Imamura Yoshito, Kato Taketo, Shimada Satoko, Ueno Harushi, Nakamura Shota, Mizuno Tetsuya, Chen-Yoshikawa Toyofumi Fengshi
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Department of Pathology, Nagoya University Hospital, Nagoya, Aichi, Japan.
Ann Thorac Cardiovasc Surg. 2025;31(1). doi: 10.5761/atcs.cr.25-00097.
Primary pulmonary sarcoma is a rare disease and is much less common than lung cancer among tumors arising from pulmonary cysts. We report the case of a female patient who showed multifocal cysts in the left S9-10. Follow-up computed tomography (CT) revealed that the cyst tended to regress, but the solid component of the cyst wall continued to thicken, growing to a 10-cm-diameter tumor. Thoracoscopic left lower lobectomy was performed to diagnose and treat the cystic lung lesions. For the pathology of the pulmonary cystic lesion, it was marked by solid tumors composed of proliferative atypical spindle cells, with some trapped bronchial tissue. Based on the imaging and pathological findings, the diagnosis was primary pulmonary sarcoma arising from the pulmonary cyst. The present case highlights that, even when a pulmonary cyst appears to shrink, careful follow-up and timely surgical consideration are warranted if cyst wall thickening is observed.
原发性肺肉瘤是一种罕见疾病，在源自肺囊肿的肿瘤中，其发病率远低于肺癌。我们报告了一例女性患者，其左肺S9-10区域出现多灶性囊肿。后续计算机断层扫描（CT）显示囊肿有缩小趋势，但囊肿壁的实性成分持续增厚，最终长成一个直径达10厘米的肿瘤。遂行胸腔镜下左肺下叶切除术以诊断和治疗该肺囊性病变。对于该肺囊性病变的病理检查，其特征为肿瘤由增生的非典型梭形细胞构成实性肿块，并伴有一些陷入其中的支气管组织。根据影像学和病理检查结果，诊断为源自肺囊肿的原发性肺肉瘤。本病例强调，即使肺囊肿看似缩小，但如果观察到囊肿壁增厚，仍需仔细随访并及时考虑手术治疗。
