第11巻 2015年6月　第3号

■症例報告

自然気胸術後病理組織検査で偶然発見されたpTis肺癌の2症例
岡本　淳一^1,2, 北山　康彦³, 竹内　千枝², 許田　典男³, 窪倉　浩俊^1,2, 臼田　実男^2
1日本医科大学武蔵小杉病院呼吸器外科
²日本医科大学呼吸器外科
³日本医科大学武蔵小杉病院病理診断科

Two Cases of p-Tis Lung Cancer in Patients Diagnosed through Histological Study after Spontaneous Pneumothorax Surgery
Junichi Okamoto^1,2, Yasuhiko Kitayama³, Chie Takeuchi², Norio Motoda³, Hirotoshi Kubokura^1,2 and Jitsuo Usuda^2
1)Department of Thoracic Surgery, Nippon Medical School Musashi Kosugi Hospital
²⁾Department of Thoracic Surgery, Nippon Medical School
³⁾Department of Pathology, Nippon Medical School Musashi Kosugi Hospital

Background: Spontaneous pneumothorax is a relatively rare complication of lung cancer. Herein, we report two cases of lung cancer in situ with spontaneous pneumothorax as the initial symptom.
Cases: Case 1: A 63-year-old male presented to our outpatient clinic with chest discomfort. He had a collapsed lung, and we inserted a chest drainage tube through the thoracic cavity to re-expand the lung. Computed tomography of the chest showed a large emphysematous bulla at the lung apex. Video-assisted thoracoscopic surgery was used to resect the bulla, and the final pathological diagnosis was an emphysematous bulla with adenocarcinoma in situ.
Case 2: A 45-year-old man presented to our outpatient clinic with pain in the left chest and dyspnea. To treat an almost completely collapsed lung, we inserted a chest drainage tube into the thoracic cavity. Air leakage continued for a few days, so we resected the bulla. The final pathological diagnosis was an emphysematous bulla with a squamous cell carcinoma in situ.
Conclusion: It is important to consider the possibility of lung cancer in patients with pneumothorax and emphysematous changes, especially in middle-aged or elderly patients.

日医大医会誌 2015; 11(3), 161-166

Key words
emphysematous bulla, carcinoma in situ, pneumothorax, operation

Correspondence to
Junichi Okamoto, MD, PhD., Department of Thoracic Surgery, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
E-mail：s3021@nms.ac.jp

受付：2014年12月26日　受理：2015年2月7日