Kawasaki Hidenori, Arakaki Kazunari, Taira Naohiro, Furugen Tomonori, Ichi Takaharu, Yohena Tomofumi, Kawabata Tsutomu
Department of Surgery, National Hospital Organization Okinawa National Hospital, Okinawa, Japan.
Ann Thorac Cardiovasc Surg. 2016;22(2):116-21. doi: 10.5761/atcs.cr.15-00154. Epub 2015 Sep 2.
We report the rare and interesting case of a primary lung cancer detected 5 years after cancer of unknown primary (CUP) of a mediastinal lymph node (LN) was resected. A 40-year-old male was diagnosed with adenocarcinoma of unknown primary in a mediastinal lymph node after resection of the mediastinal tumor. Five years after resection of the CUP in mediastinal LN, a small, abnormal nodular shadow in left upper lobe was detected by chest CT. This pulmonary tumor was diagnosed as a lung adenocarcinoma. The pathological and immunohistological findings of the resected pulmonary tumor resembled those of the LN resected 5 years before. We speculated that the pulmonary lesion represented primary lung cancer that enlarged later than the metastatic mediastinal LN. This case illustrates the importance of careful observation and long-term follow-up in patients treated for CUP of a thoracic LN.
我们报告了一例罕见且有趣的病例，该病例为一名40岁男性，其纵隔淋巴结原发性不明癌症（CUP）切除5年后发现了原发性肺癌。该男性在纵隔肿瘤切除后被诊断为纵隔淋巴结原发性不明腺癌。纵隔淋巴结CUP切除5年后，胸部CT检测到左上叶有一个小的异常结节阴影。这个肺部肿瘤被诊断为肺腺癌。切除的肺部肿瘤的病理和免疫组织学结果与5年前切除的淋巴结相似。我们推测肺部病变代表原发性肺癌，其出现时间晚于转移性纵隔淋巴结。该病例说明了对接受胸段淋巴结CUP治疗的患者进行仔细观察和长期随访的重要性。
