Kinoshita A, Nakano M, Suyama N, Inoue K, Nakata T, Fujimoto S, Shigematsu K, Oka M, Hara K
Department of Internal Medicine, Nagasaki City Hospital.
Intern Med. 1994 Nov;33(11):727-9. doi: 10.2169/internalmedicine.33.727.
We report two cases of intrapulmonary lymph nodes detected by a chest roentgenogram or CT scan. The first patient was a 61-year-old fisherman referred complaining of cough and hemosputum. Chest roentgenogram showed a subpleural small nodular shadow at the superior segment of the right lower lobe. Thoracotomy showed a small anthracotic lymph node. The other case was a 68-year-old female patient admitted for further examination of a subpleural small nodular shadow at the latero-basal segment of the left lower lobe detected on a chest CT scan. Thoracoscopic surgery revealed that the black nodule was an anthracotic lymph node. The appearance of an intrapulmonary lymph node on radiological examination is rare, however, it should be considered in the differential diagnosis of a solitary or multiple peripheral pulmonary nodules in adults. A small nodular shadow should be resected if malignancy is suspected though not proven. Subpleural intrapulmonary lymph node warrants thoracoscopic surgery.
我们报告两例通过胸部X线片或CT扫描发现的肺内淋巴结病例。首例患者为一名61岁的渔民，因咳嗽和咯血前来就诊。胸部X线片显示右下叶上段胸膜下有一个小结节阴影。开胸手术显示为一个小炭末沉着性淋巴结。另一例是一名68岁的女性患者，因胸部CT扫描发现左下叶外基底段胸膜下有一个小结节阴影而入院进一步检查。胸腔镜手术显示黑色结节为炭末沉着性淋巴结。肺内淋巴结在影像学检查中的表现较为罕见，然而，在成人孤立性或多发性周围型肺结节的鉴别诊断中应予以考虑。如果怀疑有恶性肿瘤但未经证实，应切除小结节阴影。胸膜下肺内淋巴结值得进行胸腔镜手术。
