コンベックス走査式超音波気管支鏡（CP-EBUS）を用いた経食道的超音波内視鏡下穿刺吸引法（EUS-FNA）により診断された悪性胸膜中皮腫の1例
背景．コンベックス走査式超音波気管支鏡（CP-EBUS）は，経食道的超音波内視鏡下穿刺吸引法（EUS-FNA）に用いることも可能である．我々は本法により診断しえた悪性胸膜中皮腫の1例を経験した．症例．72歳，男性．職業性アスベスト曝露歴あり．咳嗽，発熱，呼吸困難を契機に当院受診，胸部単純X線で左肺野に複数の腫瘤影，結節影を認め，胸部CTでそれらは胸膜に接していた．うち最大病変の1個は気管・気管支には接さず食道に接しており，同部に対してCP-EBUSを用いた経食道的EUS-FNAを施行し，生検組織より上皮型悪性胸膜中皮腫と診断した．結論．胸郭内病巣の位置によっては経気管支的・経皮的アプローチと同...
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| Published in | The Journal of the Japan Society for Respiratory Endoscopy Vol. 38; no. 3; pp. 218 - 223 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器内視鏡学会
2016
The Japan Society for Respiratory Endoscopy |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0287-2137 2186-0149 |
| DOI | 10.18907/jjsre.38.3_218 |
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| Abstract | 背景．コンベックス走査式超音波気管支鏡（CP-EBUS）は，経食道的超音波内視鏡下穿刺吸引法（EUS-FNA）に用いることも可能である．我々は本法により診断しえた悪性胸膜中皮腫の1例を経験した．症例．72歳，男性．職業性アスベスト曝露歴あり．咳嗽，発熱，呼吸困難を契機に当院受診，胸部単純X線で左肺野に複数の腫瘤影，結節影を認め，胸部CTでそれらは胸膜に接していた．うち最大病変の1個は気管・気管支には接さず食道に接しており，同部に対してCP-EBUSを用いた経食道的EUS-FNAを施行し，生検組織より上皮型悪性胸膜中皮腫と診断した．結論．胸郭内病巣の位置によっては経気管支的・経皮的アプローチと同様に，CP-EBUSを用いた経食道的EUS-FNAも有用な診断法と考えられた． |
|---|---|
| AbstractList | Background. Convex probe endobronchial ultrasonography (CP-EBUS) can be used as an instrument for transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In this study, we report a case of malignant pleural mesothelioma successfully diagnosed by this method. Case. A 72-year-old man with a history of occupational exposure to asbestos was admitted for cough, fever, and dyspnea to our hospital. Chest radiograph at the initial visit showed multiple mass shadows and nodular shadows in the left lung field. Those shadows were adjacent to the pleura in CT images. One of the largest lesions was adjacent to the esophagus but not adjacent to the trachea or the bronchus. A biopsy specimen was obtained from this lesion by transesophageal EUS-FNA using CP-EBUS and a histological diagnosis of malignant epithelial mesothelioma was made successfully. Conclusion. Depending on the site of the lesion in the thorax, transesophageal EUS-FNA using CP-EBUS might be a useful method for diagnosis as well as percutaneous or bronchial approaches.
背景．コンベックス走査式超音波気管支鏡（CP-EBUS）は，経食道的超音波内視鏡下穿刺吸引法（EUS-FNA）に用いることも可能である．我々は本法により診断しえた悪性胸膜中皮腫の1例を経験した．症例．72歳，男性．職業性アスベスト曝露歴あり．咳嗽，発熱，呼吸困難を契機に当院受診，胸部単純X線で左肺野に複数の腫瘤影，結節影を認め，胸部CTでそれらは胸膜に接していた．うち最大病変の1個は気管・気管支には接さず食道に接しており，同部に対してCP-EBUSを用いた経食道的EUS-FNAを施行し，生検組織より上皮型悪性胸膜中皮腫と診断した．結論．胸郭内病巣の位置によっては経気管支的・経皮的アプローチと同様に，CP-EBUSを用いた経食道的EUS-FNAも有用な診断法と考えられた． 背景．コンベックス走査式超音波気管支鏡（CP-EBUS）は，経食道的超音波内視鏡下穿刺吸引法（EUS-FNA）に用いることも可能である．我々は本法により診断しえた悪性胸膜中皮腫の1例を経験した．症例．72歳，男性．職業性アスベスト曝露歴あり．咳嗽，発熱，呼吸困難を契機に当院受診，胸部単純X線で左肺野に複数の腫瘤影，結節影を認め，胸部CTでそれらは胸膜に接していた．うち最大病変の1個は気管・気管支には接さず食道に接しており，同部に対してCP-EBUSを用いた経食道的EUS-FNAを施行し，生検組織より上皮型悪性胸膜中皮腫と診断した．結論．胸郭内病巣の位置によっては経気管支的・経皮的アプローチと同様に，CP-EBUSを用いた経食道的EUS-FNAも有用な診断法と考えられた． |
| Author | 友國, 佳奈 守本, 明枝 鏡, 亮吾 白石, 幸子 大西, 康貴 望月, 吉郎 水守, 康之 佐々木, 信 河村, 哲治 中原, 保治 塚本, 宏壮 勝田, 倫子 |
| Author_FL | Ohnishi Yasutaka Katsuda Rinko Tomokuni Kana Kawamura Tetsuji Nakahara Yasuharu Shiraishi Sachiko Sasaki Shin Morimoto Akie Tsukamoto Hiroaki Mochizuki Yoshiro Mizumori Yasuyuki Kagami Ryogo |
| Author_FL_xml | – sequence: 1 fullname: Tomokuni Kana – sequence: 2 fullname: Mizumori Yasuyuki – sequence: 3 fullname: Nakahara Yasuharu – sequence: 4 fullname: Mochizuki Yoshiro – sequence: 5 fullname: Kawamura Tetsuji – sequence: 6 fullname: Sasaki Shin – sequence: 7 fullname: Morimoto Akie – sequence: 8 fullname: Tsukamoto Hiroaki – sequence: 9 fullname: Katsuda Rinko – sequence: 10 fullname: Kagami Ryogo – sequence: 11 fullname: Shiraishi Sachiko – sequence: 12 fullname: Ohnishi Yasutaka |
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| References | 9. 厚生労働省. 都道府県 (21大都市再掲) 別にみた中皮腫による死亡者数の年次推移 (平成7年～25年) 人口動態統計 (確定数) より. 2014. http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/tokusyu/chuuhisyu13/dl/chuuhisyu.pdf 4. 廣島健三, 石川雄一, 岡田守人, ほか. 悪性胸膜中皮腫病理診断の手引き. 第1版, 日本肺癌学会; 2013:1-20. 10. Koga Y, Tominaga M, Sanada H, et al. Malignant pleural mesothelioma in 14 patients who underwent thoracoscopy under local anesthesia. J Jpn Soc Respir Endoscopy. 2013;35:593-599. 11. Oki M, Saka H, Ando M, et al. Transbronchial vs transesophageal needle aspiration using an ultrasound bronchoscope for the diagnosis of mediastinal lesions: a randomized study. Chest. 2015;147:1259-1266. 6. Rice DC, Steliga MA, Stewart J, et al. Endoscopic ultrasound-guided fine needle aspiration for staging of malignant pleural mesothelioma. Ann Thorac Surg. 2009;88:862-869. 5. Bean SM, Eloubeidi MA, Cerfolio R, et al. Endoscopic ultrasound-guided fine needle aspiration is useful for nodal staging in patients with pleural mesothelioma. Diagn Cytopathol. 2008;36:32-37. 12. Peric O, Schuurbiers CJ, Veseliç M, et al. Transesophageal endoscopic ultrasound-guided fine-needle aspiration for the mediastinal staging of extrathoracic tumors: a new perspective. Ann Oncol. 2010;21:1468-1471. 2. Boutin C, Ray F. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 1: Diagnosis. Cancer. 1993;72:389-393. 7. Hamamoto J, Notsute D, Tokunaga K, et al. Diagnostic usefulness of endobronchial ultrasound-guided transbronchial needle aspiration in a case with malignant pleural mesothelioma. Intern Med. 2010;49:423-426. 13. Tournoy KG, Burgers SA, Annema JT, et al. Transesophageal endoscopic ultrasound with fine needle aspiration in the preoperative staging of malignant pleural mesothelioma. Clin Cancer Res. 2008;14:6259-6263. 1. Adams RF, Gray W, Davies RJ, et al. Percutaneous image-guided cutting needle biopsy of the pleura in the diagnosis of malignant mesothelioma. Chest. 2001;120:1798-1802. 3. Stigt JA, Boers JE, Groen HJ. Analysis of "dry" mesothelioma with ultrasound guided biopsies. Lung Cancer. 2012;78:229-233. 8. Lococo F, Rossi G, Agostini L, et al. "Dry" pleural mesothelioma successfully diagnosed on endobronchial ultrasound (EBUS) -guided transbronchial needle aspiration (TBNA). Intern Med. 2014;53:467-469. |
| References_xml | – reference: 12. Peric O, Schuurbiers CJ, Veseliç M, et al. Transesophageal endoscopic ultrasound-guided fine-needle aspiration for the mediastinal staging of extrathoracic tumors: a new perspective. Ann Oncol. 2010;21:1468-1471. – reference: 7. Hamamoto J, Notsute D, Tokunaga K, et al. Diagnostic usefulness of endobronchial ultrasound-guided transbronchial needle aspiration in a case with malignant pleural mesothelioma. Intern Med. 2010;49:423-426. – reference: 9. 厚生労働省. 都道府県 (21大都市再掲) 別にみた中皮腫による死亡者数の年次推移 (平成7年～25年) 人口動態統計 (確定数) より. 2014. http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/tokusyu/chuuhisyu13/dl/chuuhisyu.pdf – reference: 13. Tournoy KG, Burgers SA, Annema JT, et al. Transesophageal endoscopic ultrasound with fine needle aspiration in the preoperative staging of malignant pleural mesothelioma. Clin Cancer Res. 2008;14:6259-6263. – reference: 11. Oki M, Saka H, Ando M, et al. Transbronchial vs transesophageal needle aspiration using an ultrasound bronchoscope for the diagnosis of mediastinal lesions: a randomized study. Chest. 2015;147:1259-1266. – reference: 4. 廣島健三, 石川雄一, 岡田守人, ほか. 悪性胸膜中皮腫病理診断の手引き. 第1版, 日本肺癌学会; 2013:1-20. – reference: 2. Boutin C, Ray F. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 1: Diagnosis. Cancer. 1993;72:389-393. – reference: 5. Bean SM, Eloubeidi MA, Cerfolio R, et al. Endoscopic ultrasound-guided fine needle aspiration is useful for nodal staging in patients with pleural mesothelioma. Diagn Cytopathol. 2008;36:32-37. – reference: 10. Koga Y, Tominaga M, Sanada H, et al. Malignant pleural mesothelioma in 14 patients who underwent thoracoscopy under local anesthesia. J Jpn Soc Respir Endoscopy. 2013;35:593-599. – reference: 6. Rice DC, Steliga MA, Stewart J, et al. Endoscopic ultrasound-guided fine needle aspiration for staging of malignant pleural mesothelioma. Ann Thorac Surg. 2009;88:862-869. – reference: 1. Adams RF, Gray W, Davies RJ, et al. Percutaneous image-guided cutting needle biopsy of the pleura in the diagnosis of malignant mesothelioma. Chest. 2001;120:1798-1802. – reference: 8. Lococo F, Rossi G, Agostini L, et al. "Dry" pleural mesothelioma successfully diagnosed on endobronchial ultrasound (EBUS) -guided transbronchial needle aspiration (TBNA). Intern Med. 2014;53:467-469. – reference: 3. Stigt JA, Boers JE, Groen HJ. Analysis of "dry" mesothelioma with ultrasound guided biopsies. Lung Cancer. 2012;78:229-233. |
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| Snippet | ... Background. Convex probe endobronchial ultrasonography (CP-EBUS) can be used as an instrument for transesophageal endoscopic ultrasound-guided fine needle... |
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| SubjectTerms | Convex probe endobronchial ultrasonography Malignant pleural mesothelioma Transesophageal endoscopic ultrasound-guided fine needle aspiration コンベックス走査式超音波気管支鏡（CP-EBUS） 悪性胸膜中皮腫 経食道的超音波内視鏡下穿刺吸引法（EUS-FNA） |
| Title | コンベックス走査式超音波気管支鏡（CP-EBUS）を用いた経食道的超音波内視鏡下穿刺吸引法（EUS-FNA）により診断された悪性胸膜中皮腫の1例 |
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