Yoshizu Akira, Kamiya Kazunori
Department of General Thoracic Surgery, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
Kyobu Geka. 2012 Jun;65(6):507-9.
A 71-year-old woman was admitted to our hospital because of a mediastinal mass. Chest computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (FDG-PET) showed only 1 swollen mediastinal lymph node. Serum levels of carcinoembryonic antigen (CEA) were found to be elevated. Preoperative examination did not detect the primary lesion. A mediastinal lymphadenectomy was performed, and histologically, the tumor demonstrated poorly differentiated adenocarcinoma. Immunohistochemical staining for cytokine( CK) 7 and thyroid transcription factor( TTF) -1 were positive but were negative for CK20, suggesting a pulmonary origin. During 2-years postoperative follow-up, no signs of primary site growth can be detected. Surgical resection of mediastinal lymph node carcinoma of unknown primary site has the possibility of a good prognosis.
一名71岁女性因纵隔肿块入住我院。胸部计算机断层扫描（CT）和氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）仅显示1个纵隔淋巴结肿大。发现癌胚抗原（CEA）血清水平升高。术前检查未发现原发灶。行纵隔淋巴结切除术，组织学检查显示肿瘤为低分化腺癌。细胞角蛋白（CK）7和甲状腺转录因子（TTF）-1免疫组化染色呈阳性，但CK20呈阴性，提示起源于肺。术后2年随访期间，未发现原发部位生长迹象。对原发部位不明的纵隔淋巴结癌进行手术切除有可能获得良好预后。
