Hanada T, Hizawa N, Ogura S, Isobe H, Miyamoto K, Narita Y, Kawakami Y
First Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Mar;33(3):369-72.
A 43-year-old woman was referred for examination because of an abnormal shadow on a chest X-ray film. She had a 12-year history of seropositive rheumatoid arthritis. Chest X-ray films and CT scans showed a pleurabased solitary nodule without a cavity. Cytological examination of a transbronchial biopsy specimen did not lead to a diagnosis, so thoracoscopic enucleation was performed. Histologically, the nodule consisted of lymphocytes and fibroblasts surrounding a central necrotic area, which indicated that it was a rheumatoid nodule. This solitary necrobiotic nodule was radiographically indistinguishable from lung adenocarcinoma, so histologic confirmation was necessary.
一名43岁女性因胸部X光片出现异常阴影而前来接受检查。她有12年血清阳性类风湿关节炎病史。胸部X光片和CT扫描显示一个位于胸膜的孤立结节，无空洞。经支气管活检标本的细胞学检查未能得出诊断结果，因此进行了胸腔镜摘除术。组织学检查显示，该结节由围绕中央坏死区域的淋巴细胞和成纤维细胞组成，这表明它是一个类风湿结节。这个孤立的坏死性结节在影像学上与肺腺癌无法区分，因此需要进行组织学确认。
