A Case of T0 Small Cell Lung Cancer

概要

論文の詳細を見る
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.
2005-08-20