Oshikawa K, Ohno S, Ishii Y, Kitamura S
Department of Pulmonary Medicine, Jichi Medical School, Tochigi, Minamikawachi.
Intern Med. 1998 Apr;37(4):349-53. doi: 10.2169/internalmedicine.37.349.
To clarify the bronchoscopic findings in metastatic spread to the bronchi, we analyzed the records of 65 cases of metastatic pulmonary disease in which fiberoptic bronchoscopy had been done. Forty-five patients (69.2%) had abnormal bronchoscopic findings. These patients could be divided into three groups, according to bronchoscopic findings and route of metastatic spread to the bronchi: endobronchial metastasis (n=15), bronchial involvement (that is, direct extension to the bronchi from adjacent metastatic foci, n=15), and lymphangitis carcinomatosa (n=15). Breast cancer and colon cancer were common in cases of endobronchial metastasis, and the bronchial tumor often presented as a polypoid or nodular lesion covered with necrotic material. Submucosal swelling with an irregular margin and narrowing of the bronchial lumen were seen in cases of bronchial involvement. In conclusion, each type of primary extrapulmonary tumor is associated with characteristic endobronchial findings of pulmonary metastases such as endobronchial metastasis and bronchial involvement, which should be discriminated if possible, because of their different metastatic process.
为了阐明转移至支气管的支气管镜检查结果，我们分析了65例行纤维支气管镜检查的转移性肺病患者的记录。45例患者（69.2%）有异常支气管镜检查结果。根据支气管镜检查结果及转移至支气管的途径，这些患者可分为三组：支气管内转移（n = 15）、支气管受累（即从相邻转移灶直接蔓延至支气管，n = 15）和癌性淋巴管炎（n = 15）。支气管内转移病例中乳腺癌和结肠癌常见，支气管肿瘤常表现为覆盖坏死物质的息肉样或结节样病变。支气管受累病例可见黏膜下肿胀，边缘不规则，支气管腔狭窄。总之，每种类型的肺外原发性肿瘤都与肺转移的特征性支气管内表现相关，如支气管内转移和支气管受累，由于其转移过程不同，应尽可能加以鉴别。
