with lower lobe lung cancer.
一名73岁女性，5年前因肺腺癌（S10，pT1aN0M0，ⅠA期）接受了右下肺叶切除术，因背痛前来我院就诊。全身计算机断层扫描（CT）显示腹腔动脉周围腹部淋巴结肿大，氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）呈阳性。对该淋巴结进行了开放性活检，组织病理学诊断为腺癌转移。进一步的免疫组织学检查显示细胞角蛋白（CK）7和甲状腺转录因子（TTF）-1呈阳性，但CK20呈阴性，提示该病变为肺癌转移。对于下叶肺癌患者，应考虑腹部淋巴结转移的情况。
