Sakamaki F, Nakano M, Urano T, Mori M, Yamaguchi K, Kanazawa M, Izumi Y, Kikuchi K, Kobayashi K, Kuramochi S
Department of Medicine, School of Medicine, Keio University, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Aug;33(8):906-10.
A 64-year-old man with a history of smoking was admitted to our hospital, because he was noted to have a solitary mass lesion at the apex of the right lung on a chest roentgenogram. Eight months before admission, he had come to our hospital because of hemoptysis. At that time, however, no abnormal shadow was seen on his chest roentgemogram, except for multiple bullae at both apexes. Based on chest CT findings on admission, the tumor appeared to be a hematoma growing inside the bulla. The resected tumor was found to contain a large amount of coagulated blood in the bulla. Histopathological examination of the bulla revealed a proliferation of large atypical cells from the inner surface of the bulla toward the inner space. Thus, the diagnosis was large cell carcinoma within the wall of the pulmonary bulla, the inside of which was filled with hematoma. We believe that the hematoma in the bulla allowed us to make an early diagnosis, and thus to succeed in curing the patient.
一名有吸烟史的64岁男性因胸部X线片显示右肺尖有一个孤立性肿块病变而入住我院。入院前八个月，他因咯血前来我院。然而，当时他的胸部X线片上除了双肺尖多发肺大疱外未见异常阴影。根据入院时胸部CT表现，肿瘤似乎是在肺大疱内生长的血肿。切除的肿瘤在肺大疱内发现含有大量凝血。对肺大疱的组织病理学检查显示，从肺大疱内表面向内部空间有大量非典型细胞增殖。因此，诊断为肺大疱壁内的大细胞癌，其内部充满血肿。我们认为肺大疱内的血肿使我们能够做出早期诊断，从而成功治愈该患者。
