Small Cell Lung Cancer with Hilar Lymphadenopathy Mimicking Pulmonary Embolism in Conventional Computed Tomography: A Case Report

小細胞肺癌合併肺門淋巴結－仿造急性肺栓塞

陳克旻(Ke-Min Chen) ； 楊宗穎(Tsung-Ying Yang) ； 許正園(Jeng-Yuan Hsu)

《胸腔醫學》 25卷6期 (2010/12) Pp. 322-327

https://doi.org/10.29806/TM.201012.0007

摘要

一位69歲的男性，這幾個月來因為感覺胸口悶及呼吸急促，而住院做檢查。胸部X光片顯示在左邊的肺中葉有個毛玻璃樣的病灶；胸部電腦斷層檢查(CT)顯示左邊的肺動脈有部分的顯影缺損及週邊楔形實質化病變。由影像的變化，高度懷疑為急性肺部血管栓塞合併肺梗塞。由於臨床症狀和電腦斷層圖像不一致，多探頭斷層攝影(MDCT)肺血管造影被安排檢查並且顯示了左邊的肺動脈有部分的顯影缺損其實是左門的淋巴結病向外壓迫到左邊的肺動脈，仿造肺栓塞（非真正的肺栓塞）。在超音波的導引下經胸廓的肺切片檢查，證實為小細胞肺癌。

關鍵字

肺栓塞 ； 肺血管攝影 ； 多探頭斷層攝影MDCT肺血管造影

並列摘要

A 69-year-old male was admitted because of intermittent chest tightness and shortness of breath for several months. Chest radiography showed a ground-glass lesion in the left middle lung field. The chest computed tomography showed a partial filling defect in the left pulmonary artery and peripheral wedge-shaped consolidation. Pulmonary embolism with pulmonary infarction was highly suspected from the computed tomography results. Because of the discordance between the clinical symptoms and the images, a multidetector computed tomographic pulmonary angiography was performed, and showed left hilar lymphadenopathy with external compression to the left pulmonary artery, mimicking a pulmonary embolism. Small cell carcinoma was proved by transthoracic lung biopsy from the peripheral lung lesion under sonographic guidance.

並列關鍵字

pulmonary embolism ； pulmonary angiography ； multidetector computed tomographic MDCT ； pulmonary angiography