Motoishi Makoto, Okamoto Keigo, Kataoka Yoko, Sawai Satoru, Oshio Mayumi, Hanaoka Jun
Department of Thoracic Surgery, National Hospital Organization Kyoto Medical Center.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:595-8. doi: 10.5761/atcs.cr.12.02187. Epub 2013 Apr 11.
An abnormal shadow was detected in a 75-year-old man on a chest roentgenogram, and the patient was referred to our institution. A transbronchial biopsy was carried out and the specimen resulted in a diagnosis of organizing pneumonia. During the follow-up period, the left lung lesion became enlarged. Partial resection of the left lung was performed. Postoperatively, pathological examination of the tumor showed an organizing pneumonia. Approximately 3 years later, a new calcified heterogeneous mass shadow was detected in the left lung and left pleura, which had gradually enlarged. Computed tomography (CT)-guided fine-needle biopsy of the nodule of the left pleura was performed. Microscopically, the specimen led to the diagnosis of low-grade osteosarcoma. Re-evaluation of the primary and secondary lesions were confirmed as the same histopathological findings. A further systemic examination was performed. Finally, the lesion was confirmed as low-grade osteosarcoma of the lung. The patient refused further treatment and died due to respiratory failure.
一名75岁男性胸部X线片检查发现异常阴影,遂转诊至我院。进行了经支气管活检,标本诊断为机化性肺炎。随访期间,左肺病灶增大。行左肺部分切除术。术后肿瘤病理检查显示为机化性肺炎。约3年后,左肺及左胸膜发现新的钙化不均匀肿块阴影,且逐渐增大。对左胸膜结节进行了计算机断层扫描(CT)引导下细针穿刺活检。显微镜下,标本诊断为低级别骨肉瘤。对原发灶和继发灶重新评估,确认组织病理学结果相同。进一步进行了全身检查。最终,病变确诊为肺低级别骨肉瘤。患者拒绝进一步治疗,因呼吸衰竭死亡。