Nakamura Yusuke, Iwazaki Masayuki, Watanabe Rinako, Isono Hisayo, Masuda Ryota, Sato Teiko, Miyamoto Matakiti, Shimada Akihiko
Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, 220-0012, Japan.
Gen Thorac Cardiovasc Surg. 2013 Apr;61(4):234-7. doi: 10.1007/s11748-012-0126-z. Epub 2012 Jul 5.
Pulmonary inflammatory pseudotumor is rare. A 34-year-old woman visited our hospital due to an abnormal chest shadow. Computed tomograhy showed a nodule in the right upper lobe. Bronchoscopy showed a polypoid endobronchial nodule obstructing most of the orifice of B2a. The nodule was white, glossy, and smooth, and it seemed to be covered with bronchial mucosa. However, transbronchial biopsy could not facilitate a diagnosis. To obtain a definitive diagnosis, we performed lobectomy of the right upper lobe using video-assisted thoracic surgery and removed the nodule completely. The pathologic diagnosis made during surgery was inflammatory pseudotumor. Immunohistochemical examination showed proliferating spindle cells were positive for vimentin and smooth muscle actin, but negative for epithelial markers. These findings were consistent with the staining pattern of inflammatory pseudotumor previously reported. Careful follow-up is necessary to detect any sign of local recurrence and distant metastases.
肺炎性假瘤较为罕见。一名34岁女性因胸部阴影异常前来我院就诊。计算机断层扫描显示右上叶有一个结节。支气管镜检查显示一个息肉样支气管内结节阻塞了B2a的大部分开口。该结节呈白色、有光泽且表面光滑，似乎被支气管黏膜覆盖。然而，经支气管活检未能明确诊断。为获得明确诊断，我们采用电视辅助胸腔镜手术对右上叶进行了肺叶切除术，并完整切除了结节。手术中的病理诊断为炎性假瘤。免疫组织化学检查显示增殖的梭形细胞波形蛋白和平滑肌肌动蛋白呈阳性，但上皮标志物呈阴性。这些发现与先前报道的炎性假瘤染色模式一致。需要进行仔细的随访以检测任何局部复发和远处转移的迹象。
