左心腔に巨大な進展を来した大細胞肺癌の1剖検例

概要

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A 76-year-old woman was referred to our hospital because of cough and chest pain. Echocardiography revealed the left atrium to be largely occupied by a tumor. Magnetic resonance imaging (MRI) of the chest showed a tumor extending directly into the left atrium via the left superior pulmonary vein. Biopsy yielded a diagnosis of non-small cell lung cancer. Her condition deteriorated until death due to occlusion of blood flow. Autopsy revealed the presence of a massive tumor occupying almost the entire left upper lobe of the lung. The tumor directly infiltrated the left superior pulmonary vein, progressing into the left atrium, a part of which extended even into the left ventricle. Autopsy yielded a diagnosis of large cell lung cancer. Echocardiography was minimally useful in delineating tumor progression route into the heart chamber. Since MRI delineates blood vessel walls while showing the vascular space as a non-signal region, it is considered to be useful for heart or large artery infiltration by a malignant tumor. Although it is difficult to diagnose metastasis to the heart during life, echocar-diography and MRI may allow metastasis to the heart and the route of progression to be assessed. Both are potentially useful tools for determining treatment policy.
東京女子医科大学の論文