论文部分内容阅读
作者报道1例在胸部X线片上没有发现病灶,但经光束纤维支气管镜检查才发现为肺部隐匿性原位癌(TxNoMo)。患者男性,71岁。每天吸烟20支达40年之久,其B.I.(Brinkman index)为800。以主诉左侧肋间神经痛、心悸入院, X线胸片上未发现病灶,但在左肺上野的肺动脉尖后枝有可疑的异常阴影。进一步用光束纤维支气管镜检查,发现左肺上叶支气管的尖后枝和前枝的入口部粘膜,呈轻度肥厚和纵行皱襞轻度消失,活检和刷洗物检查为鳞癌。手术未见转移。讨论:关于气管和支气管部的原位癌早在1951年Papanicolaou等尸解时发现的。这类隐匿性原位癌在临床上多无症状,胸片亦无发现。据大畑等报道,在
The authors reported that 1 case had no lesions on the chest X-ray films, but it was only diagnosed as occult lung carcinoma (TxNoMo) by fiberoptic bronchoscopy. The patient was male, 71 years old. Smoking cigarettes 20 times a day for 40 years. The Brinkman index is 800. The patient complained of left intercostal neuralgia and palpitations. There was no lesion on the X-ray film, but there was a suspicious abnormal shadow on the posterior branch of the pulmonary artery in the left lung field. Using fiberoptic bronchoscopy, the mucous membrane at the entrance of the upper lobule of the left upper lobe and the entrance of the anterior branch was slightly thickened and the longitudinal folds disappeared. The biopsy and brushing examinations were squamous cell carcinoma. No surgery was seen. Discussion: In situ carcinoma of the trachea and bronchi was discovered as early as 1951 when Papanicolaou et al resolved. This type of occult carcinoma in situ is clinically asymptomatic and no chest radiograph is found. According to reports by Otsuka et al.,