Hashimoto Shintaro, Yamasaki Naoya, Doi Ryoichiro, Hatachi Go, Kamohara Ryoutaro, Miyazaki Takuro, Matsumoto Keitaro, Tsuchiya Tomoshi, Hashisako Mikiko, Tabata Kazuhiro, Nagayasu Takeshi
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Kyobu Geka. 2017 Mar;70(3):187-190.
A 66-year-old woman underwent right lower lobectomy and partial resection of the middle lobe for Stage I A double lung cancer. Five years after the operation, a routine computed tomography (CT) scan showed a mass on the staple line at the middle lobe. The mass was enlarged on CT scan after 6 months. A definitive diagnosis could not be made by bronchoscopic examination and fluoro-2-deoxy-glucose(FDG)/positron emission tomography( PET)-CT showed FDG uptake in the mass( early phase:SUVmax=3.24, late phase:SUVmax=4.31). Local recurrence of lung cancer was not completely denied, and right middle lobectomy was performed. Histopathologically, the resected specimen revealed granuloma with foreign body reaction. We should keep in mind the possibility of granuloma as differential diagnosis of lung cancer when using stapler.
一名66岁女性因I A期双肺癌接受了右下叶切除术及中叶部分切除术。术后五年，常规计算机断层扫描（CT）显示中叶吻合钉线处有一肿块。6个月后CT扫描显示该肿块增大。支气管镜检查无法做出明确诊断，氟代脱氧葡萄糖（FDG）/正电子发射断层扫描（PET）-CT显示肿块有FDG摄取（早期：SUVmax = 3.24，晚期：SUVmax = 4.31）。不能完全排除肺癌局部复发，遂行右中叶切除术。组织病理学检查显示，切除标本为伴有异物反应的肉芽肿。使用吻合器时，我们应牢记肉芽肿作为肺癌鉴别诊断的可能性。
