Mukaida T, Morita I, Nogami A, Kojo M, Hara F, Nakajima T
Department of Surgery, Kurashiki Daiichi Hospital, Japan.
Kyobu Geka. 1993 Nov;46(12):1077-9.
Mucoepidermoid carcinoma (MEC) of the lungs is thought to arise in the bronchial glands. It is a tumor that rarely develops and it has a low grade of malignancy. In this paper, we describe one case of infiltrative MEC, which we were able to diagnose preoperatively. Surgery revealed a high grade malignancy which is reported here with a discussion based on the related literature. The patient was a 63-year-old male who was referred to our hospital by another physician due to a cough and left chest pain. A simple chest X-ray revealed a tumor shadow and a fascicular shadow on its periphery in the upper left lobe. Bronchoscopy disclosed complete circumferential stenosis at B1+2,3 and reddening from this region to the main bronchus, but it was impossible to directly confirm the tumor. Pulmonary arterography did not depict the left upper pulmonary vein, but obstruction due to a tumor of that vein was observed. Given the above findings, under a diagnosis of infiltrative MEC, a left total lobectomy accompanied by a combined left atriectomy was performed. Although most cases of MEC have a low grade malignancy, there have been some reported cases with a very high grade of malignancy. Therefore, evaluation of the progress of this type of carcinoma by preoperative diagnosis as well as radical excision appropriate to lung cancer are considered to be important.
肺黏液表皮样癌(MEC)被认为起源于支气管腺体。它是一种罕见的肿瘤,恶性程度较低。在本文中,我们描述了一例浸润性MEC病例,该病例我们能够在术前做出诊断。手术显示为高等级恶性肿瘤,本文报告该病例并结合相关文献进行讨论。患者为一名63岁男性,因咳嗽和左胸痛被另一位医生转诊至我院。胸部X线平片显示左上叶有肿瘤阴影及其周边的条索状阴影。支气管镜检查显示B1+2、3处完全环形狭窄,从该区域至主支气管发红,但无法直接确认肿瘤。肺动脉造影未显示左上肺静脉,但观察到该静脉因肿瘤而阻塞。鉴于上述发现,在浸润性MEC的诊断下,实施了左全肺叶切除术并联合左心房切除术。尽管大多数MEC病例恶性程度较低,但也有一些报告的病例恶性程度非常高。因此,通过术前诊断评估这类癌症的进展以及采取适合肺癌的根治性切除被认为很重要。