肺非結核性抗酸菌症治療中に発症した肺大細胞神経内分泌癌の1例

Pulmonary Non-tuberculous Mycobacteriosis Complicated with Pulmonary Large Cell Neuroendocrine Carcinoma；Report of a Case

はじめに　肺非結核性抗酸菌症（pulmonary non-tuberculous mycobacteriosis：NTM）と原発性肺癌の同時発症例の報告は散見され，診断および治療法選択に苦慮することがある1，2）．われわれは，左上葉NTMに対する薬物療法中に対側肺右上葉に発症した大細胞神経内分泌癌（large cell neuroendocrine carcinoma：LCNEC）を経験し，両病変に対して外科治療手術を施行したので報告する．

A 64-year-old man with pulmonary non-tuberculous mycobacteriosis （pulmonary NTM） who had been treated by antituberculous chemotherapy, developed a new nodule of 8 mm in size in the segment 3 of the right upper lobe. The cavity of 4.0 cm in size in the segment 1＋2 of the left upper lobe due to Mycobacterium avium infection was preexisted. Radiologically, new nodule of the right lung was suspected to be lung cancer. Left upper lobe apical trisegmentectomy was performed at first. Three months later, enlarging of the right lung nodule with increased fluoro-2-deoxy-D-glucose （FDG） activity was noted, and the diagnosis of lung cancer was made by transbronchial lung biopsy（TBLB）. Then, right upper lobectomy with systematic nodal dissection were performed.