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Vol.38 No.6 contents | Japanese/English |
- Case Report -
A Case of Resected Multiple Subpleural Intrapulmonary Lymph Nodes Preoperatively Thought to be Multiple Lung Metastases from a Sigmoid Colon Carcinoma
Koji Kojima, Hiroaki Osada, Kumio Yokote, Atsushi Shimada, Noboru Yamate and Masayuki TakagiThe Third Department of Surgery and the Department of Pathology, St. Marianna University, School of Medicine, Kawasaki, Japan
A 70-year-old woman was found to have multiple coin lesions on chest CT scans prior to a planned sigmoidectomy for a cancer. Seven coin lesions scattered over both lung fields were thought to be metastases of the colon cancer. Following the sigmoidectomy the patient was transferred to us for thoracotomy. On the bilateral thoracotomy the lesions, each around 1cm in diameter, were recognized to all be located subpleurally and have anthracosis. Pathological examination revealed that each lesion was a subpleural lymph node encountered only rarely in the vicinity of visceral pleura. In the present case it had been impossible preoperatively to distinguish the lesions from lung metastases. In the differential diagnosis of peripheral pulmonary nodules it should be kept in mind that they may be subpleural intrapulmonary lymph nodes case even if they are multiple. Thoracoscopic treatment of these lesions may be the first choice in light of the visible superficial anthracosis uniformly found in them.
key words: Intrapulmonary lymph nodes, Coin lesion, Lung metastases
Received: November 18, 1997
Accepted: August 7, 1998
JJLC 38 (6): 709-713, 1998
