Two Cases of Peripheral Small Adenocarcinoma of the Lung Diagnosed by CT-guided Transbronchial Biopsy Using Virtual Bronchoscopy, and Treated With Stereotactic Radiotherapy
作者： Naofumi Shinagawa , Koichi Yamazaki , Yoko Ishibashi , Yuya Onodera , Hirotoshi Akita(Dosaka)
DOI: 10.2482/HAIGAN.43.47
关键词: Nuclear medicine 、 Medicine
摘要: 背景. Virtual bronchoscopy (以下VB) によるナビゲーション後, 極細径気管支鏡を用いたCTガイド下生検にて診断し, 定位放射線治療を施行した末梢小型肺腺癌の2症例を経験したので報告する. 症例. 1例目は68歳, 男性, 急性心筋梗塞による入院時に撮影された胸部CTにて左S1+2bに径18×16mmの結節影を指摘された. 2例目は82歳, 女性, 気管支炎で近医に入院した際に右S2に径22×18mmのGGO (ground glass opacity) を指摘された. 両症例ともVBによるナビゲーション後, 極細径気管支鏡を用いたCTガイド下生検にて肺腺癌と診断された.1例目は低心機能, 2例目は高齢, 多発GGOのため手術適応外と判断され, 定位放射線治療 (stereotactic radiotherapy: SRT) を施行した. 検査, 治療を通して特に問題となる合併症はなく, 現在まで再発も認められていない. 結論. 手術不能な症例においても, VB併用CTガイド下生検とSRTを組み合わせることにより, 低侵襲に確定診断と根治的な治療が可能であると考えられる.
sci-hub.st 参考文章(9)
Naoto Hashimoto, Hiroshi Honjo, Masamichi Koyama, Hiroshi Moriya, Interactive Virtual Bronchoscopy as a Guide for Transbronchial Biopsy in Two Cases The Journal of the Japan Society for Respiratory Endoscopy. ,vol. 20, pp. 610- 613 ,(1998) , 10.18907/JJSRE.20.7_610
Masao Nakata, Hideyuki Saeki, Nobuji Yokoyama, Akira Kurita, Wataru Takiyama, Shigemitsu Takashima, Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy. The Annals of Thoracic Surgery. ,vol. 70, pp. 938- 941 ,(2000) , 10.1016/S0003-4975(00)01513-7
Tadashi Shimizu, Takeshi Nishioka, Kazuo Miyasaka, Hiroki Shirato, Shinichi Shimizu, Real-time tumour-tracking radiotherapy The Lancet. ,vol. 353, pp. 1331- 1332 ,(1999) , 10.1016/S0140-6736(99)00700-X
David J. Vining, Kun Liu, Robert H. Choplin, Edward F. Haponik, Virtual Bronchoscopy: Relationships of Virtual Reality Endobronchial Simulations to Actual Bronchoscopic Findings Chest. ,vol. 109, pp. 549- 553 ,(1996) , 10.1378/CHEST.109.2.549
Toshiyuki Harada, Hiroki Shirato, Shigeaki Ogura, Satoshi Oizumi, Koichi Yamazaki, Shinichi Shimizu, Rikiya Onimaru, Kazuo Miyasaka, Masaharu Nishimura, Hirotoshi Dosaka-Akita, Real-time tumor-tracking radiation therapy for lung carcinoma by the aid of insertion of a gold marker using bronchofiberscopy. Cancer. ,vol. 95, pp. 1720- 1727 ,(2002) , 10.1002/CNCR.10856
Shin-ichi Fukumoto, Hiroki Shirato, Shinichi Shimzu, Shigeaki Ogura, Rikiya Onimaru, Kei Kitamura, Koichi Yamazaki, Kazuo Miyasaka, Masaharu Nishimura, Hirotoshi Dosaka-Akita, Small‐volume image‐guided radiotherapy using hypofractionated, coplanar, and noncoplanar multiple fields for patients with inoperable Stage I nonsmall cell lung carcinomas Cancer. ,vol. 95, pp. 1546- 1553 ,(2002) , 10.1002/CNCR.10853
Fumihiro Asano, Yoshihiko Matsuno, Tomomichi Matsushita, Hirohito Kondo, Yoshio Saito, Akira Seko, Yoichiro Ishihara, Transbronchial Diagnosis of A Pulmonary Peripheral Small Lesion Using an Ultrathin Bronchoscope with Virtual Bronchoscopic Navigation Journal of Bronchology. ,vol. 9, pp. 108- 111 ,(2002) , 10.1097/00128594-200204000-00007
Todd L Demmy, Jackie J Curtis, Minimally invasive lobectomy directed toward frail and high-risk patients: a case-control study The Annals of Thoracic Surgery. ,vol. 68, pp. 194- 200 ,(1999) , 10.1016/S0003-4975(99)00467-1
P. Thomas, C. Doddoli, S. Yena, X. Thirion, F. Sebag, P. Fuentes, R. Giudicelli, VATS is an adequate oncological operation for stage I non-small cell lung cancer European Journal of Cardio-Thoracic Surgery. ,vol. 21, pp. 1094- 1099 ,(2002) , 10.1016/S1010-7940(02)00179-3