手術後長期生存が得られた二相性肺芽腫の1例

Biphasic Pulmonary Blastoma without Recurrence for Six Years After Surgery：Report of a Case

はじめに　肺芽腫は上皮性成分と間葉系成分からなるきわめてまれな肺悪性腫瘍である．二相性肺芽腫（biphasic pulmonary blastoma：BPB）とも呼ばれる．われわれは，近医で胸部異常陰影を指摘され，当院で手術により肺芽腫と診断された長期生存例を経験したので，若干の文献的考察を加えて報告する．

A 62-year-old man was referred to our hospital for a lung tumor. Computed tomography （CT） of the chest showed a 62×55×68 mm well-circumscribed tumor in the upper lobe of the right lung. A transbronchial lung biopsy was performed, but a diagnosis was not achieved. Positron emission tomography-CT demonstrated intense F-fluorodeoxyglucose uptake in the mediastinal side of the tumor. Surgery was performed under the suspicion of primary lung cancer. The intraoperative pathological examination indicated a non-small-cell carcinoma. Thus, right upper lobectomy and wedge resection of the right lower lobe were performed. Microscopically, the tumor was composed of epithelial components, mimicking fetal lung tissue and embryogenic stroma. Therefore, the tumor was diagnosed as a biphasic pulmonary blastoma （p-StageⅡA）. After the post-operative adjuvant chemotherapy, he has remained healthy without recurrence six years after the surgery.