冠状動脈バイパス術前に確定診断された前胸部気管支原性囊胞の1例

Subcutaneous Bronchogenic Cyst in the Anterior Chest Diagnosed before Coronary Artery Bypass Grafting：Report of a Case

はじめに　前胸部腫瘤は臨床所見だけでは確定診断が困難な場合があり，病理学的な炎症所見や悪性所見の有無はその後の胸部手術，特に胸骨正中切開を伴う手術における手術時期やアプローチの決定に影響を及ぼす可能性がある．われわれは，冠状動脈バイパス術（CABG）前に前胸部皮下に発生したまれな気管支原性囊胞の1例を経験したので報告する．

A 65-year-old woman was transported to our hospital by ambulance because of severe dyspnea. She had had a subcutaneous tumor on her anterior chest since her childhood. Coronary angiography revealed three vessel disease with significant stenosis in the left main trunk. Excision of anterior chest tumor, 70×60×50 mm in size, was performed before coronary artery bypass grafting （CABG）. It was a unilocular cyst adhering to the sternum, and was composed of ciliated epitheliums, goblet cells and smooth muscle cells. Based upon the existence of smooth muscle cells, the tumor was diagnosed as bronchogenic cyst. CABG was performed through mid-sternum about two months after the tumor excision, and the postoperative course was uneventful.