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第45巻第4号目次 | Japanese/English |
 | Full Text of PDF (98K) Article in Japanese |
─ 症例 ─
A Case of T0 Small Cell Lung Cancer
Ryoji Kawano1, Enjo Hata1, Shingo Ikeda1, Toshiya Yokota1, Shin Karita1, Kazuyoshi Tamaki11Surgical Department of Respiratory Center, Mitsui Memorial Hospital, Japan
Background. Lung cancer rarely shows a lymph node metastasis to pulmonary hilar and/or mediastinal regions without the primary site of the lung being unable to be detected. Case. A 68-year-old man demonstrated a right abnormal hilar shadow on a chest X-ray film. A computed tomography (CT) revealed an enlarged mass at the right pulmonary hilar node, and this mass was diagnosed to be poorly differentiated carcinoma by transbronchial aspiration cytology. However, no primary lesion in the lung was apparent, and the extrathoracic findings showed no abnormalities despite a thorough examination. We thus performed a tumorectomy with right upper lobectomy and mediastinal nodal dissection because of the possibility of a lung origin based on the lymphatic routes to the tumor. The microscopical and immunohistochemical findings were consistent with small cell carcinoma in the pulmonary hilar node. Although no primary lesion of the resected lobe and also other lobes of the lung was found despite detailed examinations, positive immunoreactivity against anti-thyroid transcription factor-1 (TTF-1) antibody revealed this tumor to have originated in the lung. Therefore, we consider that this patient is a rare case of primary unknown T0 lung cancer with metastasis in the pulmonary hilar lymph node. Conclusions. In case of T0 lung cancer, since the primary lesion may later be identified, a strict follow-up study after the operation is necessary.
索引用語：T0 lung cancer, Small cell carcinoma, Thyroid transcription factor-1（TTF-1）, Lymph node metastasis, Cancer of unknown primary site
受付日：2005年3月10日
受理日：2005年5月30日
肺癌 45 (4)：377─380，2005
