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タイトル: 腫瘍のほとんどが淡明な胞体を有する原発性肺癌の1例
その他のタイトル: A case of primary lung cancer in which almost all of the tumor contained glycogen-rich clear cytoplasm
著者: 松本, 勲 link image link image
小田, 誠 link image
吉田, 政之
澤, 重治
藤井, 奨
斉藤, 健一郎
Matsumoto, Isao
Oda, Makoto
Yoshida, Masayuki
Sawa, Shigeharu
Fujii, Susumu
Saito, Kenichiro
発行日: 2003年11月15日
出版社(者): The Journal of the Japanese Association for Chest Surgery = 日本呼吸器外科学会雑誌
雑誌名: 日本呼吸器外科学会 = The Japanese Association for Chest Surgery
ISSN: 0919-0945
巻: 17
号: 7
開始ページ: 782
終了ページ: 786
キーワード: 淡明細胞癌
clear cell carcinoma
large cell carcinoma
抄録: 腫瘍のほとんどがグリコーゲンの豊富な説明胞体を有する原発性肺癌を経験したので報告する.症例は73歳,男性.von Recklinghausen病.肺癌検診で胸部X線写真上,右下肺野に異常陰影を指摘された.胸部CT検査では右肺S^9を中心に径約5cmの胸壁に接する不整形腫瘤が存在した.超音波ガイド下肺針生検で多量のグリコーゲンを有する説明な細胞質を有する癌細胞が検出された.腎癌の転移を疑い精査するも肺以外に病変がなく,原発性肺癌の診断で手術を施行した.手術は右肺下葉切除およびND2aリンパ節郭清を行った.組織学的には細胞質と核は大型で多核細胞も認めた.ほとんどは説明な胞体を有する細胞が占めていた.細胞間橋や角化あるいは管腔形成はなく,一応説明細胞癌像を示す肺原発火細胞癌であると診断した.肺の淡明細胞癌は独立した組織型とする意義を疑わしいとされており,幾種類かの組織型が混在している可能性がある. We report a case of primary lung cancer in which almost all of the tumor contained glycogen-rich clear cytoplasm. The patient, a 73-year-old male, suffered from von Recklinghausen disease. A chest X-ray taken in lung cancer mass screening detected an abnormal shadow in the right lower lung field. The results of analysis of tumor markers were normal, but chest CT examination showed an irregularly shaped tumor with a diameter of about 5 cm at S^6 to S^9 of the right lung. The tumor was adjacent to the thoracic wall without infiltration. A pulmonary needle-biopsy taken under ultrasonic guidance yielded tumor cells with clear cytoplasm. Pulmonary metastasis of renal cancer was suspected, so a detailed examination was conducted, but no abnormalities were found in areas other than the lung. Therefore, the right lower lobectomy and ND2a lymph node dissection were performed. Resection yielded a grayish fragile tumor measuring 50 X 45 X 45 mm at the periphery of right lower pulmonary lobe S9. Microscopic examination revealed proliferation of large filled tumor cells. Their nuclei were large and some cells were polynucleated, and the cytoplasm was eosinophilic in some areas and contained clear cytoplasm in others, with the latter being dominant. The clear cytoplasm was PAS-positive and digested by diastase, suggesting that the contents were rich in glycogen. The tumor was devoid of elements specific to an adenocarcinoma or squamous cell carcinoma, therefore, the diagnosis was large cell carcinoma originating in the lung and presenting feature of clear cell carcinoma. There is still a controversy about whether or not a clear cell cancer is an independent histological entity. It was difficult to decide if our case represented a subtype of large cell carcinoma or clear cell carcinoma. In either instance, it seems that there are several histological types among those containing glycogen rich cells, and further analvsis of additional cases is awaited.
URI: http://hdl.handle.net/2297/24827
関連URI: http://www.jacsurg.gr.jp/
資料種別: Journal Article
権利関係: Copyright (c) 2003 日本呼吸器外科学会
版表示: publisher
出現コレクション:1. 査読済論文(医学・保健)

このアイテムを引用あるいはリンクする場合は次の識別子を使用してください。 http://hdl.handle.net/2297/24827



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