肺動静脈との交通を有する胸膜孤立性線維性腫瘍

Solitary Fibrous Tumor of Pleura Communicating with Pulmonary Artery and Vein

孤立性線維性腫瘍（solitary fibrous tumor：SFT）は未分化間葉系細胞由来の比較的まれな腫瘍であり，胸膜が好発部位である1）．われわれは，肺動静脈と交通を有する胸膜原発SFT（SFT of the pleura：SFTP）の1例を経験した．本例では特徴的な画像所見がみられ，SFTPの理解を深めるうえで貴重な症例と考えられたので報告する．

A 68-year-old man was noted to have an abnormal shadow on chest X-ray. Chest computed tomography （CT） showed a 100 mm mass in the lower right thoracic cavity. The mass was lobulated and compressed the surrounding lung tissue and diaphragm. Contrast-enhanced CT showed that the mass was heterogeneously enhanced and contained expanded blood vessels within it. The expanded vessels communicated with the pulmonary artery and vein via the diaphragmatic surface of the right lung. The mass was diagnosed as a solitary fibrous tumor of the pleura （SFTP） by CT-guided lung biopsy. We performed partial resection of the lung including the tumor via right eighth intercostal lateral thoracotomy. Intraoperative examination showed that the tumor was pediculated from the diaphragmatic surface of the right lung. The stem was about 3 cm long and easily cut with a stapler. The tumor was definitively diagnosed as a malignant SFTP. No recurrence was found for 12 months postoperatively.