Nishimura H, Aoki T, Haba Y, Kato K, Muramatsu A, Odajima H, Koyama M, Ito M
Department of Surgery, Kofu City Hospital, Japan.
Kyobu Geka. 1996 Feb;49(2):99-104.
ACTH-producing thymic carcinoid tumor with Cushing syndrome in a 41-year-old male was reported. Plasma ACTH and cortisol was high, and chest X-ray film and CT scan revealed a tumor mass in the anterior mediastinum. Extended thymectomy with pretracheal lymph node dissection was performed. The microscopic findings revealed that the mass was carcinoid tumor with metastasis of anterior mediastinal lymph node. ACTH and cortisol were restored to normal range 1 week after operation. Unfortunately, he admitted seven months later because of high level of ACTH and right supraclavicular lymph nodes swelling. He underwent right neck dissection. Pathological examination proved metastatic carcinoid tumors in the dissected nodes. It is important to perform supraclavicular lymph node dissection together with extended thymectomy for thymic carcinoid tumor.
报道了一名41岁男性患有产生促肾上腺皮质激素（ACTH）的胸腺类癌肿瘤并伴有库欣综合征。血浆促肾上腺皮质激素和皮质醇水平升高，胸部X线片和CT扫描显示前纵隔有肿瘤肿块。实施了扩大胸腺切除术并进行气管前淋巴结清扫。显微镜检查结果显示该肿块为类癌肿瘤且伴有前纵隔淋巴结转移。术后1周促肾上腺皮质激素和皮质醇恢复至正常范围。不幸的是，7个月后他因促肾上腺皮质激素水平升高和右锁骨上淋巴结肿大而入院。他接受了右颈部淋巴结清扫术。病理检查证实清扫的淋巴结中有转移性类癌肿瘤。对于胸腺类癌肿瘤，在进行扩大胸腺切除术的同时进行锁骨上淋巴结清扫很重要。
