Shomura Shin, Suzuki Hitoshi, Yada Masaki, Kondo Chiaki
Department of Thoracic Surgery, Mie General Medical Center, Yokkaichi, Japan.
Kyobu Geka. 2015 Jul;68(7):539-42.
We report a case of lung abscess misdiagnosed as adenocarcinoma based on cytologic findings of the sample obtained from needle biopsy. A 45-year-old man consulted our hospital because of fever, wet cough and an abnormal shadow on a chest X-ray film. A chest computed tomography revealed gradually enlarging pulmonary mass in the left S6 infiltrating the S5. A diagnosis of lung cancer was suspected and surgery was performed. Pathological findings of the specimen showed atypical cells with a large nucleus and a gross papillary neoplasm by needle biopsy. The patient underwent left lower lobectomy and partial resection of upper lobe with standard nodal dissection. The final diagnosis was a lung abscess with pneumonia without evidence of malignancy. When an indeterminate pulmonary tumor must be diagnosed during an operation, we should perform partial resection if possible.
我们报告一例基于经皮穿刺活检样本的细胞学检查结果而被误诊为腺癌的肺脓肿病例。一名45岁男性因发热、湿性咳嗽及胸部X线片上的异常阴影前来我院就诊。胸部计算机断层扫描显示左肺上叶S6段有逐渐增大的肺部肿块,并浸润至S5段。怀疑为肺癌并进行了手术。经皮穿刺活检标本的病理检查结果显示为非典型细胞,核大,大体表现为乳头状肿瘤。患者接受了左下肺叶切除术及上叶部分切除术,并进行了标准的淋巴结清扫。最终诊断为肺脓肿合并肺炎,无恶性肿瘤证据。当术中必须诊断不明的肺部肿瘤时,应尽可能进行部分切除术。