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Vol.49 No.7 contents | Japanese/English |
 | Full Text of PDF (831K) Article in Japanese |
- Case Report -
Mycobacterial Granuloma on the Staple-line Eight Years After Middle Lobectomy for Adenocarcinoma of the Lung
Shuji Murakami1, Haruhiro Saito1, Masahiro Tsuboi1, Haruhiko Nakayama1, Youichi Kameda2, Kouzo Yamada11Department of Thoracic Oncology, 2Department of Pathology, Kanagawa Cancer Center Hospital, Japan
Background. Mycobacterial granuloma on the staple-line after lobectomy is rare. Case. A 72-year-old woman underwent curative middle lobectomy for bronchioloalveolar carcinoma (type B), pT1N0M0, stage IA in 2000. Surgical staplers were used for completion of the interlobar fissure. In 2007, 7 years later, a routine computed tomography (CT) scan revealed a pulmonary lung nodule, 23 mm in size, on the staple-line. Since the positron emission tomography (PET) standardized uptake value was high (4.59), the nodule was considered to be malignant, we performed right upper lobectomy. Histopathologically, this nodule was an epithelioid granuloma with caseating necrosis. Ziehl-Neelsen stain revealed mycobacteria. Conclusion. In addition to local recurrence or secondary primary lung cancer, the possibility of mycobacterial granuloma should be considered in cases in which pulmonary nodules are detected on the staple-line after pulmonary resection. It can be difficult to distinguish malignant pulmonary solid nodules from benign nodules by CT and PET.
key words: Lung cancer, Staple-line, Mycobacterium, Granuloma
Received: March 14, 2009
Accepted: July 16, 2009
JJLC 49 (7): 1038-1042, 2009
