Thoracic Surgery Unit, University Hospital of Modena, Modena, Italy.
Department of Pathology, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy.
Chest. 2019 Oct;156(4):e85-e89. doi: 10.1016/j.chest.2019.05.007.
A 72-year-old man underwent endoscopic resection of a 10-mm polypoid sessile lesion of the rectum. Histologic examination found a well-differentiated, low-grade (G1), neuroendocrine tumor. A thoracoabdominal CT scan was performed for staging purposes. The chest CT scan revealed a so-called cannonball-like distribution of multiple rounded nodules, with well-defined margins, ranging from 0.5 to 5 cm, scattered in both lungs (Figs 1A, 1B). The abdominal CT scan showed no abnormalities. A recent colonoscopy showed no evidence of malignancy. No prior chest imaging was available and the patient had never complained of respiratory symptoms. The patient was a former smoker, with a smoking history of 20 pack-years. He had a history of hypertension, mild stenosis of both carotid arteries, and benign prostatic hypertrophy. He reported the presence of long-standing multiple cutaneous hemangiomas on the trunk and face and a larger hemangiomatous lesion on his left lower limb, which was previously investigated by color Doppler ultrasound imaging. All these lesions were reported as unaltered and unchanged since early infancy.
一位 72 岁男性接受了内镜下直肠 10mm 息肉样无蒂病变切除术。组织学检查发现分化良好、低级别(G1)神经内分泌肿瘤。为了分期目的进行了胸腹 CT 扫描。胸部 CT 扫描显示双肺内存在多个边界清楚、大小 0.5-5cm 的圆形结节,呈所谓的炮弹样分布(图 1A、1B)。腹部 CT 扫描未见异常。最近的结肠镜检查未发现恶性肿瘤的证据。无既往胸部影像学检查,患者也从未有过呼吸系统症状。患者为既往吸烟者,吸烟史 20 包年。他有高血压病史,双侧颈动脉轻度狭窄和良性前列腺增生。他报告在躯干和面部有长期存在的多发性皮肤血管瘤,左下肢有一个较大的血管瘤病变,之前通过彩色多普勒超声成像进行了检查。所有这些病变自婴儿早期以来均未改变。