対側胸部外傷に起因すると推測され肺腫瘍との鑑別を要した肺内血腫の1例

Pulmonary Hematoma Likely due to a Contralateral Chest Injury, Requiring Differentiation from Lung Tumor：Report of a Case

はじめに　肺内血腫は肺胞および間質腔内の血液の存在を示し，単発性もしくは多発性の境界明瞭な腫瘤影や結節影を呈する．鈍的胸部外傷が原因であることがもっとも多く，外傷が先行し腫瘤のすみやかな縮小を認める場合の診断は容易であるが，腫瘍性病変との鑑別が困難な場合も少なくない．われわれは，対側の胸部外傷が原因と考えられ，肺腫瘍との鑑別を要した肺内血腫を経験したので報告する．

A 23-year-old man was referred to our department for chest abnormal shadow. Computed tomography （CT） of the chest revealed a well-defined 1.2 cm nodule in the S4 segment of the right middle lobe and a well-defined 1.8 cm nodule in the S10 segment of the right lower lobe. The patient was found to have a fracture in the left fifth rib due to the falling accident at playing snowboard, two months before. He was diagnosed with a benign tumor in the right middle lobe and the right lower lobe and was performed surgery. Thoracoscopy revealed a yellowish-brown tumor in the right middle lobe （S4） and a yellow-brown tumor in the right lower lobe （S10）. Both lesions were diagnosed as clots by rapid intraoperative pathologic diagnosis. Histopathological diagnosis was an intrapulmonary hematoma.