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肺腺癌罕见的主动脉周围纵隔复发：何时确实需要进行诊断

Unusual Periaortic Mediastinal Recurrence of Pulmonary Adenocarcinoma: When Making Diagnosis Is Really Necessary.

作者信息

Caterino Umberto, Amore Dario, Cesaro Cristiano, Zamparelli Enzo, Cesaro Flavio, Palma Alba, Cicalese Marcellino, Casazza Dino, Lucci Raffaella, Cancellieri Alessandra

机构信息

Unit of Bronchology, Monaldi Hospital, Naples, Italy.

Unit of Thoracic Surgery, Monaldi Hospital, Naples, Italy.

出版信息

Case Rep Oncol. 2022 Mar 21;15(1):300-304. doi: 10.1159/000523736. eCollection 2022 Jan-Apr.

DOI:10.1159/000523736
PMID:35529285
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9035963/
Abstract

We report an unusual mediastinal recurrence along descending thoracic aorta during oncologic follow-up in a 47-year-old female smoker issued by lung adenocarcinoma with a history of left lower lobectomy and lingulectomy en bloc followed by adjuvant chemotherapy for stage III A-N2. Regional recurrence occurring along the staple line was suspected and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combined to PET/CT allowed to reach definitive tissue diagnosis. High focal hypermetabolic activity on PET/CT at the site of suspect recurrence was necessary to check the lesion sampling by EBUS-TBNA.

摘要

我们报告了1例47岁女性吸烟者，其在肺癌随访期间出现沿降主动脉的罕见纵隔复发。该患者有肺腺癌病史，曾接受左肺下叶及舌叶整块切除术，随后因ⅢA-N2期接受辅助化疗。怀疑沿吻合线出现区域复发，经支气管超声引导下经支气管针吸活检（EBUS-TBNA）联合PET/CT检查得以明确组织诊断。PET/CT上可疑复发部位的高灶性高代谢活性对于通过EBUS-TBNA检查病变采样很有必要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4944/9035963/66462d2f04d7/cro-0015-0300-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4944/9035963/f4eec6d26586/cro-0015-0300-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4944/9035963/5bd4e0e4c8cf/cro-0015-0300-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4944/9035963/66462d2f04d7/cro-0015-0300-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4944/9035963/f4eec6d26586/cro-0015-0300-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4944/9035963/5bd4e0e4c8cf/cro-0015-0300-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4944/9035963/66462d2f04d7/cro-0015-0300-g03.jpg

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本文引用的文献

1
Pulmonary Staple-Stump Granuloma After Segmentectomy: Two Case Reports and Comparison with Cases of Stump Recurrence.肺段切除术后肺钉合残端肉芽肿：两例报告并与残端复发病例对比
Am J Case Rep. 2019 Jul 19;20:1049-1056. doi: 10.12659/AJCR.916906.
2
The expanding role of endobronchial ultrasound in patients with centrally located intrapulmonary tumors.支气管内超声在中央型肺内肿瘤患者中的作用不断扩大。
Lung Cancer. 2019 Aug;134:194-201. doi: 10.1016/j.lungcan.2019.06.006. Epub 2019 Jun 24.
3
Prognostic factors for post-recurrence survival in patients with completely resected Stage III (N2) non-small-cell lung cancer.
完全切除的 III 期（N2）非小细胞肺癌患者复发后生存的预后因素。
Eur J Cardiothorac Surg. 2018 Sep 1;54(3):554-559. doi: 10.1093/ejcts/ezy063.
4
Transbronchial and transesophageal fine-needle aspiration using a single ultrasound bronchoscope in the diagnosis of locoregional recurrence of surgically-treated lung cancer.使用单一超声支气管镜进行经支气管和经食管细针穿刺抽吸术在手术治疗的肺癌局部区域复发诊断中的应用
BMC Pulm Med. 2017 Feb 28;17(1):46. doi: 10.1186/s12890-017-0388-4.
5
FDG uptake at the bronchial stump after curative lobectomy for non-small cell lung cancer.非小细胞肺癌根治性肺叶切除术后支气管残端的氟代脱氧葡萄糖摄取情况。
Eur J Nucl Med Mol Imaging. 2016 May;43(5):832-838. doi: 10.1007/s00259-015-3234-z. Epub 2015 Oct 28.
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Comparison of Endobronchial Ultrasound-Guided Fine Needle Aspiration and Video-Assisted Mediastinoscopy for Mediastinal Staging of Lung Cancer.支气管内超声引导下细针穿刺活检与电视辅助纵隔镜检查在肺癌纵隔分期中的比较
Lung. 2015 Oct;193(5):757-66. doi: 10.1007/s00408-015-9761-3. Epub 2015 Jul 18.
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Differences in patterns of recurrence in early-stage versus locally advanced non-small cell lung cancer.早期与局部晚期非小细胞肺癌复发模式的差异。
Ann Thorac Surg. 2014 Nov;98(5):1755-60; discussion 1760-1. doi: 10.1016/j.athoracsur.2014.05.070. Epub 2014 Aug 7.
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Integrated imaging of non-small cell lung cancer recurrence: CT and PET-CT findings, possible pitfalls and risk of recurrence criteria.非小细胞肺癌复发的综合影像：CT 和 PET-CT 表现、可能的陷阱和复发标准的风险。
Eur Radiol. 2012 Mar;22(3):588-606. doi: 10.1007/s00330-011-2299-8. Epub 2011 Oct 4.
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Lung Cancer. 2009 Jan;63(1):45-9. doi: 10.1016/j.lungcan.2008.04.004. Epub 2008 Jun 2.