リンパ性間質を伴う小結節性胸腺腫の2手術例
【症例1】59歳男性．CT検診で前縦隔腫瘤を指摘された．CTで不均一に濃染される15 mm大の軟部濃度結節を認めた．MRIでT1強調・T2強調画像とも低信号を呈する陰影を認め，高濃度のタンパク質を含む囊胞もしくは胸腺腫疑いとして胸腔鏡下縦隔腫瘍摘出術を施行し，リンパ性間質を伴う小結節性胸腺腫（MNT）と診断した．【症例2】63歳男性．直腸癌術後で，前縦隔腫瘍と直腸癌の肺転移を疑う陰影を認め当科紹介となる．CTで縦隔に淡く濃染され増大傾向の13 mm大の結節と右肺下葉に小結節を認めた．MRIで縦隔にT1強調・T2強調画像とも低信号を呈する境界明瞭な陰影を認め，淡く均一に造影された．胸腺腫疑いと直...
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| Published in | 日本呼吸器外科学会雑誌 Vol. 34; no. 2; pp. 166 - 170 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器外科学会
15.03.2020
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.34.166 |
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| Abstract | 【症例1】59歳男性．CT検診で前縦隔腫瘤を指摘された．CTで不均一に濃染される15 mm大の軟部濃度結節を認めた．MRIでT1強調・T2強調画像とも低信号を呈する陰影を認め，高濃度のタンパク質を含む囊胞もしくは胸腺腫疑いとして胸腔鏡下縦隔腫瘍摘出術を施行し，リンパ性間質を伴う小結節性胸腺腫（MNT）と診断した．【症例2】63歳男性．直腸癌術後で，前縦隔腫瘍と直腸癌の肺転移を疑う陰影を認め当科紹介となる．CTで縦隔に淡く濃染され増大傾向の13 mm大の結節と右肺下葉に小結節を認めた．MRIで縦隔にT1強調・T2強調画像とも低信号を呈する境界明瞭な陰影を認め，淡く均一に造影された．胸腺腫疑いと直腸癌の転移性肺腫瘍疑いとして胸腔鏡下縦隔腫瘍摘出術と右肺下葉部分切除を施行し，MNTと直腸癌の転移性肺腫瘍と診断した． |
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| AbstractList | 【症例1】59歳男性．CT検診で前縦隔腫瘤を指摘された．CTで不均一に濃染される15 mm大の軟部濃度結節を認めた．MRIでT1強調・T2強調画像とも低信号を呈する陰影を認め，高濃度のタンパク質を含む囊胞もしくは胸腺腫疑いとして胸腔鏡下縦隔腫瘍摘出術を施行し，リンパ性間質を伴う小結節性胸腺腫（MNT）と診断した．【症例2】63歳男性．直腸癌術後で，前縦隔腫瘍と直腸癌の肺転移を疑う陰影を認め当科紹介となる．CTで縦隔に淡く濃染され増大傾向の13 mm大の結節と右肺下葉に小結節を認めた．MRIで縦隔にT1強調・T2強調画像とも低信号を呈する境界明瞭な陰影を認め，淡く均一に造影された．胸腺腫疑いと直腸癌の転移性肺腫瘍疑いとして胸腔鏡下縦隔腫瘍摘出術と右肺下葉部分切除を施行し，MNTと直腸癌の転移性肺腫瘍と診断した． |
| Author | 岡本, 卓 喜田, 裕介 徳永, 義昌 |
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| Copyright | 2020 特定非営利活動法人 日本呼吸器外科学会 |
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| References | 4. Kim NR, Lee JI, Ha SY. Micronodular Thymoma with Lymphoid Stroma in a Multilocular Thymic Cyst: A Case Study. Korean J Pathol 2013; 47: 392-4. 3. Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart. Fourth edition. Lyon: IARC Press; 2015: 205-6. 2. Suster S, Moran CA. Micronodular Thymoma With Lymphoid B-cell Hyperplasia: clinicopathologic and immunohistochemical study of eighteen cases of a distinctive morphologic variant of thymic epithelial neoplasm. Am J Surg Pathol 1999; 23: 955-62. 6. Qu L, Xiong Y, Yao Q, Zhang B, Li T. Micronodular thymoma with lymphoid stroma: Two cases, one in a multilocular thymic cyst, and literature review. Thorac Cancer 2017; 8: 734-40. 8. Ströbel P, Marino M, Feuchtenberger M, Rouzière AS, Tony HP, Wulbrand U, et al. Micronodular thymoma: an epithelial tumor with abnormal chemokine expression setting the stage for lymphoma development. J Pathol 2005; 207: 72-82. 1. 日本胸腺研究会編. 臨床・病理縦隔腫瘍取扱い規約. 第1版. 東京: 金原出版; 2009. 7. Ishikawa Y, Tateyama H, Yoshida M, Takami K, Matsuguma H, Taniguchi T, et al. Micronodular thymoma with lymphoid stroma: an immunohistochemical study of the distribution of Langerhans cells and mature dendritic cells in six patients. Histopathology 2015; 66: 300-7. 9. Weissferdt A, Moran CA. Micronodular thymic carcinoma with lymphoid hyperplasia: a clinicopathological and immunohistochemical study of five cases. Mod Pathol 2012; 25: 993-9. 5. 門松由佳, 中島 潔, 上野陽史, 岡阪敏樹, 森 正一. リンパ性間質を伴う小結節性胸腺癌の1例. 肺癌 2015; 55: 59-64. |
| References_xml | – reference: 2. Suster S, Moran CA. Micronodular Thymoma With Lymphoid B-cell Hyperplasia: clinicopathologic and immunohistochemical study of eighteen cases of a distinctive morphologic variant of thymic epithelial neoplasm. Am J Surg Pathol 1999; 23: 955-62. – reference: 3. Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart. Fourth edition. Lyon: IARC Press; 2015: 205-6. – reference: 5. 門松由佳, 中島 潔, 上野陽史, 岡阪敏樹, 森 正一. リンパ性間質を伴う小結節性胸腺癌の1例. 肺癌 2015; 55: 59-64. – reference: 6. Qu L, Xiong Y, Yao Q, Zhang B, Li T. Micronodular thymoma with lymphoid stroma: Two cases, one in a multilocular thymic cyst, and literature review. Thorac Cancer 2017; 8: 734-40. – reference: 4. Kim NR, Lee JI, Ha SY. Micronodular Thymoma with Lymphoid Stroma in a Multilocular Thymic Cyst: A Case Study. Korean J Pathol 2013; 47: 392-4. – reference: 7. Ishikawa Y, Tateyama H, Yoshida M, Takami K, Matsuguma H, Taniguchi T, et al. Micronodular thymoma with lymphoid stroma: an immunohistochemical study of the distribution of Langerhans cells and mature dendritic cells in six patients. Histopathology 2015; 66: 300-7. – reference: 8. Ströbel P, Marino M, Feuchtenberger M, Rouzière AS, Tony HP, Wulbrand U, et al. Micronodular thymoma: an epithelial tumor with abnormal chemokine expression setting the stage for lymphoma development. J Pathol 2005; 207: 72-82. – reference: 9. Weissferdt A, Moran CA. Micronodular thymic carcinoma with lymphoid hyperplasia: a clinicopathological and immunohistochemical study of five cases. Mod Pathol 2012; 25: 993-9. – reference: 1. 日本胸腺研究会編. 臨床・病理縦隔腫瘍取扱い規約. 第1版. 東京: 金原出版; 2009. |
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| SubjectTerms | リンパ性間質を伴う小結節性胸腺腫 縦隔腫瘍 胸腺 |
| Title | リンパ性間質を伴う小結節性胸腺腫の2手術例 |
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