Nishi Wataru, Hayashi Kouji
Department of Thoracic Surgery, Kumamoto University, Kumamoto, Japan.
Kyobu Geka. 2021 Dec;74(13):1091-1094.
A 46-year-old patient man was pointed out multiple abnormal shadows on the chest X-ray. Computed tomography( CT) scans showed diffuse multiple granular shadows associated with ground-glass opacity in the surrounding area. Therefore, sarcoidosis or inflammatory lung disease was suspected. Bronchoscopic examination could not establish definitive diagnosis. Since an increase in the size and number of granular shadows was observed during the follow-up period, surgical biopsy was performed. Pathologically, adenocarcinoma with lepidic tumor growth into the surrounding area was observed suggesting primary lung cancer. Positron emission tomography (PET) after surgery for establishing stage of disease detected an abnormal accumulation in the pancreatic head which was demonstrated to be pancreatic cancer by biopsy. The final diagnosis of multiple lung tumor was metastases from pancreatic cancer.
一名46岁男性患者胸部X线检查发现多个异常阴影。计算机断层扫描(CT)显示弥漫性多发颗粒状阴影,周围区域伴有磨玻璃样混浊。因此,怀疑为结节病或炎症性肺病。支气管镜检查未能明确诊断。由于在随访期间观察到颗粒状阴影的大小和数量增加,遂进行了手术活检。病理检查发现为腺癌,呈鳞屑样肿瘤生长并累及周围区域,提示原发性肺癌。术后进行正电子发射断层扫描(PET)以确定疾病分期,结果发现胰头有异常放射性浓聚,活检证实为胰腺癌。最终诊断为多发性肺肿瘤是胰腺癌转移所致。