Murakami Kotaro, Yutaka Yojiro, Nakajima Naoki, Yoshizawa Akihiko, Date Hiroshi
Department of Thoracic Surgery, Kyoto University Hospital, 54 KawaharachoSakyo-ku, ShogoinKyoto, 606-8507, Japan.
Diagnostic Pathology, Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan.
Surg Case Rep. 2020 Sep 29;6(1):231. doi: 10.1186/s40792-020-01012-7.
Ciliated muconodular papillary tumor (CMPT) is a rare papillary nodule tumor with benign and malignant characteristics that occurs in the peripheral lung.
A 70-year-old woman who underwent right hemicolectomy for colorectal cancer (CRC; pT3N0M0, p-stage II) 2 years prior, presented with a sub-centimeter growing cavity shadow on chest computed tomography (CT), which was suspected to be a CRC metastasis. Because positron emission tomography CT suggested there was no other site suspicious of recurrence, thoracoscopic resection with preoperative pleural dye marking was planned to remove the small lesion, which seemed to be hardly palpable on CT. Immediately after pleural dye marking adjacent to the lesion using cone beam CT in the hybrid operating room, thoracoscopic wedge resection was performed and the tumor was finally diagnosed as CMPT, characterized by the papillary growth of mucus-producing cells in the alveoli.
We resected the non-palpable small lung lesions following preoperative marking using cone-beam CT in the hybrid operating room. This case highlights a rare cavitary CT image of a CMPT mimicking a metastatic lung tumor from colorectal cancer.
纤毛黏液结节状乳头状瘤（CMPT）是一种发生于肺外周的具有良性和恶性特征的罕见乳头状结节肿瘤。
一名70岁女性，2年前因结肠癌（CRC；pT3N0M0，p分期II期）接受了右半结肠切除术，胸部计算机断层扫描（CT）显示有一个直径小于1厘米的空洞性阴影，怀疑是CRC转移灶。由于正电子发射断层扫描CT显示没有其他可疑复发部位，计划在术前进行胸膜染色标记后行胸腔镜切除术以切除这个在CT上似乎难以触及的小病变。在杂交手术室使用锥形束CT对病变附近进行胸膜染色标记后，立即进行了胸腔镜楔形切除术，最终肿瘤被诊断为CMPT，其特征为肺泡内产生黏液的细胞呈乳头状生长。
我们在杂交手术室使用锥形束CT进行术前标记后切除了难以触及的小肺部病变。该病例突出了CMPT罕见的空洞性CT图像，其酷似结直肠癌肺转移瘤。
