Shimizu Koichiro, Segami Kenki, Aoyama Toru, Yukawa Norio, Tamagawa Hiroshi, Numata Masakatsu, Atsumi Yosuke, Chyu Mifa, Mizutani Momoyo, Tsuchiya Kohei, Yokoyama Ko, Rino Yasushi
Dept. of Surgery, Yokohama City University.
Gan To Kagaku Ryoho. 2023 Mar;50(3):387-389.
We present a case of benign esophageal leiomyoma with video-assisted thoracic enucleation. A 39-year-old woman was found to have an abnormal shadow in the mediastinum on a chest X-ray on a medical check-up. Chest CT performed for the purpose of close examination revealed a tumor with a size of 62×33 mm from the middle intrathoracic esophagus to the lower esophagus. Upper gastrointestinal endoscopy revealed a left half-circumferential elastic soft submucosal bulge in the thoracic middle-lower esophagus. Endoscopic ultrasonographic fine-needle aspiration biopsy(EUS-FNA)was performed, and immunostaining showed positive muscular markers SMA, but negative for CD34, c-kit, and S-100, and the diagnosis was esophageal leiomyoma. Therefore, thoracoscopic-assisted esophageal leiomyoma resection was performed. Postoperative immunohistological examination showed positive for SMA and Desmin, and the diagnosis was leiomyoma.
我们报告一例采用电视辅助胸腔镜摘除术治疗的良性食管平滑肌瘤病例。一名39岁女性在体检时胸部X线检查发现纵隔有异常阴影。为进一步检查而进行的胸部CT显示，从胸段食管中段至下段有一个大小为62×33 mm的肿瘤。上消化道内镜检查发现胸段食管中下段有一个左半周向的弹性软质黏膜下隆起。进行了内镜超声引导下细针穿刺活检（EUS-FNA），免疫染色显示肌肉标志物SMA阳性，但CD34、c-kit和S-100阴性，诊断为食管平滑肌瘤。因此，实施了胸腔镜辅助食管平滑肌瘤切除术。术后免疫组织学检查显示SMA和结蛋白阳性，诊断为平滑肌瘤。
