[胸腔镜观察到的肺淀粉样变性:一个病例的报告]。

Q4 Medicine Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-06-01
Hirotaka Kinoshita, Hiroaki Komatsu, Nao Furukawa, Masashi Akioka, Atsushi Ueyama, Kazunori Okabe
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引用次数: 0

摘要

病例是一名患有斯约格伦综合征的 80 岁妇女。在对多发性肺结节进行随访期间,发现右侧 S3 叶间区外围有一个增大的结节。氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)显示,只有 S3 结节内有 FDG 累积,因此怀疑是原发性肺癌。由于支气管镜难以到达结节位置,因此对其进行了右肺 S3 区段切除术。术中发现胸膜下有一个黄白色硬结节。病理检查显示,结节由嗜酸性无结构物质组成,刚果红染色阳性,高锰酸盐处理后消失。根据上述结果,我们诊断为淀粉样蛋白 A(AA)型淀粉样变性。在本病例中,结节位于胸膜下方,我们可以通过胸腔镜观察到它。关于胸腔镜观察肺淀粉样变性的报道很少,我们报告的是术中发现。
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[Pulmonary Amyloidosis Observed by Thoracoscopy:Report of a Case].

The case is an 80-year-old woman with Sjögren's syndrome. During the follow-up of multiple pulmonary nodules, an enlarged nodule was observed in the peripheral of the right S3 interlobar region. Fluorodeoxyglucose- positron emission tomography (FDG-PET) showed FDG accumulation only in the S3 nodule, which led to suspicion of primary lung cancer. Because of its difficult location to reach by bronchoscopy, a right lung S3 segmentectomy was performed. Intraoperative findings revealed a hard yellowish- white nodule just below the pleura. Pathological examination showed that the nodule consisted of an acidophilic structureless material, which was positive for Congo red staining and disappeared after permanganate treatment. Based on the above findings, we diagnosed amyloid A( AA)-type amyloidosis. In this case, the nodule was located just below the pleura and we could observe it by thoracoscopy. There have been few reports of thoracoscopic observation of pulmonary amyloidosis, and we report with intraoperative findings.

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