Sugimoto M, Yamawaki I, Katsura H, Hashimoto I, Inano H, Iizuka M, Sano M, Mizuno T
Department of Pulmonary Medicine, Seirei Hamamatsu Hospital, Shizuoka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Nov;34(11):1289-93.
A 75-year-old woman had an irregularly shaped cavitary lesion in the right upper lung field on a chest X-ray film and a CT scan. Primary lung cancer was suspected, but no evidence of malignancy or of infection was found on examination of specimens obtained by transbronchial biopsy and by lavage. Seven months after the first examination the cavity was found to have enlarged and an intra-cavitary fungus ball like shadow was seen. On the basis of these findings, pulmonary aspergilloma with or without primary lung cancer was suspected. Examination of a specimen obtained by transbronchial biopsy revealed squamous cell carcinoma. Right upper lobectomy was done, and the resected tissue included a polypoid nodule and a cavity wall composed of a milky-white solid tumor. Microscopic examination revealed a moderately differentiated squamous cell carcinoma in both the cavity wall and the polypoid nodule, and no evidence of fungal involvement.
一名75岁女性的胸部X光片和CT扫描显示右上肺野有一个形状不规则的空洞性病变。怀疑为原发性肺癌，但经支气管活检和灌洗获取的标本检查未发现恶性或感染迹象。首次检查七个月后，发现空洞增大，可见腔内有真菌球样阴影。基于这些发现，怀疑为伴有或不伴有原发性肺癌的肺曲菌球。经支气管活检获取的标本检查显示为鳞状细胞癌。进行了右上叶切除术，切除组织包括一个息肉样结节和由乳白色实性肿瘤构成的空洞壁。显微镜检查显示空洞壁和息肉样结节均为中分化鳞状细胞癌，未发现真菌累及迹象。
