転移性肺腫瘍と鑑別を要した肺類上皮血管内皮腫の1例

Pulmonary Epithelial Hemangioendothelioma Needed to Differentiate from Metastatic Lung Tumor；Report of a Case

はじめに　肺類上皮血管内皮腫（pulmonary epithelioid hemangioendthelioma：PEH）は血管内皮細胞の増殖を特徴とし，緩徐に経過する低～中悪性度の腫瘍で，まれな疾患である．われわれは，悪性リンパ腫の経過観察中に増大・増加し，画像上，多発肺転移と鑑別を要したPEHの1例を経験したので報告する．

Pulmonary epithelioid hemangioendthelioma （PEH） is rare malignant disease known to originate from hemangioendthelial cells. We report a case of PEH that is difficult to differential diagnosis on image. A 55-year-old woman was diagnosed with malignant lymphoma 15 years ago and had been followed-up. She referred to our hospital due to abnormal shadow on chest X-ray. Multiple nodules of 0.2～1.0 cm in size with clear but irregular margin were found in bilateral lungs on chest computed tomography （CT） scan. Nodules were found to be increased both in size and in number compared to those of 10 years ago. Pulmonary metastases of lymphoma, lung cancer or granulomatous disease were suspected and a thoracoscopic lung biopsy was performed, which led to a diagnosis of PEH pathologically.