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論文
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柴田, 和彦 ; 野田, 八嗣 ; 広瀬, 仁一郎 ; 太田, 五六 ; 藤村, 政樹 ; 松田, 保
概要:
金沢大学医薬保健研究域医学系<br />A 51-year-old man was admitted to our hospital complaining of anterior chest pain. Plain chest X-ray
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showed multiple nodules in bilateral lung fields, and thoracic CT showed an anterior mediastinal mass. Whole body bone scintigram revealed abnormal accumulation in the cervical and lumbar vertebra, sternum and right iliac bone, suggesting multiple bone metastases. Exploratory thoracotomy yielded a histological diagnosis of thymoma with pulmonary metastases. He was treated with repeated combination chemotherapy and radiotherapy. Because thymomas with distant metastases at the time of diagnosis are rare, we reported the case and reviewed the literature.多発結節型肺転移で発見された胸腺腫のまれな1例を報告した.症例は51歳,男性.前胸部痛を主訴に受診,胸部X線上転移性肺腫瘍を疑う両側肺野の多発性結節影をみ,原発巣検索中,胸部CTで前縦隔の腫瘤陰影を認めた.経皮的針生検,TBLBでも確診に至らず,開胸生検を施行,胸腺腫の診断を得た.骨スキャンで頸椎,胸骨,右腸骨,腰椎に異常集積を認め,多発性骨転移と考えられた.化学療法,放射線療法をを繰り返し施行した.
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柴田, 和彦 ; 金森, 一紀 ; 吉見, 雄三 ; 飯岡, 壮吾 ; 藤村, 政樹 ; 松田, 保
概要:
金沢大学医薬保健研究域医学系<br />69歳,男性.大量心嚢水貯留のため入院.心嚢穿刺,心膜生検で癌性心膜炎と診断,原発巣は左上葉の肺癌と考えられ,T4N3M0,stageIIIBと診断された.心嚢ドレナージ,心嚢内抗癌剤注入,CDDP,
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VDS,MMC併用による全身化学療法3コースによって,部分寛解を得,以後病変の進行を認めなかった.初診から3年後に原発巣の増大を認め,リンパ節転移,心嚢水の再発や他臓器転移を認めないことから,salvage surgeryとして左上葉切除術を施行した.病理組織所見は低分化腺癌で形態的に3年前の心膜生検の際の腫瘍細胞と共通性が見られた.リンパ節,心膜には腫瘍の残存を認めなかった. A 69-year-old man was admitted to our hospital because of massive pericardial effusion,which was diagnosed as malignant by pericardocentesis and pericardial biopsy. He underwent surgical pericardial drainage with topical installation of cytocidal drugs. Subsequent three cycles of systemic chemotherapy consisted of cisplatin, vindesine and mitomycin C resulted in partial response. The disease did not progress until the primary nodule enlarged three years later. No recurrence of lymph node metastases and pericardial effusion or emergence of other organ metastases were seen. He underwent left upper lobectomy as salvage surgery. Histologically, the tumor was diagnosed as poorly-differentiated adenocarcinoma composed of malignant cells with morphological similarity to those found in the biopsy specimen of the pericardium three years previously. No tumor cells were found in the dissected mediastinal lymph nodes and in the re-biopsied pericardium.
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論文
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柴田, 和彦 ; 野田, 八嗣 ; 広瀬, 仁一郎 ; 太田, 五六 ; 藤村, 政樹 ; 松田, 保
概要:
金沢大学医薬保健研究域医学系<br />多発結節型肺転移で発見された胸腺腫のまれな1例を報告した.症例は51歳,男性.前胸部痛を主訴に受診,胸部X線上転移性肺腫瘍を疑う両側肺野の多発性結節影をみ,原発巣検索中,胸部CTで前縦隔の腫瘤陰影を認
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めた.経皮的針生検,TBLBでも確診に至らず,開胸生検を施行,胸腺腫の診断を得た.骨スキャンで頸椎,胸骨,右腸骨,腰椎に異常集積を認め,多発性骨転移と考えられた.化学療法,放射線療法をを繰り返し施行した. A 51-year-old man was admitted to our hospital complaining of anterior chest pain. Plain chest X-ray showed multiple nodules in bilateral lung fields, and thoracic CT showed an anterior mediastinal mass. Whole body bone scintigram revealed abnormal accumulation in the cervical and lumbar vertebra, sternum and right iliac bone, suggesting multiple bone metastases. Exploratory thoracotomy yielded a histological diagnosis of thymoma with pulmonary metastases. He was treated with repeated combination chemotherapy and radiotherapy. Because thymomas with distant metastases at the time of diagnosis are rare, we reported the case and reviewed the literature.
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西, 耕一 ; 金森, 一紀 ; 中積, 泰人 ; 藤村, 政樹 ; 松田, 保 ; 野々村, 昭孝
概要:
金沢大学医薬保健研究域医学系<br />A case of a 32-year-old man rith primary satcoma originating from the left main pulmonary artery was
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reported . The left hilair mass was found on chest roentgenogram . Pulmonary arteriogra-phy showed complete obstruction of the left main pulmonary artery and long segmental stenosis of the right main pulmonary artery . The open biopsy specimen was composed of pleomorphic tumor cells vaguely fascicular but generally disorganized. By electron microscopy, the tumor cell cytoplasm was shown to contain numerous microfilaments aligned longitudinally, associated with dense bodies, suggestive of my-ogenic sarcoma. Regression of the tumor was obtained by radiation therapy followed by chemotherapy with-out improvement of the pulmonary arterial obstruction . The patient died of acute renal failure after high dose methotrexate chemotherapy . At autopsy, the tumor was confirmed to originate from the left main pulmonary artery and was alrnost com pletely composed of necrotic cells suggestive of the effect of treatment. 32才男性の左肺動脈原発肉腫で,腫瘍が左肺動脈を完全に閉塞した1剖検例を経験した.この肉腫に対して放射線療法及び化学療法を施行したが,CT上腫瘍は縮小したものの,肺動脈内の病変は改善せず,患者は急性腎不全により死亡した.剖検所見では,腫瘍細胞はほとんど壊死に陥っており,この様な症例に対する内科的治療は今後の検討課題と考えられる.
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