Sasaki Y, Yamagishi F, Suzuki K, Miyazawa H, Sugimoto N, Abe Y
Division of Thoracic Disease, National Chiba Higashi Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Dec;33(12):1454-8.
A 65-year-old woman was referred to our department because of an abnormal shadow on the chest roentgenogram. The chest roentgenogram showed infiltrative shadows in the right middle and lower lung fields. The chest CT scan showed non-segmental infiltration with a hazy margin and a clear air bronchogram in the right S8 area. A transbronchial aspiration cytology specimen showed atypical lymphocytes, and a transbrochial lung biopsy specimen showed infiltration by atypical lymphocytes. Malignant lymphoma was suspected from the results of the biopsy examination, and a right middle and lower lobectomy was done. The pathological findings showed proliferative atypical lymphocytes in the alveolar and interstitial areas. Malignant lymphoma (diffuse medium cell type by LSG classification) was diagnosed and an immunohistiochemical examination showed monoclonal proliferation of T lymphocytes, which were positive for T lymphocyte surface marker (UCHL-1). Therefore, we believe this was a case of primary pulmonary malignant lymphoma of the T-cell type.
一名65岁女性因胸部X线片出现异常阴影而转诊至我科。胸部X线片显示右中肺野和下肺野有浸润性阴影。胸部CT扫描显示右S8区有非节段性浸润,边缘模糊,可见清晰的空气支气管征。经支气管针吸细胞学标本显示非典型淋巴细胞,经支气管肺活检标本显示非典型淋巴细胞浸润。根据活检检查结果怀疑为恶性淋巴瘤,遂行右中肺叶和下肺叶切除术。病理结果显示肺泡和间质区域有增生性非典型淋巴细胞。诊断为恶性淋巴瘤(根据LSG分类为弥漫性中等细胞型),免疫组织化学检查显示T淋巴细胞单克隆增殖,T淋巴细胞表面标志物(UCHL-1)呈阳性。因此,我们认为这是一例T细胞型原发性肺恶性淋巴瘤病例。