Manabe Takehiko, Kuwata Taiji, Taira Akihiro, Shinohara Shinji, Kuroda Koji, Tanaka Fumihiro
Department of Second Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2020;42(4):365-369. doi: 10.7888/juoeh.42.365.
A 73-year-old woman was diagnosed by bronchoscopic examination with primary left lung cancer (Adenocarcinoma, cT3N0M0, stage IIB), which was closely adjacent to the descending aorta in contrast enhanced computed tomography (CT). This CT did not reveal any invasion of a tumor into the descending aorta, and a dynamic fourth dimension CT (4D-CT) indicated that there was no invasion of the aorta by this tumor, so we decided to perform surgery. The operative procedure was a left lower lobectomy and lymph node dissection with the use of a thoracoscope. An intraoperative finding was that the tumor had not invaded the aorta. There are few reports about the evaluation of vascular invasion using the dynamic 4D-CT. We consider that the dynamic 4D-CT gave very useful information about vascular invasion.
一名73岁女性经支气管镜检查诊断为原发性左肺癌(腺癌,cT3N0M0,IIB期),在增强计算机断层扫描(CT)中,该肿瘤与降主动脉紧密相邻。该CT未显示肿瘤侵犯降主动脉,动态四维CT(4D-CT)表明该肿瘤未侵犯主动脉,因此我们决定进行手术。手术方式为胸腔镜下左肺下叶切除术及淋巴结清扫术。术中发现肿瘤未侵犯主动脉。关于使用动态4D-CT评估血管侵犯的报道较少。我们认为动态4D-CT为血管侵犯提供了非常有用的信息。