術後5年半経過して癌性リンパ管症で発症した胃癌肺転移の1例

Pulmonary Metastasis of Gastric Cancer as Carcinomatous Lymphangiosis at Five and Half Years after Surgery；Report of a Case

はじめに　肺の癌性リンパ管症は悪性腫瘍の肺転移形式として時にみられ，予後不良な病態である．術後5年半経過して両肺スリガラス状陰影で発症した癌性リンパ管症の胃癌肺転移例を経験したので報告する．

A 51-year-old woman underwent radical operation for a gastric cancer and adjuvant chemotherapy with tegafur, gimeracil, and oteracil potassium. Five and a half years later, screening chest computed tomography（CT）scan showed slight ground glass opacity（GGO）of the both lungs and they were regarded as inflammatory change. Several months later, she experienced a dry cough. CT scan showed aggravation of GGO, and she was refered to our hospital to investigate these lesions 6 years after operation. We performed a wedge resection of right middle lobe. A postoperative pathology revealed metastatic carcinomatous lymphangiosis of gastric cancer. Chemotherapy using capecitabine and oxaliplatin, and then docetaxel was performed and talc pleurodesis was done for the malignant pleural effusion. These treatments did not improve condition, and she died 7 months after lung operation. In conclusion, we need to consider GGO as the possibility of carcinomatous lymphangiosis in case of patient with gastric cancer.