1998 Volume 38 Issue 6 Pages 745-749
A 42-year-old man was admitted to our hospital with a diagnosis of left pneumothorax. Chest CT scan accidentally showed a nodular shadow 5 mm in diameter in the left upper lobe (S4a). This was his first episode of pneumothorax and chest drainage resulted in improvement. The pulmonary nodule was suspected to be lung cancer based on thinsection CT findings. Bronchoscopic examination failed to obtain a definitive diagnosis.
Thoracoscopic resection of the nodule was performed, and the pathological diagnosis of the nodule was adenocarcinoma. Left upper lobectomy with mediastinal lymph node dissection (R2a) and bullectomy were performed serially. The final histopathological diagnosis was bronchiolo alveolar cell carcinoma (p-T1N0M0 p0pm0). Because the tumor was located apart from the visceral pleura, this pneumothorax was due to the bulla.
As in the case of elderly patients, we should keep in mind associated lung diseases.
