肝細胞癌における肺動脈腫瘍塞栓の臨床病理学的検討

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Clinicopathological studies were underwent on hepatocellular carcinoma (HCC) with tumor emboli in the pulmonary artery (PA). 106 autopsy cases of HCC were classified into three groups. Group A: 14 cases with macro-and microscopical tumor emboli in the PA. Group B: 32 cases with microscopical tumor emboli. Group C: 60 cases without macro-and microscopical tumor emboli. 1) Incidence of tumor emboli in the PA was 46 out of 106 cases (43.4%). 2) Main symptoms were dyspnea, cough and chest pain. Especially dyspnea was the most important sign. 3) Maximum diameter of the right descending PA on chest X-ray was the greatest in group A (18.4±2.6mm). 4) Arterial PO<SUB>2</SUB> showed the lowest value in group A (63.8±13.4 mmHg). 5) <SUP>99m</SUP>Tc-MAA perrusion image was the most useful examination for clinical diagnosis. 6) Few cases died of tumor emboli in the PA in group A and B. 7) Tumor emboli in the PA was frequently encountered in cases with infiltrative type of HCC associated with tumor emboli in the hepatic vein, inferior vena cava or right atrium of the heart.
社団法人日本肝臓学会の論文