The Journal of the Japanese Association for Chest Surgery
Online ISSN : 1881-4158
Print ISSN : 0919-0945
ISSN-L : 0919-0945
A case of pulmonary sarcoidosis with lung cancer and sclerosing hemangioma
Kiyotomi MaruyamaYoshihiro MinamiyaHideki KawaiJun-ichi Ogawa
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1999 Volume 13 Issue 5 Pages 705-709

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Abstract

A 56-year-old woman, who had been followed up for an abnormal shadow in the hilar region of the right lung since the age of 51 years, was admitted for glaucoma caused by ocular sarcoidosis. Blood chemistry data were unremarkable except for elevated levels of angiotensine converting enzyme (26.0 IU/L) and lysozyme (14.3 μg/ml). CT scan showed a well-defined mass about 3 cm in diameter in the right S5 region, a nodule with pleural indentation about 1.5 cm in diameter in the peripheral region of the left S3, and multiple mediastinal lymph node swellings. Positron emission tomography showed a high uptake in the left nodule, but not in the right mass. Since a definite diagnosis could not be obtained by fiberoptic bronchoscopy and needle biopsy under CT scan, open chest biopsy was performed and the diagnoses of adenocarcinoma in the left S3 and sclerosing hemangioma in the right S5 were made by frozen sections. And then tumor resection of the right lung and left upper lobectomy were performed. Multiple nodules about 2 3 mm in diameter on the surface of the bilateral lungs, which were diagnosed as sarcoid-nodules by frozen section, were also found. We finally made a pathological diagnosis of adenocarcinoma (T1N0M0) with sclerosing hemangioma and pulmonary sarcoidosis. The postoperative course was uneventful with hospital discharge on day 15.

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