右下葉肺癌切除断端に発生した非結核性抗酸菌症の1例

Pulmonary Nontuberculous Mycobacteriosis Appeared at the Surgical Margin of the Lung Cancer Surgery；Report of a Case

はじめに　肺癌に対する積極的縮小手術の術後断端再発は，外科医にとって危惧すべき再発形式の一つである．肺切除後のステープルラインに腫瘤性病変の出現を認めた場合，炎症性肉芽腫や感染よりも，まず断端再発を念頭におくのが一般的である．われわれは肺癌術後の区域切除断端に発生した肺非結核性抗酸菌症の1例を経験したので報告する．

A 70-year-old woman had undergone right S8＋9 segmentectomy for stageⅠA lung cancer. Surgical staplers were used for an intersegmental line. Two years after surgery, routine chest computed tomography （CT） showed a 40-mm mass around the staple line in the right lower lobe, and positron emission tomography （PET） was positive. The mass was suspected to be local recurrence of lung cancer, and she was done additional surgery for resection of the remaining right lower lobe. The pathologic diagnosis was lung nontuberculous mycobacteriosis. It was suggested that nontuberculous mycobacteriosis developed at the atelectasis around the staple line. In addition to local recurrence, the possibility of nontuberculous mycobacteriosis should be considered in cases of pulmonary nodules appearing at the staple line after pulmonary resection.