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多発気管支内病変を示す疾患として,multifocal endobronchial fibromas1)2),多発気管支内過誤腫3-5),良性肉芽腫性疾患6),multiple carcinoids and tumorlets7),気管支内乳頭腫症8)9),endobronchial inflammatory myofibroblastic tumors10)などが過去に報告されている。今回我々は,まれな画像所見を示したmultiple peripheral endobronchiolar fibromata with lymphatic-like cystsの病理像を呈す症例を経験した。文献検索上,画像上および病理学的に本症例と同様の所見を示した報告は確認できなかった。その病態や画像所見に関して,若干の文献的考察を加えて報告する。
A 54-year-old woman was referred to our hospital for the evaluation of abnormal opacities found on chest radiograph as part of health check. Chest radiograph showed multiple pulmonary nodules. Chest computed tomography revealed that some of the nodules had water attenuation with the air crescent sign suggestive of their endobronchial location. There was no contrast enhancement in the nodules, and 18F-fluorodeoxyglucose-positron emission tomography(FDG-PET)showed no increased uptake. The pathological specimen of a right partial pneumonectomy consisted of fibrous proliferation and cystic spaces lined by lymphatic epithelium. These pathological findings are considered to fall into the category of hamartoma.
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