アレルギー性気管支肺アスペルギルス症と鑑別を要した悪性黒色腫の気管支内転移の1例

A case of endobronchial metastasis of malignant melanoma that required differentiation from allergic bronchopulmonary aspergillosis

悪性黒色腫の気管支内転移はまれではあるが，悪性腫瘍の気管・気管支転移の中では比較的多い。今回我々は，胸部単純X線やCTにて両側肺の拡張した気管支に沿って広がるソーセージ様の腫瘤を認め，アレルギー性気管支肺アスペルギルス症との鑑別が困難であった悪性黒色腫の気管支内転移を経験したため，若干の考察とともに報告する。

A man in his 50’s was admitted to our hospital with chronic cough. A plain chest X-ray showed the finger-in-glove sign, and a CT scan showed a soft tissue mass in the dilated bronchial lumen. Allergic bronchopulmonary aspergillosis was suspected on imaging diagnosis, but metastasis from malignant melanoma that had been resected 2 years previously was also raised as a differential diagnosis. A bronchoscopic biopsy revealed a diagnosis of bronchial metastasis from malignant melanoma. Bronchial metastasis from malignant melanoma showing the finger-in-glove sign is rare, and we are pleased to report this case.