Cabuk Devrim, Gullu Y Taha, Basyigit Ilknur, Acikgoz Ozgur, Uygun Kazım, Yildiz Kursat, Yildiz Fusun
Department of Medical Oncology, Kocaeli University Hospital, Umuttepe, 41380 Kocaeli, Turkey.
Case Rep Pulmonol. 2013;2013:794642. doi: 10.1155/2013/794642. Epub 2013 Sep 15.
Endobronchial involvement of extrapulmonary malignant tumors is uncommon and mostly associated with breast, kidney, colon, and rectum carcinomas. A 68-year-old male with a prior diagnosis of colon non-Hodgkin lymphoma (NHL) was admitted to the hospital with a complaint of cough, sputum, and dyspnea. The chest radiograph showed right hilar enlargement and opacity at the right middle zone suggestive of a mass lesion. Computed tomography of thorax revealed a right-sided mass lesion extending to thoracic wall with the destruction of the third and the fourth ribs and a right hilar mass lesion. Fiberoptic bronchoscopy was performed in order to evaluate endobronchial involvement and showed stenosis with mucosal tumor infiltration in right upper lobe bronchus. The pathological examination of bronchoscopic biopsy specimen reported diffuse large B-cell lymphoma and the patient was accepted as the endobronchial recurrence of sigmoid colon NHL. The patient is still under treatment of R-ICE (rituximab-ifosfamide-carboplatin-etoposide) chemotherapy and partial regression of pulmonary lesions was noted after 3 courses of treatment.
肺外恶性肿瘤的支气管内累及并不常见，主要与乳腺癌、肾癌、结肠癌和直肠癌相关。一名68岁男性，既往诊断为结肠非霍奇金淋巴瘤（NHL），因咳嗽、咳痰和呼吸困难入院。胸部X线片显示右肺门增大，右中带模糊，提示有肿块病变。胸部计算机断层扫描显示右侧有一肿块病变延伸至胸壁，第三和第四肋骨破坏，以及右肺门肿块病变。为评估支气管内累及情况，进行了纤维支气管镜检查，显示右上叶支气管狭窄，伴有黏膜肿瘤浸润。支气管镜活检标本的病理检查报告为弥漫性大B细胞淋巴瘤，该患者被诊断为乙状结肠NHL的支气管内复发。该患者仍在接受R-ICE（利妥昔单抗-异环磷酰胺-卡铂-依托泊苷）化疗，3个疗程后肺部病变出现部分消退。
